The Merry-Go-Round: Planning for a Prosperous Practice in 2018

 

Progress in practice is made by steady persistence and passion.

In Angela Duckworth’s new book, she calls this “Grit.”

Think of evolution, think of growing crops… think of growing children!  Whether it is child development or practice development, growth is achieved through steady and unrelenting nurturing and adjusting according to circumstances.

I recommend you take some time to do some planning before the New Year gets in high gear. January and February are good months to do this.  Do it by yourself – and do it with your team. But…

Don’t reinvent the wheel… Just make it go faster with less effort.

 The Vital Few

A few of our actions are always more productive than most of the other actions that we do. Unfortunately, we can get distracted and spend far too much time on activities that, in retrospect, just don’t give us that much of a return.

The “vital few” actions that have helped you the most will be camouflaged, even countered, by the “trivial (but useful) many.” This is a term used by Nathan Juran, famous for his approach to business and quality improvement and the Pareto Principle.

And, I would like you to consider this: In many respects, your business has succeeded in ways that – perhaps – you have not yet recognized.  Therefore, I don’t recommend abandoning all you did last year and start chasing the newest “shiniest” procedures that seem appealing.

The key is to dust off all your actions from 2017 – review everything you did — and see the great things that worked and the victories you and your team achieved.

Then, just find better approaches to do more of this!

Diamonds in Your Office

The idea of having diamonds in our backyard, a story made famous by Russell Conwell (1843 – 1925) of the 1800s, applies. There are many variations, but it goes something like this: there once was a man who wanted more wealth, so he sold his house and left in search of diamonds. Years later, penniless, he happened back to his village where he roomed at a shelter for the poor. The shelter was supported by a grant from a local resident. In inquiring who the resident was, the diamond searcher discovered that it was the person to whom he had sold his house.

One day he paid a visit to his old house, now renovated into a beautiful estate. He talked to the new owner who told him that he had become rich. He said that when he bought the house, he needed to do some digging in the backyard where he discovered thousands of diamonds.

The moral of the story is obvious: you already are rich – you already have the diamonds. You just need to polish them.

Many of the components of your future success are already in your office. But we overlook them, or use them once and then forget about them, like teenagers looking for the next new article of clothing to make a fashion statement.

As entrepreneurs, creatively – we are all looking for that next dopamine high… and seek the next new “shiny” thing.

You have a show on the road. Just make it better. Make it fresh. Set a new standard, and make a new game to “level up!” Add a few new things here and there, but keep doing what is working.

Looking for Your Diamonds

Review what has been working for you. Reaffirm it and keep at it. Look at what hasn’t worked that well and fix it so that it does, or drop it like barbell that you have been holding over your head for too long.

By yourself, and later, with your team, here are some areas to look into:

____1. Review Your Mission Statement. Does it apply? How? Does it need to be customized? Beyond your mission, what is your WHY? Does the mission satisfy this?
____2. What Are Your Outcomes? For example: “People relieved of pain, healthier, educated so that they can and will continue to improve their health… and refer others?” You can also define Minimal Viable (Valuable) Outcomes, e.g., “A patient who accepts care.” Etc.
____3. How Is the Office Vibe? This is determined by your values and how everyone is living up to them. Are these values posted for all to see and check how they are “measuring up?” Are they defined? Do we need to add more, change some, delete some? Should we better define each value? Should we add:

• Trust. Are we worthy of trust with our patients and ourselves?
• Mission Oriented. Do we help each other cheerfully achieve our mission – each day?
• How well are we living up to these?
• How can we live up to these better?

____4. How Were the Numbers? Up, or down?

• When the numbers went up, what did, or didn’t we do? How can we improve upon this?
• When the numbers went down, what did, or didn’t we do? Should we improve or discontinue those actions?

____5. Individual. What can each one of us do professionally this next year to improve our ability to contribute to our team and its mission?

Some of this should be on simple, brief checklists and memo’s. Add it to your Practice Playbook. Document it so that it can be referred to for training and coaching in the future.

Merry-Go-Round

Imagine that your practice is a merry-go-round, the kind you find at children’s playgrounds.

It takes a lot of energy to push it and get it going. But… once it is moving, it takes less effort to gradually get it going faster. And faster! And faster…

Take some time to review how you are pushing your merry-go-round. What procedures worked better for pushing it faster? Focus on these… Makes these better.

