Tag Archives: chiropractic

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 Has the eagerness to achieve your goals been replaced by an attitude of “now I have to go to work.”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

Faith Demands to Make a Difference

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GoalDriven.com - Faster to a Better YearDecember 30, 2021

A year ago, who knew what the next 12 months would be like?

Yet, here we are today.

As the New Year is just before us, again, one can only wonder at what the future holds. Is this the “New Normal?”  How far will it shift in the next twelve months? For you, your patients, and your business?

Whathe goal driven businesstever new realities lie ahead, we are ready to help you and your business. We will be launching a new approach to practice and business building with the theme of Faster to Your Future in January. It is based upon the book the Goal Driven Business.

 

But just before we start the New Year, I wanted to pass along a message of encouragement.

It often amazes me that with all the wars, both “hot” and cold, the greed, the fear, and tyranny, with all of mankind’s utter insanity over the centuries, we are doing as well as we are. Somehow, as Abraham Lincoln predicted in his first inaugural address in 1861, “…the better angels of our nature…” came through and prevailed. Whatever challenges we may have, his were enormous. He was facing a nation divided, secession of the southern states, the policy of human slavery, civil war, and a world of other conflicts.

But in the end, there is something about the Innate Goodness of Life that seems to propel mankind forward towards a better future, however slightly. I think that the more we trust in the Better Angels of our Nature, and in the Goodness of Life itself, the more sure our road will be toward a better year for us all and a happier future.

“I have one life and one chance to make it count for something . . . I’m free to choose what that something is, and the something I’ve chosen is my faith. Now, my faith goes beyond theology and religion and requires considerable work and effort.

My faith demands — this is not optional — my faith demands that I do whatever I can, wherever I am, whenever I can, for as long as I can with whatever I have to try to make a difference.”

― Jimmy Carterjimmy carter supervising

So with this, we look forward to working with you to help make 2022 both prosperous and rewarding.

With admiration from all of us at Petty Michel and Associates,

Ed

Medicare Reimbursement Cuts Delayed in 2022!

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On December 10th 2021,  President Biden signed into law a bill to delay reimbursement reductions for physicians. Further, the proposed 2% sequestration reimbursement reduction to physician services as well as to farmers, has been delayed.

Please see the 2022 Wisconsin Chiropractic physician fee schedule below.

For your reference, here are the 2020 and 2021 Wisconsin Chiropractic physician fee schedules:

For over 35 years, Petty, Michel & Associates has been at the forefront of keeping up to date with CMS Medicare & Medicaid Service’s billing and coding standards. Questions? Contact us at 414-332-4511 or email Lisa-lisa@pmaworks.com

Source: https://www.jdsupra.com/legalnews/bill-averting-medicare-sequester-cuts-4029291/

For more details on fees and relative values in your practicing state, refer to your Medicare Administrator Contractor’s (MAC’s) website.

David Michel

The Problem With Seminars

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the problem with seminars

I am all for seminars. Been to many myself. I know I have gotten useful information and, no doubt, have benefited from them.

But, their usefulness is often wasted.

I just talked to a business owner that came back from a seminar he and his doctors and staff attended. He told me that they have started hitting their best-ever weekly numbers. His office manager told me that everyone is excited.

For now.

I have seen it time and time again… go to a seminar, get stoked, come back, numbers go up for a month or so, and then everything returns to how it always was. In essence, the seminar was only a short-term, “acute care” fix that addressed symptoms. Nothing was really improved or corrected.

There is a solution on how to benefit the most from seminars. I discuss it in my book, The Goal Driven Business, from which most of this article is quoted from. The following is a story related to me from a chiropractic staff member a few years back:

“Our office was really slowing down last year. So, the owner decided to take everyone out of town to a weekend business seminar. The speakers discussed new and efficient methods for doing our work. It was entertaining and informative. Plus, we also gained some great marketing ideas. It was a fun seminar, so we were all excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members had to take care of urgent matters first, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting, but then customers begin arriving for their afternoon appointments. We had to call the meeting to an end without getting through very much of our agenda, but we agreed to continue the meeting the following week. Turns out, we never did meet again about the seminar.

“But we were still pretty motivated from the out of town trip to the seminar and, as I recall, we had one of our best months ever. It’s my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were never opened; so I stored them for future reference. Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. Some of us are a little burned out and I don’t think we ever did implement anything from that seminar.”

Sound familiar?

