Goal Driven Job Descriptions

Posted on February 22, 2022 by Edward Petty

playbook goal chart

In a Goal Driven Practice, Goal Driven Job Descriptions are short, fast, and to the point.

And they are used!

They help improve the quality and quantity of services and are motivational.

So, how is this different from other job descriptions?

Most job descriptions are usually a hodge-podge and catchall of unrelated tasks. For example, the front desk job description may include getting supplies, taking x rays, calling attorneys, and scheduling patients. Billing may include marketing and equipment repair.

Staff will do the tasks assigned but end up zigzagging from one function to another, losing focus on what they are doing, and often disengaged in their activities.

In typical job descriptions, the goals are not clearly defined, measured, nor are the expectations stated. Further, employees don’t always see or get recognized for the results of the work detailed on their job descriptions.

Yet another failing of most job descriptions is obvious – they just aren’t used.

Let’s look at how to power up job descriptions so that they are Goal Driven.

Many job descriptions contain the duties of several different roles. A role is an assumed identity. For example, in a restaurant, there are the roles of a server, cashier, dishwasher, and chef, or cook. In a small restaurant, one person may take on a number of these roles, and all these roles would be their job description. Hence the idiom: “chief cook and bottle washer.”

But to be effective, each role needs to be separated, well defined, and organized with the other roles.

In a Goal Driven Practice, job descriptions are broken down into different roles and described in job checklists.

The job checklist begins by clarifying the goals. This includes the mission, the outcomes, what is used to measure performance, and the level of performance expected of that role.

For example, for the role of Patient Accounts, the mission might be something like: “To help the patient pay for all of the services they received in such a way that they will continue to receive services.” The outcome might be a zero balance or “no accounts receivable more than 30 days.” The statistics used to measure this role could be the “percent of collections to adjusted services.” And finally, the expectation might be something like: “All patients very happy with the encounters with Patient Accounts and continuing with their services, with a collections percent of at least 95% of adjusted services average.”

We now list the most important procedures to achieve this goal. The CEO of the office defines WHAT the goals should be – that is leadership. But the manager and those working in patient accounts would work out HOW the goals would be achieved.

Encouraging the team member to define the best procedures to achieve their goals empowers them and gives them autonomy and responsibility for their role. According to Self-Determination Theory, real motivation is intrinsic. It comes from one’s desires and needs rather than external rewards or threats. Edward Deci, in his book Why We Do What We Do, says people “strive for personal causation.” (This is more fully covered in my book, The Goal Driven Business)

If the cook understands that their goal is to make tasty meals that the customers enjoy and for which they will pay, they can be more responsible for how best to achieve that goal.

A team member may have five or more roles, each with a job checklist, as part of their job description. As the doctor and owner, you may have 25! (And if so, that could be a big capacity barrier right there!)

Once the goals are clearly defined … and kept in mind, the rest of the checklist can be easily worked out.

Once per month or more, you or the manager can meet with each team member and do what we call a Coaching Review. This is a fast review of employee performance: at what they are excelling and at what they need to improve. In addition, the job checklist can act as an assessment.

But it is all geared around the goals of their roles. You also ask them what could be added or changed to improve both the quantity and the quality of their outcomes. They can make the changes to the job checklist and make sure you have a copy.

None of this takes a long time to do each month.

Management of your office is not just about getting procedures done. It is about constant improvement in the quantity and quality of their goals.

You may have told your patients something like: “If you do not make time for your wellness, you will be forced to make time for your illness.”

The same applies to managing your business. “If you do not take time to improve your procedures and your people to achieve the goals in their roles, you will be forced to make time to rebuild your practice.”

Steven Covey, in his book The 7 Habits of Highly Effective People put it simply and best:

Begin with the end in mind.

The Goal Driven Front Desk

Posted on February 15, 2022 by Edward Petty

A dynamic front desk can increase your visits by 20%, maybe more if you have the room. On the other hand, a dysfunctional front desk can constrict the flow of patients and hold your office back.

I have seen instances of both.

There is much more going on and at stake at the front desk than most doctors and staff appreciate.

Ordinarily, you would think that the billing department is the most demanding. There are hundreds of details that need to be learned and followed with excellent discipline. This position requires professionalism and expertise.

But this function is not on the front lines of the constant patient, phone, and doctor interactions and interruptions. Managing patient accounts can be regulated and organized to maintain a calm and comfortable workflow.

Therapy and adjunctive services are often undervalued, but the patient flow is usually smooth, and they are not faced with unexpected patients or phone calls.

It is interesting to note that the front desk has the highest turnover in most offices.

But properly set up and managed, this department can be an engine of growth and stability in your office.

Let’s look at some of the more important attributes of the front desk:

It represents you and your services. It is your ambassador to the world outside your office. The front desk reflects what you stand for and the quality of your services.
It is the first and the last contact – and impression –with anyone in the office.
It can convert inquiries to new patient appointments.
Rapport and relationships. The front desk can provide world-class service to patients, improving patient retention, reviews, and referrals. (The 5 Rs)
Direct marketing. The front desk can directly promote clinic services to patients, hand out coupons, and promote upcoming events to generate patient referrals.
Team member support. The front desk can support the insurance department and all team members to create a positive, upbeat day every day.
Case Management. The front desk can contribute to case management by relaying any comments or observations relative to the patient’s care to the doctors.
Fully Scheduled Day. The front desk fills the appointment book and keeps it full.

Let’s imagine an ideal front desk and put it at a “5” on a 5 Point Scale.

