Tag Archives: chiropractic

Case Management for Better Service and Retention

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Start Each Day with Service First

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

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

Beginning Each Day With Service Goals for Each Patient

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

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

Case Management Meeting Procedure

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

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

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

More Than Case Management – Keeping It Fun.

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

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

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

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

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

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

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

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

It only works if it is done.

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

Over to you!

Carpe Posturum! (Sieze the Future)

Ed

Reactivation: Fast, easy, and healthful promotion.

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This promotion has rarely failed. It is simple, fast, and not gimmicky. It is aimed at patients who have not been in for a while.

Patients drift off, and life gets in the way, but your patients still know you, like you, and trust you. And, like all of us, they could now use a nudge to improve their health.

So why not send them a personal letter? In your own words, tell them to get their rear back in here so they can stay in the best of health for the winter months.

Special promotions work best if they are linked to a genuine cause. In this case, the cause is National Chiropractic Month and also the fact that you have a sincere desire to ensure that people you have seen in the past continue to do well.

Special promotions also have an offer. It could be a free service or a discounted service, or the fact that your payment will serve as a donation to a worthy charity. It could also just be special Halloween organic pumpkin cupcakes from your local bakery (give the business a plug for a discount!) when they come in.

Make the offer for the entire month of October, or perhaps just for the last week.

Headline the letter with something like

It’s Chiropractic Checkup Time

October is National Chiropractic Month

You can then, for example, use your own words to say:

Our records indicate that you may not have been in to see us for a while. If that is the case, I’d (for multiple doctors – we’d) love to see you and like to offer you…[your offer.]

Remember, postural and spinal problems are often present long before any pain occurs. Therefore, getting a periodic chiropractic exam is good health insurance to ensure you remain healthy. Chiropractic is great for helping with back pain, headaches, arm and leg pain, and many other problems.

But even if you aren’t experiencing pain now, don’t wait until you have a problem. I sincerely believe the old saying, “An ounce of prevention is worth a pound of cure.”

You can also encourage them to make appointments for their family and friends.

Even if you have all the patients you can handle, this is still a good reminder for those you have seen to stay healthy.

Because that is their goal as well as yours.

Seize the future,

Ed

Going Public or Going Purpose

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Be like a juvenile delinquent!

The chiropractic model for care follows three main stages, according to many patient educational articles. These are 1) Relief, 2) Correction and 3) Maintenance and Wellness.

I am sure it could be nuanced into other levels or worded differently, but these three make sense to me — so much that it inspired me to write a book – The Goal Driven Business.

But I had another inspiration.

I read a book about a young French-Canadian rock climber who lived in Southern California and was not finding the equipment he needed. So, he became a blacksmith and started making his own. In the late 1950s and ’60s, he started the Chouinard Equipment Co and made climbing gear for other climbers. He also wanted better outdoor gear, and so founded Patagonia, a clothing company.

The name of the book was Let My People Go Surfing. It was by Yvonne Chouinard and tells the story of how he grew Patagonia.

Patagonia, now a 50-year-old company, has done very well financially. It has also done very well for the quality of its products and services and its employees. But it is also driven by the goal of making Earth healthier.

Patagonia demonstrates three goals I believe every business has: 1) profit, 2) expert service and people, and 3) higher purpose. In my book, I reference examples of how the best companies focus, knowingly or unknowingly, on these three goals.

The best offices I have worked with over the years have also been committed to these three goals. They cared about providing the best service to their patients, but also to their staff. They were committed to helping as many people as possible be healthier. And, of course, they insisted on profits.

Chouinard, with his family, own Patagonia.

That is until this month. Valued at 3 billion dollars, Chouinard announced that they are giving the company away. He could have sold it to … Amazon, for example, or they could have made it a public company. Instead, he donated it to a fund called the Patagonia Purpose Trust. He says, “Earth is now our only shareholder.”

“Instead of “going public,” you could say we’re “going purpose.” Instead of extracting value from nature and transforming it into wealth for investors, we’ll use the wealth Patagonia creates to protect the source of all wealth.”

I encourage you to look into Chouinard’s lessons on business, which he acquired through trial and error as we do! I have some links over on the blog (see below.) There are many business lessons to learn by studying the trials of other business owners in different types of businesses.