I bet it does. I have seen it play out almost exactly the same way countless times. Starting, and not following through. No management and marketing system is set up, and no time scheduled to ensure the system is followed, and no lasting improvement is realized.

And I am sure, for most of us, this phenomenon applies to our personal lives as well. For instance, how is your exercise program coming along? Hmm? You’ve set goals to work out more often and eat better, right? To work ON your body, not just in it. Yet, my guess is it’s been pretty hit and miss.

We want to improve, we make improvement goals, but what happens? Why can’t we achieve them? Consistently. Is it that we’re all too busy? Too lazy? There seems to be no solution, so we accept our condition and do our best.

Yet, there IS a solution, and it’ll seem like science fiction—but, it’s actually a science fact.

The Goal Driven System of Business Development covers 20 Big Shifts, or actual office adjustments, that need to be made to reach your goals — and stay there. It takes you out of the Practice Roller Coaster that forces you to finally “settle” and accept a lower level of success because the stress of the ups and downs becomes too much.

Here’s how to get the most out of seminars from The Goal Driven Business.

goals lab goaldriven.com “BIG SHIFT #1: Introducing the Goals Lab
You can’t improve your car while you’re speeding down the freeway. You must take it to a mechanic at a garage. Athletes and musicians alike spend time away from their audience to practice their game skills or their music, always improving their performance. Businesses need to do this as well. But where? And when?

 

The answer is you need to create a Goals Lab where you go to work on your business.

Your Goals Lab is a special place, a laboratory, an oasis for change. Here, you can think, study, learn, practice, become inspired, and have conversations. Here is where you go to reset your thinking and improve your actions—and the actions of others in your office as well.

I call it the Goals Lab, but you can give it another title, if you wish. Whatever you call it, this is the first Big Shift you’ll take on your journey to achieving your new goals.

Goals Lab to engineer your best route to your goals, Goalddriven.com

Why do you need a Goals Lab? Because you simply cannot focus on the other Big Shifts when you are in your office, juggling customers, staff, bills, phone calls, emails, vendors, and everything else that consumes your energy and brainpower.

Management companies and consultants may have advised you to work on your business, not just in it. While the idea of working on your business, as opposed to in it, is a clever and useful concept, I have rarely seen it applied consistently or comprehensively. Why? Because real business improvement can be more demanding than meets the eye. It is a separate activity that requires its own distinct time and place, and it has its own rules which must be followed to be effective.

I use the term Goals Lab because it is a virtual location that you visit to improve business performance. As an example, you spend most of your time with your car driving it. But you also take time to take your car to a special place where you let a mechanic work on it.

Not knowing about this place, this Goals Lab, its rules, and how it operates, is a fundamental reason why all your management books, marketing manuals, and practice improvement notes from seminars rarely get implemented.

Your Goals Lab has been mostly hidden from you. It almost has a fourth-dimensional location, which is outside the time and space continuum.”

Why don’t we spend more time on improving the business, not just working in it?

This is the real question, and it is answered in the book, The Goal Driven Business. You can read about it now, or wait for my next article where I explain WHY business improvement is so difficult and what to do about it.

Meanwhile, keep improving.

Ed

Learn more about book and get it here: https://www.GoalDriven.com

the goal driven business by edward petty

Key Updates and Workarounds For the New ICD-10 Codes That Impact Your Office.

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icd-10, key updates for 2022Dear Chiropractors and Staff:

Are you having issues with not getting reimbursed due to the new ICD-10 codes and the deleted low back code? Having difficulty getting reimbursed from Humana and BCBS due to precertification requirements and other crazy denial codes?

Please read below where I provide you three key updates to the ICD-10 Codes and some workarounds that are of interest to your revenue cycle.

UPDATES: ICD-10 code Changes relevant to chiropractic

1. Deleted code: M54.5 low back pain.

2. NEW codes to replace the above deleted code include:
• M54.50 Low back pain, unspecified
• M54.51 Vertebrogenic low back pain
• M54.59 Other low back pain

3. Other Chiropractic-Relevant New codes added:
• M45.A0: Non-radiographic axial spondyloarthritis of unspecified sites in spine
• M45.A1 : Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region
• M45.A2 : Non-radiographic axial spondyloarthritis of cervical region
• M45.A3 : Non-radiographic axial spondyloarthritis of cervicothoracic region
• M45.A4 : Non-radiographic axial spondyloarthritis of thoracic region
• M45.A5 : Non-radiographic axial spondyloarthritis of thoracolumbar region
• M45.A6 : Non-radiographic axial spondyloarthritis of lumbar region
• M45.A7 : Non-radiographic axial spondyloarthritis of lumbosacral region
• M45.A8 : Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region
• M45.AB : Non-radiographic axial spondyloarthritis of multiple sites in spine

