“You can make more friends in two months by becoming interested in other people…
…than you can in two years by trying to get other people interested in you.”
~Dale Carnegie, How to Win Friends and Influence People
For a printable copy of this tent poster visit: Making Friends
Linda Skiles
Actually, seems much longer as our relationship goes back to the great and honorable Dr. Gaylord Culp of Lake Geneva. And what a grand privilege that was – he was a master Chiropractor.
And then I bumped into you again as the office manager at the renown Wheelock Clinic in Burlington. WI. A dynamic multiple-doctor office that is still going strong.
You certainly had good experiences with solid chiropractic with these doctors and at these offices so there was no doubt in my mind as to your credentials. You were Chiropractic Assistant of the Year here in Wisconsin too… back a few years it was!
A person can have credentials and training but these are minor compared to the exceptional and outstanding qualities of character that you have demonstrated. It is too rare to find people who have the personal ethics and courage and selflessness to continue to provide support services through thick and thin, day and night, when needed, as needed, year after year.
In a quiet corner of the world your industriousness has been unflagging…and directly and indirectly because of you and your work, hundreds if not thousands of people are living better lives through better chiropractic offices.
You are always ready to provide us consultants, our clients, and our company with fast service any time.
We don’t say this enough, but your continued support has made a difference to all of us and so many others. But here it is, on your 15th Anniversary:
Thank You Linda. We love you.
🙂
Mexico Surfing Trip with Chiropractors from around the globe!
A little movie from bits of video casually taken, and below, some photos as well.
Gracias!
June, 2016
REMINDER: Wisconsin License Renewal Credentialing Requirements
Doctors of Chiropractic (DCs):
Starting in October 2016 and prior to December 14th, renew online: DC Renew
Chiropractic Technicians (CTs):
Starting in October 2016 and prior to December 14th, renew online: CT Renew
Chiropractic Radiological Technicians (CRTs):
Starting in October 2016 and prior to December 14th, renew online at: CRT Renew
TIP: Keep your transcripts and file them safely, in the event of a continuing education audit.
All licenses (DC, CT, CRT) expire on December 14, 2016 at midnight.
Questions? Contact Lisa Barnett, PM&A Consultant, at 920-334-4561
~~~~
Links
DC Approved Courses: https://dsps.wi.gov/Default.aspx?Page=b74564c8-7d6c-4258-9809-cd118336a9f5
DC Renew: https://online.drl.wi.gov/UserLogin.aspx
CT Approved Course Listing:http://dsps.wi.gov/Default.aspx?Page=830a2718-a0f7-414c-8e97-2481f983bc78
CT Renew: https://online.drl.wi.gov/UserLogin.aspx
CRT Approved Course Listing: https://dsps.wi.gov/Default.aspx?Page=bcfb3543-eb0a-46bf-ba89-8f1fe6d84325
CRT Renew: https://online.drl.wi.gov/UserLogin.aspx
Printable Version of this quick checklist of requirements. [LINK]
Lisa J. Barnett
HIPAA, Covered Entity, OSHA, HITECH – – Compliance. What’s happening in the world of compliance and why do you as a chiropractor need to be educated and remain in the know? Find out below . . .
First and foremost, according to the Health and Human Services (HHS), chiropractors are included in the covered entity category, and this is regardless of whether or not you have received Electronic Health Records incentive monies. Covered entities are required by federal law to comply with all areas of protected health information and employee safety standards. Impact of non-compliance? In February 2016, a covered entity was fined $239,800 for non compliance.
Further, according to a March 2016 survey among small practices designated as covered entities, 60 percent of the 900 plus professionals surveyed are still unaware of pending compliance audits, and 58 percent have not appointed a securities/privacy officer in their practice. Audits to our profession are forthcoming, and we cannot opt out. Keep reading on how to safeguard yourself and your practice. Also keep in mind that it takes approximately 40 to 50 hours to develop and secure a compliance program.
The three main areas of compliance you need to be aware of, educated in, and be an active participant include: HIPAA, OSHA, and IT Securities.
Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act (HIPAA) law of 1996 was enacted to improve the portability and accountability of health insurance coverage, and it brought individual privacy rights to patients and requires that we notify them of their rights. It also serves to eliminate fraud, waste, and abuse in healthcare. The focus here is to safeguard your practice by securing personal (patient) health information (PHI) and personal identifiers, be it paper or electronic (ePHI). This can include data encryption, secure messaging, compliant Cloud storage, compliant software, and unique password setups. One of the areas I assess when I visit a clinic is locating where the patient paper files are kept and if they are well out of viewing from others.
Your HIPAA requirements to be compliant at the clinic level include:
OSHA
The United States Occupational Safety and Health Administration (OSHA) Act was signed by President Nixon in December 1970. It is designed to protect worker safety and promote healthy work environments. Some of you Docs have been involved in workplace safety and onsite workplace assessments in factories. Kudos to you! You were advocating OSHA’s mission by: Educating your client and their employees on workplace safety by conducting posture and ergonomic assessments, and finding the best ways for workers’ compensation patients to get back to work and continue contributing safely and appropriately within their restrictions.
At the clinic level (can be delegated), your requirements to meet OSHA requirements include:
Information Technology (IT) Security/HITECH
The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of HIPAA and the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. Section 1176(a) of the Social Security Act was revised during this timeframe to allow for significant monetary penalties up to $1.5 million for breaches/violations of protected health information. However, an interim revision (later known as The Omnibus Rule) set prohibitions on enforcing such significant monetary penalties if it was found in investigation that the covered entity did not know and with the exercise of reasonable diligence would not have known of the violation. In these cases, the breaches were punishable under the lowest tier of penalties, and further, prohibited the imposition of penalties for any violation corrected within a 30-day time period, as long as the violation was not due to willful neglect. A final ruling in January 2013 reiterates all of the above standards.
Your responsibilities to get IT Securities compliant include:
Impact of non-compliance? Another covered entity was fined $25,000 for posting patient information online.
Feeling overwhelmed? We can help. Contact me on how you can get an initial Compliance Assessment and a Medicare Documentation Assessment with a Report of Findings sent to you, for a ridiculous low price of $299!*
References:
*Mileage cost may apply.
Lisa J. Barnett
Have you ever thought you could be both a great documenter and repeatedly educate your patients on their innate intelligence . . . if you only had the time? Keep reading on how to both bulletproof your documentation for a potential audit and maintain the energy of our profession’s principles.
Let’s help build your ammunition.
First . . . did you know that the US Health and Human Services advised Medicare to target chiropractors to curb questionable and inappropriate payments, projected at $280,000,000? Seriously! And clinics are, as I write this, being audited. How do I know? Because we’re receiving phone calls and emails asking, “What do I do? I received a letter from Medicare.” As a result, I’m traveling around to help chiropractic offices prepare.
To insure yourself and what you’ve worked hard for, make sure your documentation (that is, every single note in the patient’s file/your EHR software) is citing the following information:
Let me be clear: The above documentation requirements are not PM&A’s. They are Medicare’s.
Other Tips:
In closing, get out there, do what you do best to attract and help anyone with a spine, and follow the above documentation requirements to armor yourself in the event of an audit by Medicare and other payers. Need help staying relaxed and focused, and getting paid? Give us a call. That’s why we’re here.
Sincerely in Chiropractic,
Lisa
Lisa is now providing a no charge initial consultation regarding your Medicare documentation. You can contact at (920) 334-4561 or by email at Lisa (at) @ pmaworks.com
More information on Lisa[LINK]
Download a printable copy of this newsletter [June newsletter]
Download a customizable copy of the Checklist: [Medicare Documentation ChecklistDOC]
Print Checklist (PDF)[Medicare Documentation Checklist-PDF]
“There’s no way I can single-handedly save the world, or perhaps, even make a perceptible difference –
but how ashamed I would be to let a day pass without making one more effort.” ~ Isaac Asimov
For a printable copy of the Tent poster click here: Make a Difference
I am standing on a beach by the partially ice-covered Lake Michigan, sometimes referred to as part of the “Third Coast.” It is a good day!
