The Big Practice Barrier: Overcoming Growth Challenges in Chiropractic and Health Businesses

chasm between service and net income

Many practice owners aspire to run million-dollar or multimillion-dollar businesses, but they often face barriers that hinder growth. Despite working hard, many practice owners struggle to achieve the financial success they desire.

 The Core Barrier to Practice Growth

In The Millionaire Next Door by Stanley and Danko, the authors highlight that self-employed individuals are more likely to become millionaires than employees. As chiropractic and health business owners, financial success should be a natural outcome—but it isn’t always the case.

While it may seem like poor revenue stems from lack of new patients, poor retention, inadequate equipment, or economic factors, these are just symptoms of a deeper issue. The real barrier to growth is the **Practice Dilemma**—the challenge of providing excellent patient care while managing a growing business.

The Practice Dilemma

New practices typically don’t face this dilemma because they operate at low capacity. But as your practice grows and reaches 60-70% capacity, balancing high-quality service with the administrative and marketing tasks becomes increasingly difficult. The business requires both leadership and management, but most practice owners struggle to bridge the gap between providing top-notch service and handling business operations.

The primary reason many practice owners don’t become millionaires is their inability to balance quality service with effective business leadership.

 The Solution: The Fast Flow CEO Systemsm

The Fast Flow CEO System (FFCEO) offers a solution to the Practice Dilemma. It allows practice owners to manage their growing business while continuing to deliver world-class service. The FFCEO system divides leadership and management functions between the CEO (the practice owner) and a trained manager.

The **Practice MBA** program trains a trusted employee to handle management tasks, while the business owner focuses on key leadership responsibilities. This system follows the **Pareto Principle**, which suggests that 20% of your efforts yield 80% of the results. By empowering a trained manager to handle most of the operational duties, the CEO can stay focused on patient care and strategic decisions.

 Why Management Training Matters

There is a noticeable lack of management training programs for chiropractic and health business managers. Effective growth requires expert leadership and management, combined with excellent patient care. The FFCEO system enables the doctor to focus on their expertise while a trained manager handles day-to-day operations, bridging the gap between service and business leadership.

Conclusion

If you’re ready to scale your practice and achieve financial success, consider the **Fast Flow CEO System** and the **Practice MBA program**. This approach will allow you to lead effectively while maintaining high-quality care. Take the steps today to ensure your practice’s future success.

Seize Your Future

Ed

The Next Generation of Chiropractic and Healthcare Practice Development: Growing Your Practice from the Inside Out

it's the manager book cover by clifton and harter

To grow a successful chiropractic practice, there are four key principles that can help improve both your practice and business. These principles are based on years of experience working with doctors and staff in the field.

1. Practice Success Depends on Two Key Factors

  • Quality clinical outcomes: Delivering effective results for your patients.
  • Quality support: Ensuring your practice has the infrastructure and administrative help to maintain and grow.

While excellent results are critical, support is equally important. As your practice grows, administrative demands increase, and these are often overlooked. The key is balancing patient care with behind-the-scenes tasks like scheduling, billing, staff management, marketing, and more. Without proper support, your clinical focus can be distracted.

Remember: It’s not chiropractic that slows you down—it’s everything else!

2. Better Support Leads to More and Better Services, Resulting in Increased Revenue

The equation is simple:  Improving the support for your practice will enhance both the quality and quantity of services provided. With increased and improved services, your revenue will naturally rise. It’s a logical and proven cycle.

3. Better Management Leads to Stronger Practice Performance

Studies show that the most successful practices often have someone in a managerial role, even if they’re not fully trained. These offices tend to have higher and more stable production. The best business owners understand the importance of having a manager, even if they’re still training them.

4. Gallup’s Insight: Management is Key to Long-Term Success

Gallup, a global analytics company, confirms the importance of good management. In their book *It’s the Manager*, they state that **the quality of managers and team leaders is the single most important factor in long-term organizational success. This underscores how critical it is to invest in strong management.

Enter the Goal-Driven Practice MBA

Based on these insights, a new program was created to train chiropractic managers: the Goal-Driven Practice MBA. This program focuses on improving the support system within your practice to enhance both patient care and practice performance. If you’re interested in a personalized training program for your practice, the next session starts in April. Only 10 offices are accepted, ensuring a highly tailored experience.

If you’re interested, contact Linda, the program coordinator, to discuss whether it’s the right fit for your practice.

Seize the Future: Take action now to elevate your practice.

Ed

The “New Will of the World” Chiropractic and Natural Health Care.

smiling female gardener with a box of fresh tomatoes

The “New Will of the World,” Chiropractic, and Natural Health Care: Embracing Purpose-Driven Change

Gallup, a global analytics company, has identified emerging trends in society through data analysis. One significant trend is the “New Will of the World,” which reflects a shift in social values, including a growing desire for meaningful, purpose-driven work. This trend is influencing both the workplace and health care, where people are seeking more than just a job or pain relief—they’re looking for purpose in their lives.

The “New Will of the World”

This shift involves a broad societal movement towards work and health practices that focus on meaning and personal fulfillment. People—whether in the workplace or as patients—are increasingly searching for deeper connections to their work and well-being.

