Tag Archives: chiropractic

Medicare in Your Chiropractic Office: Is Your Documentation In Order?

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Lisa J. Barnett

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:

  • History Obtained at Initial Visit:
    • Symptom(s) causing patient to seek care
    • Family history if relevant
    • Past health history (general health, prior illness, injuries, hospitalizations, surgeries, current medications)
    • Mechanism of trauma
    • Quality and character of symptoms/problem
    • Onset, duration, intensity, frequency, location, radiation of symptoms
    • Aggravating or relieving factors
    • Prior interventions, treatments, medications, secondary complaints
  • Initial Visit or New Onset
    • History (as stated above)
    • Description of the present illness:
      • Mechanism of trauma (how did it happen?) For example, getting out of bed, twisting, gardening.
      • Quality and character of symptoms/problem
      • Onset, duration, intensity, frequency, location, radiation of symptoms
      • Aggravating or relieving factors,
      • Prior interventions, treatments, medications, secondary complaints
      • Symptoms causing patient to seek care. Symptom(s) must be related to the level of the subluxation documented.
    • Evaluation of spine/nervous system through physical examination.
      • PART: pain and tenderness, asymmetry/misalignment, range of motion abnormality, tissue, tone changes
    • Diagnosis: Primary diagnosis must be a subluxation, including the level or identified descriptive term of location, i.e., condition of the spinal joint involved, direction of position assumed by the named bone.
    • Treatment plan, to include the following:
      • Recommended level of care (duration and frequency of visits), specific goals, objective measures to evaluate treatment effectiveness, date of the initial treatment.
      • Though not a documentation requirement, this is where you will educate the patient face to face, as to their subluxation and what will happen if they don’t get it corrected, as well as educate them on their innate intelligence.
  • Subsequent Visits:
    • Review of chief complaint, changes since last visit, systems review if relevant
    • Physical Exam
      • Exam – area of spine involved in diagnosis
      • Assessment of change in patient condition since last visit
      • Evaluation of treatment effectiveness.
      • Though not a documentation requirement, this is a perfect time to re-educate the patient on chiropractic principles.
      • Documentation of the presence or absence of a subluxation
      • PART: pain and tenderness, asymmetry/misalignment, range of motion abnormality, tissue, tone changes
    • Documentation of treatment given on day of visit (technique(s) used and areas adjusted)
    • Progress or lack thereof, related to goals and treatment plan (is the patient meeting goals?)

Let me be clear: The above documentation requirements are not PM&A’s. They are Medicare’s.

Other Tips:

  • Your subjective findings in initial visits/new onsets should tell a story about what happened, how it happened, and when it happened.
  • The Visual Analog Scale (VAS) is not sufficient documentation as your sole objective tool. Use additional tools to measure objectives findings.
  • See below for a typical VAS:

VAS-Lisa

  • You should self-audit your documentation on a regular basis.

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]

 

Extreme Chiropractic Practice DevelopMENT! California Jam®, 2016

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Go Cal Jam

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

Your Most Important Set of Chiropractic Office Procedures

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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.

chiropractic practice playbook

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

The 3Goals Practice Development Process for Chiropractic Success

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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.

Practice Development Process icon

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.

Kaizen

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:

  1. Access
  2. Plan
  3. Supervise
  4. Document

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.assess and review

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.

game plan

 

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.

playbook

 

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.

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.

goals sun

Kaizen: Constant Practice Improvement – From Wooden to Deming

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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. 

Seek the small improvement one day at a time. That’s the only way it happens – and when it happens, it lasts.”

 

In Japan they have something called Kaizen. This means continuous improvement. Part of this was developed by another Midwesterner (Wooden was from Indiana), Edwards Deming (Iowa).

Kaizen

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.)

