“I learned this, at least, by my experiment: that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours. … If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them.”
Henry David Thoreau Walden
For a printable version of this tent poster click: Castles in the Air-Walden
I’ll do whatever it takes to win games, whether it’s sitting on a bench waving a towel, handling a cup of water to a teammate, or hitting the game-winner shot.”
– Kobe Bryant
For a printable copy of this tent poster click: What it Takes to Win – Bryant
The Centers for Medicare and Medicaid Services(CMS) recently released a new ABN Form.
The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on 8/31/2020. We are including the links to the forms for your convenience and they can also be viewed at the CMS Web-site.
In addition to the expiration date on the form, there are a few other minor changes. If you have further questions please feel free to contact Lisa at 920-334-4561.
I try to visit Facebook at least once a week. When I do, I sometimes see posts by others labeling the behavior of the public as “sheeple.” The term, I guess, refers to people acting obediently like sheep. The context usually includes those who believe that COVID-19 is a scam and view people who wear facemasks and observe CDC rules for quarantining as weak and stupid, and easily manipulated.
There certainly are indications, as well as precedents, that can support this view. The promotion of potential threats to generate fear has often been used to motivate people. Think of all the weapons of mass destruction that we were told Iraq had – which they didn’t have — that justified a 3 trillion-dollar war (estimated, Wikipedia) to the U.S. alone—not counting up to 400,000 killed. Someone made money off that scam.
There are over 100 cataloged types of biases, and we all have our own odd fears and weird ideas. Included with this is our basic “I-am-right” mechanism that makes others wrong and emboldens our ego.
Recently, I was talking to someone on their speakerphone while they drove in their car. They were wearing a mask and their voice was slightly muffled. I thought to myself that it was odd to talk to someone who was wearing a mask while in their car. Then, I was reminded that the person I was talking with has unselfishly devoted his entire life to taking care of his severely health-compromised daughter.
We all have our own stories and fight our own battles – with the best knowledge we have.
Another method to control people is to dissuade them from education and from learning to think critically and question authority.
So, I invite you to consider this as your #1 duty as a doctor – and as support staff — to educate your patients and community. Doctor, after all, means teacher.
People do not know what you know.
Perhaps they don’t want to know, are too tired, or seem too lazy to make an effort to learn. Maybe they have already made up their mind, and their view reinforces their own identity. But don’t give up on people — they are part of your family. They are your brothers and sisters.
Use newsletters, social media (even Facebook!), webinars, and especially Table Talk.
Educate because you care for people. Market your services from an attitude of compassion.
We are not sheep. We just don’t know. And regardless of what we say, privately, we look to you and your integrity — for your wisdom, your help, and your friendship.
Ed
The Story of Selling Yourself by B.J. Palmer
A tree withstands storms but continues with its systems.
Just a note here about procedures:
Keep the structure of your business – its policies and procedures — in place. As much as you can, stick to your usual routines.
Certainly, you want to integrate needed changes to prevent the spreading of the virus. And obviously, for many of you, patient volume has changed, so you may have to adjust your work hours and staff hours.
You do need to be flexible. Improvise — where needed, adapt, and overcome! (Paraphrase of Marine slogan!)
But do not let the virus be the tail that wags the dog!
Keep the recalls going. Keep the billing going. Hold staff meetings, if only by Zoom. Rally the team! Review numbers and SET GOALS. Give staff study assignments. If anything, increase your patient communication 5 times – or more.
Strengthen your network.
I bring this up as I have seen a few offices start to slack off on their procedures, and while this is understandable in many situations, it can be a slippery slope. This can set a precedent for neglecting other procedures. This is what leads to office anarchy and what I call “Procedural Atrophy.”
Procedural Atrophy is the gradual dropping out of procedures. For example, you used to call every new patient after their first adjustment and send out birthday cards. Then, you became so busy that you “didn’t have time” to do the calls or to makes sure the staff sent out birthday cards. Two years later, you wonder what happened to all your patients.
We are NOT victims. We will respond positively and use this opportunity to strengthen our resolve and our health network.
Hold true to time tested procedures during unusual conditions.
Stability breeds confidence. Your patients are looking to you to be the rock that they can count on.
Management’s job is to hold the structure of the organization in place. (And then improve upon it.) It may have to be abbreviated, economy of time, effort and money come into play, but … do the usual. Set your goals and stick to your successful procedures to reach them.
Do this, and after this storm passes — your business will be busier than ever.
Working now for the future,
Ed
I have been in touch with most of you and, for the most part, you all are doing relatively well during these days of COVID-19. Of course, the keyword here is… relatively.
Whatta time, eh? Historic, that is for sure. It will change our society and our world as nothing has since, perhaps, WW 2.
The Lighthouse in the Storm
Your role, right now, is so very important. Perhaps more than you know. Your patients have fears, questions, and doubts. Their parents could contract COVID, perhaps they could. They are out of work or soon will be, and there is the apprehension that all of this is a government plot towards totalitarianism.
With all the communication regarding our current situation, you have to remain as a calm source for sound, researched data that provides comfort and solutions. You will have to be a lighthouse in this storm.
YOU are independent. You do not work for a drug company, and you are not beholding to a boss that works for a hospital or a government agency. Therefore, when patients come to you with worries and questions, they trust that what you tell them is unadulterated, unbiased, and accurate information.
And even more, they hope that you genuinely care.
Time to See the World Anew
In some sense, the world is experiencing a big “Time Out.”
Perhaps we can all take this time to become closer to our families and friends. My daughter is cooking more, my son is homeschooling his kids, and I am practicing guitar tunes from my old 1960’s book of folk songs!