“Make America Healthy Again” Movement

Coined by Robert F. Kennedy Jr. during his presidential campaign, the “Make America Healthy Again” (MAHA) movement has gained momentum, particularly in the context of promoting chiropractic and natural health care. Kennedy, an advocate for these approaches, has proposed several initiatives:

  • Nutrition and Food Policy: Kennedy focuses on improving nutrition, including revamping the FDA’s oversight of food labeling, limiting ultra-processed foods, and banning harmful additives.
  • Pesticide Reduction: He aims to enforce stricter limits on pesticide use and encourage sustainable farming practices.
  • Revised Dietary Guidelines: Kennedy’s plan is to prioritize whole foods, organic options, and regenerative farming over corporate interests.
  • Support for Small Producers: He pledges to revise regulations to support smaller farmers and create a more level playing field in agriculture.
  • Creating Meaningful Change in Your Practice

Chiropractic offices and health care providers have a unique opportunity to align with this broader movement by offering a work environment and services that reflect purpose and community well-being. You can inspire both your team and patients by adopting the “Make America Healthy Again” ethos. Consider creating local initiatives, such as a “Make [Your Town] Healthy Again” campaign, in collaboration with health food stores, gyms, and local farmers. Hosting workshops, talks, and podcasts can bring the community together while promoting your services.

Engaging Your Team and Community

Your team is seeking more meaningful work, and your patients are looking for more than just pain relief—they desire holistic well-being. By tying your practice to this larger, purpose-driven movement, you can foster a sense of fulfillment and connection with both your staff and the local community. Activities like health-themed workshops or collaborative events with professionals in the community can deepen this mission and benefit everyone involved.

In summary, embracing the “New Will of the World” allows you to create a practice with greater purpose, connecting people to a healthier, more meaningful lifestyle while supporting the growing trend of chiropractic and natural health care.

ED

References and Full Article at [LINK]

He Fired the Chiropractic Assistant When the Stats Went Up

green light for accepting patients

In the article *He Fired the Chiropractic Assistant When the Stats Went Up*, Ed Petty discusses how a positive attitude at the front desk can significantly impact the success of a chiropractic office. He compares busy and struggling offices, noting that busy offices often have a welcoming, “open” attitude, with a motto like “Always room for one more!” These offices focus on getting as many people as possible in for adjustments, creating an atmosphere of openness and enthusiasm. In contrast, less busy offices tend to have more rules and prioritize collections over patient care.

Petty shares a story of an office where the front desk assistant, despite being new to computers, became incredibly enthusiastic after attending a chiropractic seminar. Her attitude transformed, and visit numbers skyrocketed. However, due to computer issues and billing frustrations, the doctor fired her, which resulted in a decline in visits and the eventual loss of an associate. Petty argues that the doctor should have hired someone for data entry, allowing the front desk assistant to continue her work of promoting chiropractic care.

The article emphasizes that the front desk plays a crucial role in driving office volume and that a “high capacity” mindset is essential. Petty encourages chiropractic teams to ask their front desk if they can handle increased patient visits, and similarly, evaluate their own capacity for growth. He concludes with a call to adopt a “Big Capacity” attitude, referencing his book *The Goal Driven Business* and his upcoming Practice MBA program, to help chiropractic offices grow and succeed.

Read the full article here [LINK]

Sign up for Waitlist

The Cobbler’s Children Have No Shoes

shoe cobbler sitting with 4 children telling a story.Are Your Chiropractic Staff on Health Programs?

You may recall the proverb about the cobbler’s children not having shoes, which illustrates how people often neglect their own needs while helping others. This happens in various fields—like a laundromat where the employees wear dirty clothes or a car repair shop with poorly maintained cars.

Recently, many offices we work with have had staff missing work due to illness, which can be costly. As the saying goes, “An ounce of prevention is a pound of cure.” Health should be a core value for your team, something everyone strives for, not just a business mission. It should be like a fun quest—finding ways to get healthier.

Unfortunately, some teams aren’t on health programs or aren’t as informed as they could be. Your staff should be the healthiest and fittest in town, with strong immune systems and natural remedies to boost their health during flu season.

While taking care of patients is a priority, it’s equally important to focus on improving your own team. This includes training your employees to enhance their skills and knowledge of your services. A trained, motivated practice manager can support both your people and your practice.

If you’re interested in having someone trained as your manager, sign up for our waitlist, and I’ll send you details about the upcoming program starting March 31.

In the meantime, encourage your team to start their mornings with planks, Vitamin D, and green drinks—and maybe a little dancing!

Take care of your people, including yourself, and stay goal-driven.

Ed

Read the full article here [LINK]

Sign up for Waitlist

Overcoming the Barrier to Consistent Marketing

4 month marketing calendar The biggest challenge in marketing is inconsistency. There are a few key reasons for this:

  1. No one is in charge of marketing.
  2. Time constraints. Many businesses struggle to find time for marketing.
  3. Uncertainty about how to plan. It can be difficult to know where to start or how to structure marketing efforts.

The Community Education Program addresses these issues, drawing from the experience of managing over 20 offices in Wisconsin. This program provides a clear, actionable framework for marketing your services consistently.

Marketing Principle: Newton’s Third Law

Marketing works like Newton’s Third Law of Motion: for every action, there’s an equal and opposite reaction. This means that when you promote something, you will get a response. By setting up a monthly marketing plan in advance, you ensure something is always going out, even if you add extra activities later.