But I guarantee you that if you commit to these three goals, in the long run, just like with your patients, your business and your life will thrive.

And one other note!

I think ol’ Yvonne would have been a natural chiropractor. He reminds me of you guys. In an interview in 2017, he says:

“One of my favorite quotes is if you want to understand entrepreneurs, study the juvenile delinquent because they’re saying, you know, this sucks. I’m gonna do it my own way. And that’s what the entrepreneur does. They just say this is wrong. I’m gonna do it this other way. And that’s the fun part of business actually.”

So, have fun, and seize the future,

Ed

For links and other references, go to our blog here: Goal Driven

Ed Petty in front of Chouinard Equipment Company, Ventura California

 

Patagonia home page
https://www.patagonia.com/home/

Interview with Chouindard
https://www.npr.org/2018/02/06/572558864/patagonia-yvon-chouinard

News articles
https://www.reddit.com/r/climbing/comments/xebzib/yvon_chouinard_gives_patagonia_to_charitable/

https://www.inc.com/yvon-chouinard/patagonia-ceo-let-my-people-go-surfing-why-company-mission-is-not-profit.html

Book
https://www.barnesandnoble.com/w/let-my-people-go-surfing-yvon-chouinard/1124064053?ean=9780143109679

Are You Ready For Flu Season?

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Are ready for flu season?

Big Pharma is.

If you haven’t seen the ads yet, you will soon. And so will your patients and potential patients.

It’s just business. “The global influenza vaccine market size was valued at USD 7.02 billion in 2021. The market is projected to grow from USD 7.54 billion in 2022 to USD 13.58 billion by 2029.” (Market Research Report, Fortune Business Insights, Sept 2022)

So, what does this have to do with practice and business development?

Your Unique Selling Proposition

In a practical sense, you are the uncola of the cola healthcare world.

You are health doctors – not disease doctors or drug doctors. However you want to frame it, you can define what you do as different than the pharmaceutical alternatives in such a way that you stand out from the crowd.

Remember, it is not necessarily what you do that counts. It’s what you stand for.

You stand for natural health. As Simon Sinek reminds us, “People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”

Better Service and Better Health

In my book, the Goal Driven Business, I reference how consumers want more information about their services and products. Especially in this age of abundant and ready information. Patient education is not a chore, it is a service that, if it is well presented, patients appreciate.

But even more, you know about the immune system and what improves it. But natural approaches to boosting the immune system are not emphasized by the medical “information” that is promoted and posted. But you know better: adjustments, exercise, vitamin D, C, and all the rest. Acupuncture too!

It does take a little more time to educate your patients and community. But think of it as a clinical service that makes you unique and special. Think of it also as a marketing expense.

Pride and Purpose

There might be another reason to educate your community on natural approaches to viruses, one that is more personal.

You might feel that your patients and neighbors are being misled and that vital information is being kept from them. You may want to right this wrong!

And lest anyone tries to reframe you as unscientific, the leading cause of death is errors in medicine.(2)

So… the Flu Season is on its way. Go for it!

Enter the race and position yourself and your team as the good guys, the Natural Health Clinic that gets results. And by the way, don’t overlook that you all need to practice what you preach!

There is a very large portion of the population that is seeking a more natural lifestyle. Google search terms show strong interest in natural remedies. You will appeal to them — they are just looking for a health-oriented team to help them maintain and improve their healthy lifestyle.

Seize Your Future,

Ed

Links to the above references and others on the blog, here:

Learn how to create a Goal Driven practice that is more profitable and fun – get The Goal Driven Business

Preparing for Autumn

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“When you fail to prepare, you’re preparing to fail.”

John Wooden (QuoteInvestigator)

September is upon us, and Autumn is just ahead.

