Coaching Your Chiropractic and Healthcare Patients

Posted on July 29, 2025 by Edward Petty

Consider adding this to your Report of Findings

“Mrs. Jones, it will take 3 things to get better.”

Many, many years ago, I heard this from an extraordinarily successful chiropractic doctor. He invited me to observe him discuss this in a report of findings with one of his patients.

I sat on the side, next to his knee-chest table, and with the patient’s permission, observed, paid attention.

The first part of the report was typical: a review of the findings, an explanation of the condition, a treatment plan, and a description of the potential consequences of not treating the condition.

Pretty standard, even now.

Then, he told the patient: “Mrs. Jones, it will take 3 things to get better: Time. Repetition. Effort.”

He then went over each point. For example, it is obvious that it takes time to improve anything. It also requires repeated applications, such as painting a house, cleaning out a garage, or watering a garden.

But the last element he emphasized: Effort.

Any improvement takes work, he said, and gave examples. These included activities such as performing home exercises to improve their condition, attending a class on spinal fitness, and simply making it to the office to maintain their schedule.

He was an athletic doctor, and I believe this influenced his approach. He was coaching his patient, much like an athletic coach would motivate a player.

Yes, you are a well-educated, skilled, and caring doctor. But consider your role as a coach as well. You want to get your patient, as a “player,” to improve, and you know what it takes. You want them to win. So – you tell them!

They have a responsibility, just as you do. Seek your patient’s agreement on these three ingredients for a successful course of treatment, and remind them at approximately every 6 visits.

I have seen this work. It also applies to all aspects of our lives whenever we want to improve something.

In fact, I remind the offices we work with that these are the 3 factors needed to improve their business.

Educate your patients. But coach your chiropractic and healthcare patients on what it takes to get better, and that is:

Time
Repetition, and
Effort.

Keep caring, coaching, and stay Goal Driven.

Should Old Acquaintances Be Forgotten in Your Chiropractic and Healthcare Practice?

Posted on July 22, 2025 by Edward Petty

Tips for Your Patient Newsletter

Your healthcare practice is built on relationships, sustained through service and communication. Without ongoing patient engagement—active or inactive—your practice may struggle. A newsletter is a powerful, affordable way to maintain these connections, extending your office’s warmth, excellent care, and positive outcomes to patients’ homes.

A well-crafted newsletter keeps the doctor-patient dialogue alive, portraying your office as a friendly, health-focused space. It drives retention, encourages referrals, and serves as a low-cost marketing tool. While often overlooked or outsourced to generic pamphlet companies, a newsletter’s impact lies in its authenticity and simplicity.

Crafting a great newsletter requires some skill, but the key is to just do it! Here are practical tips to make it effective:

Keep it concise: Aim for under 600 words. Include a brief doctor’s note, a health tip, a simple recipe, and a promotion.
Make it personal: Write as if chatting with a patient during a visit. Share a story, case success, or health advice like recommending a lumbar cushion. Have a staff member transcribe your thoughts, then edit for clarity.
Stay informal: Think of it as a casual check-in, like catching up with a friend or neighbor. Share what’s happening at the office in a warm, relatable tone.
Show genuine interest: Highlight your passion for chiropractic care through patient success stories or testimonials. Include family and friends in your outreach to broaden the connection.
Be authentic: Avoid generic or overly polished content. Patients value real, heartfelt communication over artificial or spammy material.
Frequency: Send monthly, though more often is fine if manageable.
Assign a coordinator: Delegate newsletter management to a staff member to ensure consistency.

Newsletter Checklist:

Doctor’s Letter: A friendly note with a photo, written to one patient, tying into a case, event, or health tip.
Office News: Share updates like new equipment, staff achievements, or recent seminars.
Upcoming Events: Promote events like Patient Appreciation Day or a community 5K to show your office is vibrant.
Patient Testimonial: Include a written or video success story.
Recipe: Share a healthy, relatable recipe with a personal touch, like a family favorite.
Health Tip (Optional): Offer a simple, relevant health suggestion.
Use an Email Service: Avoid sending from personal email clients for professionalism.

Keep communicating with your patients to foster a thriving practice. Stay goal-driven!

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

Posted on July 15, 2025 by Edward Petty

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,

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

Should You Scale Your Chiropractic or Healthcare Practice?

Posted on July 8, 2025 by Edward Petty

chiropractic scaling graph

Scaling a chiropractic or healthcare practice involves more than just growth—it’s about achieving exponential progress through strategic systems. Unlike linear business growth, scaling leverages economies of scale, scope, learning, digitalization, and networking effects to accelerate success.