Once a year I send out a promotion for the wildest and most unique chiropractic seminar I have seen in 30 years.
“Out-of-the-box” is a cliché that doesn’t really do Cal Jam justice. Like extreme sports, Cal Jam pushes the boundaries of what is customary and conventional.
But isn’t that chiropractic? Isn’t that you?
Chiropractic is unique (and wild) because it has purpose and soul.
Purpose and Soul, plus plenty of… Rock and Roll.
At Cal Jam!
Hope to see you there!
Date: March 18-20, 2016
Link to site: California Jam: www.CaliforniaJam.com
An Introduction to the Practice Development Process of Continuous Improvement
A key difference between a successful and profitable chiropractic business and a roller coaster type practice can be traced back to procedures and systems.
Many practice problems occur because procedures are not established, consistently followed, and regularly improved. This has been the secret to franchising. Starbucks may offer new products and services now and then, but for the most part, they follow their checklists and manuals of successful procedures. The local New Age coffee shop down on the corner with the unemployed guitar player usually lasts for about a year before the owner’s savings and inspiration dry up, along with the last cup of coffee.
Of all the categories of systems in your office, what would you say would be the most important?
☐Patient Accounts (Billing/Collections) Systems
☐Marketing Systems
☐Front Desk Systems
☐Therapy and Clinical Support Systems
☐ Doctor Systems
☐ Business Systems (Payroll, Financial Planning, Taxes,)
☐ Leadership
☐Office, Practice Management Systems
My guess is that you usually keep most billing procedures in place as… obviously, you need to be paid. And, you will usually keep most front desk procedures in place. These deal with patients and patients are obviously in the office, or not. And you, of course, follow your clinical procedures.
Your marketing procedures come and go, at least they do in most offices. They are just not consistent. This is why I put together the Marketing Manager System in 2000. The biggest error in most offices with their marketing is that it simply isn’t done consistently.
But the most important category of systems is not so obvious. These are the management procedures and systems. Why are these most important? Because they keep all the other procedures in place and are continually being improved upon.
Why do you think CEO’s are paid so much money? Because they are in charge of the management of a business and are able to increase its bottom line by the millions. They have procedures that they follow and insist that others do as well. These procedures all add up to systems.
Over the years, Petty Michel and Associates has been very successful at increasing the revenues of practices. One of the reasons is that we implement what we call the Practice Development Process. It is a monthly system of management that gradually works to objectively improve the business, repetitively over and over. It integrates into your current systems and does not take that much extra time. But in the end, it saves you a great deal of time, extra work, and lost revenue.
To learn more about the 3Goals Practice Development Process: 3Goals PDP
Four steps to continuously develop and improve your practice
The Practice Development Process is a simple, yet powerful practice building system that can help take you and your business to its full potential of a systematized, team driven and profitable business.
It transforms your practice. Month by month, it helps move your practice to a more profitable service oriented business that runs at near full capacity – with less ups and downs that demand your time and extra work.
It is based upon the idea of constant improvement.
The principle of constant improvement in management science has been a major factor in the success of large manufacturing corporations around the world. The success of the Japanese automobile manufacturing rests heavily on a process of constant improvement called Kaizen (kai = change, zen = good). Motorola developed its own program called “Six Sigma”, a process of continuous improvement.
We have adapted these processes to be applied in practice management and call it the 3Goals Practice Development Process (PDP).
The Practice Development Process has four steps:
Integrate This Process As Part Of Your Team Meetings. The first two steps, Assess and Plan, are usually done before or during the first staff meeting of the month. Supervision goes on during the month to ensure that the plan gets completed. At the end of the month, successful procedures are documented in a practice playbook for future training and assessments.
Your Consultant and Coach. This process is best done with your practice and business coach. Each month, the two of you should work through step 1 and 2. During the month, your coach may also be able to help with the implementation of the plan.
THE 4 STEPS OF THE PRACTICE DEVELOPMENT PROCESS:
1. Assess and Review. At the end of the month, look over the statistics and note what areas improved and what areas didn’t. Then check what was actually done, or not done in each area. Use your departmental checklists from your Practice Playbook if you have started this.
