Tag Archives: management

Preparing for a Powerful New Year in Your Chiropractic Healthcare Business

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Previously posted on (Goal Driven.com)

petty michel and associates end of year business preparation checklist

42 more days until a New Year is here.

Before we know it, it will be at our morning doorstep. Like a happy eager dog ready to be taken for its morning walk, tail a wagin’.

But before we look at all what is coming, we have the next few weeks to wrap up 2025. This includes the Holidays, both in business and in our personal lives. We also have all the year-end admin details to complete.

NOW is the time to nail everything down — to plan the events and complete the admin tasks.

And while doing this, filling the end of the year with Christmas cheer, ready for 2026 — your best year yet!!

We’ll prepare for the New Year in a few weeks, but let’s finish off this year with a flourish. Consider these 4 actions:

  • Relationships. Focus on re-bonding with all your patients and supporters from this last year.
  • End of year care. Encourage them to come in and get care.
  • Referrals. Bring in their family and friends for an end of year check-up.
  • Year end admin checklist. Review and complete all year end admin duties that need to be done.

Most important is your connection with current and past patients and supporters.

Remember:

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

Be ready to take a little extra time to chat, to communicate, and to listen — and an extra “a cup of kindness, yet.”

Marketing. I gave a list of some marketing activities you can do for November and December in a recent newsletter. You can review them here. Get those planned and going.

End of Year Administrative Checklist for Chiropractic and Healthcare Businesses

In addition, we have put together a short list of administrative items that should be reviewed and completed by year end for your chiropractic and healthcare office. It is by no means complete, but the idea is you want to get them taken care of as soon as possible, or at least scheduled, so you can focus your creative energies on launching your 2026.

Block 2-3 hours in early December to work through this list. Delegate sections to your manager, billing staff, and bookkeeper.

You can also contact Lisa who is an expert in these subjects. You can contact her anytime.

Just Ask Lisa! (Lisa@pmaworks.com)

The checklist covers these categories:

2025 ADMIN WRAP UP CHECKLIST

  • FINANCIAL & TAX
  • CREDENTIALING & LICENSING
  • EMPLOYEE ADMINISTRATION
  • INSURANCE & PATIENT ACCOUNTS
  • COMPLIANCE & OPERATIONS
  • BUSINESS ENTITY & LEGAL

Download the ADMIN LIST below and tend to the admin.

Meanwhile, have a great time with your patients over the next 6 weeks.

And let’s prepare for your best year ever – in practice, in business, and in life!

And stay…Goal Driven,

Ed

Download the Checklists HERE

What is Special about L.L. Bean and How Does it Compare to Your Chiropractic or Healthcare Practice?

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“Originally published on Goal Driven.com – republished with permission.”

LL bean womens boot
The Key to Building a Chiropractic and Healthcare Practice that Lasts

L.L. Bean. You’ve probably heard of them.

I just received a Christmas shopping catalogue from them (hard copy!). They are a clothing company out of Maine. Founded in 1912 by Leon Leonwood Bean. I probably bought something from them years ago, and I am on their Christmas list.

We also receive a catalogue from Patagonia each year. It is another clothing company. It was founded more recently, in 1973 by a rock climber, Yvon Chouinard.

I like both companies and I will tell you why – in a minute.

= = =

Recently, I saw an ad of a young man (chiropractor) coming off a stage saying that he just sold his practice for “seven figures.” It was a bit of brag and sounded like he wanted to help other doctors reach that level. He said he was able to grow his business quickly and sell it thanks to his marketing.

I’m all for marketing, and I truly hope he can help with other chiropractic practices.

But it made me think: aren’t there significant financial advantages to owning a business in the long term that compound?

When you own a practice for 10-20 years, you’re not just collecting a salary — you’re able to take advantage of tax benefits that can add $30-50K annually to your real compensation! These can include vehicle expenses, health insurance, retirement contributions, continuing education, and equipment depreciation. These can all reduce your tax burden.

Over 20-25 years, these ownership benefits can add $500K-$1M in value that disappears the moment you sell.

And beyond tax advantages, long-term ownership allows your business equity to compound alongside your income. A practice worth $500K in year 5 might grow to $2M by year 10 or $5 -10M by year 25 – or more — IF you have good management, create a strong reputation, and even bring on other providers, or add other locations. And all the while — taking profit distributions, building retirement accounts, and enjoying the flexibility that ownership provides.

The doctor who sells early gets one payday; the doctor who builds strategically gets decades of tax-optimized income plus a potentially much larger exit.

Back to L.L. Bean and Patagonia

Now, back to those Christmas catalogues! Both show how patient, long-term ownership and excellent management, products, and services can build generational wealth over decades of brand-building and customer loyalty.

L.L. Bean, a billion-dollar empire, is still family-owned. Patagonia, now worth billions, wasn’t sold at all. Chouinard transferred ownership to the Patagonia Purpose Trust to ensure profits protect the planet in perpetuity.