Go faster… and push less.

And as you do, watch those, including yourself, hold on tighter and smile bigger.

Enjoy the ride!

With admiration,

–Ed

The Real Reason For Low New Patients

Why Two Chiropractic Doctors Couldn’t Grow Their Practice

A few years back, a long-time client of ours gave me a call and said that he had hired two new doctors.  He asked if I would visit his office and see if I could help them grow their caseloads.

I told him that I was happy to pay him a visit.  A month later, I was touring his office and interviewing his team.  I then went out to lunch with the two new associate doctors.

I got to know them and asked them questions.  They were not shy about their goals. They told me that they wanted a “high volume” practice.  They boasted that they felt that it would not be difficult to see as many visits per month as the senior doctor by the end of the year.

They went on about philosophy, BJ Palmer’s “Green” Books, clean food and wellness. Both were young and looked fit and seemed eager.

They said that they wanted marketing help. They talked about how they had been working on social media, but felt that the owner doctor wasn’t supporting them enough by buying advertising.  It wasn’t blatant, but they seemed to be blaming him.  I acknowledged this and said that was something we could look into.

I knew that their practice statistics were very low. I told them that marketing comes down to caring about people – caring enough to talk to them, and caring enough to be honest about how you can help them.

They nodded like zealots. “Absolutely!”

I then said:

OK, look around this restaurant and describe a possible health issue with some of the customers. Just pick one and do a very preliminary screening based upon the way they are sitting or walking.”

This didn’t go as well as I had thought it would. Both doctors, I discovered, didn’t look at the fellow customers in the restaurant.  So, I prodded and finally got one of them to mumble a possible health issue with someone who was walking out.

I then asked each for their business card. Neither had one on them.  I paused to give them a look: “What?”

I had taken a couple of their cards each before lunch and placed two of them in front of each doctor.

Then I said:

“I liked what you both said about wanting a large practice and wanting to help more people. I would like to help you. So, to start, I would like you to get up from this table and find someone in the restaurant, introduce yourself, and hand out your card. If possible, make an appointment for them to come see you.”

They both looked at me as if they saw a ghost.  Gripped by fear, they both slumped down in their chairs. Neither would do it.

Seeing this, I suggested they talk to the cashier or waitress, or the manager.  Now the fear turned to a dismissive attitude, as if this exercise was beneath their dignity.

We ended lunch and went back to the office. We met with the owner doctor and discussed the situation. Over the following weeks the two doctors agreed that the relationship wasn’t working out and decided to leave on good terms to start their own office.

— — —

You don’t have to be a hyper-extroverted charming salesperson to be an effective marketer. In fact, this may act against you. The largest office I have ever worked with was seeing over 2,000 visits per week.  And the owner was serious and gruff, and talked like an angry fishing boat captain.

Marketing starts with a burning desire. It begins with an almost obsessive drive and purpose to help others by getting them into your office.  Marketing then depends on your belief and confidence in your skills and service. And it hinges entirely on how much you really care and empathize with each patient or prospective patient. And then, there is the effort you put in. You gotta do the work, and this means sometimes long hours, long weeks, and long months.

And as the C.E.O of your business, it also means getting the rest of your team to feel the same.

Again:

  1. Desire. Drive
  2. Confidence and belief.
  3. Compassion and empathy.
  4. Effort. Work. Sweat!

There are thousands of different methods to market your services. These may include “social media,” big goals, and “philosophy.” They may include newsletters, workshops, or back to school promotions. But in the end, marketing is communication, whether done electronically, through print, in groups, or one on one.  It is always and especially – one on one. In time, you will find what works best for you.

But no number of manuals, books, or coaching will do a damn thing for you if you don’t have the desire, the belief, the empathy or put in the work.

Patient Education: A Simple and Fun Method for Chiropractic Offices

Patient education is definitely a clinical function.  But… it is also good marketing.

And note that your entire office IS the marketing department and each team member has a marketing role.

To help everyone on your team better participate in patient education, use this simple and fun method:

Get a whiteboard and place it where patients can see it.  Assign someone to write something on it each day so that your patients, or you, can comment on it.

For example, you could write:

  • What does this mean?

“Pain is the last to show
… and the first to go.”

This will be a cue for the doctor or a team member to talk to your patients – and can also provoke your patients to talk to you.