Key factors include reducing overhead, adding services carefully, improving skills through experience, and using efficient software.

However, scaling requires a solid leadership and management structure to avoid pitfalls like the “Practice Roller Coaster.” Whether aiming to expand one office, add doctors, or prepare for a sale, scaling can drive your goals. Specialized training on scaling will be part of an updated MBA program this fall.

Key Points:

Scaling vs. Growth: Scaling is geometric, not linear, leading to faster growth as you expand.
Critical Elements: Economies of scale, scope, learning, digital tools, and networking effects fuel scaling.
Foundation Needed: Agile leadership and management are essential to avoid instability.
Applications: Scaling suits single or multi-doctor offices and can prepare a business for sale.
Next Steps: Upcoming MBA training will cover scaling strategies.

Please let me know if you’re interested in this fascinating subject.

Meanwhile…

Help others achieve their goals!

For more details, contact Ed Petty, the author of the Goal Driven Business and founder of the Goal Driven MBA Program.

Ask Lisa: Not a Robot – But Some Cool Technologies to Advance Your Practice.

Posted on July 1, 2025 by Lisa Barnett

Not a Robot – But Some Cool Technologies to Advance Your Practice, and Best Software Programs for the Chiropractic Practice

My computer technology training started in the 1980s. Here we are in 2025, and the demands for and surges in healthcare technology are real. But now I write with a fresh perspective. Technology can benefit, and even potentially save, your practice while maintaining human connection and personalized care. We’ve done some research for you – keep reading to learn about some healthcare technology to help your practice grow… and a link to the best practice management software programs based on Capterra surveys.

Let’s start with the patient record or SOAP note.

Your practice management software should work for you and the patient, not against, in recording subjective complaints that meet documentation standards and best practices.

Diagnostics Technology can include the use of Goniometers, scanners such as Surface EMG (sEMG), NeuroThermal, x-ray, inclinometer, and newer traumatic brain injury scanners such as quantitative electroencephalography (say this slowly, out loud).

In conjunction with your objective diagnostics, your practice management software should be a gateway to a solid clinical assessment of the patient’s condition, care plan, and expected outcome. Is your program user-friendly in assessing a patient’s case, and does it offer you the ability to present a sound assessment and expected outcome?

Using technology to administer and record a precise adjustment can include the use of the Activator, Impulse Adjuster, SOT (Sacro-Occipital Technique) Blocks, Impulse Adjusting Instrument, ArthroStim Adjusting Tool, Pulstar FRAS Adjusting Instrument, and the Atlas Orthogonal Percussion Instrument.

How to improve patient compliance with care plans
The use of AI and algorithms to assist in customizing treatment plans that patients stay engaged and comply with is at the forefront of the future of chiropractic care.(1) Technology devices as part of a patient’s care plan to help alleviate subjective complaints can include Utrasound and Laser units, electronic pulse devices such as Shockwave Therapy (extracorporeal shockwave), and Pulse RadioFrequency devices.

Ready to learn which software programs made the top-rate list? Click on the link below to review the top practice management software programs that made Capterra’s(2) list. Note that billing and invoicing capabilities are also part of the ratings:

https://www.capterra.com/chiropractic-software/

Other than the ratings included in the link, what else should you look for before investing in new practice management software, if you’re in the market?

Stephanie Maharjan, a brand leader at WellReceived, a corporate member of the American Chiropractic Association, gives the following guidelines in researching software:(3

Ensure it is compliant with HIPAA and CMS
Reviews from other chiropractic practices. When assessing a new software solution, gather reviews from other chiropractic clinics. Select reviews from a few clinics and see if they still use the technology. Stephanie points out that reviews and feedback are a great way to understand areas for improvement so you can boost patient retention.
Ask for a free trial or a demo before committing to new technology, so you can test various scenarios and evaluate its functionality. Assess how well the technology meets your clinic’s specific needs and determine if there are any workarounds.

Email me if you would like to chat!

Lisa
lisa@pmaworks.com

References:

Streamlining Patient Flow for Better Service Capacity in Your Chiropractic and Healthcare Practice

Posted on June 25, 2025 by Edward Petty

team meeting strategy planning for good setting good goals

A well-designed patient pathway enhances patient experience and increases a practice’s capacity by optimizing scheduling and treatment efficiency. Drawing from Eli Goldratt’s The Goal and the Theory of Constraints, identifying and resolving bottlenecks—such as delayed doctor’s notes, overwhelmed front desk staff, or unclear patient billing—can significantly improve patient flow. Common issues include administrative burdens at the front desk and patient confusion over charges, which can lead to missed appointments.