Presidential Award Given to Dave Michel of Petty Michel & Associates

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Dave's CSW Award

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:

  • Those who have made significant contributions to the mission of CSW
  • Those who have served selflessly expecting little in return
  • The acknowledgement is to give thanks and recognition to the individual for all their hard work and commitment

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

Medicare Changes: National Government Services LCDs: Effective 12/1/2015

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*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

Tent Poster – The Parable of Responsibility

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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)

Shaw

Printable version of the tent poster The Parable of Responsibility

Tent Poster – Mr. Rodgers Responsibility

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“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

Shaw

Printable version of the Tent Poster  Mr Rodgers Responsibility

The Marketing Flywheel versus the “Paleo” Practice

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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.

Definition of a Practice

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?

The Other “Paleo” Practice

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?

The Practice Flywheel

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.

How Do You Do This?

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.

Your Newsletter: CONTENT

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The purpose of your newsletter is to keep the conversation going. It is designed to sustain the relationship that you have started. It can even help create new relationships. It serves to remind the patient that you are there for them and can continue to help them.

Marketing IS communication. Nothing beats live two-way communication – in person or via the phone. But next to live communication, the personal letter is best. The letter is a tried and true form of communication.

A newsletter is NOT a brochure, or a pamphlet, or regurgitated “content.” It is a personal communication from you to someone else.  Too many newsletters are mass produced and have generic types of “content.” The one thing that is becoming more valuable in today’s world is authenticity. This is important because it creates trust – which is also scarce.  So, keep your newsletter personal, even “folksy” and your patients will feel that the real you is talking to the real them and will have a greater impact.

Components of a patient newsletter should include some the following:

1. Letter from the Clinic Director
A short letter to the patients from the Clinic Director anchors the newsletter. If you include nothing else, this is the most important part of your newsletter.

It can be short or long. Shorter is better, with only 4 or 5 paragraphs. A longer letter also works ONLY if it is compelling. A worthy story or rant against some injustice…these can work. If it expresses your VOICE, it will work.

Your letter should usually include some reference to you personally. For example: “Yesterday, when I was taking my kids to school, my youngest mentioned she was told that she needed to receive 43 vaccinations next week….”

You can include some health news, with statistics and cite a reference, or refer to an article in another part of the newsletter. You can include office news. Refer to a photo attached of the new carpet, painted wall, or gift from a patient.  New research, celebrities utilizing similar services, recent chiropractic success cases in the office, clinic expansion or renovation, new computer system, and personal adventures … all of these are good.

This can also be done via a short video as well.

Whatever you say, it should be delivered as if you are talking to just one person, perhaps the last patient you just saw.   End the letter by saying something like… “I look forward to seeing you soon.”

2. Health Tips
Information for a “Health Tips” column, such as “Health Sleep Habits for Kids” The topic should be consistent with the time of year (September – back to school month) or Community Education Program theme (Children’s Health). Dr. Mercola has built his empire with great health tips from his newsletter. If you are not a subscriber, I encourage you to look into it. (www.mercola.com)

3. Special Promotions
Information on any upcoming promotions, spinal care classes, community education lectures, or anything else of a special nature.

4. Staff News
Include any news about staff, such as a new baby, new staff, new staff promotion, continuing education or seminar attendance. Pictures please.

5. Doctor/Clinical News
Include news about doctors, such as new seminars attended, advanced training, specialties, new associates, new diagnostic or treatment equipment, etc.

6. Patient News
Any news that is appropriate about patients, such as patient of the month, patient success stories (include photograph of patient), patient news: “Joe Smith wins the lottery and enrolls at Palmer!” Ensure you have a signed release from any patients that you want to include information about. Some clinics like to include a copy of their “thank you for referring board.”

7. Community Education Calendar
List the dates, times, places, and other pertinent information about community events that you will be sponsoring during the next month or quarter.

8. Just for Fun
Begin a recipe column. Assign this to one of the staff as appropriate. For example, if your office manager’s name is Jean, have a column called “Jean’s Recipes”. Each month, Jean can feature a different recipe, including, for example, the doctor’s favorite special chili recipe. Recipes should be simple (or at least not take up too much space). “Jean” should make some comments about the recipe.