I encourage you to be thinking about your practice development plans for the last quarter of this year – October, November, and December. Let’s start with some fast ideas on promotions:

  • October is National Chiropractic Month (Used to be National Spinal Health Month). October 16th is World Spine Day. Not sure who comes up with these “Observances,” and I don’t really care. Don’t think it makes much difference… You can call October “National Get Your Rear in Here Month” if you want. I like to use the word “national” as it seems to imply that everyone now must comply and “report in.” It’s official, at least in your office.
  • November is a good time for “Cause” promotions. These are promotions that are linked to a worthy charitable cause that you feel genuine about. Word of warning: Don’t fake it. TV stations that promote “Toys for Tots” are so obviously insincere that I can’t believe they still do them. Find a charity that you and your team, and patients, want to support. Done right, you’d be surprised at how popular these promotions can be.
  • December is an opportunity to hunker down with all your patients, active and inactive. Parties, events, showing some gratitude and best wishes for the New Year.
  • Improvement Goals. Look at what you can do to improve clinic performance, including:o Continuing education for you.
    o C.E. for your team. Seminars, webinars, podcasts, books!
    o Team trainings in the office.
    o Individual team member training in the office.
    o Procedures: “How can we do this better?”
    o Software updates
    o Backlogs eliminated
    o Decor

• 2023 Sometime in November, you should also look at your plans for January. The New Year also approaches fast.

All this may seem a bit much to consider, but time waits for no one.

Schedule a couple of sessions this month with your team and do some planning.

GET PREPARED

And Seize the Future,

Ed

You can find links to references in this newsletter and more on our blog here:
https://www.worldspineday.org/

https://www.chiroeco.com/plan-now-for-national-chiropractic-health-month-2022-theme-announced/

https://pmaworks.com/observations/chiropractic-practice-marketing-ideas-for-fall-2016/

The Value of Creating a Practice Community

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Where everybody knows everybody else’s name

Do your patients consider your practice so cool that they want to hang out with you more?

Do they come in early just to soak in the vibes and chat with other patients?

Do you have a practice club?

There are sizable benefits to creating and sustaining your own practice community. The fact is you probably loosely have one already. It is a rich resource that, if better organized and cultivated, can improve patient retention and referrals.

People want to be part of something larger than themselves. This includes belonging to a group whose values they share. Edward Deci, Ph.D., says it is an intrinsic, innate motivation we all have.

A practice club, or organized community relations program, strengthens your connection with each patient. But in addition, it builds relationships between your patients and even non-patients who are supportive of your practice.

I grew up in a small farm town. We had a very busy barbershop. It was always full of men, smoking cigarettes and talking to the barbers – and each other – about the comings and goings of our small town. I think my dad dropped in at least every other day. The barbershop had created its own interactive and slightly exclusive club.

As a more organized example, the motorcycle company Harley-Davidson established the Harley Owners Group, nicknamed HOG. You must own a Harley motorcycle to belong, and then you are eligible to attend many events the company sponsors and receive discounts on all its products. I know a few HOG members, and they are loyal to the brand and share a bond with each other. And they are active, servicing their bikes and using Harley products.

Organizing Your Community

You can sponsor your own “rallies” and probably have. Patients attend, see you and your staff outside the office, and get a chance to talk. But even more, they can connect with other patients. This is how your practice network strengthens.

You can better organize your community by delegating someone to be your Community Services Coordinator for a few hours every month. They would plan and implement various events, with everyone on staff would participating.

In addition, they could start an online club, such as a private Facebook Group. Your patients would be invited to join, as well as local businesses who share your values.

In my experience, most community-building efforts rarely amount to much because there is no one in charge to keep the group energized. Events are “one and done,” with little follow-up. This contributes to the Practice Roller Coaster effect. They do work at generating referrals and improving retention, for a while, but the energy created ebbs away.

Authentic newsletters, events, phone calls, a social media group, success stories, and special bonuses help keep the community humming along.

Network Effects

Network Effects is an economic term. It simply means that the more people use a company’s product or service, the more valuable it becomes. The larger your network becomes, the better the service improves. And the better your services improve, the larger your network becomes.

It is momentum related. Think of a flywheel or pushing a car with a dead battery. (ugh). Once you get it going, the going gets easier.

From my favorite HOG advertisement:

“It’s a free country. Live like it.
Screw it, let’s ride.”

And also,

Seize your future,

Ed

Want to improve your community building? Schedule a call and we can look at options. To schedule, go here.

In the Sierra’s

The Phone Experience and Your New Patients

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I just read about a new study sponsored by a tech company (Invoca.com*) that sought to understand the buying habits of consumers better.

It revealed that as inflation increases, the expectations of customers do as well.