To address this, practices should map out key patient interactions (e.g., Day 1, Day 2, and Day 12) with the entire team, creating a clear flow chart of actions like payments, doctor visits, therapy, and financial consultations. Rehearsing this flow, like a sports team or musical group, helps identify redundancies or missing steps, ensuring a smooth, efficient process. This patient train follows a predictable track, helping patients understand their treatment plan and stay committed to their health goals.

By regularly reviewing and refining this pathway, practices can maximize capacity—potentially handling 40-70 daily visits plus 2-4 new patients—while improving patient satisfaction. Working on the business in this way keeps operations streamlined, helping patients achieve better health outcomes faster.

Be a Goalineer(sm) and keep your practice on track!

Read the full article online [LINK]

PS Want help with this? Contact me If you have any questions about creating a Goal Driven Business, just schedule a call or reply to this email.

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

PS: Get on our waiting list for our next MBA program if you are interested. I will be sending you special information about practice management, leadership, and marketing.

Sign Up Now for Fall 2025 Waitlist

———————————————

For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book,

The Goal Driven Business at www.GoalDriven.com

What Do You Stand For In Your Chiropractic and Healthcare Practice?”

Posted on June 18, 2025 by Edward Petty

grandfather and grandmother reading a book to a toddler and coddling another

In your chiropractic and health practice, it’s not what you do, it’s why you do it.

In chiropractic and healthcare practices, defining your brand hinges on your “Why”—the core purpose or passion driving your work, as emphasized by Simon Sinek’s Golden Circle concept.

While most can explain what they do and some how they do it, articulating why you do it sets you apart and inspires others.

Your “Why” stems from deep motivations like justice, love, or curiosity, not just analytics. To build a strong brand, identify what makes your practice unique compared to competitors, as Roy Spence suggests in It’s Not What You Sell, It’s What You Stand For.

Know your patients, yourself, and your competition to highlight what you offer that others can’t. Stay connected to your purpose to avoid burnout, as Jon Gordon notes, and boldly define and discuss your unique qualities with your team regularly to maintain a distinctive, meaningful brand.

Jump here to read the Goal Driven Newsletter in it’s entirety. [LINK]

References:

* Virgil, a Roman poet, 19 B.C.
Simon Sinek – Golden Circle

Ask Lisa: The Art of Navigating Insurance Network Participation

Posted on June 4, 2025 by Lisa Barnett

participation in insurance networks building blocks

One of the most critical decisions you will need to make in your practice is, should you be “in-network” with a payer group, or out? It’s a tough choice, and one size does not fit all.

So, what do you do?

First, determine which companies you already are in network with, and assess.

Do you have a contract?
What are your obligations as a participating provider?
Are you getting reimbursed what the contract’s fee schedule says it will reimburse?
Are you currently enrolled in Medicare, and are you a participating or non-participating provider?
Are you also currently enrolled as a provider in your state’s Medicaid program?
Are you enrolled as a provider with the Veteran’s Administration in your area?

Additional items to consider prior to enrolling in a plan include:

What is the reimbursement rate?
What percentage of the approved charges are taken out for contract discounts?
Is there a fee to join?
Do they want you to participate in their worker’s compensation, PI programs? (In our experience, opting in to the WC and PI products means no steerage to you, and cut reimbursements).
Are there pre-authorizations required prior to care?
Is there a visit limit?
What is the initial credentialing and re-credentialing process?

Next, make sure you have a profile set up with the National Council for Affordable Quality Healthcare (CAQH) universal provider database and that the information is current, and re-attested quarterly. There is no charge to create and maintain your profile in this credentialing database.

Third, audit your patient demographic. Run a report in your practice management software, to determine

What percentage of your reimbursement comes from insurance?
What percentage comes directly from patients?
Which payers are you mainly seeing patients from and are you finding that patients are requesting you be in network with a certain company?
Who are the main employers in your area insured with?

Fourth, develop a spreadsheet called “Insurance Networks” to help you and your insurance department keep the information organized and up to date.

Once you have a grasp on the above, you’re ready to determine if you need to pursue network participation with additional companies. Treating this like a sales or business venture, you’ll want to have insurance companies coming to you and requesting you be in their network.

Remember, it is to their benefit and their obligation to keep their paying policyholders happy.