I notice on my walks and runs that here, in Milwaukee, the air is fresher, cleaner, and the sky is bluer. Less smog from our southern neighbors and nearby freeways and overhead airplanes. The difference is striking and one can only imagine what we have been breathing in all this time!
It is spring, you have a family and friends, and you have your own self. COVID-19 doesn’t change this.
Good to Great: Redesign your NEW Business.
But what I am most looking forward to is the NEW.
Right now, you have a unique opportunity, during this temporary slump, to reimagine and redesign your business.
You’ve had a good, perhaps a very good business before. But as Jim Collins explains in his book, Good to Great, good can be the enemy of great.
The Good is now the Old, and we have this moment to review our goals and engineer better pathways to them. Now, you can create the Great! This will be your new version of your business based upon all you have learned as a professional and as a business owner or stakeholder. This new version can be your best creation ever.
Over the next few months, we will be discussing this, and I and all of us at PM&A, look forward to helping you and your team create the business of your dreams.
Looking forward to the future,
Ed
PS Happy Earth Day!
I am sure that all of you are trying to stay up with unfolding events regarding the virus and the governmental recommendations – and enforcement — to deal with it.
We are, as well.
I am sending this email out to encourage you to watch an informative video by Del Bigtree, who reviews the facts and numbers of the virus pandemic. It is a bit long, so I am sending this out this weekend in case you have more time to watch it.
I have also included an article by Bruce Lipton. Dr. Lipton is a cellular biologist who taught medical students at the University of WI medical college and often speaks at chiropractic seminars.
Plus, an article that states 99% of those who died from the virus had other illnesses.
(Links below.)
We must watch out for the GENERALITY of the virus. For example: “COVID-19 could kill us all!” “Who says?” “They do.” “Who is “they.”” “The authorities.” “Who are the authorities?” “Those who are in charge.” You have to break it down and be as logical as you can.
I recommend that you review these sources, add to it what you are learning, and using your best judgment, continue educating your team members and patients/members/clients!
Be the lighthouse in your community.
Education and knowledge displace fear and uncertainty.
Let’s eradicate what Dr. Lipton calls the “nocebo” effect — the opposite of a placebo.
And let’s continue our fight to help people get healthier!
Keep educating,
Ed
By the way, no one is saying you must close your office. Even in California where San Francisco has a “Shelter in Place” or strict quarantine. For example, the California Chiropractic Board of Examiners, on their website, states:
YOUR SERVICES ARE VITAL!
The Exec. Director of the Kansas Chiropractic Association, in a letter to their state Governor (March 20, 2020), stated:
“We understand that with the severity of the current pandemic hospital emergency rooms may soon be filled with patients complaining of pulmonary symptoms. We offer our services in diagnosis and treatment of musculoskeletal complaints presenting to emergency rooms. Many Doctors of Chiropractic have arranged to be a referral point for their local emergency rooms on these conditions.
“We are prepared to see these patients in our offices that are already taking every precaution available to prevent the transmission of COVID-19.”
REFERENCES
Del Bigtree Coronavirus Quarantine March 19
Bruce Lipton Cornonvrus 2019-Covid-19 UPDATE
Bloomberg News March 18, 2020 99% of those who Died From Virus Had Other Illness, Italy Says
(Painting by Norman Rockwell, 1943)
When you engage in work that taps your talent and fuels your passion – that rises out of a great need in the world that you feel drawn by conscience to meet – therein lies your voice, your calling, your soul’s code. (Stephen Covey)
For many of your patients, it may be difficult to tell how far to take precautions regarding COVID-19. Who can your patients turn to for a frank conversation and useful information?
Somewhere there is a middle ground between stockpiling hand wipes, toilet paper, and hiding in your bedroom and showing up at the gun show for a family barbecue and square dance. People are looking for reasonable answers without feeling that they are fearfully overreacting, or pridefully underacting.
You have to be that middle ground – and you can be. You do not have a boss that is beholding to Merck, or a company whose board members belong to the AMA. You are independent.
Use your voice and be a source of reason and information. Get in the conversation. You are only beholding to your patients and your community. They know your kids, and you know theirs. You are honest, thoughtful, and know that we are all in this together. You will ask your patients for their best advice on plumbing, cars, taxes, and other life needs. They will seek your advice regarding the best health for themselves and their family. You rely on them, and they rely on you – this year, now, and in the years to come.
Now is not the time to cocoon – not for you. Now is the time to speak up – to stand up.
Keep your practice open, but if not, keep communicating. Aside from seeing your patients in person, you can consider other activities that do not require face to face encounters:
You are a doctor – an educator, a leader. This applies to your team as well – they, too, are leaders and educators. Your community needs you now more than ever. Years from now, it will remember who was there, who stood up, who helped.
Use your Voice! Download the Poster Here
Always communicating,
Ed
We, too, are here to help.
How has the Coronavirus plague been affecting you and your practice…so far?
Most offices I talk to across the country seem to be doing just fine, thank you!
I ran across an interesting thread on a social media site for chiropractors and as a limited sample survey of how other offices are being affected, most report that they are also doing well.
I want to add a few thoughts from a marketing vantage point that might help. I am sure you are following the clinical aspects of this virus, but I have links below to articles from Bruce Lipton, Ben Lerner, and Joe Mercola that are very informative.
More importantly, a great link from our old buddy, George Carlin just to put things into perspective. So, you might want to save this email just for the links. (Gotta watch Carlin!… WARNING… as usual cursing included!)
So, marketing…
The idea of the Coronavirus is that it could kill you, or at least make you very sick. Consider these three promotional actions:
Safe Space. Promote your office as a Safe Zone. In your clinic, use plenty of disinfectant around the office. Let the patients see you wipe down tables, doorknobs, pens, clipboards, and have plenty of Purell (or something similar) around for hand wipes. This is to demonstrate that your office is taking all precautions to be a safe, sterile healing facility.