NEW Cough codes:
• R05.1:Acute cough
• R05.2: Subacute cough
• R05.3: Chronic cough
• R05.4: Cough syncope
• R05.8: Other specified cough
• R05.9: Cough, unspecified

WORKAROUNDS
If you have claims to send (hopefully only a few) with DOS prior to October 1, with low back pain diagnoses, what should you do to ensure they do not reject by the clearinghouse and payer for adjudication? Your clearinghouse should, by now, be updated to include accepting claims with the old M54.5 code IF the DOS is prior to 10/1/2021. The commercial payer claims adjudication systems should also be updated now to accept claims prior to 10/1/2021 DOS if you billed with the old M54.5 code. Please make sure to get any outstanding claims with DOS prior to 10/1 submitted as soon as possible, if you have not already. If you only have a few claims going to commercial, you also have the option of sending these on paper instead of through your clearinghouse. Do not do both.

State Medicaid programs and Medicare will still require the use of the M99 codes for billing, so continue using those codes for these claims.

HUMANA is requiring pre-authorizations on all chiropractic therapy codes. The latest news is that starting in January, there will now be three entities that will be doing the pre-authorizations. a. Optum, b. Humana itself, or c. A new vendor, Cohere Health. Humana has advised us that the entity will be selected based on the patient’s policy.

When you verify a patient’s benefits you will need to make sure to ask:
if preauthorization on your therapy/rehab codes is required on the member’s policy,
which entity will be preauthorizing/reviewing,
and the process to follow when requesting services requiring preauthorization.

Not getting paid by BCBS, with crazy denial codes? No one at BCBS to help? You’re not alone. Offices across the country are experiencing this. So what can you do at this point? First, do a claims audit on your BCBS claims. Do you have the GP modifier attached? Is preauthorization on therapies required on the patient’s plan using AIM Specialty Health?

Your other option is to ask the patient to call into BCBS and advise that claims are being denied even though they have been billed out correctly. We do have scripting available to help your patients with the communication. Click here and request more information.

Questions? We’re here to help!

Lisa Barnett
PH: 920-459-8500
Email: lisa@pmaworks.com

“Increasing your collections through better billing and documentation”

The Mental Immune System

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mental health, immune system, goaldriven.com

A healthy body has a well-functioning system to protect it or make it physically immune from disease. I am sure you have seen this occur with your patients as you adjust and treat them.

But there is no doubt that the mind also affects the body. In your practice, could you improve your patient’s mental immune system? Of course, and already do. I am sure you bolster your patient’s mental immune system even though you or your team may not have looked at it this way. Providing your patients with genuine positive feedback and showing them gratitude for their regular visits can go a long way in enhancing their mental well-being.

A mental immunity system would help individuals be protected, or immune, from negative influences or circumstances in the environment. This would be the ability to “roll with the punches” and keep one’s stress level low despite potentially stressful situations. You can’t be expected to help your patients achieve this in all areas of life, but you can help them with this regarding their health.

Your patients and clients are under a constant deluge of frightening and drug-related messages that can be demoralizing and lead them to less than optimum health choices. There is not much incentive for large corporations to promote exercise, eat organic food, take vitamins, and encourage people to be nice to their neighbors. Instead, there is more money in promoting drugs and fast food, and beer. It took a long time and great expense to stop cigarette advertising, but pharmaceutical advertising has now taken its place.

So, it is for this reason I recommend positive health advertising to your patients regularly. The more they know and understand how to maintain their physical health, the better prepared they will be to critically interpret the corporate advertising of products masquerading as “healthy.”

Here are some methods to improve your patient’s mental immune system regarding health:

  • Extraordinary customer service. Through empathic communication, get to know your patients so that they know you care about them and can trust you. You are in their corner and have their “back.”
  • Positive reinforcement. Genuinely recognize their good efforts to improve their health and any positive responses to your program of care.
  • Table Talk. Listen to their stories and provide quick positive educational tips about health related to their story.
  • Educational themes. Pick an educational them each week and have literature for patients.
  • Patient successes. You can include notable case successes with your education themes each week or each month. Spread the good news!
  • Lending Library. Stock your book shelves with books on subjects you would like your patients to read. Encourage your patients and staff to study. (See a sample list of books we selected a few years ago over at pmaworks.com.)
  • Workshops. These can be done virtually or in person.
  • Newsletters. These can be electronic as well as hard copies by snail mail. They help “keep the conversation going.”