Patients should feel free to call their insurer requesting you be on their plan. Patients have done this, and outcomes have been successful. Why? Because the worst phone call an insurance company can receive is from an upset policyholder who can’t afford to see their favorite doctor who is helping them (that’s you!) because the doctor is not on the plan.

We’ve just touched the surface of network plans and credentialing. PM&A can provide specialized and unique advice on making the choice of which networks to join, which to be out of network, and which to run away from! We also will run those audit reports to assess if you’re getting the best bang for your buck.

Email me for assistance with how these processes work for your practice. You may reach me at Lisa@pmaworks.com.

Lisa

Engage Your Chiropractic Practice with Your Community

Posted on June 3, 2025 by Edward Petty

Get Out and Connect with Your Community

Summer brings farmers markets, parades, festivals, and run/walks—perfect opportunities for your chiropractic or healthcare practice to engage with your community. Community events are a powerful way to build relationships through networking, a form of relationship marketing.

As Ivan Misner, founder of Business Networking International, says in The World’s Best Known Marketing Secret “You have to be visible in the community… It’s called networking. You have to work at it.” But with the right attitude, it’s fun, not just work.

Why Community Engagement Matters

Whether your practice is established or new, staying active in your community is crucial. Markets evolve, and without consistent marketing, your practice’s momentum can quietly fade, leading to unexpected drops in patient numbers. For newer practices or those needing a boost, community involvement is even more essential.

How to Engage

Join Local Events: Participate in festivals, car shows, or races. For example, one clinic sponsors the “Cheesehead Chase,” providing T-shirts to patients who join, creating a visible group of “ChiroHealth Cruisers.”
Set Up Booths: Offer consultations, screenings, or giveaways like pens, and greet people with friendliness.
Wear Your Brand: Sport clinic polo shirts and share your “Get to Know Me” attitude.
Plan with Your Team: Discuss upcoming events, schedule participation, and practice positive marketing attitudes (downloadable resource linked in original).

Build Trust Through Familiarity

People choose businesses they know, like, and trust. Break out of your routine, as Misner notes, and connect face-to-face. Community engagement makes your practice familiar and approachable, fostering lasting patient relationships.

Stay Goal-Driven

Get out there, have fun, and keep your practice thriving by staying active in your community!

—

Community Engagement Guide for Chiropractic Practices

Why Engage with Your Community?

Build Relationships: Networking at local events fosters trust and familiarity, encouraging patient loyalty.
Stay Competitive: Consistent marketing prevents gradual declines in patient numbers, especially in evolving markets.
Boost New Practices: Community involvement is critical for new or struggling practices to gain traction.

How to Get Involved

Identify Local Events:
1. Farmers markets, festivals, parades, or charity runs (e.g., “Cheesehead Chase”). Check your town’s calendar for events like Olive Festival or Pioneer Days.
2. Participate Actively:
  1. Set up booths for consultations, screenings, or giveaways (e.g., branded pens).
  2. Offer incentives, like clinic T-shirts for event participants.
3. Be Visible:
  1. Wear branded apparel (polo shirts or T-shirts).
  2. Share business cards and a friendly, approachable attitude.
4. Plan with Your Team:
  1. Discuss upcoming events at team meetings.
  2. Schedule participation and practice positive marketing attitudes (resource: 8 Marketing Attitudes).
5. Follow Up:
  1. Track event outcomes and plan for future involvement.

Key Quote
“You have to be visible in the community… It’s called networking.” — Ivan Misner, The World’s Best Known Marketing Secret

Action Steps

Research local events for the next 3 months.
Assign team roles for event participation.
Order branded materials (T-shirts, pens, etc.).
Stay goal-driven and make networking fun!

Boost Patient Retention Through Genuine Curiosity

Posted on May 27, 2025 by Edward Petty

Why Patients Leave Chiropractic or Healthcare Practices

Patients don’t primarily leave due to cost, outcomes, equipment, or location. Studies reveal the real reason: lack of empathy and perceived indifference from staff.

Study #1: 68% of customers leave due to employee indifference, far outweighing issues like price (9%) or product (14%). Empathy fosters loyalty.
Study #2: Disinterested, unempathetic staff drive dissatisfaction and churn. Personalized, caring service is key.
Study #3: 59% of customers abandon a brand after one poor, unempathetic experience, while 73% stay loyal after a positive, caring one.

Patients value feeling cared for over clinical expertise. As Jimmy Parker, D.C., emphasized with “Present Time Consciousness,” staying fully engaged with patients is vital but challenging in a busy, high-volume practice.

