Ask Lisa: Setting Up Finances With Your Patients

Posted on December 3, 2024 by Lisa Barnett

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

Posted on November 5, 2024 by Lisa Barnett

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]

Insurance: The Changing Landscape & How to Best Prepare

Posted on October 25, 2024 by Lisa Barnett

Download the Slides: 2024-10-24- The Changing Landscape Slides

Does Your Chiropractic Practice Have Team Bonuses?

Posted on October 22, 2024 by Edward Petty

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

Posted on October 15, 2024 by Edward Petty

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.

The Goal Driven Business

By Edward Petty

The Chiropractic Patient Engagement Scale

Posted on October 1, 2024 by Edward Petty

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

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

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

Where Is Your Chiropractic Marketing Department?

Posted on September 24, 2024 by Edward Petty

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,

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

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

Posted on September 17, 2024 by Edward Petty

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:

Lecture: 5%
Reading: 10%
Audio-Visual: 20%
Demonstration: 30%
Discussion: 50%
Practice by Doing: 75%
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,

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)

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

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

Overcoming the Barrier to Improvement

Posted on September 10, 2024 by Edward Petty

lumberjack with ax and pile of logs Sharpening 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,

*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

Revenue Cycle Management (RCM)

Posted on July 1, 2024 by Lisa Barnett

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:

Prospective patient calls inquiring about services, and making appointment. This is where your revenue cycle begins. Proper intake sets the stage for future revenues.
Insurance eligibility and benefits verification, is critical for you and the patient to determine best estimates.
Clinicals (doctor treatment(s); diagnoses; and entering charges which can be done by doctor or staff, depending on your office procedures.
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.
Payment Receipt or denial from remittances, & Payment Posting
Insurance follow-ups on denials/records requests
A/R Follow Ups
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

Posted on June 25, 2024 by Edward Petty

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,

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

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.

2 Simple Tools for Marketing Success

Posted on April 30, 2024 by Edward Petty

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,

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

Unexpected Successes in Practice

Posted on April 23, 2024 by Edward Petty

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!

Goals for the Present

Posted on December 19, 2023 by Edward Petty

Goals for the Present

Goals are about the future.

But sometimes, they are about the present – and respecting the past.

December is one of those times. There’s a distinct vibration that moves in this time of year, subtle waves of friendliness that sparkle like Christmas tree lights. Almost an instinct — whether connected to a Sunday service before the 25th, a Jolly Old Saint Nick, the candles of Hanukkah, or the winter solstice, we feel a sense of fellowship during this time of year.

With the traditions of other cultures over the millennia, people have gathered with a Spirit of compassion and celebration. People even take time to pause in war.

One example was the Christmas Truce of 1914 during World War I, when soldiers from opposing trenches laid down their weapons and initiated an unofficial ceasefire. The truce began on Christmas Eve and continued into Christmas Day, with soldiers exchanging seasonal greetings, singing carols, and even venturing into no man’s land to fraternize with the enemy. Troops from both sides shared food, tobacco, and souvenirs and engaged in impromptu soccer games.

I think this speaks to our fundamental nature, that we are supportive and kind when unprovoked by the agitations of those who might profit from our conflicts.

As a practice and business goal for your chiropractic and healthcare office, I suggest that this week and next, focus on the present and appreciate the many accomplishments of the past year. Consider your blessings – your patients, profession, teammates, and family.

The Future Can Wait

For now, take time for some gratitude and have a cup of kindness and good cheer.

And play some Christmas jazz. Man!

Below is a link to some mellow Christmas Jazz – 4-hour playlist. Christmas Jazz: https://www.youtube.com/watch?v=Dbgx5ChU3ZM

Carpe Diem,

Don’t Let Old Acquaintances Be Forgotten in Your Chiropractic Practice

Posted on December 5, 2023 by Edward Petty

Strengthen Your Network in December

“Remember, George: no man is a failure who has friends.”*

Three weeks till Christmas!

Yikes! Let’s make the most out of this month before we get into the fast lane of the New Year.