Both companies show how owners who focus on purpose-driven growth and lasting customer relationships can build enduring companies that dwarf what any early buyer would have paid.

Purpose and Values of Your Healthcare and Chiropractic Practice

But here is what does not show up in the spreadsheets of these two companies: their values and purposes.

And, their discipline to stick to them!

Selling your business earlier rather than later can be a valid choice. However, if you ensure it remains focused on its purpose and values, you’ll enhance its profitability and make it more valuable for whoever takes ownership next.

L.L. Bean built its reputation on an unconditional guarantee and commitment to customer satisfaction. “At L.L.Bean, we design products that make it easier for families of all kinds to spend time outside together.”

Patagonia’s environmental purpose became so central that Yvon Chouinard ultimately gave away his $3 billion company. “We’re in business to save our home planet.”

The lesson is that a business rooted in purpose beyond profit attracts loyal customers and dedicated employees and creates a brand that competitors can’t copy.

Your purpose — and the discipline to stay creatively and positively true to your goals — pays off.

So…

Stay Goal Driven!

Ed

P.S. And have fun doing so – maybe fishing, camping, or just outside and enjoy the fall. (Or spring, if you’re Down Under.)

2026 Marketing Habits for Your Chiropractic and Healthcare New Year

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social media marketing for consistent marketing in the Chiropractic Practice for 2026

2026: The Year to Make Your Healthcare Practice Thrive

2026 will be a make-or-break year for healthcare business owners—potentially your best ever. More details in future newsletters, but for now: build unbreakable marketing habits starting today.

Trust: The Core of Healthcare Marketing

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.” – Aristotle (via Will Durant)

You’re selling the invisible—outcomes patients can’t see upfront. That’s why trust is everything. Build it through:

  • Consistency
  • Empathy
  • Proven Results

Your brand = how you consistently show genuine care and deliver excellence.

The #1 Killer of Momentum?  Stopping What Works

I’ve seen it repeatedly:
Q: “What were you doing when patient numbers were high?”
A:

  • “We sent newsletters.” → Not anymore.
  • “We called new patients post-visit.” → Nope.
  • “We did thorough financial consultations.” → Are you kidding? No!”

Stopping proven tactics = death by roller coaster.
You lose trust, momentum, and the systems that made it effortless.

Your Fix: The Recurring Marketing Checklist

Discipline is hard—but checklists make it stick. Systems atrophy without them.

Monthly Discipline Hack:

  1. List your top 10 internal + external marketing actions (70–80% of your total efforts).
  2. Assign ownership to your manager.
  3. Review at every staff meeting.
  4. Grade % completed—full accountability.

Layer In: Special Promotions

With recurring actions locked in, plan 2–3 months ahead for:

  • Facebook ads with a partner
  • Food drive with a local pantry (especially needed now)
  • Health talk at a yoga studio

Deliverable:Monthly Marketing Planner
→ % of recurring actions completed
→ # of special promotions scheduled

Let’s Make 2026 Your **Best Ever**

Download Free Tools:[LINK]
— Ed

“What’s Wrong with a Chiropractic and Healthcare Personality Practice, He Asked?”

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a group of women sitting at a chiropractic vendor booth waiting for potential clients to stop by and visitJust wrapped up an outstanding chiropractic convention put on by the Wisconsin Chiropractic Society here, you guessed it, in Wisconsin!

We enjoyed catching up with old friends, some we’ve known for decades. And making new friends.

For more on the Convention, you can check out our Facebook site, link below.

Personality Practice

While I was out listening to a presentation, I was told that a doctor dropped by the booth and asked about my book, The Goal Driven Business. He was told that it was about how to improve profits and outcomes by shifting from a personality-driven practice to one that was goal-driven. He felt that the personality practice was better.

I am sorry I wasn’t there to explain more – and hopefully he is reading this email.

Let me explain: A Personality Driven practice is propelled by the doctor’s behavior – their feelings, attitudes, and habits. What they personally do.

When opening a new office, the new business owner, of course, builds their new business on their behavior. It is their ambitious determination that is driving the initial growth of the practice. So, yes, a Personality Driven practice works at the launch of a new endeavor. What else is there? A dream, and the raw desire to manifest it.

So, the Personality-Driven practice works — at first.

However, after the practice is up and running, it needs to transition into a Goal Driven and systematized business.

The concept of a systematized business was hugely popular in the 1980s, thanks to Michael Gerber’s book, The E-Myth. In it, he says:

“The system runs the business. The people run the system.”

B. J. Palmer said something similar, much earlier. And he built a school that many of you may have attended. In his book, Up From Below the Bottom, he says:

“The size of a chiropractor’s business depends upon:

1st – His ability to notify people who he is, what he is, and where.

2nd – His systematization to take care of it as it grows and increases in volume.”

Gerber comically explains what happens when you don’t have systems running your business.

“If your business depends on you, you don’t own a business—you have a job. And it’s the worst job in the world because you’re working for a lunatic!”