The Solution: Stay Curious and Be Interested

Empathy starts with curiosity. Genuine interest in patients as individuals—not just cases—builds strong relationships and boosts retention. Ask about their lives, like their hobbies or unique traits:

“Betty, where did you get those blue shoes?”
“Frank, why’s your group called Kiwanis?”

This authentic curiosity makes patients feel valued and fosters loyalty.

Test Your Team’s Curiosity

To embed this approach, routinely quiz your team during case management meetings about patients’ personal details, like a new patient’s favorite sport or where an active patient shops. This friendly exercise keeps everyone engaged and curious, strengthening patient relationships.

Stay Curious and Goal-Driven

A practice thrives on relationships, not just clinical skills or billing codes. By staying genuinely interested in patients, you’ll enhance retention and build a loyal community.

Key Points: Patients leave due to perceived indifference, not cost or outcomes. Empathy, driven by curiosity, is the solution. Test and encourage your team to stay interested in patients’ lives to improve retention.

References

#1 Rockefeller Corporation Study (1999) CustomerThink, Help-Desk-Migration.
#2 Temkin Group Study (2016)
#3 PwC Consumer Intelligence Series, Experience is Everything. (2018)

Using offline and online tactics to grow your chiropractic practice

Posted on May 7, 2025 by Edward Petty

mothers day greeting with floral bouquet

Grow Your Chiropractic Practice with Online and Offline Strategies

Many chiropractic offices see success with online advertising, especially on social media. While effective, it often requires digital expertise, so many chiropractors hire agencies—some with better results than others. If you’ve worked with a good agency, sharing your recommendation could help others.

Online promotion isn’t new to chiropractic. B.J. Palmer, one of the profession’s pioneers, was a relentless advertiser who played a major role in chiropractic’s growth during the early 20th century. His legacy reminds us that consistent promotion is key.

However, in today’s tech-saturated world, offline engagement is more valuable than ever. Creating relationships with patients is critical. The relationship business in a chiropractic office revolves around building trust, fostering patient loyalty, and creating a community that supports long-term engagement and referrals. Chiropractic care is inherently personal, as it involves hands-on treatment and addressing patients’ pain, mobility, and wellness goals. The success of a chiropractic practice often hinges on strong relationships with patients, staff, and the broader community.

Your practice is essentially a network of relationships, sustained through communication and service. So:

Nurture current and past patient relationships
Use those to expand to new connections

Some effective offline tactics include:

Sending personal email newsletters with stories, health tips, and a touch of personality
Hosting in-office events (e.g., Mother’s Day giveaways or posture screenings for National Correct Posture Month)
Organizing a patient appreciation picnic or monthly spinal health talks
Visiting local businesses to give brief wellness presentations
Setting up a booth at local fairs for visibility and patient reactivation

Combining digital and personal outreach creates a powerful, sustainable marketing strategy. As Woody Allen once said, “80 percent of success is showing up.”

“80 percent of success is showing up” (Woody Allen)

Stay Goal Driven,

References:

*(B.J. Palmer, Achievers Magazine, 1989)
*Brad Glowaki
*(Woody Allen (Quote Investigator)

How Steve Jobs’ Vision Can Transform Your Chiropractic Practice Learning from Visionary Success

Posted on April 24, 2025 by Edward Petty

Apple, founded by Steve Jobs in 1976, is now the world’s most valuable company, with a market capitalization of $2.9 trillion and $54 billion in cash reserves. But in 1997, Apple was on the brink of bankruptcy. Jobs’ strategic overhaul turned it around, offering lessons for chiropractic and healthcare practices.

In a 1997 interview, Jobs shared a key insight: “If you do the right things on the top line, the bottom line will follow.” He emphasized that a clear strategy, passionate people, and a strong culture drive quality products, marketing, and operations—ultimately boosting profitability. For chiropractors, this means focusing on vision and values to achieve sustainable success.

The Top Line: Your Practice’s Foundation

Your “top line” is your practice’s vision, values, purpose, and the team that embraces them. When these are aligned, marketing, procedures, patient outcomes, and profits follow naturally.

Top-to-Bottom Framework:

Top Line: Vision, values, purpose, mission
Almost Top Line: A team aligned with these principles
Middle Line: Policies and procedures
Almost Bottom Line: Patient outcomes
Bottom Line: Net income

Focusing on the top line creates a “vision-driven” practice, much like Jobs’ approach at Apple.