5. GOAL DRIVEN FRONT DESK. The appointment book is full. The front desk staff are cheerful, having fun doing their jobs, and genuinely interested in every patient and phone inquiry. They sincerely care for each patient and non-patient. They have a strong intent on helping patients complete their programs by keeping their appointments. They personally and professionally want to achieve the mission of the office and encourage patients to help them accomplish this mission by bringing in family and friends. They also help the rest of the office achieve the office’s mission. They are sending out positive “vibrations” to help more people. They are proactive and Goal Driven.

Below this level, we find the front desk that is struggling.

2.5 A COPING FRONT DESK– The appointment book is 50-70% full. The front desk is trying, but it is not keeping up, which creates a bottleneck to patient flow. (Subluxated) Even though the staff wants a full appointment book, subconsciously, they don’t want any more work until they catch up.

2. A SLOW FRONT DESK. The front desk operates at a “comfortable” 40-50% capacity. The staff is pacing themselves, keeping up with computer tasks, insurance, and following the scripts for phone and patient encounters. However, they are mostly disengaged from the front desk and office goals.

1-2. GIVEN UP and BORED. I only describe this because I have seen this condition. The staff is ignored or badgered. In either case, they feel relegated to a 4th class employee. They hide out and pretend to work, essentially having quit and just waiting until something better comes along.

You can create a Goal Driven Front Desk. It is not achieved overnight, but once it is established, you’ll be close to a dream practice and a Goal Driven Business. We will cover some tips on how to create a Goal Driven Front Desk in another newsletter.

In the meantime, stay Goal Driven,

“Your brain sends out vibrations all the time, and your thoughts affect your life and other people’s. They pick up these thoughts and get changed by them.”

– Bruce Lipton (Biology of Belief)

Faith Demands to Make a Difference

Posted on December 30, 2021 by Edward Petty

December 30, 2021

A year ago, who knew what the next 12 months would be like?

Yet, here we are today.

As the New Year is just before us, again, one can only wonder at what the future holds. Is this the “New Normal?” How far will it shift in the next twelve months? For you, your patients, and your business?

Whatever new realities lie ahead, we are ready to help you and your business. We will be launching a new approach to practice and business building with the theme of Faster to Your Future in January. It is based upon the book the Goal Driven Business.

But just before we start the New Year, I wanted to pass along a message of encouragement.

It often amazes me that with all the wars, both “hot” and cold, the greed, the fear, and tyranny, with all of mankind’s utter insanity over the centuries, we are doing as well as we are. Somehow, as Abraham Lincoln predicted in his first inaugural address in 1861, “…the better angels of our nature…” came through and prevailed. Whatever challenges we may have, his were enormous. He was facing a nation divided, secession of the southern states, the policy of human slavery, civil war, and a world of other conflicts.

But in the end, there is something about the Innate Goodness of Life that seems to propel mankind forward towards a better future, however slightly. I think that the more we trust in the Better Angels of our Nature, and in the Goodness of Life itself, the more sure our road will be toward a better year for us all and a happier future.

“I have one life and one chance to make it count for something . . . I’m free to choose what that something is, and the something I’ve chosen is my faith. Now, my faith goes beyond theology and religion and requires considerable work and effort.

My faith demands — this is not optional — my faith demands that I do whatever I can, wherever I am, whenever I can, for as long as I can with whatever I have to try to make a difference.”

― Jimmy Carter jimmy carter supervising

So with this, we look forward to working with you to help make 2022 both prosperous and rewarding.

With admiration from all of us at Petty Michel and Associates,

The Problem With Seminars

Posted on November 9, 2021 by Edward Petty

the problem with seminars

I am all for seminars. Been to many myself. I know I have gotten useful information and, no doubt, have benefited from them.

But, their usefulness is often wasted.

I just talked to a business owner that came back from a seminar he and his doctors and staff attended. He told me that they have started hitting their best-ever weekly numbers. His office manager told me that everyone is excited.

For now.

I have seen it time and time again… go to a seminar, get stoked, come back, numbers go up for a month or so, and then everything returns to how it always was. In essence, the seminar was only a short-term, “acute care” fix that addressed symptoms. Nothing was really improved or corrected.

There is a solution on how to benefit the most from seminars. I discuss it in my book, The Goal Driven Business, from which most of this article is quoted from. The following is a story related to me from a chiropractic staff member a few years back:

“Our office was really slowing down last year. So, the owner decided to take everyone out of town to a weekend business seminar. The speakers discussed new and efficient methods for doing our work. It was entertaining and informative. Plus, we also gained some great marketing ideas. It was a fun seminar, so we were all excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members had to take care of urgent matters first, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting, but then customers begin arriving for their afternoon appointments. We had to call the meeting to an end without getting through very much of our agenda, but we agreed to continue the meeting the following week. Turns out, we never did meet again about the seminar.

“But we were still pretty motivated from the out of town trip to the seminar and, as I recall, we had one of our best months ever. It’s my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were never opened; so I stored them for future reference. Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. Some of us are a little burned out and I don’t think we ever did implement anything from that seminar.”

Sound familiar?

I bet it does. I have seen it play out almost exactly the same way countless times. Starting, and not following through. No management and marketing system is set up, and no time scheduled to ensure the system is followed, and no lasting improvement is realized.

And I am sure, for most of us, this phenomenon applies to our personal lives as well. For instance, how is your exercise program coming along? Hmm? You’ve set goals to work out more often and eat better, right? To work ON your body, not just in it. Yet, my guess is it’s been pretty hit and miss.

We want to improve, we make improvement goals, but what happens? Why can’t we achieve them? Consistently. Is it that we’re all too busy? Too lazy? There seems to be no solution, so we accept our condition and do our best.

Yet, there IS a solution, and it’ll seem like science fiction—but, it’s actually a science fact.

The Goal Driven System of Business Development covers 20 Big Shifts, or actual office adjustments, that need to be made to reach your goals — and stay there. It takes you out of the Practice Roller Coaster that forces you to finally “settle” and accept a lower level of success because the stress of the ups and downs becomes too much.