You are the positive lighthouse of health in a storm of gloom and unhealthy corporate products. You can improve the physical immune system of your patients by also improving their mental immune system regarding health.

Ed

the goal driven business by edward petty

buy the goal driven business by edward petty

Image from: Kellogg, Yevgenia Nayberg

KINDNESS and the Strength of Your Practice

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

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

I have used this definition for ages.

Customers, potential patients, and clients, seek you first and foremost for your services and results. This could be relief from a troubling condition, or perhaps general wellness care. Therefore, in marketing, you want to promote that you can deliver the outcomes people are looking for, and prove that you can produce them. There are many ways to do this, but this is the basis of direct marketing.

Next to results, your patient wants to be understood. They know that no matter how competent you are, unless you really understand their condition, you may be applying the wrong remedy. Plus, you may come across like you really don’t care. You show how much you care by seeking to fully understand how they feel about their condition. This is called deep empathetic communication – feeling how the other person feels.

I think just being genuinely interested in the other person brings about this kind of communication and feeling on the part of the patient that you do care.

This type of communication determines the quality of the relationship. But I believe that it can go deeper. Let’s look…

KINDNESS

Kindness is more than empathy.

It acknowledges not just how the other person feels, but in fact, that the other person is privately fighting their own personal battle.

Every one of your patients is suffering — to a greater or lesser degree — though they may not fully confess it. Yes, people are tough. They must be. But when they see you, they hope that you will understand their struggles, their fears and their challenges.

There are many ways you can let them know that you grasp their situation. Most of all, seeking to understand their feelings and letting them know you, now, have a better sense of what they are talking about is sufficient. You can repeat some of what they said to emphasize that you heard and understood them. You can let them know you have experienced something similar, if you have, and sometimes, as appropriate, touching them on the shoulder compassionately can go a long way.

But there is no gimmick that expresses kindness – it is just deep human empathy.

Kindness doesn’t cost you anything, except a few moments of present time consciousness and mindfulness. Yet it strengthens trust, alleviates fear, and can help your patient improve faster.

You want to be a positive coach. But in the beginning, all your advice, adjustments and treatments, education, scheduling, and payments, must be based upon the trust you earn from your patient simply through your empathy and kindness.

Patients will seek you for your services, but they will stay with you because of their relationship with you.

Deliver excellent outcomes and promote them, initiate and maintain empathetic communication, and be kind. Include these as your goals in your mission, core values, and complete outcomes and see your practice and business grow.

Edward Petty

“…in the world, what counts more than talent, what counts more than energy or concentration or commitment, or anything else – is kindness. And the more in the world that you encounter kindness and cheerfulness … the better the world always is. And all the big words: virtue, justice, truth – are dwarfed by the greatness of kindness.”

Stephen Fry (azquotes.com)

Download PDF copy

Why What You Stand For is Important

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Ed Petty, at Goal Driven, talks about masks for kids.Why What You Stand for Is so Important

I want to tell you about my experience on TV talking about masks for kids, but first, here is a related short story…

A few years back, an office asked me to meet with them for lunch. They wanted to discuss how their office was doing and if I could help them.

I liked the doctors and had known them for some time.  They had a group practice and had been in business for several years.  We met over sandwiches, and they said they had been working with a consultant who emphasized “evidenced-based” chiropractic.

My response could have been better as I look back on it now.

Barely concealing my disdain, I asked them whose approval they were seeking. Wasn’t there enough “evidence” from the results that they had with their patients over the years? Sure, double-blind studies are good for validation – but didn’t they already have enough evidence from their happy patients and their remarkable outcomes?

Had I been trying to “sell” them on our services, I would not have acted so irreverently to their seemingly serious question. But, instead, I tried to re-convince them that they did have enough proof, and the problem with their office (one of many problems) was that they were not promoting the successes they routinely achieved with their patients.

The doctors seemed equivocal about their services, so I asked them if they were committed to their profession and helping their patients reach their health goals. Unfortunately, I didn’t get a straight answer.