Insights from a Chiropractic Leader

A seasoned chiropractor recently shared a video on social media, responding to a colleague concerned about high practice expenses. He identified the biggest cost: an “under-trained” team. His solution? Hiring passionate individuals and training them not just in chiropractic techniques but in the practice’s “why”—its purpose, mission, and vision. Team members who didn’t fully align were let go. The result? A thriving practice.

When I commented that his success stemmed from his own clear “why,” he agreed: “It all starts from the inside out. If the doctor has a big WHY and can teach it, the team will follow.”

Sustaining Your Vision

Keeping your practice’s values alive requires ongoing effort. It begins with your example as the leader and continues through consistent team coaching. In our MBA program, we explore proven strategies to maintain this focus, from vision to execution.

Apple’s Core Value and Your Practice

In 1997, Jobs defined Apple’s core value: “We believe people with passion can change the world for the better.” This resonates with top healthcare practices, where passion for patient care drives impact.

Does your practice reflect this passion? A clear vision, a dedicated team, and consistent coaching can transform your chiropractic business, just as Jobs transformed Apple.

Stay Goal Driven.

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

Posted on April 15, 2025 by Edward Petty

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.

Ask Lisa: Are you fully informed about your patient’s injury?

Posted on March 30, 2025 by Lisa Barnett

The importance of understanding your patient’s condition

A 2013 Journal of Chiropractic Medicine article discussed a patient with benign neck and upper back pain. However, the patient had recently sustained a “hangman’s fracture” from a drunken fall but did not inform the doctor. A C2 fracture was detected through an x-ray and from further questioning.

The conclusion of the study states:

“Historical experience with similar [cervical pain] clinical presentations in established patients can influence health care providers to assume a benign causation of symptoms. Conscious effort must be exerted to treat established patients with typical presentations with the same diligence as those of new patients to a chiropractic clinic. This case illustrates that an unstable fracture and hematoma can present to a chiropractic clinic as a seemingly benign problem.”

Getting the full story of presentation to the office with your patient is critical for both the SOAP note and eventual third-party reimbursement, particularly with current pre-authorization requirements and patient reporting of subjective symptoms.

Subjective data includes the patient’s perception of their symptoms. You can begin collecting subjective data as soon as the patient first calls in for an appointment, and the doctor following up gathering this information through conversations and patient self-reports on Day One and Day Two.

Your practice management software will have an area to free-form type in a note, and here is where you can indicate why the patient is calling the office to schedule an appointment. The doctor will see this note when they pull up the patient on their computer, or you can verbally relay the information.

It is also critical upon existing patient re-exams to ask and document an additional story of what brings the patient into the office, i.e., any additional mechanism of injury. We all have them as part of this wonderful thing called Life.

Not completely confident with what the patient is subjectively presenting with? Follow your innate instincts and confirm through objective testings.

Email us for a free medicare documentation checklist. services@pmaworks.com

Need further assistance? We can help. Email “Clinic Rescue” in the subject line, to Lisa@pmaworks.com

Lisa
920-334-4561

References:
Fogeltantz, Kay, Ditty, Mark, Pursel, Kevin, (2013 September) Hangman’s fracture presenting to chiropractic clinic as benign neck pain: a case report. Journal of Chiropractic Medicine 2013 Sep;12(3):201–206, PubMeb

The Big Practice Barrier: Overcoming Growth Challenges in Chiropractic and Health Businesses

Posted on March 18, 2025 by Edward Petty

chasm between service and net income

Many practice owners aspire to run million-dollar or multimillion-dollar businesses, but they often face barriers that hinder growth. Despite working hard, many practice owners struggle to achieve the financial success they desire.

The Core Barrier to Practice Growth

In The Millionaire Next Door by Stanley and Danko, the authors highlight that self-employed individuals are more likely to become millionaires than employees. As chiropractic and health business owners, financial success should be a natural outcome—but it isn’t always the case.

While it may seem like poor revenue stems from lack of new patients, poor retention, inadequate equipment, or economic factors, these are just symptoms of a deeper issue. The real barrier to growth is the **Practice Dilemma**—the challenge of providing excellent patient care while managing a growing business.

The Practice Dilemma

New practices typically don’t face this dilemma because they operate at low capacity. But as your practice grows and reaches 60-70% capacity, balancing high-quality service with the administrative and marketing tasks becomes increasingly difficult. The business requires both leadership and management, but most practice owners struggle to bridge the gap between providing top-notch service and handling business operations.

The primary reason many practice owners don’t become millionaires is their inability to balance quality service with effective business leadership.