Here’s how to get the most out of seminars from The Goal Driven Business.

goals lab goaldriven.com “BIG SHIFT #1: Introducing the Goals Lab
You can’t improve your car while you’re speeding down the freeway. You must take it to a mechanic at a garage. Athletes and musicians alike spend time away from their audience to practice their game skills or their music, always improving their performance. Businesses need to do this as well. But where? And when?

The answer is you need to create a Goals Lab where you go to work on your business.

Your Goals Lab is a special place, a laboratory, an oasis for change. Here, you can think, study, learn, practice, become inspired, and have conversations. Here is where you go to reset your thinking and improve your actions—and the actions of others in your office as well.

I call it the Goals Lab, but you can give it another title, if you wish. Whatever you call it, this is the first Big Shift you’ll take on your journey to achieving your new goals.

Goals Lab to engineer your best route to your goals, Goalddriven.com

Why do you need a Goals Lab? Because you simply cannot focus on the other Big Shifts when you are in your office, juggling customers, staff, bills, phone calls, emails, vendors, and everything else that consumes your energy and brainpower.

Management companies and consultants may have advised you to work on your business, not just in it. While the idea of working on your business, as opposed to in it, is a clever and useful concept, I have rarely seen it applied consistently or comprehensively. Why? Because real business improvement can be more demanding than meets the eye. It is a separate activity that requires its own distinct time and place, and it has its own rules which must be followed to be effective.

I use the term Goals Lab because it is a virtual location that you visit to improve business performance. As an example, you spend most of your time with your car driving it. But you also take time to take your car to a special place where you let a mechanic work on it.

Not knowing about this place, this Goals Lab, its rules, and how it operates, is a fundamental reason why all your management books, marketing manuals, and practice improvement notes from seminars rarely get implemented.

Your Goals Lab has been mostly hidden from you. It almost has a fourth-dimensional location, which is outside the time and space continuum.”

Why don’t we spend more time on improving the business, not just working in it?

This is the real question, and it is answered in the book, The Goal Driven Business. You can read about it now, or wait for my next article where I explain WHY business improvement is so difficult and what to do about it.

Meanwhile, keep improving.

Learn more about book and get it here: https://www.GoalDriven.com

the goal driven business by edward petty

Tempus Fugit (time flies)

Posted on July 8, 2021 by Edward Petty

As the ancient Greek reminds us, Time Flies — and July comes at us fast.

We are halfway through the year – 2021!

While enjoying the summer, I suggest you take a Half-Time Break and reassess, readjust, and recommit where needed. That is, reassess your progress so far this year. Make any adjustments to your yearly plans. Recommit to your higher goals.

This is a team exercise. You can discuss with each team member first, but I would focus on the four categories below:

What are the goals for the rest of the year?

Yourself as a professional?
The office as a whole?
The quality of service/outcomes of your patients?
Yourself personally.

You can reprint this and send it out to your team as a memo next week. Then, meet as a group in the following weeks to discuss. Here are some tips you can pass on to the staff and doctors:

Goals for yourself as a professional. How are you going to improve your level of competence as a support professional or doctor? What subjects do you want to study, or skills you want to improve, in anatomy, customer service, chiropractic, chiropractic history, marketing, health care in society, etc.
Goals for the entire office. Review the mission, core values, and outcomes of our office, and from these, consider what improvement goals we could set for the next six months.
Goals for the services we provide our patients? Consider such things as faster service, more complete outcomes, more fun for the patients, and more engagement with our mission.
Goals for yourself personally. This is personal and can be private. It can be discussed, but that is optional. This might include such things as more time with nature, family, exercise, prayer, recreational reading, a new hobby, and travel.

Enjoy your summer but be PROactive and meet with your team to plan out the rest of the year. Keep it fun. You can meet at the lake, in the park, by the mountains or near the sea. Integrate health and an unquarantined life into your work meeting.

But remember… TIME WAITS FOR NO ONE.

Carpe Diem,

ALSO, if you haven’t yet — buy my book now while it is still only $8. The Goal Driven Business. It will help you achieve your goals.

The Future Belongs to the Best

Posted on March 23, 2021 by Edward Petty

A few years ago, a staff member at an I office visited confided in me and told me the following story:

“Our office was really slowing down last year. So, the doctor decided to take everyone out of town to a weekend practice management seminar. The speakers discussed really cool methods for doing our work. It was fun and we learned a lot. Plus, we also went over some great marketing ideas. We were all pretty excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members were still dealing with patients, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting. We were interrupted with a few phone calls, and some patients started arriving early for their afternoon appointments. We had to cut the meeting short and didn’t get to discuss much of topics of the seminar, but we agreed to continue the meeting the following week.

“As it turned out, something always came up each week and… we never did meet again about the seminar.

“But we were still pretty pumped from the seminar and we had one of our best months ever. It was my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were still on the break room table, never opened. I stored them away for future reference.

“Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. The numbers are back down, some of us are a little burned out, and I don’t think we ever did implement anything from that seminar.”

—

Sound familiar?

I bet it does. I have seen it play out almost the same way countless times.

We are in the improvement business. We help people improve their health. We should be able to do the same for our business and for each other. In fact, if you are not constantly improving, your patients will seek practices that are.

In this new decade, apart from the many new events and changing tides of culture, technology, and mega-corporate influence, your future success is up to you. And it will be primarily based on the quality of your service and your outcomes – the experience your customers receive.

A report from a survey by Microsoft underlines this:

“As customer expectations continue to climb, it becomes more challenging for brands to set themselves apart from the competition. Markets are increasingly crowded, and both price and product are being steadily overtaken by customer experience as the number one brand differentiator” (Microsoft 2018, State of Global Customer Service Report).