Many business owners still manage without looking at objective indicators. They manage by emotions, mistakes, fear, “bright ideas”and other flighty factors that ultimately hold a clinic back, or often just burn it out.
Effective clinic managers, like an athletic team coaches, base their actions first on actual outcomes and performance monitors. These are your daily, weekly, and monthly practice statistics. PM&A has developed a specialized form of review which is called Practice Analytics System which we display on our client’s personal Practice Dashboard’s.
This assessment also includes reviewing checklists of the key procedures and whether or not key duties were done.
2 Plan. Work out the key areas you want to work on in the next month. Pick just one or two areas that will make the biggest difference and make a list of a few action steps that will help improve the area in your office you have targeted. Get the actions assigned with a date on when they should be done.
3 Supervise. Regularly monitor the implementation of the action steps with yourself, your team, and your consultant. Provide help where needed to get them done.
4 Systematize. You do not want to keep inventing the wheel, so at the end of each month, document any procedure that worked well.
List all successful activities for each department and “lock them in” as standard operating procedures. Keep what works, throw out what doesn’t. Start with just a checklist of key procedures. Later, you can write or videotape a description of each procedure. It is from this that you will do your training and “coaching reviews.” Use your playbook often: refer to it and practice.
Gradually, you should have your own system of practice management and patient management and have it outlined simply in your Practice Playbook. For example, the “Smith Chiropractic System of Patient Management.”
IMPLEMENTATION SCHEDULE
Week 1. First Week of the Month: Do Steps 1 & 2 – Assess and Plan
Week 2. Supervise. Coordinate upcoming activities. Study and Train. (Optional: Separate Marketing Meeting)
Week 3. Supervise. Coordinate upcoming activities. Study and Train.
Week 4. Supervise. Coordinate on upcoming activities. Celebrate and party for a great month! Add to Practice Playbook.
REPETITION
Do The Practice Development Process Every Month.
The success of this process derives much of its power from a simple principle from Aristotle.
“We are what we repeatedly do.
Excellence, then, is not an act, but a habit.”
This often referenced quote is from a series of lectures he was to have given at the Greek Lyceum on ethics (300 B.C.). We could say, then, that continuing to do the Practice Development Assessment, and all of your procedures and systems, is ethical and leads to excellence. The contrary would also be true.
GOALS AND CONSTANT IMPROVEMENT
It is important to keep in mind WHY we are doing the PDP each month.
It is assumed we all want to improve, that improvement is possible, and that we have higher purposes and goals. Our patients do. That is why they see us and we help them improve and get closer to their goals at each visit.
By consistently working the 3 Goals Practice Development Process each month you, the practice, and each team member will also get closer to the higher goals each of you share.
“The more you are motivated by love, The more fearless & free your action will be.”
~Dalai Lama
Printable version of the tent poster email services@pmaworks.com
“There is a child inside me that wants to come out and do something to surprise all the adults.”
~Philippe Petit
Printable Version of the Tent Poster [Link]
What improvements do you need to make in your practice for 2016?
Managing your practice is similar to managing a sports team in many ways. There are goals, rules, plays (procedures,) skill development, strategies, winning and losing. There is also coaching and training.
The teams that win the most constantly work to improve. But the improvements often focus on just the refinement of the basics.
One chiropractor I worked with told me stories about his experiences with John Wooden. Coach Wooden was a very successful basketball coach who coached the UCLA basketball team to 10 national championships over a 12-year period.
Here is what Coach Wooden has said:
“When you improve a little each day, eventually big things occur…. Not tomorrow, not the next day, but eventually a big gain is made. Don’t look for the big, quick improvement.
The Deming Cycle is a process of continuous improvement that helped grow the Japanese car industry in the 60’s to what it is today. For a long time, Detroit auto companies weren’t that interested in what Deming had to say – and, of course, we can see how that turned out for them!
Constant improvement takes discipline. Those of you who had to practice a musical instrument or an athletic skill in school remember the daily routine. Improving the little things can get boring and when a colleague calls with excitement about this new seminar or gadget or website, many doctors are off to the chase the “shiny things.”