The Solution: The Fast Flow CEO Systemsm

The Fast Flow CEO System (FFCEO) offers a solution to the Practice Dilemma. It allows practice owners to manage their growing business while continuing to deliver world-class service. The FFCEO system divides leadership and management functions between the CEO (the practice owner) and a trained manager.

The **Practice MBA** program trains a trusted employee to handle management tasks, while the business owner focuses on key leadership responsibilities. This system follows the **Pareto Principle**, which suggests that 20% of your efforts yield 80% of the results. By empowering a trained manager to handle most of the operational duties, the CEO can stay focused on patient care and strategic decisions.

Why Management Training Matters

There is a noticeable lack of management training programs for chiropractic and health business managers. Effective growth requires expert leadership and management, combined with excellent patient care. The FFCEO system enables the doctor to focus on their expertise while a trained manager handles day-to-day operations, bridging the gap between service and business leadership.

Conclusion

If you’re ready to scale your practice and achieve financial success, consider the **Fast Flow CEO System** and the **Practice MBA program**. This approach will allow you to lead effectively while maintaining high-quality care. Take the steps today to ensure your practice’s future success.

Seize Your Future

The Next Generation of Chiropractic and Healthcare Practice Development: Growing Your Practice from the Inside Out

Posted on March 11, 2025 by Edward Petty

it's the manager book cover by clifton and harter

To grow a successful chiropractic practice, there are four key principles that can help improve both your practice and business. These principles are based on years of experience working with doctors and staff in the field.

1. Practice Success Depends on Two Key Factors

Quality clinical outcomes: Delivering effective results for your patients.
Quality support: Ensuring your practice has the infrastructure and administrative help to maintain and grow.

While excellent results are critical, support is equally important. As your practice grows, administrative demands increase, and these are often overlooked. The key is balancing patient care with behind-the-scenes tasks like scheduling, billing, staff management, marketing, and more. Without proper support, your clinical focus can be distracted.

Remember: It’s not chiropractic that slows you down—it’s everything else!

2. Better Support Leads to More and Better Services, Resulting in Increased Revenue

The equation is simple: Improving the support for your practice will enhance both the quality and quantity of services provided. With increased and improved services, your revenue will naturally rise. It’s a logical and proven cycle.

3. Better Management Leads to Stronger Practice Performance

Studies show that the most successful practices often have someone in a managerial role, even if they’re not fully trained. These offices tend to have higher and more stable production. The best business owners understand the importance of having a manager, even if they’re still training them.

4. Gallup’s Insight: Management is Key to Long-Term Success

Gallup, a global analytics company, confirms the importance of good management. In their book *It’s the Manager*, they state that **the quality of managers and team leaders is the single most important factor in long-term organizational success. This underscores how critical it is to invest in strong management.

Enter the Goal-Driven Practice MBA

Based on these insights, a new program was created to train chiropractic managers: the Goal-Driven Practice MBA. This program focuses on improving the support system within your practice to enhance both patient care and practice performance. If you’re interested in a personalized training program for your practice, the next session starts in April. Only 10 offices are accepted, ensuring a highly tailored experience.

If you’re interested, contact Linda, the program coordinator, to discuss whether it’s the right fit for your practice.

Seize the Future: Take action now to elevate your practice.

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

Posted on March 4, 2025 by Edward Petty

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.

References and Full Article at [LINK]

The Cobbler’s Children Have No Shoes

Posted on February 12, 2025 by Edward Petty

shoe cobbler sitting with 4 children telling a story. Are Your Chiropractic Staff on Health Programs?

You may recall the proverb about the cobbler’s children not having shoes, which illustrates how people often neglect their own needs while helping others. This happens in various fields—like a laundromat where the employees wear dirty clothes or a car repair shop with poorly maintained cars.

Recently, many offices we work with have had staff missing work due to illness, which can be costly. As the saying goes, “An ounce of prevention is a pound of cure.” Health should be a core value for your team, something everyone strives for, not just a business mission. It should be like a fun quest—finding ways to get healthier.

Unfortunately, some teams aren’t on health programs or aren’t as informed as they could be. Your staff should be the healthiest and fittest in town, with strong immune systems and natural remedies to boost their health during flu season.

While taking care of patients is a priority, it’s equally important to focus on improving your own team. This includes training your employees to enhance their skills and knowledge of your services. A trained, motivated practice manager can support both your people and your practice.

If you’re interested in having someone trained as your manager, sign up for our waitlist, and I’ll send you details about the upcoming program starting March 31.