Here are some other examples:

  • “What does a chiropractic ADJUSTMENT do?”
  • “How is pain like an iceberg to your health?”
  •  What does A.D.I.O. mean?

At your morning team meetings, or weekly meetings, go over each subject so everyone has a better idea on how to educate patients on the topic.
For active PM&A members, go here for a more complete list:  PMAmembers.com

Has Your Office Been Target by Medicare for an Audit?

Ms. Lisa Barnett with Petty, Michel and Associates specializes in preventing Medicare Audits. She has helped those who have already been targeted find a fast and safe way out of trouble.

You are not alone…. Things do Happen…..
You are busy and possibly you have overlooked a certain requirement. Your computer has gone through updates and you have not kept up. Or possibly your documentation is simply inadequate in the eyes of medicare or the government.

Whether you are faced with a prepay audit or a post payment audit. I can help !

With 10 years of experience in the chiropractic industry and with documentation; and a chiropractic advocate for 30 years I care and I want to help.

Call today for your complimentary phone consultation and record review. 920-334-4561

The 3 Key Ingredients to Motivating Your Chiropractic Team

Most of your staff are not engaged in the success of your office.  Most of them JUST DON’T CARE. 

At least that is according to a 2015 Gallup report that interviewed over 80,000 working adults.

The report showed that there are twice as many “actively disengaged” workers in the workplace as there are “engaged” workers who like their jobs.   The percentage of U.S. workers in 2015 considered engaged in their jobs averaged 32%. The majority (51%) of employees were “not engaged,” while another 17% were “actively disengaged.” (“Actively disengaged” means that they are actively sabotaging their work.)

But let’s say your office is different, which I am sure it is.  You are motivated enough to read this article and I am sure that is reflected by your team as well. But all the same, take a look with me at the level of motivation of your office.

How was your last team meeting?  Were you there? Was everyone sitting on the edge of their seat and contributing new ideas and plans on how to reach new goals in the office? Or, were most everyone pretty silent?

Sure, your employees smile and look busy when you are around, and often work hard and they do care.  But really, how much?

What would your office be like if the motivation, creativity, and level of pro-activity was always very high at “10,” or even ranged from 7-10?  If they felt that it was “their” business, where they took responsibility for the quality and quantity of outcomes, and regularly worked to improve the business – and themselves?

I have been reviewing the subject of motivation for some time, from my own experience over the years and from what social scientists have reported.

I have incorporated certain principles into a new system of business management that are specifically designed to unleash everyone’s innate motivation – including business owners like you!

Motivation is the foundational in a chiropractic office, or dental office, acupuncture – even with therapists and other service firms. It is a bedrock for any healthy practice and business.

Here is one very useful principle specifically about motivation and how you can use it to generate more engagement – and productivity — with your team.

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

You do. This is one of the reasons you went to school – and why you started your business.

We all want to have something that we can call our own where we can create and demonstrate our competence. What we get in return is feedback that we can do something good, that we have power, that we can make something beneficial happen, that we can … make a positive difference.   If only to ourselves, we can say: “Look what I did. I did this. This is my creation.”

You can see it in children, for example, when they bring you their colored scribbles on crumpled pieces of paper to proudly show you their great work of art.  This is their sandbox.

Of course, we all work for money. But we also have deeper motivations that if tapped into and nurtured, can be very powerful.  By harnessing these motivations, and then linking them with others who have a shared goal, we can create a dynamic team driven business that is very profitable.

This has been explored by social scientists who have studied what has come to be called Self-Determinism Theory.  I have also seen it in action. Essentially, it states that we all have innate drives and inherent needs that motivate us to be more self-determined rather than determined, or controlled by, outside forces.

External motivation, like the fear of being fired, can only motivate us so far. Threats, criticisms, negative reinforcement may produce short term action, but in the end, they demotivate, or worse.

The level of employee motivation has a tremendous influence over the success of your business. 

An unmotivated staff, one that only becomes engaged to the level of “I will perform just good enough so that I don’t get fired or criticized,” will weigh the office down.

Self-Determinism Theory (STD) has three components, all of which easily apply to your business. These are:

  • Autonomy
  • Competence
  • Relatedness.

And by the way, while reading this, consider how this also applies to you as well!

Autonomy

You do not want your treatment plans second-guessed by a clerk in an insurance company. Neither does your front desk want you breathing down their necks about where all the patients or practice members are, or why they used the blue pen.  You should train and educate your team, but then get out of their way and let them succeed or fail.