It seemed that they were seeking approval from some authority –  rather than from their neighbors who struggle daily with pain and poor health.

Now, years later, I recently had a friend see one of the chiropractors I met for lunch years ago. The doctor currently works as an employee for a local hospital and the office that he once co-owned no longer exists.

All this is a true story, and the lesson is that you have to have faith, confidence, and belief in your services, and mostly, in yourself.

You must stand up for what you know and use your voice to help others – find theirs.

You shouldn’t be too outrageous as this can completely alienate you from others, not unless you want to! But find your level of certainty, independence, and rebelliousness and help others to do the same.

Masks for Kids: I am on local television

I was reminded of all this recently when a local TV station asked what I thought about masks for school children. I was on our main street, and a local reporter started asking me questions. You can watch my response and that of others here. Ed’s on T.V.!

Standing up for natural health care,

Ed

Buy my book, the Goal Driven Business. It is a distillation of my 35 years of in-the-field lessons about building a profitable practice and business. It will help you help more people. Go here to learn about the Goal Driven Business –A New Business Building Methodology for Professional Practices

Tempus Fugit (time flies)

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As the ancient Greek reminds us, Time Flies — and July comes at us fast.

We are halfway through the year – 2021!

While enjoying the summer, I suggest you take a Half-Time Break and reassess, readjust, and recommit where needed. That is, reassess your progress so far this year.  Make any adjustments to your yearly plans. Recommit to your higher goals.

This is a team exercise. You can discuss with each team member first, but I would focus on the four categories below:

                What are the goals for the rest of the year?

  1. Yourself as a professional?
  2. The office as a whole?
  3. The quality of service/outcomes of your patients?
  4. Yourself personally.

You can reprint this and send it out to your team as a memo next week. Then, meet as a group in the following weeks to discuss.   Here are some tips you can pass on to the staff and doctors:

  1. Goals for yourself as a professional. How are you going to improve your level of competence as a support professional or doctor? What subjects do you want to study, or skills you want to improve, in anatomy, customer service, chiropractic, chiropractic history, marketing, health care in society, etc.
  2. Goals for the entire office. Review the mission, core values, and outcomes of our office, and from these, consider what improvement goals we could set for the next six months.
  3. Goals for the services we provide our patients? Consider such things as faster service, more complete outcomes, more fun for the patients, and more engagement with our mission.
  4. Goals for yourself personally. This is personal and can be private. It can be discussed, but that is optional. This might include such things as more time with nature, family, exercise, prayer, recreational reading, a new hobby, and travel.

Enjoy your summer but be PROactive and meet with your team to plan out the rest of the year. Keep it fun. You can meet at the lake, in the park, by the mountains or near the sea. Integrate health and an unquarantined life into your work meeting.

But remember… TIME WAITS FOR NO ONE.

Carpe Diem,

 Ed

ALSO, if you haven’t yet — buy my book now while it is still only $8. The Goal Driven Business.   It will help you achieve your goals.

What is an Adjustment

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B.J. Palmer

What is an Adjustment by B.J. Palmer

An adjustment (“setment”) is one if not THE most exact in operation in the world; greater by far than ripping out an appendix, etc. It requires that “intuitive” sense of direction, proportion, distance, and ability to deliver just that and all that, and nothing more; a sense of fitness to do this one thing, which few seem to possess, which can be acquired if one is willing to pay the price in thought, study, development of mind and body.

I have spent 40 years to do what I can do today. The “follow thru” of an adjustment IS IMPORTANT, but not nearly as important as “the approach.” If the “approach” is natural, easy, perfectly timed and distanced, then follow-thru is The sportsmanship of adjusting subluxations is no different than the perfection in tennis football, baseball, or any sport where ONE gets this top, MANY drag behind, and MANY are way down at the tail of human endeavor.

The MIND thinks all action. As the MIND understands, the muscles deliver. I will spend no less than ONE HOUR studying a DISlocation before I adjust it. WHY? The mind THINKS all action, and the MUSCLES deliver. The more the MIND knows, the better will be the delivery of MUSCLES. I had a child-like that recently — 6 months old — a DISlocation to correct. It was done in a split fraction of a second. When your muscles come through, THEN they haven’t time to think action. Action must be formed IN THE MIND ahead of time.

(Page 844, Up From Below the Bottom, B. J. Palmer, 1950)

PDF Version for downloading: What is an adjustment by B. J. Palmer