How the Community Education Program Works

  1. Project Manager: Assign someone (typically the marketing coordinator) to oversee marketing efforts, ensuring everyone is involved.
  2. Central Theme: Select a theme for the upcoming months, focusing on proven marketing tactics and common health concerns your services address.
  3. Targeted Promotions: Tailor your efforts to different groups:
    • Active Patients: Use word-of-mouth, posters, coupons, and workshops.
    • Inactive Patients: Reach out via newsletters and social media to re-engage them.
    • Community Referral Sources: Engage gyms, dentists, and other local professionals with emails, flyers, and direct contact.
    • Non-Patients: Use ads to attract new patients.

Example for a Chiropractic Practice

February: Neuropathy Awareness Month

  • Event: $29 screening exam and consultation.
  • Workshop: “Nature’s Remedies: Six Holistic Approaches to Easing Neuropathy” at your office and senior centers.

Marketing Channels:

  • Active Patients: Posters, coupons, word-of-mouth.
  • Inactive Patients: Success story newsletters.
  • External Referral Sources: Posters at senior healthcare facilities and workshops.
  • Advertising: Social media.

Fun Future Themes

  • March: Kids Health Month – “Leprechaun’s Health Month.”
  • April: Summer Fitness – Include a golf workshop.
  • May: Women’s Health – Focus on pregnancy and new baby care.
  • June: Back Pain Awareness Month.
  • July: Headache Awareness Month.
  • August: Athletics for Kids – Concussion prevention and recovery.

By planning monthly themes in advance, you can ensure consistent marketing, even if other programs are running throughout the year.

Marketing Principle: Quantum Physics

While Newtonian physics explains marketing’s action and reaction, Quantum Physics suggests that we are all connected and that our emotions and energy influence our outcomes. Stay positive, stay energized, and keep a good vibe in your marketing efforts!

How to Avoid the Groundhog Day Syndrome in your Chiropractic Office.

What would you do if you were stuck in one place and everyday was exactly the same, and nothing you did mattered?

Here is a summary of Ed’s weekly Goal Driver Newsletter.  Jump here to read the full article.

The Groundhog Day Syndrome can feel like doing the same thing over and over, with no progress or change—whether it’s handling repetitive tasks or dealing with the same issues at work. This can lead to burnout and a sense of being stuck, much like the movie Groundhog Day, where the main character endlessly relives the same day.

Life is cyclical, and each cycle offers new opportunities for growth, much like levels in a game. If your team is feeling bored, stressed, or stagnant, it might be time to move to the next level.

Here are two strategies to avoid the Groundhog Day Syndrome:

Create a Fun Theme for the Year: Choose a theme that aligns with your mission, such as encouraging fitness or community service, to motivate your team and patients.
Constant Improvement: Regularly evaluate how you can improve services, outcomes, and overall performance. Treat it like a game—always striving to level up.

Start the new year with fresh goals, and embrace growth! Consider enrolling in our Practice MBA program starting March 31, 2025, for further development.

Let’s break the cycle and keep moving forward!

Ed

MBA Program Information[LINK]

 

Ask Lisa: Setting Up Finances With Your Patients

BJ Palmer had a quote: “Chiropractic is health insurance. Premiums small. Dividends large!”

Following this super quote, we have worked with offices for many years schooling them into implementing these mottos:

  • We will accept all patients, regardless of their ability to pay, but we also must operate the clinic as a proprietary business, i.e., for profit, and the patient must want the care–not just “want a discount.”
  • Each case will be individually handled and patients will receive a copy of their financial arrangements.
  • Each patient file will have a copy of the patient’s individual financial arrangements.

How does the successful office achieve these goals?

First, to comply with Centers for Medicare and Medicaid’s No Surprises Act as a covered entity, each patient will have an idea what our range of charges are and that the charges will vary depending on what is done. Explain that the adjustment charges will vary from $XX to $XX, therapies will add $XX to $XX, and exams, diagnostic tests, etc. will add to that. Typically the average office visit will be from $30.00 to $140.00 per visit. This can be shared when the new patient calls in for their first appointment, or placed on your website.

Second, determine if you will be filing claims to insurance, and if patient has a copay or deductible. If there is a financial barrier with co-pays or deductibles, work with the patient during your meeting with them so that the patient does not drop out of care for financial reasons. To stay in compliance, note any waived fees or co-payments on your financial form, indicating why they were waived (no job, too many bills). Alert payment arrangements in your practice software so that the front desk and anyone doing follow-up knows exactly what the patient has agreed to pay each visit.

The patient should already have a good idea after Day 1 from the Report of Findings and the schedule you just worked out with them how many times they will be coming in. Ask the patient if they will have any problem with this and watch the patient to make sure that they will be comfortable with the fees you are presenting (previously calculated prior to meeting with patient).

(These next sections are specific to Wisconsin offices and offer examples. However, if you find this information interesting and you want more information and are outside WI, contact us for further information.)

If you are not filing to insurance, patients are considered self-pay. Let the patient know that they must pay at the time of service for any discount given. To be successful, you cannot reduce your fee while running up patient balances.