9. Cartoons and Jokes!
Newsletter CONTENT Checklist

Submitted in digital format (Via computer).  Bonus if you include photos or even a video.

  • Letter from the Clinic Director
  • Health Tips
  • Special Promotions Upcoming
  • Staff News
  • Doctor/Clinical News
  • Patient News
  • Community Education Calendar
  • Just for Fun
  • Cartoons and Jokes

 

Getting the Newsletter Out – Simple and Fast Steps

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There is a fast way to “keep the conversation going” with your patients, vendors, allies, and other people connected to your practice and business.

Use an email service.

It has simple templates in which you can paste the content you want. Later, with some easy editing, you can also print out the newsletter and have a hard copy for in office fliers or mailers. You can paste the content of your newsletter to your website and to your Facebook page.  You can even use short video clips.

The email service makes it easy. Smooth organization and delegation of the work makes it even easier.

Almost ANY communication is better than none. On a regular basis, get your newsletters out regardless of how neat or interesting they are. Quantity first, then improve the quality.

Here is a short outline of some of the steps you can use to get your newsletter out fast.

  1. Someone in Charge. Assign one person to be in charge of collecting the info. I call this person the “Sunshine Coordinator,” though you may want to call this person the “newsletter assistant,” or some other creative name. (Sunshine Assistant: the one who helps bring the sunshine of our office to your home.)
  2. Newsletter Content Assigned. Get different categories of the newsletter assigned. See the Content Checklist for ideas. Encourage photos of patients, staff, doctor, etc. Each person can take a section and be responsible for submitting quality content. However, they do not personally have to create the article. For example, whoever is in charge of testimonials can encourage any team member to solicit the testimonial from the patients. Not all sections need to be in each newsletter.
    • Content Letter from the doctor. (Could be a video.)
    • Recipe section. “Christina’s Cool Recipe’s”
    • Try to get a photo. Take a quote and make it into the title.
    • “Health Tips.” This is a practical section about health that the reader can use now. Sort of a home remedy section. Include citation to a study, a few tips on what to do for a condition. Always encourage them to call in for a no charge consultation. (This can also be a video.)
    • Upcoming promotional events
    • Office news, jokes, miscellaneous.
  1. Digital Content. Don’t hand in slips of paper or a photocopy. Make sure the content is sent to our Sunshine Assistant in Word or text format. Include photos and video as attachments.
  2. Set when the letter goes out and when all the content should be to the Sunshine Assistant –usually 1 week earlier.
  3. E-newsletter. Use a newsletter service. They are simple, not that expensive, and for many other reasons, just the best way to go. Constant Contact is easy to use. There is also Mail Chimp, and many others that are available.
  4. Publishing Steps.
    • Someone should be in charge of this on line service.
    • Pick a template.
    • Acquire and upload existing emails to get started.
    • Cut and paste text content in each block of the newsletter.
    • Have someone qualified to review readability and edit.
    • Regular uploading of new emails.
    • Posting important newsletter content on website blog.
    • Cross post info from website blog to Facebook.
    • Convert email newsletter to PDF handout for hardcopy newsletter for handouts, statement stuffers, and mailers as desired.
  5. Monthly. Some offices send out a short letter from the doctor two weeks after the main newsletter, along with upcoming notices on occasion. Generally, the more the better.
  6. Video. You will need to make your own YouTube Channel, or use another service to upload your video. There is special formatting for ideal optimization to keep in mind. Once posted, the video can be included in your newsletter, on your website, on Facebook, and on other Internet properties. It does take some extra work, but in the long run, it is worth it. Video is very powerful. Think of T.V. and how much it is used. With Video, you are creating your own TV station.