It pointed out that inflation has consumers rethinking their more expensive purchases, including health care. However, almost two-thirds (63%) report that they’re still willing to pay more to get better customer service.

While consumer shopping is based on price, they’re also demanding better experiences. The survey found that more than three-quarters of respondents (76%) said they would stop doing business with a company after just one bad experience.

When respondents ranked the possible reasons why they would stop doing business with a company, a bad phone experience was second only to high prices.

Another interesting fact I noted was that most consumers ranked the phone as their preferred channel when they needed help regarding a purchase. They may go to your website, but the vital moment occurs on the phone. Not texting, emailing, or even visiting the office in person, but the phone call is the preferred method of contacting you.

And the preferred use of the phone in the 2022 survey was up 8% since 2021.

How your patients and potential patients are treated on the phone has an enormous impact on your weekly practice numbers. I would estimate that up to 20% of your volume could fluctuate based upon the great experience or poor experience someone has with your front desk.

The ebullient nature of the staff person you have plays a key role, but so is that staff member’s experience while working in your office. For example, I have seen visits go up when a new happy-to-be-hired front desk staff member takes over the front desk, only to see the numbers dip after they become discouraged a few months later.

The front desk is the most demanding role you have in your office. They need to always be “on,” eager, and interested in phone calls while at the same time checking people in, collecting money, and chatting with patients as they can.

I have spent occasions rehearsing with the front desk on answering the phone. It is simple, but done correctly, it is an art.

Even if your front desk team are pros, positively rehearse with them now and then – tell them even the experts practice daily!

Constant improvement is the road to excellence, and excellent service is needed in our post-Covid world.

And in the end, all this study points to is that common courtesy, genuine interest in and care for each other, being authentic, and kindness are more valuable than ever.

Ed

*https://experience.invoca.com/2022-invoca-buyer-experience-report/p/1

Medicare Providers Re-validation Update Announced

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UPDATED FROM JANUARY 24th, 2022

Dear Chiropractors, Office Managers, and Insurance Personnel:

“The Center for Medicare & Medicaid Services is continuing to populate providers’ re-validation due dates from a ‘TBD’ date to an actual due date.

Per CMS (data.cms.gov):

  1. The re-validation data was last refreshed on August 01, 2022.
  2. ‘Adjusted’ Re-validation Due Dates for October 2022 have been added.
  3. The next data refresh is tentatively scheduled for September 1, 2022.
  4. Affiliations now include reassignments as well as Physician Assistant(PA) employment relationships.”

https://data.cms.gov/tools/medicare-revalidation-list

=====

January 24th, 2022

As you may be aware, the Center for Medicare and Medicaid (CMS) made an accommodation during the pandemic regarding your doctor re-validation due date with Medicare. As such, CMS will be adjusting doctors’ re-validation due dates in phases starting this quarter. The Medicare Enrollment online tool, PECOS, has shared information on their homepage that enrollment re-validation has resumed in a phased approach for active providers.

What this means for you: It is critical that you check your re-validation due date and re-validate your Medicare enrollment prior to your due date. If you don’t re-validate, claims will most likely deny when their software program catches a mismatch to enrollment due dates, and you may lose your billing privileges. If you reassign your benefits to your group/Type 2 NPI, you will need to re-validate the group enrollment as well. The re-validation requirement holds regardless of if you are a participating or non-participating provider. There is no fee to re-validate.

CMS has stated they will notify providers via email on file, or mail, approximately three to four months prior to their adjusted due date. You can check your re-validation due date here:
https://data.cms.gov/tools/medicare-revalidation-list

Once you open the page, you will see two due date boxes. You may disregard the original due date shown on that page. The box to pay attention to is the “Adjusted Due Date”. If it states TBD, keep checking every couple of weeks to see if that field has been populated to show your adjusted due date.

How do you re-validate? Use online PECOS (the preferred method), linked here: https://pecos.cms.hhs.gov/pecos/login.do#headingLv1

Or submit a paper 855i application, found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms855i.pdf

References:
Please see the initial communication here:
https://pecos.cms.hhs.gov/pecos/login.do#headingLv1

Additional related links:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Revalidations

https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf

Contact us if you have any questions – we’ve got you covered!
(This includes if you can’t get into your PECOS account because it’s been so long, or because of staff changes, or because you forget your password, call us and we can help you.)