Think of helping a child ride a bicycle. Sure, they will need your help for a while. A push now and then. Perhaps some training wheels. But you will have to let them fall down a few times and allow them to get the courage to get back on the bike and succeed. You can continue coaching them to improve, but you must let them go.

Even if you see employees appearing idle, or having brief personal discussion with another employee, back off. Tolerate minor errors. Give your team some rein.  Come back around later to coach them and train them to improve. Mostly educate them on the mission of the office and of their roles, and get them to understand what outcomes they are supposed to be producing. Once they see that the statistics measure their performance, they will be more self-directed and want to do all they can to win the game!

We all want to be free to create our own enterprises, even if we work for someone else. As long as what we do is in line with the purpose or mission of the business and our role, there should be no problem.  This helps us demonstrate our competence, which is the next element of Self-Determined Theory.

Competence

Doing a good job, all by itself, is its own reward. It pushes away self-doubts and shows us, and others, how good we really are. It is positive reinforcement.

And the better we can do a good job, the better the results will be, which demonstrates to us just how awesome we truly are!  Plus, as we increase our skills, we also will find that our duties are easier to perform.

Your team wants to improve their skills. Help them do so.

Sign them up for seminars, webinars, give them monthly reading assignments, and give them a coach or three of them.  But this has to be done in conjunction with your supervision. You will need to guide them through the training so that they see how it applies to their roles and the business as a whole. Quiz them on what they are learning and have them give presentations to the team on what they are learning.  The old maxim applies: “to teach is to learn twice.”

And where possible, make sure they earn certificates and can wear pins or insignia that testify to their competence. This goes along with Game Theory – people win at one level and then want to go to the next level. They want their “badges.”

Business owners throw staff into their jobs and expect them to produce with little or no training. Without exception, the offices I have seen that provide more training and coaching for their team — do better.  Companies spend an enormous amount on employee training. $161 Billion in the U.S. last year (trainingindustry.com). And, it pays off.

One study showed a comparison between car companies and how many hours they trained their new employees: Japan spends an average of 364, Europe averages 178, and the United States – 21 (Pfeffer –The Human Connection).

And you can guess which country has cars with the best frequency of repair record.

Children want to be super heroes and wear their capes.

Don’t we all!

Relatedness.

This is the feeling of being connected – and there are two aspects to this.

Family. First, “relatedness” is the feeling of not being left out of the “loop” and of being included. Staff meetings help with this as does the general work environment. This is the sense that we are in this venture, job, and profession together. That we are part of a family.

Keep your team involved with your decision making. Give them some of the issues you are dealing with and encourage their input. They are stakeholders – it is their office too!

Greater Purpose. The other aspect of relatedness is that people generally want to be associated with a greater purpose. The more that each member can connect to the greater purpose of the group and make it their own, the more motivated they will be. Taking it a step further, if employees have higher goals of their own that coincide with the organization’s and they are allowed to pursue them within the organization, there would be no reason for employees to work anywhere else.

Train your team, let them own and creatively improve their own areas – and help to do the same for the entire office. Nurture camaraderie and a spirit of family – and always remind them – and yourself — why we are doing what we are doing.

Do this, and not only will your business be more successful, but you too will be more motivated and have more fun in the bargain.

#   #   #

Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Ryan, R. M. & Deci, E. L. (2017) and Why We Do What We Do: Understanding Self-Motivation Paperback – August 1, 1996
© Edward W. Petty,    From the upcoming book: “Three Goals:  A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.”  By Edward Petty, due to be published sometime before the Singularity. © May, 2017

Our Shallow World – and What Your Chiropractic (Acupuncture, Dental, Medical) Patients Really Want

We live in a shallow and superficial culture. It is fast talking, faster messaging, with abbreviated emotions and texts.

No one seems to really care, or takes the time to care.

Communication has become digitized and synthesized. We forward messages from some people we know, and from many we don’t, to people we know, and to many we don’t. We are addicted to our smart phones and “phub” each other. (Phub: The practice of ignoring one’s companion or companions in order to pay attention to one’s phone or other mobile device. Google.)

We buy things from “clouds” that seem to know what we want, as if they had been eavesdropping on all our personal affairs.