How to Create a Wondrous Practice Life

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FORTY ONE YEARS AGO, around this time of year (August 7), a twenty four year old managed to sneak up to the twin tours of the World Trade Center, shoot a cable to the other side, get it rigged up tight, and walk across it to the other side. Actually, he made 8 passes, performed dances and entertained an audience a 1/4 of a mile below. He finally came in when it started to rain.

He was arrested, but the the charges were later dismissed if he performed for children in Central Park, which he did.

I recently had the opportunity to listen to Philippe Petit (on August 7, 2015), now 65 years old. He gave a stirring presentation in San Francisco to chiropractic health professionals at the Wave, a seminar put on by Life West Chiropractic College.

Philippe was born in 1949 and still very active. He considers himself, among all things, an artist. But he also juggles, climbs rocks, fights bulls, fences, builds structures with 18th century tools and considers himself an accomplished equestrian.

He explained that he learned early in life to follow his passion and his intuition. But his creativity seemed to be overlooked or given little importance when he was young and so he felt that it must be illegal.

In his book Creativity, Philippe writes: “The creator must be an outlaw. Not a criminal outlaw, but rather a poet who cultivates intellectual rebellion.”

In his talk to us on August 7th, he offered some tips, or precepts that he thought might help us as they have helped him in his life.

He began by talking about his passion to pursue his goals. But right next to that, he emphasized the importance of tenacity. This was a word that included determination, discipline, preparation, and training to do what was needed to be done to achieve those goals about which you are passionate.

He exhibited this nearly a half a century ago as he pursued his goal to walk from one 1,300 foot tall building to another on just a wire. He started planning the walk when he was only 17 living in Paris. The Towers were not yet built. Certainly, the walk itself took immense focus at the time. But it lasted only less than an hour. The real work was in the planning and preparation and training. This took tenacity.

He stressed to listen to your intuition. When you have a question or a problem, listen to your gut and an answer, sooner or later, will visit you. But you do have to listen.

He emphasized simplicity in all that you do, but still be elegant. And don’t be afraid to make mistakes. This is how we learn and move forward. All this, of course, takes courage.

You have to believe in yourself. (Or as Dr. Jimmy Parker used to say, you have to have “FCB – Faith, Confidence and Belief.”) In your role of doctor, provider, and as a professional team member, you have to have faith in yourself and in the services you provide.

In our 3 Goals System of Practice Development, the Third Goal includes your greater purposes. These go beyond financial demands (Goal 1), which are necessary, or profession and business competence (Goal 2), which should be sought. But above it all are your Greater Purposes, your highest values — professionally and personally, that we really seek and that make life worth living.

We learn at an early age to quell our passions and creativity and to fall in line with convention. Obey and comply. And, to some extent, this is necessary for a society and a business to function. But in the bargain, we often lose our spirit. Our creative aspirations, our sense of fellowship with each other, and the outrage at the wrongs that we see — these gradually lose their importance. Our greater purposes become blunted — or even forgotten.

Certainly, this has happened to many people in your community as they “report in,” zombie like to the local drug store for “health care”, especially if it is promoting “free flu shots.” (Average drug prescriptions per person in 1993 was 7.1 In 2014 it was 12.2 And watch out for anyone over 50 where the average prescriptions used are 19, and over for those over 65 – 27. That’s right – 27 prescription medications per person. Average!2)

It is important to keep your greater purposes in sight and to respect them enough to keep them alive. They can and should be integrated into your professional life as you do not work in a factory assembly line as your parents or grandparents may have, or as those who produce your cool t-shirts and running shoes do now. For example, if you like children, have pictures of kids on your walls and have a special “Kids Day.” If you like running, put up pictures of runners and get your patients to join more running clubs. If you want to help the homeless kids in your town, promote a donation program for the local shelter.

Back at the seminar: I noticed that some of the presentations were held in ballrooms that had special, but temporary names. For example, there was the “The Reggie Gold” ballroom, the “Frank Sovinsky” ballroom, and the “Lloyd Latch” ballroom.