Any discount or special fee must be noted on the financial agreements and in the computer. The financial agreement must indicate why there are special discounts given. This can be simply noted in the space provided, such as “patient discount to $30 per visit-financial hardship” or “patient has just started new job-discount given to $30 per visit”. The CA or doctor, and patient, must sign the form.

For self-pay patients who can afford care, are on a routine schedule and show up, in order to give a discount they should be required to prepay, for a package of XX visits, typically with up to a 35% discount.

With the above policies in place, you can help many more people increase their health dividends, removing any financial barriers. Implementing these steps are key to expanding and growing your practice!

If you have any questions regarding financial arrangements and/or insurance please feel free to reach out to me.

Lisa Barnett
920-334-4561
lisa@pmaworks.com

ASK LISA: The Vital Importance of the Post Report & Patient Financial Consultation

Greetings,

In our last two webinars, we discussed the importance of patient financial consultations.

Let’s delve into why they are so important to your bottom line and how you can set them up for success.

First, changes to insurance coverage and managed care have created an environment where third-party reviewers sometimes have more say in your patient’s length of care than you do.

Second, it is important to note that the financial consultation is a part of the overall Post Report. To be successful, all steps below should be reviewed and completed with each patient, whether they are new or re-activating their care. Why a post report?

The purpose of the post report is for the staff to fully address with the patient any obstacles to the patient getting the care they need and to set the patient up for their schedule of care. This includes setting up multiple appointment schedules, emphasizing the importance of staying on the schedule of care, discussing missed appointments, discussing any needed financial arrangements, going over how to check in at future visits, establishing where the patient should turn with questions or problems, and reassuring the patient in their decision to follow through with care.

Before you meet with the patient for the financial consultation, you also have to have a clear understanding of what you want to accomplish with your financial plans for patients. Your plans need to line up with the goals you have in your office and you need to individualize the plans. Do you want a high percentage of cash, wellness patients? An insurance-based family practice? PI or Work Comp acute care rehab practice? Is the patient undergoing a financial hardship? Each has a different set of criteria for tailoring patient financial agreements.

As these become more common, you can increase your patient retention and compliance by offering more OPTIONS for patient payments. Yes, this requires more work and more follow up, but adjusting to changing business practices in the world often require changing your internal procedures and policies. Adapt and offer ways to make care affordable, then promote these options so that patients see there is a way for them to get the care they need at a price they can afford.

Our Motto: Financial Plans are Liberal; Collections Policies Are Not.

This doesn’t mean reducing your fees or giving away services. On the contrary. For example, a new car costs many thousands more than your treatment plan, but auto dealers are adept at showing the customer ways they can drive that car home today.

Standardizing these procedures will ensure that your patients feel well taken care of at the office at all times.

Questions? We can help.

Click HERE for a sample care plan and financial plan template. [LINK]

Does Your Chiropractic Practice Have Team Bonuses?

As a business owner, you want to reward success. Heck, you want to be rewarded for your success as well (at least one of these days! lol) It’s the American Way, right?

But, unfortunately, bonus systems don’t always work and aren’t always fair. Yet, within reason, we still recommend them.

Here are four basic needs and two types of motivation when rewarding employees.

Read the full article here to find out the details:   https://www.goaldriven.com/post/does-your-chiropractic-practice-have-team-bonuses

Improving Your Chiropractic Practice Team Meetings

Team meetings can be very effective at improving the quality and quantity of your services.

At best, they bring everyone into alignment with the goals of the practice. They can release energy that results in sometimes almost magical results. I have seen it!

Here are some key tips for improving chiropractic practice team meetings:

1. Set Clear Goals and Structure

    • Hold weekly meetings, ideally on Mondays to start the week strong
    • Limit meetings to 1 hour maximum
    • Create a consistent agenda covering key areas like practice goals, statistics, department updates, etc

2. Encourage Participation

  • Require all staff to attend and come prepared to participate actively
  • Allow time for each team member to report on their department
  • Create an open forum for discussion and suggestions

3.  Focus on Improvement

  • Review practice statistics and track progress on goals
  • Discuss what’s working well and what needs improvement
  • Develop action plans to address any issues

4. Boost Motivation

  • Start with positive affirmations or recognizing accomplishments
  • Highlight exceptional work by staff members
  • Share patient success stories to reinforce the practice’s mission

5. Maintain Professionalism

  • Avoid criticizing individuals or changing policies during meetings
  • End on a positive, inspirational note
  • Follow up on action items and “to-do” lists from previous meetings

By implementing these strategies, you can transform your team meetings into productive, energizing sessions that align your staff and drive practice growth. Regular, well-run meetings are crucial for improving communication, motivation, and overall practice performance.

Read the full article here:  https://www.goaldriven.com/post/improving-your-chiropractic-practice-team-meetings

========================

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

goal driven business www.goaldriven.com
 

The Goal Driven Business

goal driven business buy now button

The Chiropractic Patient Engagement Scale

group of goal driven patient focused people “The Chiropractic Patient Engagement Scale” outlines the importance of leadership and patient engagement in chiropractic practices. It emphasizes that effective management and leadership are crucial for the success of a practice, as they enable clinic directors to focus on leading rather than being bogged down by administrative tasks. The article highlights the role of leaders in providing trust, compassion, stability, and hope to both staff and patients.