–Making the Shift from Personality Driven to Goal Driven–

Making the SHIFT from a Personality Practice to a Goal Driven business is not easy. This is because you have established survival habits that have shown you that the practice depends on you, your feelings, attitudes, and overall behavior. You are the doctor, after all. You see the practice as DOCTOR-CENTERED.

A better approach, I recommend, is to keep it GOAL-CENTERED.

There are two echelons of goals to consider:

  1. Higher goals, including your purpose and “why.” This is your North Star.
  2. Practical goals, or outcomes. For example, you could have front desk goals (percentage of appointments kept), Billing and Collections goals (percentage of collections), and marketing goals (new patients and returning patients), and patient goals (patient completing tx program with an excellent review.)

Get your team on board with these goals. If you do, they can now help you put together the best approach to achieve your goals. These are the systems.

So: Personality Practice – YES! When starting a new business.

But once it is running, NO. Gradually back out and put in place goals and systems. And train your people on these.

For more details, read The Goal Driven Business.

If you want help with this, contact me. I’d love to help. (Been doing this for a while, so lots of tips!)

Services@pmaworks.com

Stay Goal Driven. Stay Free!

Ed

Photos of us and our friends at the Chiropractic Society of Wisconsin Fall Experience

Why Clear Roles Build a Stronger Chiropractic & Healthcare Practice

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team players wearing staff hats front desk billing promotion marketing

Better teamwork, smoother operations, and improved patient care all start with clarity.

Years ago, I visited a chiropractic office where the doctor was frustrated: patients weren’t keeping appointments, and he blamed his front desk staff, “Sue.” The problem wasn’t effort—Sue was polite and friendly—but she had no clear job description, no checklist, and no real understanding of her responsibilities.

Once we clarified her role, outlined simple procedures, and scheduled regular reviews, the practice quickly improved. Patients kept their appointments, and both the doctor and Sue felt more confident and motivated.

This is a common issue: when roles are vague, results suffer. But when roles are clear, teams thrive.

—

The Three Elements of Every Role

According to the Goal Driven System, each role should include:

  1. Purpose – Why the role exists.
  2. Outcome – The measurable result it should achieve.
  3. Procedures – The specific actions to reach the outcome.

Example – Front Desk Role:

  • Purpose: Help patients achieve health goals by ensuring they stay on schedule.
  • Outcome: Patients consistently keeping appointments.
  • Procedures:
    • Greet every patient with a smile.
    • Answer the phone warmly.
    • Confirm each patient leaves with their next appointment scheduled.

—

 Action Steps for Your Practice

  1. Have every team member list their roles.
  2. Define the purpose, outcome, and 5–10 key procedures for each.
  3. Add measurable indicators (e.g., % kept appointments, total visits).
  4. Review and rehearse roles regularly, just like a winning sports team practices.

Clear roles create accountability, boost morale, and drive better patient care. Keep it simple, keep it consistent, and keep it fun.

Stay Goal Driven,

Ed

Want More New Patients in Your Chiropractic or Healthcare Practice? Start Here.

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chiropractic team going over stats to improve care and service

Most doctors think the first step to getting more new patients is marketing. But that’s not always true.

Years ago, a large chiropractic office asked for help because their new patient numbers were slipping. After analyzing their situation, it was clear their promotions were weak—but the real problem went deeper.

The senior doctor, in practice for 20+ years, had become bored. Patient visits felt routine. Long-time staff were stuck in old habits. Meanwhile, the two younger doctors had enthusiasm but lacked confidence and experience.

We started by focusing on quality of care, not ads. The senior doctor began coaching the new doctors on cases and patient communication. Staff refreshed their service procedures and rehearsed ways to create a stronger patient experience.

The result? Without launching a single new promotion, new patients and visits went up. Only after that did we create a marketing calendar—because now they had something truly worth promoting.

The Lesson

Before you spend time and money on external promotions, make sure your practice delivers the kind of care that inspires patients to return and refer. Quality care and continuous improvement are the foundation of real growth.

As Stephen Covey said, “Sharpen the Saw”—renewal and improvement keep the drive alive.

Stay Goal Driven

Ed

Read the full article here: Goal Driven Blog

Ask Lisa:What’s up with BCBS and Therapies Reimbursement?

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Within the last two years, Blue Cross Blue Shield started requiring precertification (precert or pre-auth) on select plans for therapy codes. This came about because by Insurance Equality law they can’t require precertification for chiropractic services 98940, 41, 42, and 43, so they got around that by requiring it for many therapy codes regardless of the provider type.

If you call to verify coverage for “chiropractic”, the customer service representative (CSR) may tell you that there is no precert required for chiropractic. They may or may not understand that they have separate precerts for physical therapy codes. You’ll need to give the CSR the specific codes you want verified for coverage and limits.  You can also verify benefits and usually are able to request authorization for therapies using Availity: https://www.availity.com/providers/

Specific Claim Tips for billing BCBS: 

1)  Qualifier 431: Make sure you are entering in Box 14 OR 15, the 431 qualifier to indicate onset date within a treatment plan.