More than any other short-term marketing tactics you may be using, only the best offices will thrive in the long run. And those will be the offices that are working on consistent improvement. Mediocrity could get you by in the past. But now, the future belongs only to the best.

But I have noticed that most offices just do not spend enough time consistently on improving their performance. After studying this for some time, I have observed a number of obvious and even hidden barriers that prevent us from working on improvement. I will explain what these are in a later article, but the following steps can help you ensure that you work ON your business to improve it, not just work IN it.

Your Improvement Clinic – Your Goals Lab

Time spent on improvement doesn’t cost. It pays! Some business owners are concerned that time spent on improving the business or staff is too costly. It can be if the training or planning is poorly done. But remember that:
a. Better team efficiency generates better revenue.
b. Better trained and focused team members generate better revenue.
c. Better outcomes generate better revenue.
Head Coach. As the owner and CEO, you are also the Head Coach. How your team does – the business – is in large part based upon your coaching.
Give it a name. In my new book, The Goal Driven Business (to be launched on July 4th of this year), I use the term Goals Lab as it is a location where you can go to work on getting to your goals faster. It could be your breakroom, a restaurant, a park, the reception area – anywhere really. You can call it your Practice Field, Improvement Dojo, or Mystic Garden! Just consider it a place and time that is separate from your time with patients.
What gets done.
a. Team meetings for communication, review, coordination, and planning.
b. Team training and practice.
c. One-on-one training and practice.
d. Personal training, study, meditation.
Schedule these routinely – weekly, monthly, quarterly, and as needed.
No interruptions, no calls, 100% attention present.
Be challenging. You don’t get better unless you question what you have been doing to see how it could be better.
Go over this with your team. Let them know that they, too, are coaches. And players as well. So, improvement is a team activity, one that requires responsibility and professional discipline.

Your car mechanic can’t work on your car when you are driving it down the freeway. You can’t see patients while they are driving their forklift at work or cooking dinner for their kids at home. You need a separate time and place dedicated to work on improvement.

Your goal is to create an expert office that generates expert results and gives your patients the best experience they can receive from any other comparable health care business.

Imagine your business being so good that patients not only drive in from across town, or even across the state, but fly in from all across the country to receive your services. Imagine that there is such a demand for your care that you even build a motel next to your facility to accommodate the out-of-towners.

Well, there was a Doctor of Chiropractic who was just that good. His name was Clarence Gonstead. His advice?

“Practice. Practice. Practice. Never stop.”

Ed Petty - author

The Morale Virus: What doctors say and how they are combating it

Posted on February 1, 2021 by Edward Petty

Over the last few months, I have been noticing a particular phenomenon in offices that I don’t think I have seen before… maybe ever. It is like noticing a slight hand tremor that you never knew you had or a buzzing sound from outside that has become increasingly loud and annoying.

2020 was a long year, a stressful one. And you all have been in the thick of it. Daily, seeing more people in one day than most providers see in a week – or more.

My old football coach, Johnny Pappa from Davis, made a big impression on me as a young freshman when he said: “When the going gets tough, the tough get going.” In my then youthful life, I had never heard such profound words. They still apply – especially to you. You are tough!

But stoicism has its limits. The cognitive dissonance can finally get to you.

One doctor expressed to me extreme frustration about two young and very healthy patients, who exercised, got adjusted, ate well, took their vitamins, but decided to discontinue taking their outdoor walks for fear of COVID.

Another doctor, venting his dismay, told me that he couldn’t bear to watch the medical bureaucrats talk about masking and vaccinations as the only remedies to COVID when he knew of so many methods that have been demonstrated to ameliorate the virus. “People are frightened and told to stay at home, don’t socialize, wear a mask if you go out, and wait for the vaccine. That’s it? That’s all you got for people? This really shuts people down.”

One doctor I talked to who, after dealing with depressed and suicidal patients, many of them vets, has become depressed himself. Another wonders what the hell is happening to our chiropractic colleges – have they all been taken over by medical bureaucrats? Is chiropractic finally squashed?

Your good nature can become frayed, your patience worn thin, and regardless of your professional composure and your disciplined countenance, the stresses can have an affect. I mention this because most of you are tough as nails – you have successfully dealt with many types of stressful situations in the past, as a doctor, professional, and for many of you, a business owner.

Morale Virus

So if you are feeling a bit off, recognize that you might be affected by a contagious “Morale Virus.” The Morale Virus is what I call the social sickness that occurs as an emotional response to continual fear-baiting. Frightened, your patients are told they can’t do this and shouldn’t do that.

The Morale Virus is not caused by hardship itself. It is caused when you are pushed into a corner and given no way to fight back. You tend to give up. (Or go stark raving mad!) (Reminds me of the movie, One Flew over the Cuckoo’s Nest when the star, McMurphy (Jack Nicholson), says: “You guys complain how much you hate it here, and then don’t even have the guts to leave! You’re all crazy!”)

There has been a constant assault of bad news emanating from officials and authorities. Yes, and I know the media plays a part — it is mostly owned and controlled by just a few rich people and corporations who have their own agenda — namely, more money. But still – no one buys boring newspapers. Sensation sells the news, and we, the consumers, buy it. We listen and read the “news” that riles us up and confirms our bias. Social media does the same, times ten.

Dirty Laundry (Song by Don Henley)

I make my living off the evening news
Just give me something, something I can use

People love it when you lose. They love dirty laundry
We got the bubble-headed bleach-blonde who comes on at five

She can tell you about the plane crash with a gleam in her eye
It’s interesting when people die, give us dirty laundry

Morale Virus Disinfectant

Here are some ideas on how you can fight back, disinfect your office from this disease, and better help your patients regain their spirit of hope, kindness, and free enterprise. And yours as well.