I’ve put together a Leadership Scale that you can you use or make one of your own, and recommend that you review it often. You can go over it with your team and reflect on it – get everyone’s opinion on where the office ranks. You can also have individual doctors, providers, and departments rank themselves in terms of how well they provide leadership from their role.He also shares Fives Levels of Leadership Scale where you can rank your own office

Download the scale and read the full article here:

https://www.goaldriven.com/post/your-leadership-with-your-chiropractic-patients

Ed

========================

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

goal driven business www.goaldriven.com
 

The Goal Driven Business

goal driven business buy now button

Where Is Your Chiropractic Marketing Department?

two business women discussing marketing

Excellent Service in Your Chiropractic Practice is Marketing

Here is a little exercise that can boost your new patients and improve the quality of your patient care. And create a little more excitement in the practice in the bargain.

First, let’s review a couple of wise words about marketing:

1. Jay Levinson, from his book Guerrilla Marketing.

Marketing is everything you do to promote your business, from the moment you conceive of it to the point at which customers buy your product or service and begin to patronize your business on a regular basis. The key words to remember are everything and regular basis.

2. Peter Drucker, Management: Tasks, Responsibilities, Practices (p68)

Marketing is so basic that it cannot be considered a separate function (i.e.,a separate skill or work) within the business, on a par with others such as manufacturing or personnel. Marketing requires separate work, and a distinct group of activities. But it is, first, a central dimension of the entire business. … Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise.

What Levinson says is that marketing is EVERYTHING you do consistently.

Drucker says that while there are specific marketing activities, marketing is too fundamental to have its own department. It is a “central dimension of the entire business.”

Yes, there are specific marketing activities to help your chiropractic and healthcare practice, some of which you delegate to advertisers, such as Internet marketers. Larger offices hire field representatives. I have hired and trained practice marketers who effectively generated new patients from external activities.

However, most of your practice marketing comes from the actions you and each team member take in the office. This is true in ANY business, but especially in chiropractic or smaller independent healthcare offices.

A common misconception is that some vague or distant marketing department or advertising company takes care of marketing and is not a “central dimension” to each person’s job.

Every position in your office has a marketing component. It comes with the role of a team member. Doctor, front desk, billing and patient accounts, therapy, rehab, and anyone who is on the team, is a marketer.

So, where is the marketing department? It’s your entire office! Here are a few marketing activities each team member can do:

  • Be genuinely interested in each patient.
  • Honestly care for how each patient is doing.
  • Do your very best with each patient with Present Time Consciousness.
  • When and if appropriate, invite your patient to bring in a family member or friend for a scheduled consultation or event.
  • Congratulate patients for any success.

Then, there is a list of specific marketing activities you can do: newsy newsletters, internal and external events to the office. You can find many of these suggestions on our blogs.

HEALTHCARE TEAM MEMBER MARKETING EXERCISE

In your team meeting, have each team member present at least two types of marketing actions they can do from their position every day.

Help them with this. If you have time, have your team practice their marketing procedure with each other.

As an added emphasis, consider that now that we are in the world of AI, real-life human interest and live communication is more valuable than ever. Believe it or not, one of your key marketing “niches” is just your plain ol’ non-hyped interest in the other person. Never fake that. In our ever-increasing sterile and digital world that is becoming more robotic, less human, and less spiritual each day, genuine human communication is more valuable than ever.

Don’t ask for where the marketing department is,

For it resides within thee!

Always selling health,

Ed

P.S. By the way, I left out telling jokes as a marketing action! One office up “nort” here in Wisconsin, I swear, generates new patients with the doctor’s Ole and Lena jokes! This may not be appropriate for your office though! (lol)

OLE AND LENA (A favorite!)

Ole and Lena got married.
After a beautiful ceremony and a fun but modest reception, they got in Ole’s car and headed out on their honeymoon.
When they reached Saint Paul, Ole put his hand on Lena’s knee.
Lena said, “Ole, we’re married now. You can go farder den dat.”
So Ole drove to Duluth.

========================

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

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Use the Learning Pyramid for a Better ROI in Your Chiropractic Healthcare Practice

three generations of women cooking in a white kitchen

Don’t complain. Just train

“Over the long run, superior performance depends on superior learning.”
— Peter Senge

As the Clinic Director of your chiropractic and healthcare practice, you instinctively know that if you are not continually improving the service to your patients and potential patients, they will go to practices that are.

In fact, if you do not provide the BEST outcomes and service in your area, patients and potential patients will look for other practices that are the best, or at least better than you.

The BEST health care practice wins in the long run.

So, how do you get to be the best?

By constant improvement!

This was the concept the Japanese pushed in the 1970’s with their cars. They called it Kaizen.

Speaking of Japan, there was a study that showed how many hours employees trained over a 6-month period. Japan spent an average of 364 hours, Europe averaged 178, and the U.S. a paltry 42.* I discuss this more in my book, The Goal Driven Business. (pg 156)

The formula for improvement is simple: study and train.

The purpose and goal of training is improvement. This is why professional athletes and musicians constantly train. They do this for improvement and, ultimately, to bring about a good return on their investment.

Improvement has a definite ROI! A study by the Associate for Talent Development found that companies offering comprehensive training programs have 218% higher income per employee compared to those without formalized training.*

But what are the best methods for training — reading, listening, podcasts, seminars?