2)  Taxonomy code for chiropractic, which is 111N00000X, in Box 33. Some states’ BCBS plans require the use of a ZZ prefix before the taxonomy. Please ask when verifying benefits with your patient’s state plan what their billing requirements are. For example, is the ZZ required in front of the taxonomy code? You can add the taxonomy code for specific payers by going into your Maintenance application in your practice management software, and once added to the payer information, it will automatically generate the claim form with this information defaulted.

3)  Modifiers: I understand some of you are using XS GP for therapies and are getting paid. Great! But use this with caution. The XS modifier indicates a separate and distinct service done by a different provider than the one billing under. Better to use GP and 59 for accurate billing if one licensed provider did the therapy and chiropractic adjustment. Your 59 modifier indicates a separate, distinct service but does not distinguish between providers.

What about 98940-98941-98942? For your Medicare Advantage plan patients, make sure to use AT modifier indicating the treatment was active care vs. maintenance/supportive. BCBS usually will not pay for the GA modifier use indicating maintenance/supportive care services were provided. You’ll want to advise the patient ahead of time they will be financially responsible for their maintenance/supportive care, while presenting your cash options or packages offered. Use AT when billing BCBS Medicaid plans, all states, while the patient is under a care plan.

Where are the preauthorization requirements headed?

Here’s a recent (June 2025) article from Blue Cross Blue Shield regarding precertification requirements going forward:  BCBS News

Here’s what it states: 

“Reducing prior authorizations:

BCBS companies routinely review their prior authorization requirements, and many have taken steps to reduce the volume of prior authorization requirements in recent years. We will build on these efforts and commit to reduce in-network prior authorization for medical services as appropriate for the local market each plan serves with demonstrated reductions by Jan. 1, 2026.”

Reach out to us lisa@pmaworks.com or dave@pmaworks.com, and we can give more “boots on the ground” info for your specific state.

Lisa

920-334-4561

Please share this newsletter with your colleagues so they may benefit from this information too!

Preventing Procedural Atrophy in Your Practice

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eroded asphalt highway

In any business, routines and procedures can slowly be shortened, skipped, or abandoned. When this happens, quality slips, and the practice begins to decline. I call this Procedural Atrophy, a key concept from The Goal Driven Business.

When results falter, doctors often try new approaches. These may work temporarily, but without consistent systems, the same decline sets in again. This creates the Practice Roller Coaster—a cycle driven more by personality than by clear goals and structure.

Think back to what you did when your practice was thriving. Did you call new patients after their first visit? Hold morning team huddles? Run patient education classes, progress exams, or referral drives? Chances are, when numbers dip, it’s because those proven actions have slipped away. The solution is often simple: return to what worked before.

 Solution 1: Set the Standard – Quality

Stand out in a noisy world by being consistent and excellent. Define exactly what a successful patient outcome looks like—for example, a patient who pays, stays, refers, feels healthier, understands their care, and is happy with their results.

Then, create brief checklists that outline the essential procedures needed to achieve this. Examples include:

  • Day 1, Day 2, and ongoing patient steps
  • Collections
  • Internal and external marketing
  • Team communication and coordination
  • Leadership and management

These checklists keep your practice systematic, repeatable, and reliable.

 Solution 2: Accountability Reviews

Consistency requires feedback. Use monthly statistics, chart trends, and review them with your team or a coach. This ensures everyone stays focused and motivated. Just like in life, accountability keeps us on track.

—

Bottom line: What you provide for your patients, team, and community is valuable. Don’t let your practice erode through neglect of the basics. Stay consistent, keep improving, and remain Goal Driven.

Ed

Scripts are Secondary in Your Chiropractic and Healthcare Practice

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female chiropractor discussing care plan with patient

Why Scripting Can Fail—and How to Make It Work

A script is a prepared set of phrases, questions, or responses designed to guide staff or doctors in patient interactions. Whether word-for-word or just an outline, scripts help keep communication consistent, especially for new team members. But even the best script can flop if it’s missing one thing—authentic human connection.

Connection Comes Before Words

Think of connection like a radio signal. A carrier wave must exist before any music or voice can be transmitted. Without it, nothing gets through. In patient care, that “carrier wave” is trust and genuine interest. If it’s missing, your words—no matter how polished—won’t land.

I once had a doctor greet me after a minor surgery with a cheerful, “I can’t tell you even had it done!” It was a nice line, but it felt canned. The delivery lacked authenticity, so the message didn’t connect.

How to Create the “Carrier Wave”

  • Be authentic – Avoid sounding rehearsed.
  • Be curious – Take a few extra seconds to ask a follow-up question.
  • Recognize the person – Make patients feel valued and respected.

When you connect first, your scripted lines gain power and meaning. Without it, patients may feel unheard, leading to fewer new-patient conversions, lower follow-through, and less word-of-mouth.