The Age of Artificial Intelligence that cares more for us than people who “friend” us is growing faster and faster.

Yet, somehow, shallow works. It is practical. It is fast and efficient. When I ask you “how are you?” I really don’t have the time to hear about how your kids did at their Christmas play, or how you like your new socks. I have my own deadlines and have to go.

We are caught up in minimal viable encounters. They are functional, but they provide the only the minimum amount of care. Any less, and there wouldn’t be any service at all. They are “duct tape” solutions.

This is our life now. The fast, the short, the immediate.

For all its practical aspects, this is the first goal in any business exchange. We must provide the outcomes and services that are initially wanted by our patients. This is a “drive through” consumer culture that moves quickly for things that are wanted. In return, business is trained to provide the minimum quickly, efficiently, and yet is still valuable.

But just because our society is shallow, does not mean that your patient is.

This may be the culture in which they have adapted, but privately, your new patient might not have been satisfied with the services they have been receiving from others. And as the expert and professional, you know that it is likely that they have been short-changed on their care.

No doubt, your patient wants relief – now. But if you want to know the truth, they probably want more than just a quick-fix.

Your patient is looking for someone who genuinely cares. They are hoping to find someone who listens, empathizes, and someone they can trust to help them get what they really want.

What do they really want?

Ask them:

What is most important to you about your health?

Then, find out why.

This is a broad and open ended question. It takes the both of you through the quick-fix drive-through to get to, finally, what they really want.

If I have a painful tooth, I would see a dentist to at least treat it enough so that it wasn’t causing me discomfort. But if the dentist asked me what I really considered important about my dental health, I might say that I would like cavity free teeth that never caused me pain. I would like all my teeth and gums to be healthy and look good until I am at least 105.

The dentist would then repeat back to me what I said that was most important about my dental health so that we could agree that this was my goal — something I wanted. With this disclosed and agreed upon, we could now dig into my history and perform the exam to see what was going on that was causing the symptoms.

Once all this was done, he would explain to me not only what was causing my pain, but what I needed to do, in the long term to get my mouth 100%, which we already agreed upon I wanted.

I definitely don’t want or need a hard sell for something I am not sure I need.

But if you find out what I really want and let me know that you can deliver, you won’t have to sell me. I am already motivated.

Confrontational Anxiety

Confrontational anxiety is that stress you, and your patient, can feel when discussing the length and expense of your recommended treatment plan. But it melts away and evaporates if you work towards what the patient really wants.

There are many different approaches designed to help get the patient to agree to a more complete treatment plan, including scripted words or phrases for the doctor and staff to say. Ultimately, the patient must trust you. They will have to understand what is causing the symptoms, what it will take to get better, and the benefits to be had. In the end, you will want to work out your own procedure. (Give us a call, we can help!)

Realize that your new and prospective patient is just barely trusting you, as it is. They would like to trust you more. They hope for more than just a “pop and pray” (“…and hope that they pay”) treatment and adjustment from you. What they usually offer you, or present to you as a new patient, is a symptom that may have deeper causes. Their condition is probably not new. They likely have had it, or some aspect of it, for some time. Only when it becomes more acute do they come to see you.

The analogy of the iceberg is useful.

Your patient wants relief, but also wants everything in life that the pain hampered or prevented. This might include less recurring episodes of pain, the ability to resume their hobbies and sports, improved performance in life activities, stronger immune function, better balance, increased knowledge to improve their health, more happiness, better weight management, and more energy. You can and should make a list of at least 10 benefits that come from a patient completing their treatment plan.

I buy a new car not to just have a better ride, but to feel that I have a better life. I pay for a cleaning service because I want a cleaner house, but deep down, I really do so because I want a happier wife.

Patients are too often short-changed because of a culture that is fast and shallow. You don’t have to be – and you can give your patients complete and thorough care. This is what they want – once they understand their condition and what you can provide. And, once they trust you.

Be interested in your patient and go deep to find out about their health, their history, and what they really want. Then, educate them on how the both of you, working together, can best help them get what they really want — and what you want and can deliver.

Ed Petty© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the singularity. © 2017

 

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Tent Poster – Two Wolves

Two Wolves

An elder Cherokee Native American was teaching his grandchildren about life. He said to them…

“A fight is going on inside me… it is a terrible fight and it is between two wolves. One wolf represents fear, anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority and ego.