Take this month to connect and reconnect: patients, referral sources, team members and stakeholders, family friends – those dear to us. Share some good tidings and joy. Here are some ideas:

1. Keep the show on the road. While ensuring that everyone has time off, try to keep the lights on, the tables warm, and the greetings friendly all month. Anytime you close for a period of time, you can lose momentum. If you are closed for a few days, PACK the days you are open with visits! Remember:

Health Never Takes a Holiday!!

2. Thank You’s to referral sources. Plan to get out and thank all your external referral sources. Show your appreciation: cards, cookies, and guest passes for intro services! Keep your network active. Remember:

“Your chiropractic healthcare practice is a network of relationships created and sustained through communication and service.”**

3. Thank You’s to your patients. Show extra appreciation to your patients. It takes some courage and effort to venture out to see you for care. They are taking responsibility for their health, even though they may not follow all your recommendations. Have an appreciation party, send out greeting cards, give away poinsettias to families, or offer eggnog and treats from a local independent store with the store’s promotional sign.

4. Your Team. Look at your Profit and Loss for the year. If you have any extra dough, privately reward individual team members with a bonus. If the cupboard is empty, let your team know, but give them something. And THANK THEM!

5. Your Family. Don’t forget your family! Heavens! They deserve something for putting up with you this year! (lol)

6. The Spirit! Lastly, be filled with the Spirit of the season. You can watch It’s a Wonderful Life with Jimmy Stewart. Again!

The New Year will come at us fast… so take this time to absorb all the merriment, comfort, and joy you can so you’ll start fresh and filled with renewed energy in January.

So consider the actions above and Don’t Be Forgotten!

Should old acquaintance be forgot – and never brought to mind?

Should old acquaintance be forgot – and old lang syne?

With friendship,

Ed and all of us at PM&A

*from the movie, It’s a Wonderful Life
** from the book, The Goal Driven Business

—————————————————-

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 new book, The Goal Driven Business.

goal driven business building methodology

The Goal Driven Business By Edward Petty

Who Do You Work For in Your Chiropractic Healthcare Office?

Posted on November 28, 2023 by Linda

Patients come second.

As a doctor, you work for your patients.

As a business owner, you work for the business end of the practice.

Both of these roles have different outcomes. As the doctor, your outcome is healthy and very happy patients. As a business owner, you want to see a profit.

When you begin your practice, you do so as a business owner and doctor. Any management or leadership you do is done from these roles. I call this an Entrepreneurial or Personality-Driven Practice. This is workable until you reach about 50% of your full capacity as a provider.

Beyond about 50% capacity, the practice needs focused leadership and management. It is time for you as the owner to step into the role of Clinic Director if you want your enterprise to continue to grow.

The outcome of the Clinic Director is not the same as that of doctor or business owner. In simple terms, the outcome is a well-run organization that provides excellent service at a profit.

So, who does the Clinic Director work for?

The staff! The employees. This is called servant leadership and management.

This is a major shift in mindset for most highly driven entrepreneurial business owners. But it can be done, and if done correctly, there is no limit to practice growth, prosperity, and independence.

SOUTHWEST AIRLINES

Customers Come Second, Employees Come First

Year after year, Southwest Airlines ranks at the top for customer service and profitability over other airlines. And for good reason. They are excellently managed and led!

Their goals, purpose, and values are well-defined. They are a Goal Driven Business.

In their book about Southwest, authors Keven and Jackie Freiberg reveal that Southwest believes that the love and support they show their employees will be passed on to their customers. Servant leadership is a central theme.

Chapter 18 of their book caught my attention: Customers Come Second — But Still Get Great Service. In it, they say at Southwest, “Treat your employees with care and concern if that is the way you want them to treat each other and your customers.”

WHAT YOU CAN DO NOW TO IMPROVE SERVICE AND INCOME IN YOUR CHIROPRACTIC HEALTHCARE PRACTICE

I use Southwest as an example, but there are many others.

In a smaller service company like a chiropractic or dental business, the doctor doesn’t have much time to be the Clinic Director or senior manager, isn’t paid (at least directly) for being one, and isn’t trained in management. Also, more than likely, doesn’t want to be a manager or leader. But what if there was a simple method to be an effective Clinic Director?