Using Scripts Effectively

  • Review and practice scripts every couple of months.
  • Role-play different delivery styles (bored, overexcited, glum) to sharpen awareness.
  • Use scripts to keep patient conversations moving forward, not to replace genuine interest.

Bottom line: Scripts are useful tools—but they only work if you first connect with the human being in front of you.

For more helpful business tips visit our Goal Driver Blog [LINK]

Ed

Coaching Your Chiropractic and Healthcare Patients

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Consider adding this to your Report of Findings

 

“Mrs. Jones, it will take 3 things to get better.”

Many, many years ago, I heard this from an extraordinarily successful chiropractic doctor. He invited me to observe him discuss this in a report of findings with one of his patients.

I sat on the side, next to his knee-chest table, and with the patient’s permission, observed, paid attention.

The first part of the report was typical: a review of the findings, an explanation of the condition, a treatment plan, and a description of the potential consequences of not treating the condition.

Pretty standard, even now.

Then, he told the patient: “Mrs. Jones, it will take 3 things to get better: Time. Repetition. Effort.”

He then went over each point. For example, it is obvious that it takes time to improve anything. It also requires repeated applications, such as painting a house, cleaning out a garage, or watering a garden.

But the last element he emphasized: Effort.

Any improvement takes work, he said, and gave examples. These included activities such as performing home exercises to improve their condition, attending a class on spinal fitness, and simply making it to the office to maintain their schedule.

He was an athletic doctor, and I believe this influenced his approach. He was coaching his patient, much like an athletic coach would motivate a player.

Yes, you are a well-educated, skilled, and caring doctor. But consider your role as a coach as well. You want to get your patient, as a “player,” to improve, and you know what it takes. You want them to win. So – you tell them!

They have a responsibility, just as you do. Seek your patient’s agreement on these three ingredients for a successful course of treatment, and remind them at approximately every 6 visits.

I have seen this work. It also applies to all aspects of our lives whenever we want to improve something.

In fact, I remind the offices we work with that these are the 3 factors needed to improve their business.

Educate your patients. But coach your chiropractic and healthcare patients on what it takes to get better, and that is:

  • Time
  • Repetition, and
  • Effort.

Keep caring, coaching, and stay Goal Driven.

Ed

Should Old Acquaintances Be Forgotten in Your Chiropractic and Healthcare Practice?

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Tips for Your Patient Newsletter

Your healthcare practice is built on relationships, sustained through service and communication. Without ongoing patient engagement—active or inactive—your practice may struggle. A newsletter is a powerful, affordable way to maintain these connections, extending your office’s warmth, excellent care, and positive outcomes to patients’ homes.

A well-crafted newsletter keeps the doctor-patient dialogue alive, portraying your office as a friendly, health-focused space. It drives retention, encourages referrals, and serves as a low-cost marketing tool. While often overlooked or outsourced to generic pamphlet companies, a newsletter’s impact lies in its authenticity and simplicity.

Crafting a great newsletter requires some skill, but the key is to just do it! Here are practical tips to make it effective:

  • Keep it concise: Aim for under 600 words. Include a brief doctor’s note, a health tip, a simple recipe, and a promotion.
  • Make it personal: Write as if chatting with a patient during a visit. Share a story, case success, or health advice like recommending a lumbar cushion. Have a staff member transcribe your thoughts, then edit for clarity.
  • Stay informal: Think of it as a casual check-in, like catching up with a friend or neighbor. Share what’s happening at the office in a warm, relatable tone.
  • Show genuine interest: Highlight your passion for chiropractic care through patient success stories or testimonials. Include family and friends in your outreach to broaden the connection.
  • Be authentic: Avoid generic or overly polished content. Patients value real, heartfelt communication over artificial or spammy material.
  • Frequency: Send monthly, though more often is fine if manageable.
  • Assign a coordinator: Delegate newsletter management to a staff member to ensure consistency.

Newsletter Checklist:

  1. Doctor’s Letter: A friendly note with a photo, written to one patient, tying into a case, event, or health tip.
  2. Office News: Share updates like new equipment, staff achievements, or recent seminars.
  3. Upcoming Events: Promote events like Patient Appreciation Day or a community 5K to show your office is vibrant.
  4. Patient Testimonial: Include a written or video success story.
  5. Recipe: Share a healthy, relatable recipe with a personal touch, like a family favorite.
  6. Health Tip (Optional): Offer a simple, relevant health suggestion.
  7. Use an Email Service: Avoid sending from personal email clients for professionalism.

Keep communicating with your patients to foster a thriving practice. Stay goal-driven!

Ed

He walked away when I asked, “Who is going to do it?”

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distressed overwhelmed male business man When you are the bottleneck

Many years ago, I attended a large chiropractic conference. I was new to the profession and curious about how things worked.

One of the seminars at the conference was on how to generate new patients. There must have been several hundred in the room. The speaker was charismatic and had some sensible recommendations. The audience seemed enthused.