The other stands for joy, peace, love, hope, sharing, serenity, humility, kindness, benevolence, friendship, empathy, generosity, truth, compassion and faith.

This same fight is going on inside you and every other person, too.”

They thought about this for a minute, and then one child asked his grandfather… “Which wolf will win?”

The old Cherokee simply replied… “The one you feed.”

 

For a printable copy of this tent poster click: 2017-02-Two Wolves-3

Chiropractic Spring Marketing

chiropractic marketing with petty michel
(Free sample marketing planner below.)

Practice marketing may not be entirely what you think it is.

 

If you are having challenges with your “marketing,” or you just want to generate more new patients, you need to consider something.

There are many good and great marketing activities you can do. (You can go to our website under “Free Resources” and find buckets of marketing. And, for those of you who are active members, there are mountains of even more marketing programs for you on our Member’s site.)

There are many paid programs you can purchase that explain different methods of generating more new patients. You have seen them, perhaps purchased them: DVD’s on dinner talks, workshops on how to present to businesses, Facebook and print advertising programs, and automated newsletters and Facebook posts.

These all can be useful in generating new patients, but the results often fall short from what the few successful doctors who promote the programs claim. This is usually because there were two major components missing in the marketing.

When doctors return from marketing programs, I like to ask them what they thought of the material.

“Yes, I liked it. It was good info. Learned a lot.”

“Great.” I say. “So, who is going do it?”

“Well, Susan can do it.”

“Oh really, when? She has a backlog in insurance and is working overtime trying to work with your sketchy notes as it is.”

“Hmm, well, we’ll hire someone.”

“Great. Who is going to train them? You?”

Not trying to be a jerk, but part of any good consultant’s job is to provoke analysis!

Besides the marketing event or procedure, there are two other critical elements to practice marketing that have to be included for the promotion to work. These are not always taken into account.

This was the basis of the Marketing Manager System I wrote and published some 17 years ago.

Most companies, as Simon Sinek talks about in his TED talk*, boast about what they do, or how they do it. It is all about them. Look at us!

But the better companies talk about WHY they do what they do, and they do it for YOU. They do it for your kids, grand kids, community, and the betterment of the world.

This is practice marketing. It is personal. You tell people why the heck you do what you do — and you say all this with genuine care and confidence – in your own VOICE. You do this in your newsletter, in your talks and in your ads. The best marketers do this – often naturally.

  1. So, the first missing component that must be included with your marketing is motivation. Marketing must have a mission and it has to be embraced by everyone on your team.
  2. The second missing component is organization. The events and procedures must be assigned to different people with enough time for implementation.

Complete practice marketing then, has three major components:

  1. Motivation. Why. Make sure you and your team WANT more new patients. Get that accomplished first. That may take a while. An office staff and doctor who are backlogged with their paper work, already working full time and more, who also may have a few inter-office unexpressed grievances, confusions, or doubts about your service or you… no matter how many programs you sign up for, nothing will work.
  2. Organize. Then, work out who will be doing what. Spread the marketing around to everyone and put someone in charge just to coordinate.
  3. Marketing Procedures and Events. With the above 2 components in place, you are now more likely to “rock” your marketing efforts more successfully.

Increase the WHY, increase the CAPACITY, then yes, please — lots of marketing activities.

Let the party begin!!

Ed Petty

Spring Marketing Planner- (DOC) Sample Marketing Planner for Spring

*TED Talk link: www.pmaworks.com/observations/2011/02/10/leadership-in-chiropractic-the-golden-circle/

Chiropractic Patient Reactivation Program and Sample Postcard

We recommend offering a special promotion to patients who have not been active for 6 months or more.

The links below will take you to a couple of articles describing procedures that can be used to encourage less active patients to come in to see you.

The Reactivation Program has a number of sample letters and a sample postcard and the Reactivation Card is a sample post card that can also be customized for your email newsletter.

Sample Reactivation Postcard – Sample postcard layout and instructions on how to customize your postcard.  Information can also be used for email notification.

Reactivation Program An article on the importance of regular reactivation program.

Best Wishes for your New Year!

MACRA- New Info on Medicare!

rs-medicare-info-icon

New Info on Medicare!

Happy Holidays Chiropractic Friends!

First snowfall always seems to bring renewed energies and hope – my wish is you experience this, too.