Good Vibe Year

One doctor we work with likes to anchor her practice around a yearly theme. For 2021, she is calling 2021 the year of Good Vibes and has events planned to support this philosophy. And just to reinforce the idea, she has T-Shirts made that say Good Vibes. (And by the way, she has a bustling two-doctor office.)

Study. Acquire More Knowledge. Teach

Fear is often a byproduct of lack of knowledge – so arm yourself with the facts.

For example: Roommate 1: “Oh my god! (A panic shout is heard.) The television isn’t working and the game is on. What will we do?” (Drama ensues.) Roommate 2:(Calmly) “Check the remote for new batteries.” Roommate 1: “Ah, that fixed it, thanks.”

Study, use critical thinking, avoid bias – your own and others. Go to the sources – research studies and from people who are actually working on what you are studying. Then, please educate your patients and clients on how to be happier and healthier. And educate your team, help them increase their knowledge. Arm them as well. Doctor comes from the Latin to docere – “to show, teach, cause to know.”

Leverage Point

What area in your office, if changed, will produce the most significant effect?

Obviously, first and foremost is the doctor. Each day should be a trip to the playground, the ski slope, the baseball field, the dance floor. Ideally, each day is a fresh opportunity to accept the privilege of helping as many people from suffering as possible, to teach them, and have fun doing so.

In most offices, I would also say it is your front desk. The front desk’s power is so poorly recognized in most offices that at least 20% or more production is lost. A vibrant, aggressively friendly, caring, mission and goal-oriented front desk can and will boost your volume – this week. Front Desk team members may need more support and less admin (billing) duties. They may need a better understanding of the mission and how your office is helping people.

Entrepreneur Harder

During cultural upheavals and shifts, entrepreneur businesses remain and often thrive. New opportunities open up. More established and larger companies are weighed down by dogmatic rituals, have high overhead and many vice presidents, and vast networks of suppliers. Change is difficult. But not for the entrepreneur. Most entrepreneurs are all too “change-happy.” You can adapt, innovate, and overcome quicker than companies who are afraid to or can’t. So what if in-person care classes are out for now? Get everyone on a Zoom class, give them a secret word. Test them when they come in again and if they answer correctly, give them a gift – a bottle of Vitamin D or a lunch at another patient’s business.

Stay Out of the Weeds

One doctor told me that her solution was to “stay out of the weeds.” To stay in her lane and just keep helping people and not get caught up in the storms of controversy. I suggest that this is the best course of action. You want news? Sensational news…? Just listen to your patients and staff and community. But stay on the fairway and don’t get sidetracked, mentally or in real life.

Goals

Stay with your goals. Goals are agreements that you made with yourself, and usually others. If you stay true to them, they will lead you out of the den of the morale sickness. Staying true to your goals is a point of integrity. Your goals are not in the weeds – they are straight ahead. Figure out new and better ways to get there or resurrect old ways that worked. Fall down 7 times, get up 8. Each day and each week — begin with the end in mind.

Your goals are in three categories:

Financial. This includes marketing and production.
Service. Developing individual and team expertise with constant improvement..
Purpose. Your higher purposes, those goals outside of work that are greater than this week and that are most meaningful need to be integrated into your work-life.

The Future is Bright and Roaring!

We have seen harsher times. The past is easily forgotten, and we think we are in the worst of times. Well, the 1918 flu was much worse than COVID. Plus, we were sending our young boys to suffer in horror and die in the trenches in Europe in the Great War. But society prevailed and soon ushered in the Roaring 20’s, a time of economic growth and cultural freedom.

Prepare to roar!

Carpe Deum (Seize the Day)

This is such an important subject, I encourage you to share it with your team and colleagues: To print out a hard copy

Tent Poster – What it Takes to Win – Bryant

Posted on August 4, 2020 by Linda

I’ll do whatever it takes to win games, whether it’s sitting on a bench waving a towel, handling a cup of water to a teammate, or hitting the game-winner shot.”

– Kobe Bryant

For a printable copy of this tent poster click: What it Takes to Win – Bryant

Tent Poster – Mental Toughness – Goggins

Posted on August 23, 2018 by Linda

“It’s so easy to be great nowadays because everyone else is weak. If you have ANY mental toughness, if you have any fraction of self-discipline; The ability to not want to do it, but still do it; If you can get through to doing things that you hate to do: on the other side is GREATNESS ”

— David Goggins

For a printable version of this tent poster visit: Mental Toughness:Goggins

Goal Driven: Faster to Your Goals!

Posted on June 11, 2018 by Edward Petty

David Goggins

Now and then I see a motivational talk that I find inspiring.

It doesn’t happen too often.

Below you will find links to an interview with David Goggins. I can’t say much about it other than I found it inspiring and relevant. He reminded me that by pushing through, and not dodging from, discomfort when working toward important goals can lead to success and fulfillment. An important lesson for us all.

David talks about how he achieved his goals. He is an American ultramarathon runner, ultra-distance cyclist, triathlete and former world record holder for the most pull-ups done in 24 hours. He is a retired United States Navy SEAL who took part in the War in Afghanistan and the Iraq War.

Please watch it. If it resonates with you, you may want to watch it with your team and discuss afterwards.

Sincerely,

Photo from Wikipedia
Thanks to Dr. Maxwell for the reference.

Links to interview:

NOTICE: Some use of profanity #@!*#!