Get Healthier and Stronger. Secondly, promote the healing aspect of your services – how they can improve and bolster the immune system. The virus will have the most impact on the physically weak. Encourage patients to come in and get stronger in your safe space. (Ben Lerner has a good article about this – link below.)
Communicate and Educate. Use your “table talk” time, and through newsletters and other media, to communicate with your patients. Give them health tips regarding the virus. But also relay positive activities that are going on in your office – an upcoming talk, a community clean-up drive, a patient success or a new team member. This goes for your team as well – educate your staff. People tend to hunker down during a crisis, somewhat out of fear. Standup, standout and maintain your positive presence and leadership – keep communicating.
The viruses may be real and get transmitted from person to person. But ideas can do the same. So spread the word — communicate your office as a worry-free environment where people can become stronger and healthier – safely.
-Ed
I’ve noticed that a lot less people are coming in for care, I’ve especially seen a decrease in overall NPs, is the trend global? related to coronavirus outbreak?? (people being in “survival mode” , or being more careful about their finances)? I’d love to know what you guys have noticed surrounding this issue? Cheers, Kir 2 days ago
ostninja
I’ve noticed a drop this week. I think it’s critical to wipe all surfaces with something that works and have hand sanitizer available. For reality and to create a safe space where they dont have to think about getting it from the table or face rest.
Everybody is concerned. I think it is people limiting their activities, worried about money, worried about the face rest. Let them see you wiping down face rest every time you finish. I’m wondering about sending communication detailing how we are protecting them and ourselves but I’m also wondering how useful overall that would be.
Kiirjava
Interesting… Thanks for sharing 🙂 that communication idea is actually brilliant!
It’s been a slow week so I’ll use this as an excuse lol · 2 days ago
lloydchiro
I’m just as busy as ever, and I’m in San Francisco. I imagine our town will get hit soon.
AshlamAllstar 2 days ago
CCCA here. Only a few one-off scenarios so far. One patient called to pause her treatment plan due to fear of being exposed and one came in with latex gloves, her own lysol wipes and a face mask. Otherwise, practice as usual, if not, a few more questions asking of the doctors’ opinion of the matter.
—-
DrGodzilla22
My practice had grown during since the news cycles started. Well educated patient are referring their friends and families.
—-
DrJayWill · 1 day ago
I’ve had the busiest week I’ve had in a while
Goals: Telos
The Greeks believed that everything had its own innate goal – or Telos. Telos means ultimate aim or purpose of something. The Telos of an acorn is a tree – the purpose of a pencil is to write.
Steven Covey lists Beginning with the End in Mind as an essential habit in leadership and effectiveness.
Now is a good time to review the Telos of your office. What is its innate purpose? There may be a few of them.
Take it a step further – what are the values and standards in which the office must aspire to in order to achieve this mission? For example, “Deliver WOW through service?” (A core value of Zappos).
Reviewing these often and keeping them in mind will assist you and your team to manifest the tangible outcomes of these goals – more people helped and more income collected.
Your Patient’s Goals: Health Never Takes a Holiday
Your patients have made a goal for better health. Don’t’ let them down – help to keep them on their path to a pain free, functionally improved, and healthier life. Here is a desk poster for you to remind patients to keep their appointments over the Holidays. Link
Two Marketing Engines that Help You Reach Your Goals
One aspect of your clinic’s goals should be marketing. Marketing takes many forms, but ultimately it results in more people receiving benefits from your services.
Marketing gimmicks come and go. They work for a while, and then, soon enough, you find that that “hole” is “fished out.” Special promotions and direct marketing avenues need to be pursued. They work and are especially useful for new offices. But they need to be changed often – marketing channels get clogged quickly and the public tires of spam offers.
There are two forms of marketing, however, that will never wear out: extraordinary customer service and outcomes, and your network.
Before the year is out, or just as the New Year begins, consider personally meeting with anyone in and out of your office who has sent you a patient, or supported you in any way. From patients to allied providers to the autobody repair shop down the street, send them a nice and unique gift, or a personal card, or make a phone call thanking them. Tell them you look forward to working with them and seeing them in the New Year. They are part of your network.
Lastly, on a personal note, we want you to know how much we appreciate all the great work you and your team do in helping people improve their lives. If you can, imagine all of us – you, and other offices like you, all of us working diligently as a positive force to make the world a better place.
This is a noble goal – and one we share with you in the New Year. We’ll see you then!
With admiration and respect,
Ed, David, and all of us, at Petty Michel & Associates
It’s a beautiful fall day here in Southeastern Wisconsin. Clear blue skies, the leaves are changing, and the temps are comfortably cool.
I wanted to take a few minutes of your time to introduce myself and let you know about an upcoming opportunity for you to make a difference in a child’s life both locally and globally.
My name is Linda Skiles, some of you already know me and some may not. I have been involved in chiropractic for the past 34 years in some way or another and a patient for most of my life. I began as a chiropractic assistant, graduating to an office manager, and now serve as the client services coordinator for Petty, Michel, and Associates, working with offices across the nation to promote PMA’s 3 Goals(sm)of methodology:
I am passionate about chiropractic and passionate about making our world a better place. Each and every day, I strive to find a way to live with a Higher Purpose. With that said, I’d like to invite you to help support my most recent mission.
Ed Petty and Dave Michel along with the Chiropractic Society of Wisconsin(CSW) have graciously given me the opportunity to collaborate with Wisconsin United for Freedom and Chiro Kid’s Day to host a “Kid’s Korner” at the CSW’s Fall Summit, October 18th-20th at the Wilderness Canyon Lodge Convention Center in the Wisconsin Dells.