Well, there is. It is covered in my book, the Goal Driven Business, and is gone over in detail in our Practice MBA training program. In 2024, I will post more information on this subject and the Fast Flow CEO Method, as I am 100% certain that this is the stumbling block behind all stumbling blocks that keep practices from achieving greatness.

You can do this now:

Define and communicate your goals and procedures. These need to be reviewed, in one form or another, by everyone weekly.
Clinic Director. Set time aside as the senior coach of your team to develop your people professionally, and as you can, personally.

If you put your team first, they will put the patient first.

This is, when all is said and done, the Golden Rule.

Or perhaps… we could also call it the Goal Driven Rule!

Seize the Future,

*Nuts – Southwest Airlines, Keven and Jackie Freiberg

—————————————————-

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 new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

Don’t Turn Your Staff or Yourself into Bots in Your Chiropractic Healthcare Practice

Posted on November 14, 2023 by Edward Petty

Goals First, Then Procedures in Your Chiropractic Healthcare Practice

I asked the office manager if I could review some of the staff’s job checklists.

I had observed a staff member training another on how to use a therapy device on patients. Their attention was on the equipment, how to position the patient and where to place the electrodes.

So, I looked with interest at the job description and checklists about placing patients on therapy. The therapy checklist listed all the procedures – what wire went where, what position the patient was to sit in, etc. But something was missing.

The goal, the outcome, of the checklist was not defined.

There was no mention anywhere about the purpose of the therapy, what it does, why to use it. And worse, there was nothing about the patient as a person. The checklist did not say how to introduce the patient to the procedures – and how to educate them on what it does. It might as well have been instructions on how to hook up jumper cables, wire a sump pump, or fill out tax forms.

I went over this with the practice manager and later was told that the staff were now spending more time with the patients explaining therapy procedures.

GREEN AND CLEAN

There’s a deeper principle here. Steven Covey has a great video on getting his son to take care of the lawn over the summer.

Rather than giving him procedures on what to do, he pointed to the neighbor’s lawn and had him notice that it was green and also clean. He then pointed to their lawn, which was becoming brown and littered. He told his son that all he had to do was keep their lawn Green and Clean. He didn’t care how he did it. He might want to use a hose and sprinkler or use buckets. The specific procedures were up to him. But the goal was –green and clean.

It is an entertaining story on video — the link is below on our blog. The son finally got the idea and worked out how best to take care of the lawn.

GOALS FIRST, THEN PROCEDURES IN YOUR CHIROPRACTIC HEALTHCARE PRACTICE

Checklists are useful for training, agreeing on who does what, and preventing key procedures from being overlooked. Please use them. We’ve used them for 30 years. (If you need help please contact us!)

But they should always begin with the goal, the outcome of the sum of the procedures. What do these series of procedures produce – and what is their mission?

If you just focus on procedures, you and your team might as well be algorithms, computerized, and repetitive functions that occur electronically. Like an Internet robot or bot! By omitting goals first, you may minimize the innate creativity and power of everyone, including yourself.

On the other hand, if you challenge yourself and your team to define the WHY for each major and even minor procedure:

The procedures will be better applied.
You and your staff can find ways to improve the procedures.
You will be touching upon and rekindling the innate creative force we all have.
Your work will be more meaningful…

…and more fun.

Seize the Future

Green and Clean Video

—————————————————-

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 new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

Where Are the Leverage Points in Your Chiropractic Healthcare Practice?

Posted on November 7, 2023 by Edward Petty

Find them, invest in them, and see your practice improve.

One of the aspects of practice development that you become familiar with after 30 or so years in the field is the concept of Leverage Points. Once you can spot them and work out methods to take advantage of them, your practice significantly improves.

According to Donella H. Meadows, Ph.D., leverage points “Are places within a complex system (a corporation, an economy, a living body, a city, an ecosystem) where a small shift in one thing can produce big changes in everything.” *

using leverage in chiropractic healthcare management

HIGHER LEVEL LEVERAGE POINTS IN YOUR PRACTICE

Ms. Meadows lists 12 levels of increasing effectiveness where leverage might be found. The top levels that can make the most significant changes are:

Goals
The mindset from which the business arises from
The power to transcend assumptions and accept new goals and values.