I was sitting in the back of the room. When the seminar was over, I was one of the first to leave and walk into the hallway where attendees began to cluster to discuss the presentation.

I remember one doctor in particular. He was tall and had his name tag with ribbons hanging down. I didn’t understand what the ribbons meant, but I figured he must have been important.

I asked him how he liked the seminar. He was deliberate, almost authoritative when he said that he liked it and was going to implement some marketing projects. I told him that I thought that was good.

But then, thinking about it, I asked him, “Who in your office is going to do it?”

I remember him looking down at me. He seemed perturbed, as if I had insulted him. He looked up and walked away. Didn’t say a word.

I’ll never forget it.

This was a long time ago, but it made an impression on me.

REMEMBER THE OLD MAXIM
“Do what you do best, and delegate all the rest.”

You can’t do it all.

In the beginning, when starting and growing your practice, yes, you pretty much had to do most everything.

But at some point, you must create other team members who are trained and motivated to share the load. I know practice owners know this, but it’s easier said than done.

This is why a manager is so vital to your practice. Your manager is the fulcrum point that helps you make a team. They are a servant to the team — as you are to your patients.

They help put in the systems that allow all your internal and external marketing procedures to be effective. And not just marketing. Standard procedures for patient retention, patient services, patient reimbursement, and so on.

They take the load off of you, so you are not the bottleneck!

We’ve found that most staff and managers are very willing and want to help their offices grow. But in most cases, they are not sure how, or how best to work with their team, or their doctor.

It is because of this we have developed our Practice MBA program.

Take time each week to train your team.

And for some of you, our manager training program is just what you need to answer the question,

“Who is going to do it?”

Stay Goal Driven,

Ed

P.S. Get on our Waitlist today to ensure you get a spot. First come first serve. Only 15 spots available this fall.  [LINK]

Should You Scale Your Chiropractic or Healthcare Practice?

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chiropractic scaling graph

Scaling a chiropractic or healthcare practice involves more than just growth—it’s about achieving exponential progress through strategic systems. Unlike linear business growth, scaling leverages economies of scale, scope, learning, digitalization, and networking effects to accelerate success.

Key factors include reducing overhead, adding services carefully, improving skills through experience, and using efficient software.

However, scaling requires a solid leadership and management structure to avoid pitfalls like the “Practice Roller Coaster.” Whether aiming to expand one office, add doctors, or prepare for a sale, scaling can drive your goals. Specialized training on scaling will be part of an updated MBA program this fall.

Key Points:

  • Scaling vs. Growth: Scaling is geometric, not linear, leading to faster growth as you expand.
  • Critical Elements: Economies of scale, scope, learning, digital tools, and networking effects fuel scaling.
  • Foundation Needed: Agile leadership and management are essential to avoid instability.
  • Applications: Scaling suits single or multi-doctor offices and can prepare a business for sale.
  • Next Steps: Upcoming MBA training will cover scaling strategies.

Please let me know if you’re interested in this fascinating subject.

Meanwhile…

Help others achieve their goals!

Ed

For more details, contact Ed Petty, the author of the Goal Driven Business and founder of the Goal Driven MBA Program.

Read more about scaling here:  https://www.goaldriven.com/post/should-you-scale-your-chiropractic-healthcare-practice

Streamlining Patient Flow for Better Service Capacity in Your Chiropractic and Healthcare Practice

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team meeting strategy planning for good setting good goals

A well-designed patient pathway enhances patient experience and increases a practice’s capacity by optimizing scheduling and treatment efficiency. Drawing from Eli Goldratt’s The Goal and the Theory of Constraints, identifying and resolving bottlenecks—such as delayed doctor’s notes, overwhelmed front desk staff, or unclear patient billing—can significantly improve patient flow. Common issues include administrative burdens at the front desk and patient confusion over charges, which can lead to missed appointments.

To address this, practices should map out key patient interactions (e.g., Day 1, Day 2, and Day 12) with the entire team, creating a clear flow chart of actions like payments, doctor visits, therapy, and financial consultations. Rehearsing this flow, like a sports team or musical group, helps identify redundancies or missing steps, ensuring a smooth, efficient process. This patient train follows a predictable track, helping patients understand their treatment plan and stay committed to their health goals.

By regularly reviewing and refining this pathway, practices can maximize capacity—potentially handling 40-70 daily visits plus 2-4 new patients—while improving patient satisfaction. Working on the business in this way keeps operations streamlined, helping patients achieve better health outcomes faster.

Be a Goalineer(sm) and keep your practice on track!

Read the full article online [LINK]

Ed

PS Want help with this? Contact me  If you have any questions about creating a Goal Driven Business, just schedule a call or reply to this email.

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For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book,

The Goal Driven Business at www.GoalDriven.com

What Do You Stand For In Your Chiropractic and Healthcare Practice?”

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grandfather and grandmother reading a book to a toddler and coddling another

In your chiropractic and health practice, it’s not what you do, it’s why you do it.