57 minute version: Search David Goggins on Impact Theory, With Tom Bilyeu. https://www.youtube.com/watch?v=78I9dTB9vqM&pbjreload=10
23 minute version: Abridged version: The Most Motivational Talk EVER! – David Goggins
https://www.youtube.com/watch?v=oIrT1eHs1b0
10:30 minutes How to Conquer Your Mind and Embrace The Suck

Special Promotions: When Your Motive Meets Your Mission

Posted on May 21, 2018 by Edward Petty

When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.” — “Mr. Rodgers” (Fred Rodgers)

Many offices (chiropractic, dental, etc.) hold special events, such as a “Kid’s Day,” a “Patient Appreciation Day,” an anniversary party, or in-office workshops. (We have links to examples below.)

The objective is usually to generate new patients, increase goodwill, and motivate existing patients. Sometimes these events are productive… and, as you know, sometimes they aren’t.

To be effective, you have to offer something that the patient, or prospective patient, considers valuable. It could be a workshop on practical health tips or a discounted service for a patient’s family member.

This is obvious and I am sure this is what you aim for. But there is another ingredient that you may not have considered that will make your events even more effective.

Link your promotions directly into your office mission.

Your mission is to help people. You may have it more fully defined in a “mission statement,” but it comes down to helping people achieve their health goals. Your mission is altruistic and socially responsible – you aren’t selling oxycodone at the pharmacy, high fructose corn syrup drinks at the grocery, or glyphosate at the local Round-up store. You are the good guys.

Your community will support you to the degree that they understand your pure altruistic motives. Why? Because the members of your community, by and large, are altruistic too. Your neighbors also… want to help people.

It is not a dog-eat dog world like social media or the “news” wants us to believe. Money is made from controversy and opposing sides and so it appears like we are fighting our local townsfolk… or should be. But behind all wars there are vested interests. Fear and anger motivate people and help sell media, advertising, and weapons.

But the truth is, the vast majority of us want the same things and we are not as divided as we have been manipulated to believe.

The organic food business has been growing, as have companies that sell organic clothes. Pesticides, herbicides and other poisons are not only bad to eat, they are also not healthy for the workers that bring these products to us. People are realizing this. “Fair Trade” coffee has become a major selling point. More companies are integrating social responsibility initiatives as part of their long-term strategies…for good reason.

In a study done in 2015, it was shown that consumers wanted to take personal responsibility for social and environmental issues and indicated that they looked to companies as partners in pursuing improvement efforts.

“The leading ways consumers want to get engaged with companies’ CSR [Corporate Social Reasonability] efforts are actions tied directly to their wallets, with nine-in-10 just as likely to purchase (89 percent) as to boycott (90 percent) based on companies’ responsible practices.

“If given the opportunity:

80 percent would tell friends and family about a company’s CSR efforts
76 percent would donate to a charity supported by a company they trust
72 percent would volunteer for a cause supported by a company they trust
72 percent would voice their opinions directly to a company about CSR efforts”*

How do you better apply this public trend?

You can encourage your patients to make appointments for themselves, and their family and friends, in exchange for making to make donations to a needy local charity. You can have them volunteer at a food pantry or a shelter with you and your staff – and offer all who participate a free service.

Integrate you mission in all your promotions on a regular basis and you will create a positive “network effect.” Other residents who volunteered will begin to promote your business on their own – even if they never step in to your office.

You should be way past working for United Health Care and Big Insurance. You should work for your patients and their causes – which are yours as well.

If you lead all your promotions with your heart, with your mission, with your higher goals, and deliver excellent outcomes with extra-ordinary services, your patients and your community will support you.

You are “The Helpers.”

Be true to your higher goals and all else will follow.

Ed Petty

*References:
•http://www.sustainablebrands.com/news_and_views/stakeholder_trends_insights/sustainable_brands/study_81_consumers_say_they_will_make_
• https://www.forbes.com/sites/sarahlandrum/2017/03/17/millennials-driving-brands-to-practice-socially-responsible-marketing/#61519f914990

Links to special promotions article and list of special promotions

Special Promotions-What They Are

List of Special Promotions-2018

The Merry-Go-Round: Planning for a Prosperous Practice in 2018

Posted on December 15, 2017 by Edward Petty

Progress in practice is made by steady persistence and passion.

In Angela Duckworth’s new book, she calls this “Grit.”

Think of evolution, think of growing crops… think of growing children! Whether it is child development or practice development, growth is achieved through steady and unrelenting nurturing and adjusting according to circumstances.

I recommend you take some time to do some planning before the New Year gets in high gear. January and February are good months to do this. Do it by yourself – and do it with your team. But…

Don’t reinvent the wheel… Just make it go faster with less effort.

The Vital Few

A few of our actions are always more productive than most of the other actions that we do. Unfortunately, we can get distracted and spend far too much time on activities that, in retrospect, just don’t give us that much of a return.

The “vital few” actions that have helped you the most will be camouflaged, even countered, by the “trivial (but useful) many.” This is a term used by Nathan Juran, famous for his approach to business and quality improvement and the Pareto Principle.

And, I would like you to consider this: In many respects, your business has succeeded in ways that – perhaps – you have not yet recognized. Therefore, I don’t recommend abandoning all you did last year and start chasing the newest “shiniest” procedures that seem appealing.

The key is to dust off all your actions from 2017 – review everything you did — and see the great things that worked and the victories you and your team achieved.

Then, just find better approaches to do more of this!

Diamonds in Your Office

The idea of having diamonds in our backyard, a story made famous by Russell Conwell (1843 – 1925) of the 1800s, applies. There are many variations, but it goes something like this: there once was a man who wanted more wealth, so he sold his house and left in search of diamonds. Years later, penniless, he happened back to his village where he roomed at a shelter for the poor. The shelter was supported by a grant from a local resident. In inquiring who the resident was, the diamond searcher discovered that it was the person to whom he had sold his house.