In the mid 1980’s, I worked for several years directly for and with Dr. Lloyd Latch. Though he didn’t promote it much, I am sure that he did have the largest chiropractic clinic in the world. While his personal production was high, the total office saw over 2,000 visits per week. The key was that he had created a wonderful team of doctors adjusting patients in 28 adjusting rooms and supported by a dedicate team of professionals.

And what was a key to his success? Over and over I heard Dr. Latch tell his doctors, and others who would visit, that success was “an inside job.”

I think this is exactly what Mr. Petit was getting at.

Success doesn’t come from the latest marketing procedure… it comes from deep inside. It comes from your heart, your passion, your imagination, and the tenacity to work and train daily.

Mr. Pettit says that there are –
“qualities inside all of us, that we are rarely encouraged to recognize
but that are essential to make our dreams come true, to plan, to construct a wondrous life.”3

IMG_1390 copy

Successful people learn from others, but ultimately take their own counsel.

As Philippe wrote:
“Observation was my conduit for knowledge, intuition my source of power.”3

So, follow your greater purposes and integrate them into your professional and work life. Allow your team members to also pursue their greater purposes – and you will see your practice become more creative, productive and wondrous.

Carpe Diem (seize the day),
Ed
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  1. Generation Rx How Prescription Drugs Are Altering American Lives, Minds, and Bodies by Greg Critser (https://danmurphydc.com/Critser.pdf) , also http://kff.org/other/state-indicator/retail-rx-drugs-per-capita.
  2. www.imshealth.com/deployedfiles/imshealth/Global/Content/Corporate/IMS%20Health%20Institute/Reports/US_Use_of_Meds_2013/Percent_population_prescriptions_per_capita.pdf
  3. Creativity, the Perfect Crime. Philippe Petit

Chiropractic Marketing and a Staff Member Conspiracy

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This is a tale of a staff member conspiracy.

It is about a hidden and quiet plan by scheming staff members.

The planning took place towards the end of 2014 in a chiropractic office next to a river.  By a lake. But that is not important.

Quietly, Ann and Betty met to discuss how they were going to fix the … situation. (I changed the names, but the rest is true.)

Dr. JM is an excellent and respected doctor who has a loyal following of patients. But as much as he wanted more new patients — as he was only generating about 6 per month — he just could not bring himself to do much marketing. And this is in spite of the excellent advice and support of his faithful and expert coach and consultant (moi).

But secretly, the two ladies hatched their own private strategy. And it worked.

More new patients started to come in. In fact, on my last visit to their office, they had three new patients come in, more than they usually see in a week.

What exactly did these enterprising chiropractic assistants do? Hmmm?

Maybe you could do the same?

Yes, you can and here is what they did:

Betty, the office manager, and Ann, the front desk coordinator, got together and worked up a procedure for generating patient reviews on Google.

The office manager wrote up a procedure for patients on how to post a review on Google.  Ann, who calls most of the patients “honey” and says that they are all “her” patients, can be very forward and, well, controlling.  She would simply get the agreement of key patients to make a review. She then gave them the procedure that was on a slip of paper and told them to go forth and spread the word.

In time, with her friendly but insistent nudging, they would. And now, their doctor has over twenty great reviews spread out over many months. The new patient increase is coming from people calling in off of the Internet.

Everybody is a reviewer.

People buy on the Internet from reviews.  This is like word-of-mouth of old, only now it is a 4 or 5 star review.  In fact, Amazon, the world’s largest online retailer, uses reviews as their primary marketing tool. Once you buy something from them online, you are continually asked to post a review about what you thought.

I recently posted a review for something I purchased and found out that I have a “review rank” of 16,678,570. (But at least I earned 1 “helpful vote”, so that is nice.)

There are now many web sites that a consumer can go to review you.

Everyone is a reviewer. It is the new currency used to buy and sell products and services.

Get reviewed.