In the meantime, encourage your team to start their mornings with planks, Vitamin D, and green drinks—and maybe a little dancing!

Take care of your people, including yourself, and stay goal-driven.

Read the full article here [LINK]

Sign up for Waitlist

Ask Lisa: Day One and Day Two Best Practice Procedures

Posted on February 5, 2025 by Lisa Barnett

Greetings…
You asked for this … we heard you and have got you covered.

Here at PM&A, we consistently recommend the use of checklists, and establishing and documenting your Day 1 and Day 2 procedures is no exception. Keep reading for a comprehensive checklist to make your Day 1 and Day 2 run seamless.

Day One Upon New Patient Arrival

___1. Introduce yourself, what you do, and welcome the Patient.
___2. Provide office tour
___3. Check for questions, problems, and clear up questions as needed.
___4. Doctor Sees patient, does a thorough consultation by the use of objective tools
and history of patient such that the patient feels they were completely
understood, and all relevant facts that might relate to the patient’s current
condition(s) is learned. Adjustment is performed if appropriate and is part of your
typical clinical Day 1 process.
___5. CA does insurance/third-party benefits verification using the insurance verification
form and prepares for the financial consultation on Day 2, using worksheet.

Day Two

___6. Doctor thoroughly reviews the patient’s x-ray/objective findings before the report
of findings
___7. Doctor goes over with the patient the written Report of Findings and the patient
also receives an initial treatment plan with the necessary amount of visits and
treatments (adjustments and therapy) as best suited for the patient’s condition.
___8. Doctor reiterates “Time, Repetition, and Effort” as necessary to patient’s
successful treatment program and provides folder/packet to the patient.

In a private area away from other patients… the CA works with the new patient to:
___9. Go over schedule of care and completes multiple appointment card.
___10. Stress keeping appointments.
___11. Communicate missed appointment make-up procedure and any fee associated
with no call, no show.
___12. Confirm doctor has discussed health care class, and invite patient and spouse.
___13. Discuss financial arrangements. This is your financial consultation with the
patient. Written financials are completed beforehand and made available to the
patient as part of their packet.
___14. Verify all needed paperwork in the packet.
___15. Stress that the patient review the written ROF from doctor.
___16. Go over check-in / check-out procedures, i.e., does the patient sign in using a
kiosk? Is the kiosk located at the front desk, or in the treatment area? Check-out
would include making sure their next appointment is on the schedule and
collecting any patient payments due.
___17. Validate patient’s desire for care & treating doctor’s skill.
___18. Ask the patient if there is anyone else in their family they would like to schedule
a complimentary consultation and exam, and if so, write down their names, and
follow up
___19. Provide educational pamphlets to give to the patients.

___20. Ask the patient if they thought of any further questions, and wrap-up, reminding the patient of their next scheduled visit.

After the patient has completed their care plan, the doctor recommends wellness care to each patient that achieves maximum chiropractic improvement, and the patient accepts the wellness care program.

Email us at services@pmaworks.com to request scripting examples for financial consultations.

Looking for additional information on how to customize the above checklist to your office? Give us a call – we’re here to help!

Lisa
920-334-4561

How to Avoid the Groundhog Day Syndrome in your Chiropractic Office.

Posted on January 30, 2025 by Edward Petty

What would you do if you were stuck in one place and everyday was exactly the same, and nothing you did mattered?

Here is a summary of Ed’s weekly Goal Driver Newsletter. Jump here to read the full article.

The Groundhog Day Syndrome can feel like doing the same thing over and over, with no progress or change—whether it’s handling repetitive tasks or dealing with the same issues at work. This can lead to burnout and a sense of being stuck, much like the movie Groundhog Day, where the main character endlessly relives the same day.

Life is cyclical, and each cycle offers new opportunities for growth, much like levels in a game. If your team is feeling bored, stressed, or stagnant, it might be time to move to the next level.

Here are two strategies to avoid the Groundhog Day Syndrome:

Create a Fun Theme for the Year: Choose a theme that aligns with your mission, such as encouraging fitness or community service, to motivate your team and patients.
Constant Improvement: Regularly evaluate how you can improve services, outcomes, and overall performance. Treat it like a game—always striving to level up.

Start the new year with fresh goals, and embrace growth! Consider enrolling in our Practice MBA program starting March 31, 2025, for further development.

Let’s break the cycle and keep moving forward!

MBA Program Information[LINK]

Observations

observations from our travels in the world of chiropractic

Tag Archives: chiropractic