In chiropractic and healthcare practices, defining your brand hinges on your “Why”—the core purpose or passion driving your work, as emphasized by Simon Sinek’s Golden Circle concept.

While most can explain what they do and some how they do it, articulating why you do it sets you apart and inspires others.

Your “Why” stems from deep motivations like justice, love, or curiosity, not just analytics. To build a strong brand, identify what makes your practice unique compared to competitors, as Roy Spence suggests in It’s Not What You Sell, It’s What You Stand For.

Know your patients, yourself, and your competition to highlight what you offer that others can’t. Stay connected to your purpose to avoid burnout, as Jon Gordon notes, and boldly define and discuss your unique qualities with your team regularly to maintain a distinctive, meaningful brand.

Jump here to read the Goal Driven Newsletter in it’s entirety.  [LINK]

Ed

References:

* Virgil, a Roman poet, 19 B.C.
Simon Sinek – Golden Circle

Using offline and online tactics to grow your chiropractic practice

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Grow Your Chiropractic Practice with Online and Offline Strategies

Many chiropractic offices see success with online advertising, especially on social media. While effective, it often requires digital expertise, so many chiropractors hire agencies—some with better results than others. If you’ve worked with a good agency, sharing your recommendation could help others.

Online promotion isn’t new to chiropractic. B.J. Palmer, one of the profession’s pioneers, was a relentless advertiser who played a major role in chiropractic’s growth during the early 20th century. His legacy reminds us that consistent promotion is key.

However, in today’s tech-saturated world, offline engagement is more valuable than ever. Creating relationships with patients is critical. The relationship business in a chiropractic office revolves around building trust, fostering patient loyalty, and creating a community that supports long-term engagement and referrals. Chiropractic care is inherently personal, as it involves hands-on treatment and addressing patients’ pain, mobility, and wellness goals. The success of a chiropractic practice often hinges on strong relationships with patients, staff, and the broader community.

Your practice is essentially a network of relationships, sustained through communication and service. So:

  • Nurture current and past patient relationships
  • Use those to expand to new connections

Some effective offline tactics include:

  • Sending personal email newsletters with stories, health tips, and a touch of personality
  • Hosting in-office events (e.g., Mother’s Day giveaways or posture screenings for National Correct Posture Month)
  • Organizing a patient appreciation picnic or monthly spinal health talks
  • Visiting local businesses to give brief wellness presentations
  • Setting up a booth at local fairs for visibility and patient reactivation

Combining digital and personal outreach creates a powerful, sustainable marketing strategy. As Woody Allen once said, “80 percent of success is showing up.”

“80 percent of success is showing up” (Woody Allen)

Stay Goal Driven,

Ed

References:

*(B.J. Palmer, Achievers Magazine, 1989)
*Brad Glowaki
*(Woody Allen (Quote Investigator)

How Steve Jobs’ Vision Can Transform Your Chiropractic Practice Learning from Visionary Success

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steve jobs

Apple, founded by Steve Jobs in 1976, is now the world’s most valuable company, with a market capitalization of $2.9 trillion and $54 billion in cash reserves. But in 1997, Apple was on the brink of bankruptcy. Jobs’ strategic overhaul turned it around, offering lessons for chiropractic and healthcare practices.

In a 1997 interview, Jobs shared a key insight: “If you do the right things on the top line, the bottom line will follow.” He emphasized that a clear strategy, passionate people, and a strong culture drive quality products, marketing, and operations—ultimately boosting profitability. For chiropractors, this means focusing on vision and values to achieve sustainable success.

The Top Line: Your Practice’s Foundation

Your “top line” is your practice’s vision, values, purpose, and the team that embraces them. When these are aligned, marketing, procedures, patient outcomes, and profits follow naturally.

Top-to-Bottom Framework:

  • Top Line: Vision, values, purpose, mission
  • Almost Top Line: A team aligned with these principles
  • Middle Line: Policies and procedures
  • Almost Bottom Line: Patient outcomes
  • Bottom Line: Net income

Focusing on the top line creates a “vision-driven” practice, much like Jobs’ approach at Apple.

Insights from a Chiropractic Leader

A seasoned chiropractor recently shared a video on social media, responding to a colleague concerned about high practice expenses. He identified the biggest cost: an “under-trained” team. His solution? Hiring passionate individuals and training them not just in chiropractic techniques but in the practice’s “why”—its purpose, mission, and vision. Team members who didn’t fully align were let go. The result? A thriving practice.

When I commented that his success stemmed from his own clear “why,” he agreed: “It all starts from the inside out. If the doctor has a big WHY and can teach it, the team will follow.”

Sustaining Your Vision

Keeping your practice’s values alive requires ongoing effort. It begins with your example as the leader and continues through consistent team coaching. In our MBA program, we explore proven strategies to maintain this focus, from vision to execution.

Apple’s Core Value and Your Practice

In 1997, Jobs defined Apple’s core value: “We believe people with passion can change the world for the better.” This resonates with top healthcare practices, where passion for patient care drives impact.