This is the Above Down Inside Out shift that can ignite the Innate power in a practice.

I have seen this when the clinic owner or team member becomes extraordinarily inspired and motivated, filled with a sense of mission. I also have noticed this in offices that shift from an entrepreneurial practice that is entirely dependent upon the owner to a systematized and goal-driven business.

TANGIBLE LEVERAGE POINTS

Adding a scribe or clinical assistant can be a practical example of utilizing a leverage point in a more tangible application. This might allow you to see an extra 10 patients a week and provide better service with less stress. In the end, you would have a positive Return on Investment for what you paid for the extra help.

Another example might be a situation where your front desk can’t keep up with check-ins, check-outs, call-ins, questions, data entry, cash collections, marketing reminders, and just being friendly. By adding the right person at the front desk, even a part-time during prime time in the afternoons, your volume might surge. (I have seen this.)

For a marketing example, you might be next door to a gym that sees hundreds of people each month. You could leverage your location with just a little effort to create a very beneficial relationship for their business and yours.

There are many examples of finding areas of your practice where the return will be positive when given more support.

LEVERAGING PRACTICE MANAGEMENT

In my experience, the number one leverage point is management.

As a practice grows, the admin tasks multiply exponentially. These start to fill up the doctor’s time, and eventually, growth hits a plateau.

By adding someone to take care of office administration or clarifying the duties of someone currently in that role, you can better concentrate on service, production, and leadership.

As a result, revenue increases and stress decreases. Proper training for the manager is essential and, unfortunately, usually absent.

As an aside, we are solving this now through our Practice MBA program. We are just a little more than ½ way through the training, and I am both impressed by their work and proud to be helping them become Goal Driven Managers.

But leverage points could be anywhere. Even between your ears! (haha!)

Look for where you might find a log jam or an untapped resource. Invest some time in supporting that area and see if that doesn’t make a big difference in practice.

You have untapped power in your business just waiting to be leveraged.

*Reference https://donellameadows.org/a-visual-approach-to-leverage-points/

—————————————————-

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 new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

How to End on a Win Each Day in Your Chiropractic and Healthcare Practice

Posted on October 31, 2023 by Edward Petty

LOST KEY

Remember that time you were leaving for work in the morning and just as you were about to leave, you couldn’t find your keys? (It might have been your wallet, purse, or important papers.) As you tried to quell your rising panic, you thought – what if I am late? What about the patients? What if I have to call a cab, a Lyft or Uber? All the alternative scenarios and plans start weighing on you. Worried, distraught, you get ready to call the office when…there they are! Your keys, papers, the vital components to your daily life and you make a joyous reunion. And you are on your way.

That was a big win.

Five minutes later, you have forgotten the entire dramatic event. As if it never occurred.

FORGOTTEN DISCOMFORT AFTER FINDING RELIEF WITH CHIROPRACTIC CARE

Many patients who have had pains or discomforts for years, after finally experiencing relief thanks to your chiropractic care, take it almost for granted after a day or so. Even though it was a big win.

You, too, begin to experience the daily Miracles as Usual as commonplace. You and your team become accustomed to them.

And worse, we can let the “negative few outweigh the positive many.”

OVERLOOKING THE POSITIVE MANY

Our minds are wired, especially business owners, to be alert for dangers, threats, and failures. And because of this, we overlook the accomplishments, the successes, and the wins we all have.

They happen every day. We get work DONE… when we might have just let it slide. We take the extra time and make the extra effort, even as no one notices. We make it happen.

In an otherwise cold and frightening world, we help others through our actions — and even by our positive presence.

And the world reinforces the negative. Sensation drives all media. It “click baits” us, like emergency flagmen calling our attention to the as-yet-unseen car wrecks ahead of us.

But amidst the world’s chaos, the dramas of our patients, and the struggles of our own lives, we are here to help, and to whatever large or small degree we do, that is a win. We contributed something good into the world that day.

But our wins are easily overlooked. First, by ourselves, and second, by others.

LET THE POSITIVE WIN

So… don’t let this happen. You can change this! Change it in your practice and change it at home.

And if you do, you will create a more healing atmosphere in your practice and love in your life. Your day will end better, and your next new day will start fresh with greater cheer.