Lisa Barnett
920-334-4561
Petty, Michel & Associates

Email: lisa@pmaworks.com, dave@pmaworks.com

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Here in the United States, July 4th is a date we celebrate each year, commemorating the independence as colonies from Great Britain.

And I can’t help but see a parallel between those hardy souls in the American colonies that wanted their freedom and, well, you! Chiropractors and their teams.

To colonize means to “take control of a people or area, especially as an extension of state power… to take or make use of (something) without authority or right.” (Merriam-Webster)

It could be said that the profession of medicine has been colonized by a few corporate interests. Same has been happening with other professions and industries. A few large corporations own and control more and more businesses that were once independent.

But for the most part, chiropractic as a profession has remained independent.

It hasn’t been easy, what with the AMA and Pharma coming after you, as was disclosed in the Wilk’s trail. (That was just a speed bump for them!) But Team Chiropractic has won its independence and freedom due to the courage of those who have come before you.

And it also comes from your continuing courage today.

So, this Fourth is also about your independence and your continued efforts to do the BEST for your patients and your communities.

Celebrate this!

Yes, it is just another day at the office. But this weekend, have an extra cool drink and recognize your leadership and courage in standing up for the true health of your patients and your community.

Stay free, and help others do the same.

Ed

Your Best Business Investment: Did you make First Adjustment Calls?

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When was the last time you called your patient after their first adjustment?

We’ve advised this for years, and it is one of the many items on our Marketing Checklists. The procedure was simple: the staff handed the doctors a slip of paper with the names and numbers of patients who had their first adjustment that day. Then, on the way home, the doctor would give the patient a call to see how they were doing. I remember hearing from the staff that the patients loved getting a call from their doctor and felt it was an extra effort to ensure their well-being personally.

I was reminded of this when my wife, Barbara, took a phone call from the MD from whom she recently received a light skin surgery. She was impressed and delighted. (“Wow,” she said after the call. “I think I’ll call to schedule more surgeries this month!” She’s funny!)

But we live in a world where we are becoming more insulated from each other. We almost interact as much with Artificial Intelligence, electronics, and automation as with live people. Automation runs our shopping, our money, and our communication, even much of our medical care.

I just read a report this week that Google suspended an engineer from work who said that an AI program at Google was now sentient (conscious). He said that he had “startling talks” with a chatbot program.* And never mind the masking, social distancing, and lockdowns which I am sure we haven’t seen the last of.

It seems that honest, caring, and genuine interest from a live person, especially from someone who knows us, are vanishing human qualities.

And this is the niche where you and your team are uniquely qualified to own.
As entrepreneurs, we focus on business matters – we look at our scoreboard, analyze the numbers, and review our accounts receivable. We look at how we can grow our business and improve the bottom line. And all that is fine and part of our job.

But all the numbers, the paperwork, all the administration and marketing are for nothing if the personal connection you have with each patient is absent.

And this is what makes your service exceptional – the quality of connection you and your team have with each patient. The genuine interest in and authentic care for each patient, and the outcomes you deliver, are the heart and soul of your business.

Improving this is the best investment you can make for long-term success.

Carpe Posterum (Sieze the Future)

Ed

(Yahoo News)

3 Effective Methods to Amp Up Your Team’s Motivation

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Do you sometimes feel that you are just reporting in on Mondays to work on the assembly line? Has the eagerness to achieve your goals been replaced by an attitude of “now I have to go to work.”

How about your team members? Do you suspect that they sometimes disengage from their work when you are not looking?

It happens.

Yet, the level of any team’s motivation directly affects its level of success.

Here are three keys to improving motivation:

1. GOAL ALIGNMENT

The outcomes of any job need to be matched with the mission of the job.
For example, let’s take the front desk. Many front desk new hires are trained on the appointment procedures for patients but omit teaching them on the mission of the front desk.

The mission of the front desk is to assist the patient in becoming healthier by helping them keep to their health and treatment plan. That would be its mission or higher-level goal. The lower-level, or practical, goals would include every patient keeping their appointment, or 100% kept appointments!

If the front desk is primarily busy working on insurance paperwork, their work is not in alignment with the mission of their job. This is a misalignment of goals.