One day he paid a visit to his old house, now renovated into a beautiful estate. He talked to the new owner who told him that he had become rich. He said that when he bought the house, he needed to do some digging in the backyard where he discovered thousands of diamonds.

The moral of the story is obvious: you already are rich – you already have the diamonds. You just need to polish them.

Many of the components of your future success are already in your office. But we overlook them, or use them once and then forget about them, like teenagers looking for the next new article of clothing to make a fashion statement.

As entrepreneurs, creatively – we are all looking for that next dopamine high… and seek the next new “shiny” thing.

You have a show on the road. Just make it better. Make it fresh. Set a new standard, and make a new game to “level up!” Add a few new things here and there, but keep doing what is working.

Looking for Your Diamonds

Review what has been working for you. Reaffirm it and keep at it. Look at what hasn’t worked that well and fix it so that it does, or drop it like barbell that you have been holding over your head for too long.

By yourself, and later, with your team, here are some areas to look into:

____1. Review Your Mission Statement. Does it apply? How? Does it need to be customized? Beyond your mission, what is your WHY? Does the mission satisfy this?
____2. What Are Your Outcomes? For example: “People relieved of pain, healthier, educated so that they can and will continue to improve their health… and refer others?” You can also define Minimal Viable (Valuable) Outcomes, e.g., “A patient who accepts care.” Etc.
____3. How Is the Office Vibe? This is determined by your values and how everyone is living up to them. Are these values posted for all to see and check how they are “measuring up?” Are they defined? Do we need to add more, change some, delete some? Should we better define each value? Should we add:

• Trust. Are we worthy of trust with our patients and ourselves?
• Mission Oriented. Do we help each other cheerfully achieve our mission – each day?
• How well are we living up to these?
• How can we live up to these better?

____4. How Were the Numbers? Up, or down?

• When the numbers went up, what did, or didn’t we do? How can we improve upon this?
• When the numbers went down, what did, or didn’t we do? Should we improve or discontinue those actions?

____5. Individual. What can each one of us do professionally this next year to improve our ability to contribute to our team and its mission?

Some of this should be on simple, brief checklists and memo’s. Add it to your Practice Playbook. Document it so that it can be referred to for training and coaching in the future.

Merry-Go-Round

Imagine that your practice is a merry-go-round, the kind you find at children’s playgrounds.

It takes a lot of energy to push it and get it going. But… once it is moving, it takes less effort to gradually get it going faster. And faster! And faster…

Take some time to review how you are pushing your merry-go-round. What procedures worked better for pushing it faster? Focus on these… Makes these better.

Go faster… and push less.

And as you do, watch those, including yourself, hold on tighter and smile bigger.

Enjoy the ride!

With admiration,

–Ed

The 3 Key Ingredients to Motivating Your Chiropractic Team

Posted on May 8, 2017 by Edward Petty

Most of your staff are not engaged in the success of your office. Most of them JUST DON’T CARE.

At least that is according to a 2015 Gallup report that interviewed over 80,000 working adults.

The report showed that there are twice as many “actively disengaged” workers in the workplace as there are “engaged” workers who like their jobs. The percentage of U.S. workers in 2015 considered engaged in their jobs averaged 32%. The majority (51%) of employees were “not engaged,” while another 17% were “actively disengaged.” (“Actively disengaged” means that they are actively sabotaging their work.)

But let’s say your office is different, which I am sure it is. You are motivated enough to read this article and I am sure that is reflected by your team as well. But all the same, take a look with me at the level of motivation of your office.

How was your last team meeting? Were you there? Was everyone sitting on the edge of their seat and contributing new ideas and plans on how to reach new goals in the office? Or, were most everyone pretty silent?

Sure, your employees smile and look busy when you are around, and often work hard and they do care. But really, how much?

What would your office be like if the motivation, creativity, and level of pro-activity was always very high at “10,” or even ranged from 7-10? If they felt that it was “their” business, where they took responsibility for the quality and quantity of outcomes, and regularly worked to improve the business – and themselves?

I have been reviewing the subject of motivation for some time, from my own experience over the years and from what social scientists have reported.

I have incorporated certain principles into a new system of business management that are specifically designed to unleash everyone’s innate motivation – including business owners like you!

Motivation is the foundational in a chiropractic office, or dental office, acupuncture – even with therapists and other service firms. It is a bedrock for any healthy practice and business.

Here is one very useful principle specifically about motivation and how you can use it to generate more engagement – and productivity — with your team.

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

You do. This is one of the reasons you went to school – and why you started your business.

We all want to have something that we can call our own where we can create and demonstrate our competence. What we get in return is feedback that we can do something good, that we have power, that we can make something beneficial happen, that we can … make a positive difference. If only to ourselves, we can say: “Look what I did. I did this. This is my creation.”

You can see it in children, for example, when they bring you their colored scribbles on crumpled pieces of paper to proudly show you their great work of art. This is their sandbox.

Of course, we all work for money. But we also have deeper motivations that if tapped into and nurtured, can be very powerful. By harnessing these motivations, and then linking them with others who have a shared goal, we can create a dynamic team driven business that is very profitable.

This has been explored by social scientists who have studied what has come to be called Self-Determinism Theory. I have also seen it in action. Essentially, it states that we all have innate drives and inherent needs that motivate us to be more self-determined rather than determined, or controlled by, outside forces.

External motivation, like the fear of being fired, can only motivate us so far. Threats, criticisms, negative reinforcement may produce short term action, but in the end, they demotivate, or worse.

The level of employee motivation has a tremendous influence over the success of your business.

An unmotivated staff, one that only becomes engaged to the level of “I will perform just good enough so that I don’t get fired or criticized,” will weigh the office down.

Self-Determinism Theory (STD) has three components, all of which easily apply to your business. These are:

Autonomy
Competence
Relatedness.