Does your practice reflect this passion? A clear vision, a dedicated team, and consistent coaching can transform your chiropractic business, just as Jobs transformed Apple.

Stay Goal Driven.

Ed

Momentum Magic: How the Flywheel Effect Boosts Your Chiropractic Practice and Service Business

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flywheel effect

What separates good businesses from great ones?

It’s momentum—created by doing what works consistently and improving it over time. In business, especially in healthcare services like chiropractic, success often comes not from radical change but from steady, thoughtful progress.

Avoid the Trap of Constant Change

Healthcare entrepreneurs often seek out the next big thing—new therapies, machines, or procedures. While innovation can be beneficial, abrupt changes to proven systems can disrupt staff and confuse patients. A smarter approach is to test new ideas first, and only implement them if they complement what’s already working.

“If something works—fix it, refine it, but don’t toss it.”

The Flywheel Analogy

Jim Collins, in Good to Great, uses the image of a massive flywheel to illustrate how lasting success is built. At first, it takes immense effort to turn. But with consistent effort in the same direction, the wheel picks up speed and begins to turn on its own—powered by its own momentum.

The key lesson: there’s no single breakthrough moment—just consistent, focused effort over time.

How This Applies to Your Practice

  • Identify what’s working—and keep doing it.
  • Make small, strategic improvements over time.
  • Adapt to market changes gradually and intentionally.
  • Build systems that generate results with less effort over time.

By steadily turning your business flywheel, you’ll transform your practice from good to great—creating a self-sustaining engine of growth.

Keep building. Keep refining. Momentum will do the rest.

Ed

Boosting Service and Retention Through Daily Case Management in Chiropractic Practices

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planning for a winning dayStart the Day with Purpose

A quick, structured case management meeting each morning can significantly enhance patient retention, referrals, service quality, and team morale.

The Morning Case Management Routine

Spend 20 minutes before seeing patients to meet with your team. Review the day’s patient schedule—focusing on individual needs, progress, or concerns. You don’t have to cover every patient, especially on busy days, but focus on those needing special attention.

Key points to discuss:

  • What’s the goal of today’s visit?
  • Do they need therapy, rehab, or a progress exam?
  • Have they voiced any concerns?
  • Do they need educational materials or financial consultations?
  • Should a family member attend?

Also, go over new patients—who referred them, what to expect, and how to create a warm welcome.

Keep the Energy Up

Beyond planning, these meetings set a positive tone for the day. Encourage team bonding with short activities like stretches, planks, or even a daily “bad dad joke” to keep things light.

Set achievable goals for the day—such as new patient intakes or completed cases—and review a motivational quote or revisit your practice’s core mission.

Make It Routine, Make It Stick

Assign responsibility for leading the meeting, but ensure it has leadership support. These meetings only work if they happen consistently—don’t let them fade away.

Ultimately, the purpose is to better serve patients and help them reach their health goals—this is what great case management is all about.

Seize the future!

Ed

Master Your Craft First: The Key to Success in Chiropractic, Healthcare, and Service Businesses

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chef Jiro Ono, mastering the skill of making sushi

Marketing Starts with Service Quality

A chiropractic clinic once asked for help boosting patient numbers and improving their marketing. While we did touch on marketing strategies, the real game-changer was getting back to the basics—refining the way they practiced.

Each visit, we reviewed patient interactions, discussed specific cases, and role-played challenging scenarios. This hands-on, continuous learning approach helped the doctors improve their confidence and communication. The result? Within a few months, new patient numbers nearly doubled, and total visits increased by 50%, driven by better retention and reactivations.

When Business Slows Down, Go Back to the Fundamentals

If your numbers are dipping, the first step isn’t better marketing—it’s better service. Start with yourself and your team. Are you genuinely present with each patient? Do you “really” listen and connect?

One of the most successful doctors I worked with approached every patient with deep empathy and curiosity. She didn’t rush into treatment—she listened, observed, and connected both emotionally and physically. Her retention and referrals were outstanding.

On the other hand, her associate, while friendly, lacked that same depth of connection. As a result, her performance—and the clinic’s growth—suffered. Unfortunately, without proper training or mentorship, her skills never reached the necessary level.

Excellence Is Contagious

Great service isn’t just about the doctor. Every team member needs to be aligned in delivering exceptional care. It’s a group effort.

Consider sushi master “Jiro Ono”, whose small Tokyo restaurant had a waitlist over a year long. He dedicated his life to perfecting every element of sushi, constantly refining and improving. His commitment to excellence became his best marketing tool.

As Jiro said: “You must immerse yourself in your work. You have to fall in love with your work. That’s the secret of success.”

The Takeaway

Before pouring energy into marketing tactics, ask yourself: “Have I mastered my craft? Are my team and I truly delivering top-tier care?”

A good business, like a good restaurant, eventually fills itself up—because mastery, presence, and consistent quality attract people naturally.

Keep mastering your skill

Ed