Are you ready for January 2017? Ready or not, here it comes. Today I want to introduce and give you some of the latest and greatest on what’s happening with the new Medicare reimbursement model also beginning our new year.

To start with, six new acronyms to introduce to you: MACRA, MIPS, CHIP, APM, SGR, CPIA

  • MACRA: Medicare Access CHIP Re-authorization Act of 2015
  • MIPS: Merit-Based Incentive Payment System
  • CHIP: Children’s Health Insurance Program
  • APM: Advanced Payment Model
  • SGR: Sustainable Growth Rate
  • CPIA: Clinical Practice Improvement Activities

Here’s a bit of background for you regarding the initiative. In April 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act 2015 (MACRA). This is an act to transition Title XVIII of the Social Security Act to the Medicare sustainable growth rate and strengthen Medicare access. How? By improving physician payments and making other improvements, like the Children’s Health Insurance Program. We could say MACRA is the umbrella to the program.

What is the purpose of the change in reimbursement model? The purposes include simplifying reporting for the convenience and ease of the providers participating; decreasing the current costs of healthcare, allowing patients the best quality of care; and to make patient information sharing safe and easy. The blueprint for pay for performance is the Merit-Based Incentive Payment System, and the goal is to create an acceptable payment system for physicians and the program.

Who are the stakeholders in the broader MACRA program? They include beneficiaries (your patients), businesses, payers, providers, and state partners.

Are you eligible to participate?

Both participating and non-participating providers are eligible to participate if you meet both of the following criteria: 1) Have seen 100 or more unique patients in a year, and 2) Have billed for covered services at $30,000 or more a year. You are exempt from participating in 2017 if 2017 is your first year as a Medicare provider. You are also exempt if you do not meet one of the two criteria above.

How will it work?

CMS has indicated through various webinars that they will notify via written communication if you are or are not eligible to participate. Once you learn of your eligibility, the program will require participating providers to report on three categories for the Merit-Based Incentive Payment System:

  • Quality (i.e., Physician Quality Reporting System, also known to you as PQRS but with some tweaks).
  • Practice Improvement, focusing on clinical quality measures. For examples, patient outcomes; patient engagement and compliance; adherence to your practice systems and guidelines.
  • Advancing Care Information (this is the technical component; i.e., Meaningful Use and minimum five measures recorded in your practice’s healthcare technology).

Additionally, if you are eligible to participate and choose not to, there will be a negative adjustment of 4% to your Medicare reimbursement. If you are eligible and do choose to participate, you may receive a positive adjustment of 4 to 9% depending on your level of reporting involvement, as well as a minimum 0.5% bonus for exceptional performance if your final reporting score meets or exceeds a certain point value.

You will have two reporting options: You may report for the entire 2017 calendar year, or you may report for the partial year, one quarter, and may begin no later than October 2, 2017.

PM&A will continue to monitor any changes to the above information.

In addition, I will be conducting onsite MACRA readiness assessments at chiropractic offices and am available to visit yours. Please contact me if you are interested in learning more!

Best,

Lisa Barnett, Consultant
Petty, Michel & Associates

Call: nine two zero.334.4561

Email: Lisa@pmaworks dot com

How To Make Your Chiropractic and Natural Health Lending Library Work

lending-library

A natural health lending library is a very practical marketing tool – if used.

A lending library is a collection of books, DVD’s, and other information that you can loan your patients. It is part of an ongoing patient education program. The better your patients understand what you do and why you do it, the more likely they will be to stick to a long-term care program and to refer their family and friends for services.  Patient education, compared to other marketing activities, is not that expensive.  It has a good ROI!

Download a list of suggestions here for your chiropractic or natural health care library.  [Ideas for your Lending Library]  Please give us your suggestions as well.

This all is logical, right?  We all know this.

So…why is it rarely done? Most of the offices that I have seen with lending libraries have them on the bottom shelf in some corner of their office filled with books from a garage sale and old VHS video cassettes.

Everyone knows patient education is important. Like the Spinal Care Class, or new patient education class, everyone knows this is good for the patient and helps the office grow. Right?

Funny story… I attended a small get-together of chiropractors one evening here in Southeast Wisconsin. The presentation was given by the lead doctor of a multiple doctor office. Great doctor, nice practice. He had been in practice for years and looked weathered and ready for retirement. The talk was how to give an effective Spinal Care Class for new patients. The presentation was full of practical content. The only thing… the doctor wasn’t that cheerful about his presentation.