Innovation needs to happen, certainly. But the real successful businesses and teams continually work to master what they already do.
Mastering the basics is always the key to success. Deliberate practice, study and good coaching. And this takes discipline and… a certain degree of humility to admit you can personally improve.
But since you are not a full time coach and mostly work IN the practice, you have to schedule specific times to work ON the practice. But what do you work on? ICD 11? (Yes… it IS on the horizon!) More E.H.R?
Well, maybe, but these are not the areas that will significantly improve your business over the long run and take it to the next level.
To help you uncover what should be improved, you can use our updated Practice Progress Grid. You can go over it with your team and plot where you were, where you are now… and then where you want to be next year! (Link is below.)
This can help reveal what organizational and engineering steps you need to build a better business machine for 2016.
In most cases, the improvements don’t have to be major. They just have to be continuously refined. But some areas that are holding you back from your goals can be hidden or overlooked.
If you want to dig deeper, we also have our Practice Development Assessment(PDA). It takes more time to complete but gives you a more complete analysis. (The link is below.)
The world is changing faster and faster. You have to constantly improve to keep up, let alone, to stay ahead. And if you don’t… well, your patients will be going to those offices that are.
From all of us at PM&A, we look forward to your continued improvements and to helping you get closer to your goals in the New Year.
Ed Petty
Link to Practice Progress Grid
Link to Practice Development Assessment (No charge for first 15 users, $25 thereafter.)
“If you want to build a ship, don’t drum up the men to gather wood, divide the work and give orders.
Instead, teach them to yearn for the vast and endless sea.”
~Antoine de Saint-Exupèry
For a printable version of the tent poster: Yearn for the Sea
Dr. LaGuardia, Dr. Conway with David Michel of Petty Michel & Associates
MILWAUKEE, WI – November 27, 2015 – Petty, Michel and Associates (PM&A), a national chiropractic practice management company, is pleased to announce that David Michel, a partner with PM&A, was recently awarded the 2015 Presidential Award by the Chiropractic Society of Wisconsin (CSW). The award, presented during the Awards Ceremony at the CSW’s second annual 2015 Health & Wellness Summit, held at the Kalahari Resort in the Wisconsin Dells this past October 9th through the 11th, identifies:
Mr. Michel serves on the Board of Directors for the Chiropractic Society of Wisconsin (CSW). The CSW is a member driven and member controlled State organization that develops and maintains positive relations with consumers (patients), chiropractors, legislators, lobbyists, insurance companies and medical providers.
Dr. Jay LaGuardia, President of the CSW, when presenting the award to Michel, stated: “We would not have been able to achieve the success we have thus far without his valuable service.”
David Michel has been involved with the Chiropractic Society of Wisconsin since its inception in 2012.
Petty Michel & Associates (PM&A), a practice development company, was founded in 1988 as an alternative to conventional practice management seminar programs. For more information, go to: http://www.pmaworks.com
*This notice specifically pertains to those offices where the Provider of Medicare is NGS: CT, IL, ME, MA, MN, NH, NY, RI, VT, and WI.
For those of you who have NGS as their Medicare provider (states listed above), we wanted to make sure you were aware of a new policy which has some big changes, mostly positive and where you could get more information about it.
The NGS(National Government Services) recently published the new Chiropractic Medicare Policy which will go into effect on 12/1/2015
For more information on the chiropractic medicare policy visit:
L66315 Chiropractic Services Policy
Sincerely,
Dave
Everybody, Somebody, Anybody, and Nobody were members of a group
There was an important job to do and Everybody was asked to do it.
Everybody was sure that Somebody would do it.
Anybody would have done it, but Nobody did it.
Somebody got angry because it was Everybody’s job.
Everybody thought Anybody would do it, but Nobody realized that Anybody wouldn’t do it.
It ended up that Everybody, blamed Somebody, when Nobody did, what Anybody could have done.
(abridged version of a poem by Charles Osgood)
Printable version of the tent poster The Parable of Responsibility
“We live in a world in which we need to share responsibility, it’s easy to say “It’s not my child, not my community, not my world, not my problems”.