The whole idea was born when I made the commitment to sell 600+ ornaments for the Khutsala Artisans of Project Canaan. A large task but achievable with your help.
Project Canaan is Heart for Africa’s 2,500-acre large-scale land development project being used to bring HOPE to the tiny Kingdom of Eswatini (formerly Swaziland) by focusing on four key areas: Hunger, Orphans, Poverty, and Education. It will provide training and employment, while supporting orphans and vulnerable children on the property and across the nation.
In 2013 my twenty-nine year old son, searching for a higher purpose in life, found Project Canaan and served as a volunteer missionary for one year as the bulldozer operator. I had the opportunity to visit while he was there and joined the Swazis in making jewelry. I continue to support their efforts through selling their beautiful beaded ornaments. 60% of the sales support the Khutsala Artisans’ daily living needs and 40% is donated to a local charity of my choice. Proceeds from the sales at the CSW Fall Summit will go to Oklahaven Children’s Chiropractic Center in Oklahoma City, OK.
In addition, I recently published my third book entitled, Nettie’s Fountain Pen – Another’s Days Writings. $5.00 from the sale of each of these books will go to Chiro Kid’s Day and Wisconsin United for Freedom.
Promoting the wellness of our children locally and globally is the theme of our booth. We will have informational material and resources available that focuses on the health of our children here in the US. I hope you will stop by, see what we all have to offer, and support our efforts.
Our children are our future! Can you help a child today?
If you are unable to attend the CSW Fall Summit but would like to purchase ornaments or books, please email me at linda@pmaworks.com
Sincerely,
Linda Skiles
262-749-0221
Links:
Follow my Journey at Project Canaan – Oct 17th 2013 – Nov 1st, 2013
Oklahaven Children’s Chiropractic Center
Heart for Africa – Project Canaan
Wisconsin United for Freedom
Chiro Kid’s Day
Children’s Health Defense
“Marketing is an inside job,” one business owner told me years ago.
He meant it first starts with your attitude and your drive to reach your goals.
Your mental outlook will determine the effectiveness of all of your marketing activities. The good news is that your attitude is something which you do have control over. Even if you have difficult personal and environmental factors acting against you, you still have a choice on how you decide to act. The way you look at your world is entirely up to you.
Practice marketing is ultimately an “inside-out job,” and though marketing includes “outside-in” activities, such as advertising, its success is dependent upon what is happening on the “inside.” On a scale of 1-5, where “5” is strongest, and “1” is weakest, you should work daily to reach a “5” on each of these eight attitudes.
At a team meeting every few months, you can hand this article out to each team member and have each person grade (1-5) how the office has been operating regarding each attitude. You can also have a team member summarize one particular attitude and describe it to the rest of the team in their own words. These attitudes are your marketing muscles that can drive and maintain your growth. Keep working them and making them stronger.
I have observed these eight attitudes in common with successful providers and business owners. I encourage you to use them yourself.
1. Friendliness and Cheerfulness. When you smile, the whole world smiles with you. And that is what you want: your whole community smiling with you. A positive and cheerful outlook opens the channels of communication between you and your community. It is an unspoken “open invitation” for people to interact with you. The happier you are, and the more positive your outlook is, the easier all other marketing efforts will be. “Laugh, and the world laughs with you; Weep, and you weep alone….” From a Poem by Ella Wheeler (1883)
2. Interested Attitude. Where I have been successful in selling and marketing services, this has always been my secret: be interested in the other person. Don’t fake it. Just start with whatever strikes your curiosity. You will find that having an honest interest in people is one of your best sales and marketing tools. People respond positively to sincere curiosity about them. “Betty, where did you find those blue shoes?” “So Frank, I have always wondered, why do you guys call yourselves the Kiwanis?” You don’t have to be interested in everyone. Be courteous and be professional, of course. But you’ll find that you can find something of interest in most people. Since your interest is genuine and not simulated, the other person can begin to trust you. You are not a phony operating off of a script. Even if your curiosity makes you seem a bit forward, at least you are honest. Behind your interest should be a desire to understand the other person, and this requires empathy. This kind of interest begets communication which lays the foundation for the other person knowing you, liking you, and trusting you.
3. “Get to Know Me” Attitude. You should want the community to know you. You should want them to know that you are an excellent provider and that your business gets results. Don’t assume people know what you do – or even care. Maybe they know you are a provider but think you are retired, or too busy and no longer taking new patients, or too important to talk to them. And let them get to know about you personally– that your dog’s name is Louie and you are not from Canada, even though you are very nice. Be willing to have the whole community know all about you, and believe that once they do, they’ll like you. Don’t hide. We all spend too much time in boxes – our houses, our offices, our cars, and other buildings. Get out of the boxes and be willing to be seen and heard. “It is better to be looked over than overlooked.” (Mae West)
4. “Gratitude Attitude.” This is a term often used by Zig Ziglar, meaning be grateful and appreciative. The “Gratitude Attitude” melts the ice between people. It shows respect and honors those around you, especially patients, prospective patients, your teammates, and of course, your family and friends. People hate to be ignored and too often we take for granted the amazing souls around us each day. Be thankful to be a provider and business owner and that you have an opportunity to help people. Show your gratitude to others. Let them know how you appreciate them. Count your blessings daily. “Gratitude is not only the greatest of virtues but the parent of all the others.” (Marcus Tullius Cicero. 106 BC -43 BC)
5. Service Attitude. Be a missionary on a mission to help. Be a giver. In the office, think ahead of what each patient needs each day and make sure they get it. Outside of the office, realize that people are in trouble, have problems, and want relief, so help them. Many are looking for answers. Offer information, community services, consultations, and be a “do-gooder.” Find out what people want and help them achieve it – through your services or another’s. It has been said that “The hole that you give through — is the hole through which you will receive.”