USING THE LEARNING PYRAMID TO TRAIN YOUR CHIROPRACTIC TEAM

The Learning Pyramid* illustrates the percentage of knowledge retained through various learning methods. Here are the typical percentages associated with each method:

  1. Lecture: 5%
  2. Reading: 10%
  3. Audio-Visual: 20%
  4. Demonstration: 30%
  5. Discussion: 50%
  6. Practice by Doing: 75%
  7. Teaching Others: 90%

This model emphasizes active participation in the learning process. Teaching others or practicing by doing, leads to higher knowledge retention rates compared to passive methods like listening to lectures or reading.

If you take your team to a seminar, do it for camaraderie and the sense of being part of something bigger. It can be motivational. But then, ensure that they take notes from one of the presentations and then teach it to the rest of the team at the next staff meeting.

Another angle is to have team members select a chapter from a book you all are reading (from your Lending Library!) and then have them teach it to the rest of the team a month later.

Train on your procedures every month. For example, you could demonstrate how you would like a patient to be positioned on a therapy table. (Get it recorded for future reference!) Then, have a staff member demonstrate the procedure back to you. You can also pair people and role-play the procedure. Do this for any of your office procedures. For those of you in group practices, doctors can practice their procedures.

BALANCING INFORMATION WITH PRACTICAL APPLICATION

The idea is that there are two sides to the learning coin: the information side and the practical application side. You can’t learn how to throw a fastball from reading a book. You must find a baseball and someone brave enough to catch your pitches and practice throwing hundreds of times. However, a book may have useful information on improving your throwing technique from those who have done it more than you.

It is best to go over the idea of training and improvement with your team first so they understand what you are doing and why.

Keep training fun. Your manager should ensure that training occurs every month.

And like Clarence Gonstead said:

“Practice. Practice. Practice. Never stop.”
“Our future will be our results.”

Keep training,

Ed

P.S. Who was Clarence Gonstead, D.C.

References:

ROI on training. An Evidence-Based Look at the ROI of Investing in Training (mentorgroup.us)

Clarence Gonstead https://www.gonstead.com/

The Learning Pyramid the learning pyramid – various percentages of retention. (thepeakperformancecenter.com)

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If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

order now button

Overcoming the Barrier to Improvement

lumberjack with ax and pile of logsSharpening Skills Pays Off

There is the old story about the lumberjack who said that if he were given five hours to chop down a tree or lose his life if he failed, he’d spend three of the five hours sharpening his axe.

Stephen Covey talks about “sharpening the saw,” one of his famous 7 Habits of Highly Effective People. (An essential management and leadership book.)

He says: “We must never be too busy to take time to sharpen the saw.” Sharpening the saw is about “renewal. “Renewal is the principle—and the process—that empowers us to move on an upward spiral of growth and change, of continuous improvement.”

With constant use, our bodies, cars, and practices wear out.

We don’t always notice this, but gradually, performance diminishes. This is why you encourage your patients to come in for regular maintenance, supportive, and wellness care. This is why you take your car in for maintenance.

And this is also why you take time to work ON your business.

IMPROVING YOUR TEAM

The fact is, each one of your team members desires to improve their skills and see the business where they work progress. They want to enhance their career and work life. They want to see their business going somewhere and to mean something.

And business CEOs want better performance. This is why companies spent over 100 billion dollars on employee training in 2023. And they do this for 1 reason: it pays.*

A study by Accenture (a multinational management company) found that for every dollar invested in training, companies received $4.53 in return. This equates to a 353% ROI*

There is no doubt that improvement pays dividends. But what gets in the way? Money? Maybe that is a factor, but I don’t believe it is the big one.

WHAT GETS IN THE WAY OF IMPROVEMENT

It is the idea of time. There are a couple of easily overlooked rules about time I talk about in my book, the Goal Driven Business, that if understood and used, can give you the time you need for improvement.

The first rule comes from what is known as the Pareto Principle. It states that just 20% of your work produces 80% of your desired outcomes. Conversely, 80% of your work time produces only 20% of your desired outcomes.

Improvement for your health or your business is the 20% that generates 80% of your positive outcomes. It is the little bit of effort that produces the biggest results.

Isn’t everything you do important? No! There are a few highly vital actions that you must do, and then there are less important actions. As an elementary example, it is important that you wear shoes to work. It is not as important what kind of shoes you wear. So, if you have 10 pairs of shoes, you probably only wear 2 of them 80% of the time. No matter how many shoes you have, the ratio comes out to be about 80/20.

There is another rule I refer to.

It is Parkinson’s Law of Time. It says that work expands to fill the time available.

The essential fact in both laws is that more time is available for improvement than you might think.

Just like your patients take time to come in and see you, you should ensure that you and your team take time to work ON the business and each other’s professional skills.

Training and improvement, like chiropractic, doesn’t cost. It pays.

Keep improving,

Ed

*references

https://www.mentimeter.com/blog/training/employee-training-statistics

https://www.myhrfuture.com/blog/measuring-the-roi-of-employee-training-and-development

========================

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

goal driven business buy now button

Revenue Cycle Management (RCM)

Revenue Cycle Management (RCM)

Two weeks ago we hosted a webinar, How to make insurance work for your office using six components. Since then, there has been interest in learning more about revenue cycle management or RCM. You asked, and here it is delivered.