Then there are those who see the need and respond, I consider those people my heroes.”
~Fred Rodgers
Printable version of the Tent Poster Mr Rodgers Responsibility
“The fate of the living planet is the most important issue facing mankind”
-Gaylord Nelson
Click here for a printable copy of the tent poster living planet
If you are like many chiropractors, other doctors and professionals, you are wasting potential revenue and don’t even realize it.
Before I tell you how this happens, let me give you a definition that I have been using for years that has helped many offices.
A practice is a network of relationships that is created and sustained through communication and service.
OK. Keep that definition in mind.
Now, here is how you can lose extra income and create extra work for yourself and your team: You start out spending a great deal of time and effort on generating new patients and then on processing them. You get to know the new patients and hear their stories. You empathize with them, ask them questions, and examine them. You explain what you have found about their condition and worked out what you see as their best option for treatment.
During their first few visits you are sensitive to how they are responding to your care and so continue to communicate with them. You put all this work into your new patient in order to help them follow your treatment plan and get better.
But as the patient improves and their frequency of visits decrease, your focus on them lessens. Your attention gravitates to the new patients.
When the patient has moved through your care plan, they often just drift back out into their community with an inadequate lifeline back to your office.
You have invested in, and created, a great relationship with your patient. Wouldn’t it be a good idea to stay in communication with them? They know you and like you and your team — shouldn’t you keep the connection alive and active? Just because their health condition has improved, don’t you still have approaches to help them become healthier and happier?
They have family and friends that can use your help now. They also belong to businesses and other groups that could use your help. Why let this relationship atrophy? Why not secure that lost income as well?
In some sense, the business is constantly starting and stopping. It is nomadic. This is the other “Paleo” practice: each day when the sun comes up across the plains, you are out hunting for and gathering new patients. This may be good for a diet, but not if you want a low stress practice. Wouldn’t it be better to create a business where existing long time patients would routinely stop by for care and refer their family and friends? This would save you a lot of effort, money, and stress, wouldn’t it?
A practice should be supported by business systems.
These systems are like an engine. An engine has starts and stops, but it also has a flywheel. The flywheel is a heavy wheel that, once it begins to spin, continues to do so with much less effort than it took to get it going.
A good practice is supported by a business flywheel, or a number of flywheels as there are different sub-engines in the business.
For internal marketing, the flywheel is the conversation that you first began. You want to keep it going and going. After you get it spinning in high gear, it takes little effort to keep it humming along.
You put in place a system of constant communication with your patients when they are NOT in the office through e-newsletters, hard copy newsletters, notes and cards, Facebook, and any other medium available. And of course, there is also personally seeing them at events in your community – county fair, grocery store, restaurant, salon or barber shop, etc. You want to keep the conversation going.
A very effective method is through electronic newsletters. Done right, and they usually aren’t, these newsletters can improve the numbers in your office.
We have tested this and found that the offices that do have personalized newsletters to their patients have more returning patients, more referrals, and more wellness visits as a result. Hence, more revenue and less stress about generating new patients.
See link below for a procedural article on what we have found that seems to work best for e-newsletters. Your customized e-newsletter can fuel your Facebook page, website, hard copy newsletter, and other mediums. We have worked out a relatively simple and very cost effective system that offices are using now to make this work.
Keep in mind that if your patients are not in listening to you, they will be listening to someone. For example, there are about 80 ads for drugs every hour on television (http://www.topmastersinhealthcare.com/drugged-america/) and this statistic is more than ten years old. It has been estimated that each of us are bombarded with about 2,000 advertising impressions per day. How many of these ads influence your patients toward unhealthful products or services?
Customized newsletters, and the cascading communications that they can feed, cost little but they help to keep the patient flywheel – and the communication – going. And in so doing, the patient wins, the community wins, and so does your business.
-Edward Petty
Publishing Your Newsletter – Does your mailing bottleneck when it comes to time to do the monthly newsletter Follow our easy steps to get your newsletter out “simple and fast”.
Newsletter Content – 9 suggested topics to include in your monthly newsletter to keep the conversation going.