After he finished, and as he left the front of the room looking down at the floor, he muttered, as if passing on a confidential apology to another spy… “But we don’t do the classes anymore.”

So, no need to fool ourselves here. It might be just easier to buy some nice posters and be done with it.

Ah, but there is a trick to making your lending library work… and patient education in general work!

The lending library is primarily for YOU — and each member of your professional team.

We have been looking at it all wrong.  The lending library is a reflection of YOU!

If YOU study, and if your support team studies and learns, you all will be so enthusiastic about the information that you will insist that your patients learn this information as well.

Be curious and ask yourself some questions. For example:

  • Chiropractic adjustments have been shown to significantly lower blood pressure. Do your patients know this? How does it work?
  • Why do some intervertebral discs degenerate and others (in the same spine) do not?
  • Do your patients understand the myth of cholesterol, heart disease, and how statin drugs may be causing some of the symptoms they are coming in to see you for?
  • How is the adaptive immune response affected [during “cold and flu season”] by the adjustment?
  • Is the average time for a whiplash patient to achieve maximum improvement 7 months 1 week? If so, why? If not, what is it?
  • Nonsteroidal anti-inflammatory drugs for rheumatoid and/or osteoarthritis conservatively cause 16,500 Americans to bleed to death each year. Do your patients know this? Do their families?
  • Glutamate and aspartame can cause chronic pain sensitization, and removing them from the diet for 4 consecutive months can eliminate all chronic pain symptoms. Do your patients know this? Do their spouses? *

Read a book, watch a video, question authority, ask questions — seek the truth. Get excited about learning new things about your profession.

DON’T GET BORED. If you are bored, quit and go home!

Otherwise, be grateful for the opportunities we all have to learn and expand our knowledge and understanding of the services we provide and the world in which we provide them.

Be curious.

Ultimately, you sell yourself before you sell your services. How can you sell a care class or an extended treatment plan if you are not truly excited about them?

Learning new aspects of chiropractic, health care, wellness, sickness, the sickness industry, how your patients are being manipulated and exploited… all this should agitate you one way or another.

For example, I watch Vaxxed – the movie — and then listened to Dr. Andrew Wakefield and Brandy Vaughn (former Merck employee) talk on YouTube about the movie and how they are now being covertly and overtly intimidated to shut up.  If this pharmaceutical company is trying to help members of your community get healthier, why are they now attempting to squash dissent and in such a sinister and yet powerful way? I can’t help but wonder: just how powerful are they at manipulating public opinion? How are they influencing my community and my family?

If you look further into the effects of pharmaceuticals, from Vioxx to statins to MMR and vaccines, and explore some of these questions, you can’t help but feel compelled to educate your patients on how to keep their children healthy and free from a toxic environment.vioxx

Some of the most successful offices I have seen have spent untold sums on going to seminars (and on coaches!). The verysuccessful can be reckless with book buying and webinar watching and seminar attending.

Continuing education isn’t just for re-licensing seminars. How dull!

If you are not impatiently curious about different aspects of your profession – its science, its philosophy, what it is up against in the market place, you are becoming part of the problem.

Stay curious. Question authority. Study.

Do this:

Assignment #1. You. Order a book – or video- from Barnes and Noble, your local books store, or Amazon. Read most of it on a weekend or weeknight evening rather than watching TV.  Present what you learned at the next staff meeting and put the book in your Library.

Assignment #2. Your Team. Have your staff read a few chapters from a book, or watch a video from your lending library and then give a presentation about it at a staff meeting. Everyone learns and the staff member learns twice! Give bonuses for outside study.

Just like we work on our patients, just like we work on our business, we must work ON our roles as professionals and we do this by studying.

Then, no doubt, you and your team will be dragging your patients over to the lending library to check out the latest editions to your collection.

And your patients will know that they came to the right place. They may think you are all a little nerdy, maybe even fanatical about better health, but they will know that you sincerely care about them and their wellbeing, not just in collecting some money for some fast or rushed service.

Assignment #3. Stay curious and learn – and provoke others to do the same.

Sincerely,

Ed

See our attached list of sample books and videos for your Lending Library Ideas for Your Lending Library

Please give us your suggestions for informative books or videos!

*Questions taken from Dan Murphy’s web site.www.danmurphydc.com