At the office, after the day is done, ask the staff to tell you about at least one success they had! Listen. Applaud or cheer or hug. Hurrah! Tell them about an accomplishment you had!
And when you get home, and get a moment with your spouse or kids, ask them to tell you about a win they experienced.

You are doing good work. You are helping people. So are others with whom you work and live.

Recognize and celebrate this, and at the end of each day, simply ask each person with whom you work to tell you and the others their win or wins and cheer for them. Let them do the same for you.

You deserve It – and so do they.

End on a win.

PS I was reminded of this at the recent Chiropractic Society of Wisconsin conference in Wisconsin. One very successful doctor with whom I had the privilege of talking to mentioned that at the end of the day, he would meet with his team and acknowledge a win each of them had. I too, years ago, had done this with a team I had worked with, but as the world turns, I’ve let this very successful procedure drop aside.

—————————————————-

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 new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

End of Year Preparation for Your Chiropractic and Healthcare Practice

Posted on October 24, 2023 by Edward Petty

From the front to the back of your practice

As farmers know, you must plan ahead and then work your plan. That is part of the Law of the Farm we discussed last week.

This is a short and fast reminder of some activities to consider as we enter into the last two months of the year:

Marketing – The front end of your practice. Keep it hopin’!
Business — The back end of your practice. Organize for the future.

MARKETING YOUR CHIROPRACTIC PRACTICE

With good scheduling and planning, there is no reason for disappointment in production for November and December. To help keep the atmosphere thankful, cheerful, and productive, here are a few promotional ideas:

Thanksgiving (U.S.A.) Turkey giveaways have been popular with many practices. The basic idea is to refer a friend and enter a drawing for a free turkey.

Thank-a-Veteran Day. Veterans Day – November 11. Special promotions, including free or discounted services or donations to local veterans’ organizations.

Donation Drives. Holiday time always brings an increased demand for helping those less fortunate. Within your office, you can set up a collection area for donation programs in your area.

Girl’s Night Out. This is a shopping/gift exchange that can take place in your office that builds community and helps generate referrals.

Poinsettia Give Away. Give away free poinsettias, one per family. Include cards with a gift certificate for family members or friends for your services.

Your External Referral Network. Deliver a fruit basket or other present personally during December with a card of thanks and mention how you are looking forward to another year working together for better health. Your External Referral Network would include any person or organization that referred a new patient to you, where you gave a lecture or screening, or in any way directly contributed to your office.

Patient Appreciation. Have a party. Your patients are part of your practice and health community. They are a select group of like-minded health seekers. Bring them together, recognize their efforts to improve their health in 2023 and 2024, and encourage them to help others do the same. Everyone gets Guest Passes to hand out to family and friends when they leave. (I still love the Flying Elvis’ coming in for a big patient appreciation party one office used to have!)

CHIROPRACTIC HEALTHCARE BUSINESS

Once you get your marketing plan worked out and in gear, take time to review the business situation of your chiropractic or healthcare practice. These behind-the-scenes details are important but not always urgent! They are pretty obvious – this is just a reminder!

Accountant. You will want to meet with your accountant to review your financial statements, including your balance sheet and profit and loss. There have been changes to retirement laws, so check with them about how they may affect you. Review your tax situation and explore strategies to minimize it. Ensure that all tax-related documents and filings are up to date.

Legal and Licensing. Check the status of licenses and permits and renew them as needed. Consult with your attorney to review contracts and legal obligations.

Employee benefits. Consider benefit reviews as well as bonuses.

Payors. You’ll want to review your insurance contracts and dump any that don’t bring a good return.

Fees. Take a look at your fees and make any adjustments that are needed.

Compliance. This can be delegated, but ensure that you at least minimally meet basic HIPAA and OSHA standards. You can check with your local state association for recommendations for these and any other requirements.

Budget Planning. Work out a general budget for next year that incorporates all the findings from your financial review and business goals.

This is not a complete list, of course.

Preparation is working on your business, not just in it, but it is just as essential.

Let’s end the year prosperous and secure for the future.

—————————————————-

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 new book, The Goal Driven Business.