6. Big Capacity Attitude. “Whatever the mind can conceive and believe, it can achieve.” (Napoleon Hill.) Hold the concept that everyone in your community should receive your services. THINK BIG. Think abundance. Be willing to meet hundreds of new people each day and be open to scores of new patients. The mechanics of paperwork, finances, and procedure will all follow. Don’t let yourself become encumbered mentally by these things now. Get rid of the yellow light in your business and turn them all green. “Think little goals and expect little achievements. Think big goals and win big success.” (David J. Schwartz, The Magic of Thinking Big.)
7. Industriousness Attitude. Your outlook towards moving the business forward has to be a vigorous one. You must be ready to jump into the thick of things any time and get the work done. You will need a “can do, will do” attitude, one that enjoys being productive. It takes much more energy and effort to get and keep a business going than most people think. Marketing is simply physics. If you expend energy into your business and the community, there will be a reciprocal force — in terms of goodwill and new patients – coming back. Like planting seeds in the spring. You harvest what you sow. Don’t blame the politicians if the tomatoes didn’t come in at harvest time this year because you were too lazy to plant them. The more you sow, the more you can reap.
8. Have Faith, Confidence, and Belief. Be forthright and confident about the benefits of your profession, your skills as a provider, and the services your office can bring about. From this knowledge, you can be authoritative in telling your story and scheduling new patients. Know that you can help your patient. Believe and decide that they will win and you will succeed. If you are confident in what you are selling, then others will be too.
Edward Petty
In late summer, many offices sponsor a promotion for children and their health. This is often in the form of a backpack check-up, scoliosis and posture check, or a school supply drive. The idea is to link the new school year with children’s health to better promote clinic services, generate new patients, and of course, improve the health of the kids.
It’s been my experience that these events are usually only marginally effective. Still useful, I feel that the real opportunity is being missed.
You could be getting more families under care. How?
Educate your families and your community on:
1. The results you deliver. How the outcomes you generate with children’s health are extraordinary. Use written and video testimonials and endorsements.
2. What you stand for. Today’s children face more challenges to their health than their parents. In fact, our children today are sicker than earlier generations. Learn about this and make it your anthem, a flag you wave. Stand up for the kids in your community, and you will earn respect and allegiance of parents. Be their guardians in health.
3. Provide special promotions and events. These could be workshops, screenings, or a special day of services with donations going to a local charity.
4. Alliances and Partnerships. It would be a good idea to create alliances with midwives, doulas, biological dentists, acupuncturists, and other professionals who share a similar concern and goal for healthier children. Invite them to participate in your events. Have them contribute a short article in your newsletter – in exchange, you could do the same with them in their newsletters. Create partnerships.
5. Schedule an event every two months, or every month. Never stop.
Your leadership, based upon your awareness of the health crisis facing our youth, is the primary element that will drive the success of your kid’s programs.
Read the following from the ebook, The Sickest Generation and follow the link below to the entire article, and other resources to become even more acquainted with the challenges the next generation of children face.
Sincerely,
Ed Petty
The following are some sources of information regarding the health crisis affecting our children.
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The Children’s Health Defense is a powerful organization that is on the front lines in fighting corporate propaganda promoting harmful drugs for kids. They have many lawyers, including Robert F. Kennedy, Jr., working on exposing false information and corruption regarding children’s health.
eBook Sign-Up—The Sickest Generation
Free eBook: The Sickest Generation: The Facts Behind the Children’s Health Crisis and Why It Needs to End Children are the key to a successful future and a prosperous nation, yet American children have never been sicker with a vast array of chronic illnesses. (Also available in Spanish.)
The Pharmaceutical Industry’s Front Men
By the Children’s Health Defense Team
The Medical Journals’ Sell-Out—Getting Paid to Play
By the Children’s Health Defense Team
Science Library
This database contains hundreds of peer-reviewed, published articles on environmental contaminants that are implicated in the rise of the childhood epidemics we are currently experiencing in the U.S. and other industrialized nations.
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Pathways is a long-standing publication with health articles that is free to members of the International Chiropractic Pediatric Association. Its website has links to many articles, a few of which are below:
Are We Making Our Children Sick?
http://pathwaystofamilywellness.org/Nutrition/are-we-making-our-children-sick.html
Natural Immunity
http://pathwaystofamilywellness.org/Informed-Choice/natural-immunity.html
Ear Infections in Kids: Natural Remedies to Ease Ear Pain and Enhance Function
http://pathwaystofamilywellness.org/Holistic-Healthcare/ear-infections-in-kids-natural-remedies-to-ease-ear-pain-and-enhance-function.html
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There are many books on children’s health, and it is fascinating to search to find them. Commit to buying at least one per month, reading it, reporting on it to a team meeting, and placing it in your Lending Library. Have your team members do the same! Here are three:
A Compromised Generation: The Epidemic of Chronic Illness in America’s Children Paperback – September 16, 2010 by Beth Lambert
The Vaccine-Friendly Plan: Dr. Paul’s Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child’s Teen Years Paperback – August 23, 2016 Paul Thomas M.D.
How to Raise a Healthy Child in Spite of Your Doctor: One of America’s Leading Pediatricians Puts Parents Back in Control of Their Children’s Health Mass Market Paperback – May 12, 1987
by Robert S. Mendelsohn MD
Just imagine… imagine that you have SO many patients that you need to move to a larger office to accommodate them all.
A few years later, once again, you are seeing more patients than your office can hold, so you build the office of your dreams – a custom designed 19,000 square foot clinic. And the patients keep coming, so you bring on other doctors. Some days, you and the doctors see 600 visits.