“The psychologists Ken Sheldon and Tim Kasser have found that people who are mentally healthy and happy have a higher degree of ‘vertical coherence’ among their goals — that is, higher-level (long-term) goals and lower-level (immediate) goals all fit together well so that pursuing one’s short-term goals advances the pursuit of long-term goals”. (The Happiness Hypothesis – pg145)

In the Goal Driven System, we have found that everyone works more efficiently and with a better attitude if the mission of the job is connected to its outcomes.

You, as the doctor, come to the office to work with patients, yet much of your work involves getting administrative tasks completed. Your higher clinical goals as a doctor do not line up with all the admin chores needed.

Here is a sample chart showing higher-level goals and lower-level goals.

Action Step: Regularly review the mission for everyone’s job, including your own, with the outcomes it needs to produce. Keep higher-level and lower-level goals connected.

2. TEAM INCLUSION
Your employees will be more motivated if they are included in the progress and direction of the business in which they work.

“Motivation requires that people see a relationship between their behavior
and desired outcome…” (Edward L. Deci). (Why We Do What We Do, Deci, page 59)

Action Step. Keep your team updated on the progress towards your goals, as we discussed in our last newsletter.* Do this in regular staff meetings to monitor the progress in achieving lower-level and higher-level goals.

3. COACHING AND ACCOUNTABILITY
Several studies indicate that people are more likely to achieve their goals with accountability and support.*

This is one reason why weight-loss programs do so well – there is someone you must answer up to who also guides you, supports you and keeps you on track to your goals.
There are many barriers that can cause us to lose our enthusiasm to achieve our goals and settle for substitutes. Owning and growing a business as a doctor is very challenging and sometimes a lonely endeavor.

Action step: The solution is to recruit trusted advisors – colleagues, and professionals for accounting, legal, and practice development (our specialty.)

Carpe Posterum (Seize the Future)

Ed

This is covered more thoroughly in my book, the Goal Driven Business. Buy it here.

*Last Goal Driven Newsletter: https://www.goaldriven.com/post/those-numbers-do-you-manage-by-emotions-or-by-goals

* Study on Accountability. Psychological Bulletin © 2015 American Psychological Association 2016, Vol. 142, No. 2, 198 –229 Does Monitoring Goal Progress Promote Goal Attainment?

Improve Patient Retention Through Onboarding and Gamification

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

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

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

Let’s take a look at each:

Onboarding

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

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

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

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

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

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

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

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

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

It is all about goals, yours and especially theirs.

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

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

Ed

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

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

Call Your Mom: The most important person in your practice

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

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

And he did, but not often enough.

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

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

Mother is always there.

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

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

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

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

Always show special gratitude to the mothers in your office.

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

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

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

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

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

Ed

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

Chester Wilk Was Not to Be Bullied

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A chiropractor that stood up for chiropractic.

chester wilk: a chiropractor that stood up for chiropractic

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

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

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

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

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

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

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

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

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

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

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

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

Seize the Future!

Ed

PS links:

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

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

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

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

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

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

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

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

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

But it was actually an ad.

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

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

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

Direct Marketing

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

Indirect Marketing

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

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

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

Marketing Mix – Direct, Indirect, and Internal, External

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

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

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

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

Carpe Posterum (Seize the Future),

Ed
GoalDriven.com

Ode To Joy

Make each day an Ode to Joy!

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

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

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

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

-Ed

 

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

The Missing Role in Your Practice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Three Functions of the CEO

The role of CEO includes these functions:

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

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

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

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

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

Ed Petty

March 14, 2022

Motivation

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

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

This is a key element in a Goal Driven Business.

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

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

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

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

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

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

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

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

These are the three intrinsic goals we all share:

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

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

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

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

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

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

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

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

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

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

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

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

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

Seize the Future,

Ed

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

 

How to Create a Full Appointment Book with Goal Driven Marketing

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busy desk, planning calendar

Happy Valentines Month!

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

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

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

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

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

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

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

Goal Driven marketing is helping people get to their goals!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Happy Valentines Month! Spread the Love!

Ed

 

Are Your “Engines” Driving Your Practice?

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

Five engines drive your business to its goals.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A great new February to you all,

Ed