According to TechTarget*, revenue cycle management is the financial process facilities use to manage the administrative and clinical functions associated with claims processing, payment, and revenue generation. The below diagram will give you a visual. The diagram consists of eight elements, listed here:

  1. Prospective patient calls inquiring about services, and making appointment. This is where your revenue cycle begins. Proper intake sets the stage for future revenues.
  2. Insurance eligibility and benefits verification, is critical for you and the patient to determine best estimates.
  3. Clinicals (doctor treatment(s); diagnoses; and entering charges which can be done by doctor or staff, depending on your office procedures.
  4. Clean Claims submission: Mistakes can happen here, but once you are aware of what needs to be done to create a clean claim, you’ll know what to watch for when you review your claims batches prior to sending.
  5. Payment Receipt or denial from remittances, & Payment Posting
  6. Insurance follow-ups on denials/records requests
  7. A/R Follow Ups
  8. Statistical Reporting (we recommend running: Daily Collections; and then monthly/quarterly/annually running stats on New Patients, Patient Visits, Services-Charges, and Collections.

Revenue Cycle Management (RCM) Diagram

The important thing here is to be consistent, meaning every step and each element of the flow must align with the goals and mission of the clinic. For example, a pediatric/wellness practice will have different polices each step of the way for RCM than a sports medicine clinic would. If you are having issues, you need to examine which step in your RCM is bottlenecked, or which step is not in alignment.

Ed’s book, The Goal Driven Business, will help you ground your practice goals and develop and maintain the consistency needed to keep your goals in alignment with the cycle.

Oh, and if you are leaning towards planning for less insurance participation, watch for details on our next upcoming class, Converting to a Patient Self-Pay Model — Preparing for Your Future Practice.

Happy Fourth of July!

Lisa

PS: Download the RCM Diagram

References:
*https://www.techtarget.com/searchhealthit/definition/revenue-cycle-management-RCM

Why You Should Have a Turnkey Chiropractic and Healthcare Practice

keys in a door of a goal driven turnkey chiropractic office

The Practice Development Scale

If you were going to buy a practice, wouldn’t you prefer it to be “turnkey?”

If you were to work as a chiropractic doctor or provider in another clinic, you’d want it to be “turnkey,” right?

Or, as a support professional and assistant, I bet working in a turnkey office would be your preference.

WHAT IS A TURNKEY PRACTICE?

The term “turnkey” implies that the necessary operational elements of a practice are in place so that all the owner or practitioner has to do is “turn the key,” and the practice just goes!

A turnkey practice is so well organized that the stress level is low, the revenue is high, and the service outcomes are excellent.

Consider a scale of 1-5, where 5 is a turnkey practice, and 0 is an insolvent practice.

SCALE OF PRACTICE DEVELOPMENT

___5: Turnkey Practice

  • The practice is fully equipped and operates at close to full capacity. It is ready to be sold, to bring on additional providers, or just happily and profitably cruise.

  • There is a strong, established patient base ensuring regular revenue.

  • Administrative, billing, scheduling, and management systems are highly efficient.

  • The practice is financially robust, accumulating income over expenses each month.

  • The practice has a trained and established manager who ensures the seamless operation and continuity of all systems and procedures.

  • Staff are highly skilled, well-trained, and capable of independently managing the practice. Morale is high.

  • The business owner spends just a few hours each month on administration.

___4: Well-Established Practice

  • The practice is well-established and runs well.

  • There is a large, loyal client or patient base.

  • Administrative systems are efficient.

  • The practice is financially stable.

  • Staff members are trained and experienced.

  • The owner spends a few hours each week on administration.

__3: Growing practice

  • The practice is showing signs of growth.

  • The client or patient base is stable and increasing.

  • Administrative systems are more organized.

  • Financial health is improving.

  • Staffing is more stable, with ongoing training.

  • Owner works hard each week

___2: Basic Operational Practice

  • The practice has the basic elements required for operation.

  • There is a modest, gradually growing client or patient base.

  • Basic administrative systems are in place but may be inefficient.

  • Financial stability is tenuous but improving.

  • Staff are present but may lack competence or numbers.

  • Daily admin operations are dependent on the owner

___1: Struggling practice

  • The practice is operational but faces significant challenges.

  • There is a small, inconsistent client or patient base.

  • Administrative systems are inefficient or nonexistent.

  • Financial difficulties are prevalent, with cash flow issues and potential debt.

  • Staff may be minimal, overworked, or inadequately trained.

  • Owner stressed by dealing with administrative tasks

___0: No Practice / Insolvent

SELL, CLONE, OR CRUISE

Once you have achieved turnkey practice, you can sell it for the highest price.

Or, you now have the option to add another provider profitably. There is no limit – if you develop each provider to a turnkey level before adding more.

But the third option is just to cruise and have fun seeing patients with a great team supporting you and the practice. This option allows you to continue helping your patients while integrating your personal life with your practice life.

In a subsequent article, I will list the key roadblocks, some of them hidden, that can get in your way from creating a turnkey practice. I will also show you how to get to a turnkey practice faster.

But just knowing this scale will give you a map to better chart your course to success.

Keeping the end in mind,

Ed

=============================

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.

goal driven business www.goaldriven.com
The Goal Driven Business
By Edward Petty
goal driven business buy now button

2 Simple Tools for Marketing Success

calander and checklist

At least half of your marketing success lies in how it is organized and managed. Short-term advertising or special promotions can work. But like a sugar rush, they don’t last.