Since patients travel to see you from all over the world, you build a motel next to your office. You also set up a limousine service from the nearby airport to your office.
Could you do this?
Clarence Gonstead did. Here, in Wisconsin, from the 1920s to the early 1970s
What made him so successful?
He was an expert. He was a master at his art. He was committed and focused on his craft and his outcomes.
A founder of a chiropractic college would later say that Dr. Gonstead was not a “commercial chiropractor.” He didn’t focus on management or marketing – just chiropractic. (As a management consultant, I can only wonder how expansive his operation would have grown had he had managers as dedicated and competent as he was!)
He was focused on results and said: “Our future will be our results.”
According to people who have studied exceptional performance, there are definite ingredients needed to become an expert, all of which are available to you. And by the way, “natural talent” is not one of them. Let’s look at each one:
It doesn’t matter what method of adjusting you use, or if you are a dentist or a chef or a cello player. It does matter if you are an expert. Achieving a high level of skill is not always fun or easy, but the rewards are worth it.
Tiger Woods was recognized as the world’s top-ranked golfer in the first 10 years of the 21st Century. He then fell into a slump with domestic issues and physical injuries. But with continued training, he came back to win his 5th Master title and 15th Major title at the Augusta National Golf Course just last weekend! (By the way, Tiger also praises chiropractic for his success!)
I have seen the ads, and I am sure you have as well, on how you can be a laptop chiropractor, travel the world, and make “six figures.”
I love the Internet and laptops and do travel the world and have nothing against being wealthy. But you are a doctor, a provider of service and outcomes, and if what you deliver is not exceptional and extra-ordinary, then the world will pass you buy.
There has been a great “shake-out” occurring in commerce. We have seen it happen with retail – where now the Internet and Walmart dominate. The store on Main Street is shuttered. This will be happening to the service industry as well. Only the very best will survive. Don’t fall for schemes that promise to get rich with easy effort.
What should you do?
You should become the best in the world.
You should work tirelessly, like Tiger Woods and Clarence Gonstead, to become the world class masters.
And as Clarence Gonstead said,
Sincerely,
Ed
PS
If you have the time, I encourage those of you who use Dr. Gonstead’s method, and even those who don’t, to come by his clinic in Mount Horeb and listen to some of the stories of those who worked with him directly.
And especially… bring your team.
Time and Place
Also, during the weekend, the Gonstead Methodology Institute is sponsoring a “GCSS Knee Chest Extravaganza.”
It is a New Year and already we are knee-deep in its work.
But it is a NEW YEAR and it is important that you take time out to make new plans and then review them often.
Each year in Wisconsin, the leaves fall and then the snow falls. But by July the strawberries are ready for the pickin’. Every month, we can see the full moon. Each day, we can see the sunrise – if it is not cloudy.
In human endeavors, we seem to follow this natural rhythm of following cycles. After we finish the 9th grade, we are ready to begin the 10th grade. We are excited to finish when we get out of school for the summer, and then again, eager to start the new grade when we begin again in the fall.
These are all cycles.
What would happen if you stayed in the 9th grade, year after year? How would you feel?
Yet, in our work life we fall into the trap of doing the same thing over and over and over. This is not the first unique and special patient you have ever seen…this patient is a customer just like all the others — just another case. Today is not the first day of the rest of your life, it is just like yesterday which is the same as a long line of days that go on and on. And on…
We get beaten down by the tedium, working endlessly for some forgotten purpose, as if the assembly line we were on never stopped and was always the same.
This is a major cause of stress.
You can’t do one thing forever, like in the movie “Groundhog Day.” In it, the main character visits a town in Pennsylvania where everyone watches to see if a groundhog can see its shadow. This is traditionally on February 2 (This year, it is on a Saturday.) The only problem is, for this character, the day keeps repeating and repeating, the same each day. It drives the character to suicide, but even that doesn’t work. Finally, he falls in love and wins the girl and has a new life.
Anything in life that begins, it seems, must end. It can start again, but it must end so that a new iteration can be created. It is the cycle of life.
This is an important factor in what is called Gamification. With the advent of computer games, design elements are added in to make the game fun, challenging, and motivational.
But games are nothing new. Baseball is a game. It has a season and games and innings. It has cycles. Games have been part of human behavior since the beginning. The Olympics started in 776 BCE.
One aspect of games that can be overlooked is the fact that they are just an activity for play. Play is something we do naturally as toddlers. As we grow older, this activity becomes structured into organized sports and games, but at the core is the desire to have fun. To play.
We can lose this sense of play when what we do has no end and no beginning. Persistence is a good quality, but it can lead to an enforced dullness that buries our enthusiasm.
It is important to keep in mind that in business, as in sports, keeping the perspective of play is more effective than bearing down on one’s duties with serious gravity. Practices that incorporate some of the components of a game into their operations are more productive and have a better time.
What are your goals for 2019? For the 1st Quarter? For this month… or for today? Higher numbers? New team members? Community wide outreach program? New training and greater knowledge?
As soon as you make a goal, you start a new cycle and begin a new game. Try to win. But you could lose. Either way, don’t get too serious about it and just be grateful to be able to be in the game.
Set new goals and play. Play — to win. Have fun. Smile a little more!
“My reaction, was what’s next? How are we going to make it better?
Craig Counsell, Manager, Milwaukee Brewers, Professional Baseball Team
For a printable copy of this tent poster click the link: What’s Next Craig Counsell
OK, I admit it. Medicare is not the most glamourous topic to write about, nor does much of it pertain to our world of the chiropractic profession as we know it. However with that said, I am doing due diligence for you and fulfilling my duty to inform you of the necessary requirements a Covered Entity must follow (that’s us included!) to keep the Office of Inspector General off our backs and to help you take preventive measures so you’re not sending back reimbursement money you earned from providing patient care.