To help you, we have provided links on our blog for the following:

  1. Article for staff on how to generate web reviews. (PDF)
  2. Procedure sheet for patients on how to make a review on Google. (PDF)
  3. Procedure sheet for patients on how to make a review on Facebook. (PDF)
  4. A patient log for the staff to follow up on patients who have agreed to post a review. (PDF)

If you are an active client, you can go to our members site and download the same files as customizable WORD files. Get Reviewed info on PMAmembers.com

Start your own conspiracy to help share the successes of your services. But… get reviewed and watch the new patients come in.

Health Independence and Freedom – For Chiropractors and Your Patients

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Here in the good Ol’ USA, we are about to celebrate Independence Day, the date we commemorate the signing of the Declaration of Independence and declared our freedom from the yoke of the British Empire.

I think for those of us in health care this day bears special significance.  In fact, I think of the chiropractic profession in particular.

Chiropractic has remained independent for 120 years. It has been fought by monopolist trade organizations, suppressed, and slandered, but it still stays outside of the clutches of Eli Lilly, Merck, or Monsanto.

To Chiropractors and those who work in the profession: You are brave, tough, and independent. You are living the American Way. You are a gritty bunch for sure and have maintained your integrity for putting care before profits.

The challenge you have is not only to remain free, but to help your patients and community also be free and independent.

Your patients are at the receiving end of billions and billions of dollars that are spent to manipulate them to purchase products that are known to be unhealthy.  Through pervasive and clever marketing and massive efforts to influence government, Americans have become over fed, over medicated, and under nourished.  Obesity rates have tripled (11% in 1960’s, 37% 2010)1, drug consumption has soared (average 7 per person in 1993 to 12.2 per person in 2014).2 Vaccination recommendations for our children from our government has increased from 64 in the 1950’s to over 1000 in 2013 (69 doses of 16 vaccines between day of birth and age 18).3

And the results?  American’s health rates compared to other countries are abysmal. We are the worst or close to it in many categories. 4    Yet this is not what is advertised, so it would be shock for most Americans to hear that in the competition with other countries for the best health care, that they are losers.

The true American Way5 was and is to question authority, seek the truth and to stand up for justice.

But the truth can be obscured and the path of least resistance is easier, and it can seem more acceptable to simply follow convention and herd mentality.  But the facts are there – provided by whistle blowers, mothers, and researchers, and we all need to look at the facts, do our research, and continue to educate ourselves and stay vigilant.

We can’t forget our patients… they too need to learn how their health choices have been manipulated, how they have been deceived, and what they should do to truly improve their health.

There is a price to pay for freedom. It takes work and is not always easy, but — it is the American thing to do.   Stay brave, stay alert, and continue to help your patients achieve better health.

Happy Independence Day from Whitefish Bay, Wisconsin, USA

References.

  1. Obesity.
    http://seekingalpha.com/article/2419425-2-healthcare-stocks-that-appear-to-trade-below-fair-value-estimates
  2. Drug Usage.
    Generation Rx How Prescription Drugs Are Altering American Lives, Minds, and Bodies by Greg Critser (https://danmurphydc.com/Critser.pdf) , also http://kff.org/other/state-indicator/retail-rx-drugs-per-capita. www.imshealth.com/deployedfiles/imshealth/Global/Content/Corporate/IMS%20Health%20Institute/Reports/US_Use_of_Meds_2013/Percent_population_prescriptions_per_capita.pdf
  3. Vaccinations.
    http://www.nvic.org/CMSTemplates/NVIC/pdf/49-Doses-PosterB.pdf
  4. Rating American Health Care.
    http://www.nvic.org/CMSTemplates/NVIC/pdf/49-Doses-PosterB.pdf
    http://www.oecd.org/unitedstates/Briefing-Note-UNITED-STATES-2014.pdf
  5. The American Way.
    “The American Way of life is individualistic, dynamic, and pragmatic.” (Wikipedia: The American Way)