Good marketing is planned and consistent. Marketing by the latest bright idea, or what your school chum is doing in Kankakee, is, at best, a short-term fix. So, use these 2 tools, and over the next 6 months, your new patients and returning patients will improve.

Your Chiropractic Practice Marketing List

Make a list of all your successful marketing procedures and events. Organize it by daily, weekly, monthly, and yearly. You could have 20 procedures or events, from calling the new patient after their first adjustment and treatment, visiting external referral sources, your monthly newsletter, and a reactivation campaign in October as part of National Spinal Health Month. You can even include smiling! 😊

Give this list to an assistant to manage. (Download a free sample below.)

Then, review it every month. Ask these questions and take action as needed:

  • Were these items completed?
  • How did they work?
  • How can they be improved?
  • Should we consider pausing one or adding another?

Your Healthcare Practice Marketing Calendar

While your Marketing List includes most of your recurring actions, the Marketing Calendar shows your future scheduled special events. This would include upcoming events such as workshops, a special promotion like a food drive donation, a paid advertising campaign, a patient appreciation, or a booth and march in the town parade.

This is your plan for the next 2-4 months. Update it at least monthly. Post it in a communal area for the entire team to view.

Why post it?

Remember- where is the marketing department? That’s right – THE ENTIRE OFFICE! So, everyone has a role in “selling health.” Everyone is in the marketing department.

Just do these two actions – review your list and complete the actions on it, and schedule your marketing events on a calendar and complete them – and your new patients and returning patients will improve.

Persistence and Discipline

While these tools are simple to use, your challenge will be to keep using them. This will require persistence and discipline. As I recall Harvey Mackay saying, “Knowing what to do is not the same as having the discipline to do it.”

Keep doing what works and schedule your success.

Seize your future,

Ed

Download a sample Marketing List of procedures and events. [Marketing List]

See also

Unexpected Successes in Practice

smiling woman with a stack of binders and books

Why Your Chiropractic Patients and Practice Can Improve in Multiple Ways

If you continue to work on improvement, you will see results. That’s just physics — a reduction of Newton’s laws, which state that causes create effects.

And if you keep improving what you are doing to make the improvements, the results will be even better. That, too, is physics. (See pages 47 and 256 of the Goal Driven Business!)

However, the results may not always be what you expect, at least not at first.

For example, you start adjusting your patient for their lower back pain. When they started with you, they also had a limp. After several visits, they stopped limping, but their back pain, while better, was still annoying. In time, their back pain was relieved as they continued with their care.

But what about the fact that their limp is gone, their gate is excellent, and they can walk and even run more easily? Didn’t anyone notice?

I mentioned this to someone who coaches people on weight loss. She understood immediately what I said. She referred to it as Non-Scale Victories. NSV’s, she called it!

THE CAUSE OF NONLINEAR POSITIVE RESULTS IN PRACTICE

I have been following the graduates of our first Practice MBA program carefully. I am delighted with the results, but they were not entirely what I expected. I had expected and hoped that practice numbers would increase! Well, this has been happening, in fact, in some cases, Best Evers in years.

But other pleasant surprises have been showing up. For example, chiropractic doctors mention how their offices are calmer and friendlier than before. Another acupuncture office is successfully bringing on a second associate, and another is expanding its marketing reach in entirely new and innovative ways. Even old system problems that have been buried for years are arising and getting resolved.

These and other practice improvements were not directly addressed in our training. I have been consulting for over 30 years and have never seen results like this.

I was at first puzzled by what was happening. I think I finally figured it out. Here are three reasons:

  • The Hidden Ripple Effect. Imagine a pebble dropped into a calm pond. The initial splash is visible, but the ripples extend far beyond the point of impact.
  • Holistic Growth. Improvement is rarely isolated. Improving one component in a system improves other elements.
  • Consistent Weekly Improvement. This is the biggest reason. The function of management and leadership in a practice is powerful, even if only worked on for a few hours per week. This is what we did for over 3 months, both doctor, manager and the team.

Imagine what would happen if you stuck to your exercise program consistently for a year! Yes, you might lose weight, build muscle, and improve your agility. But can you imagine how it might also affect other areas of your life?

But, like exercise, practice improvement gets put off too often. We focus on urgent practice issues, but because improvement, while important, is NOT urgent, we can tend to put it off.

UNSEEN BENEFITS: THERE ARE MORE SUCCESSES IN PRACTICE THAN WE ACKNOWLEDGE

We also aren’t inclined to notice nonlinear beneficial outcomes.

  • Our Instinct is to Look for the Negative. The sympathetic nervous system that governs our fight or flight response has evolved over the millennium as a survival mechanism. We are looking for poisonous snakes on the road and other possible threats.
  • We Also Have Tunnel Vision. We tend to focus on just our specific goals. This is essential but limits our perspective. We miss peripheral benefits.

So, one of the lessons I have learned from our Practice MBA program is that if we continue to work ON improving our practice and ourselves, if we just keep at it, successes will occur – often in multiple areas. When they do, they should be recognized and appreciated.

Keep improving – your office, your patients, and yourself!

That’s our goal!

Ed