Because . . . based on my observations in the field – and this is a review for those of you who read our PM&A articles and utilize our library- how many of you know, for example, what a Part C Medicare plan is? How many of you know that all Part C providers are required to undergo annual Fraud Waste and Abuse training?
Second example: How many of you are aware that Medicare, starting in April of this year and going into April of 2019, is sending all of their beneficiaries new ID cards in an effort to do away with social security numbers for the sake of safeguarding identification?
So how do my two examples above directly impact you, your practice, and your bottom line?
Let’s circle back to the first example. A Part C Medicare Plan is known as a Medicare Advantage Plan. It oftentimes covers more services than a straight Medicare plan does. HMO/PPOs such as Humana and Blue Cross Blue Shield have developed their own Medicare Advantage Plans and offer them to their policyholders, your patients. A patient who signs up for an Advantage Plan must also be enrolled in Medicare A (hospital), and Medicare B (outpatient provider services). Medicare Part C providers to date have been required to, annually, undergo what is called Fraud, Waste and Abuse Training. Let’s take each of the three words and define them from the Medicare and Medicaid world.
*Downcoding is also a misuse of billing codes. Stop doing it. Although not intended to increase reimbursement it is a red flag to Medicare, and your services will be questioned as to if they were “medically necessary.”
Back to the training . . . I urge you now to complete this training by the end of December. It is intended for doctors and staff. Download the PowerPoint below, read thoroughly and after completion have each staff and doctor sign off to attest, they read through the PowerPoint. The sign-off can be as simple as logging signatures and completion date in a notebook or a spreadsheet. It is not necessary to print out the PowerPoint. Oh, and many insurance contracts require this training as a contract obligation to be part of their network as well. You can access Medicare’s training PowerPoint here: Fraud, Waste and Abuse
Referring back to the second example of new Medicare cards. You can review our previous article and checklist here: New Medicare Beneficiary Indentifiers to be Assigned Your Patients
Your staff should be asking Medicare patients for their new cards, making a copy, and making sure the address in your practice management program matches the address the Social Security office has on file. If there is a mismatch like the patient has moved and not updated their address, you will have problems getting reimbursed. Make sure your Insurance Profiles in your programs have the new Medicare IDs.
Stay tuned for more helpful articles like this. If you have any questions on the above, contact me! I’m here to help.
Lisa Barnett
920-334-4561
lisa@pmaworks.com
And remember . . .
“The Future Will Be Our Results” (Clarence Gonstead, D.C.)
How do we overcome these barriers to extra-ordinary service?
Let’s first define “service.” Service in a professional service firm or professional practice includes two categories:
A. Outcomes. These are the results from the provider.
B. Customer experience. This comes from what the customer experiences as they move along their pathway through your business.
Let’s begin with your goals.
To create world class outcomes and service, you first need to review your most senior goals. Then, you have to ensure everyone understands them, agrees to them, and commits to doing everything possible to achieve them.
Setting purposeful goals over a lunch meeting does not take into account the sacrifice and effort that will be necessary to achieve them. You may commit to your own goals, but like New Year’s resolutions to go to the gym, you get distracted and discontinue after a few weeks. Some of your team may say they understand the goals – even agree to them – but in fact are only passengers along for the ride.
So, you should review and recommit to your goals each week. Be insistent, allowing for shortfalls now and then, but not compromising in the long run. Be true to your goals or make new ones. Spend time on these three:
a) Mission
This is the purpose of your office. It should be short and to the point and should include something about excellent service and outcomes and helping as many as possible.
b) Core Values
These are the standards for professional behavior and performance. List what values you consider most important in providing health care.
c) Patient Outcomes
Define where you are taking your patients. Relief care only? Or are you taking them further to better health and wellness?
Be true to your goals.
Because of your clinical skill, you can produce wonderful outcomes. But can you do even better? Here are some masters in their field as examples of professionals that never stopped improving their craft:
Music: Pablo Casals
Pablo Casals was a cellist – regarded as the best that ever lived. He was born in 1876 in Catalonia, Spain. In 1963 he was awarded the Presidential Medal of Freedom by President John F Kennedy, and in 1971, two months before his 95th birthday, he performed for the United Nations and accepted the U.N. Peace medal.
Casals was talented, but he practiced daily. There is a story about Casals and his training regimen:
He [Casals] agreed to have Robert Snyder make a movie short, “A Day in the Life of Pablo Casals.” Snyder asked Casals, the world’s foremost cellist, why he continues to practice four and five hours a day.
Casals answered: “Because I think I am making progress.”
Food Preparation: Chef Jiro Ono
If you want and value good sushi, Chef Jiro Ono is your guy. He was 92 at the time of this writing. He still works in his small restaurant in Tokyo that holds only 20 people at a time. The waiting list can be over a year. Still, at his age, he works on perfecting every aspect of the sushi, from selecting the exact right fish early at the fish market, to the exact texture of the rice. And every night he considers how he can improve on that day’s production. He is considered the foremost sushi chef in the world. (Jiro Dreams of Sushi, David Gelb 2011 documentary, Wikipedia)
“Once you decide on your occupation… you must immerse yourself in your work. You have to fall in love with your work. Never complain about your job. You must dedicate your life to mastering your skill. That’s the secret of success…… Even though I’m eighty-five years old, I don’t feel like retiring.” Jiro Ono (Jiro dreams of sushi, 2011)
Health Care: Clarence Gonstead
Clarence Gonstead was a chiropractor, born in 1898 and grew up in Wisconsin. In 1923, Dr. Gonstead graduated from Palmer Chiropractic College and began practicing. In 1939, he built a new chiropractic office in Mount Horeb, Wisconsin.
Because of the growth of his practice, a new Gonstead Clinic of Chiropractic was completed 1964. It was a two-level facility with 29,000 square feet. In 1965, adjacent to the new clinic, a full-service motel was built. Gonstead’s reputation as a remarkable chiropractor had spread beyond the United States and he had patients flying in from all over the world. To assist these patients, he set up a limousine service between the Madison, Wisconsin, airport and the Gonstead clinic about 30 miles away. Patients with their own private planes could fly in and land at Gonstead’s personal airport located next to his home on the outskirts of Mount Horeb.
With no marketing, his practice grew so that that he was seeing over 250 patients per day, working six-and-a-half days a week. He often treated his last patient at 2:30 in the morning.
Gonstead studied and improved his craft. He was not, as a founder of a chiropractic college would later say, a “commercial chiropractor.” He was focused on results and said: “Our future will be our results.”
Eventually, he began teaching others his system which is now recognized around the planet as one of the most effective and popular forms of chiropractic technique. He encouraged other chiropractors to study and to “Practice. Practice. Practice. Never stop.”
So, be like Jiro, Pablo, or Clarence! Use “deliberate practice” and look to see how you can improve your skills and methods so that your customers can achieve their goals faster and better.
Never stop improving your craftsmanship.
It is almost impossible to focus on excellent patient outcomes and run a growing business at the same time. You need a strong support infrastructure. This means professional team members that are trained and motivated to apply procedures that are both simple and effective.
Chiropractic works. Not having a smooth-running support structure is the primary element that is in your way from developing your practice to its full potential.
This has been the major focus of our work over the last 30 plus years. We have found that the better the support, the better the outcomes and the happier the doctor and staff.
Improve your people and systems.
“If you go into any organization that’s customer-facing, you can tell in five minutes when the employees are feeling abused. They retaliate on the customers.” Jeffrey Pfeffer, professor at Stanford University
The way the employees are treated directly affects the service that they will provide to the customer.
Sure, work can be stressful at times. Maybe someone snaps at someone else. This happens in any high-performance activity. But as long as we all share the same mission and values, we can address our personal slights to each other and move on.
It is everyone’s responsibility to create a cheerful work environment for each other. If you are having fun, so will our patients.
Smile more — and make work fun!
“If I’d asked customers what they wanted, they would have told me, ‘A faster horse!’.” Henry Ford.
Of course, you give people want they want – what they consider urgent and important.
But people didn’t want a faster horse, they just wanted faster transportation. Horse, car, airplane… they wanted to get to where they wanted to go – faster. They just didn’t know about how simple, fast, and easy a Model-T was.
You must show them through education that you have what they want and need.
Most offices provide relief. That is what the patient is aware of and willing to pay for. But since you are providing a product that is not tangible using procedures that are invisible, your customer may have a difficult time understanding anything beyond the “quick fix.”
They may know they want more but lack the understanding of what is available.
I know I need to pay my taxes, but what I really want is to pay as little as possible. I also would like to contribute to my children’s education. With some education, my accountant could make me aware of different strategies that would take me to my full goal.
“Customers are thirsty for more information and knowledge,” according to studies by ThinkJar, a customer strategy consultancy.
To deliver your best and complete outcomes, you need your patient’s motivation to do so. It is a path and a partnership that you travel together.
The better that they understand their condition and your unique remedy, the easier it will be for you to help them achieve the best outcome possible.
The more they know — the further they’ll go!
Making the patient experience “WOW” takes a team effort.
If studies show that customers discontinue a service mostly because of a lack of interest on the part of the service provider — and your own personal experience validates this fact, then the solution is simple. Just be genuine and interested in your patients. Be empathetic. Take the time to be totally present, in the “now,” and have “present time consciousness.” You only have 1 patient, and that is the one you are with, or about to see.
Then, when you practice with your team at team meetings, focus on this: the level of honest interest, curiosity, and care.
Practicing scrapes off the “barnacles” that attach to us all as we soldier through our work days. Here are some training tips for working on improving customer service with your team:
Lay out the pathway to and through your services. Do this with your team.
This begins even before your patients contact you. Who are they? Mom’s, seniors, kids? What brings them to you? What other solutions have they tried before they came to you? Get to know them and empathize with their condition.
Then, list the sequence of actions, or a flow chart of what occurs from first contact through their first service and leaving. Drawing this out with your team will expose many areas for improvement.
Against this flow chart, you and your team can now look at where you can add more benefits for your customers.
I have found that practicing a “walk-through” reveals many hidden plusses – and embarrassing weaknesses, in service. The doctor or a team member takes on the role of a customer. They then travel some portion of the patient pathway with the usual team in their roles, acting as if they are dealing with an actual patient.
You are guaranteed to find areas where service can be improved.
Bain Consulting, an international management company, identified 30 different elements of value relative to consumer needs in an extensive study. They categorized these customer values into four categories:
In their research, Bain noticed that the companies that had the highest ratings on the most values had more loyal customers than the rest. They also found that these companies had faster revenue growth than others.
Good service pays. Great services pay even better!
With this in mind, look again at your flow chart and notice where you can add more value to your services. Start with the direct service to your customer, the “functional” areas of your business. For example, how could your customers receive their services:
In the next category that Bain used, what kind of “emotional” values could you add, including:
The next two categories relate to higher purposes. “Life changing” and “Self-transcendence,” including:
Edward Petty
“Our future will be our results.”
Clarence Gonstead, D.C. (1898 – 1978)
For a printable version of this tent poster click Future Results – Gonstead