And by the way, while reading this, consider how this also applies to you as well!

Autonomy

You do not want your treatment plans second-guessed by a clerk in an insurance company. Neither does your front desk want you breathing down their necks about where all the patients or practice members are, or why they used the blue pen. You should train and educate your team, but then get out of their way and let them succeed or fail.

Think of helping a child ride a bicycle. Sure, they will need your help for a while. A push now and then. Perhaps some training wheels. But you will have to let them fall down a few times and allow them to get the courage to get back on the bike and succeed. You can continue coaching them to improve, but you must let them go.

Even if you see employees appearing idle, or having brief personal discussion with another employee, back off. Tolerate minor errors. Give your team some rein. Come back around later to coach them and train them to improve. Mostly educate them on the mission of the office and of their roles, and get them to understand what outcomes they are supposed to be producing. Once they see that the statistics measure their performance, they will be more self-directed and want to do all they can to win the game!

We all want to be free to create our own enterprises, even if we work for someone else. As long as what we do is in line with the purpose or mission of the business and our role, there should be no problem. This helps us demonstrate our competence, which is the next element of Self-Determined Theory.

Competence

Doing a good job, all by itself, is its own reward. It pushes away self-doubts and shows us, and others, how good we really are. It is positive reinforcement.

And the better we can do a good job, the better the results will be, which demonstrates to us just how awesome we truly are! Plus, as we increase our skills, we also will find that our duties are easier to perform.

Your team wants to improve their skills. Help them do so.

Sign them up for seminars, webinars, give them monthly reading assignments, and give them a coach or three of them. But this has to be done in conjunction with your supervision. You will need to guide them through the training so that they see how it applies to their roles and the business as a whole. Quiz them on what they are learning and have them give presentations to the team on what they are learning. The old maxim applies: “to teach is to learn twice.”

And where possible, make sure they earn certificates and can wear pins or insignia that testify to their competence. This goes along with Game Theory – people win at one level and then want to go to the next level. They want their “badges.”

Business owners throw staff into their jobs and expect them to produce with little or no training. Without exception, the offices I have seen that provide more training and coaching for their team — do better. Companies spend an enormous amount on employee training. $161 Billion in the U.S. last year (trainingindustry.com). And, it pays off.

One study showed a comparison between car companies and how many hours they trained their new employees: Japan spends an average of 364, Europe averages 178, and the United States – 21 (Pfeffer –The Human Connection).

And you can guess which country has cars with the best frequency of repair record.

Children want to be super heroes and wear their capes.

Don’t we all!

Relatedness.

This is the feeling of being connected – and there are two aspects to this.

Family. First, “relatedness” is the feeling of not being left out of the “loop” and of being included. Staff meetings help with this as does the general work environment. This is the sense that we are in this venture, job, and profession together. That we are part of a family.

Keep your team involved with your decision making. Give them some of the issues you are dealing with and encourage their input. They are stakeholders – it is their office too!

Greater Purpose. The other aspect of relatedness is that people generally want to be associated with a greater purpose. The more that each member can connect to the greater purpose of the group and make it their own, the more motivated they will be. Taking it a step further, if employees have higher goals of their own that coincide with the organization’s and they are allowed to pursue them within the organization, there would be no reason for employees to work anywhere else.

Train your team, let them own and creatively improve their own areas – and help to do the same for the entire office. Nurture camaraderie and a spirit of family – and always remind them – and yourself — why we are doing what we are doing.

Do this, and not only will your business be more successful, but you too will be more motivated and have more fun in the bargain.

# # #

Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Ryan, R. M. & Deci, E. L. (2017) and Why We Do What We Do: Understanding Self-Motivation Paperback – August 1, 1996

© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the Singularity. © May, 2017

Our Shallow World – and What Your Chiropractic (Acupuncture, Dental, Medical) Patients Really Want

Posted on March 15, 2017 by Edward Petty

We live in a shallow and superficial culture. It is fast talking, faster messaging, with abbreviated emotions and texts.

No one seems to really care, or takes the time to care.

Communication has become digitized and synthesized. We forward messages from some people we know, and from many we don’t, to people we know, and to many we don’t. We are addicted to our smart phones and “phub” each other. (Phub: The practice of ignoring one’s companion or companions in order to pay attention to one’s phone or other mobile device. Google.)

We buy things from “clouds” that seem to know what we want, as if they had been eavesdropping on all our personal affairs.

The Age of Artificial Intelligence that cares more for us than people who “friend” us is growing faster and faster.

Yet, somehow, shallow works. It is practical. It is fast and efficient. When I ask you “how are you?” I really don’t have the time to hear about how your kids did at their Christmas play, or how you like your new socks. I have my own deadlines and have to go.

We are caught up in minimal viable encounters. They are functional, but they provide the only the minimum amount of care. Any less, and there wouldn’t be any service at all. They are “duct tape” solutions.

This is our life now. The fast, the short, the immediate.

For all its practical aspects, this is the first goal in any business exchange. We must provide the outcomes and services that are initially wanted by our patients. This is a “drive through” consumer culture that moves quickly for things that are wanted. In return, business is trained to provide the minimum quickly, efficiently, and yet is still valuable.

But just because our society is shallow, does not mean that your patient is.

This may be the culture in which they have adapted, but privately, your new patient might not have been satisfied with the services they have been receiving from others. And as the expert and professional, you know that it is likely that they have been short-changed on their care.

No doubt, your patient wants relief – now. But if you want to know the truth, they probably want more than just a quick-fix.

Your patient is looking for someone who genuinely cares. They are hoping to find someone who listens, empathizes, and someone they can trust to help them get what they really want.

What do they really want?

Ask them:

What is most important to you about your health?

Then, find out why.

This is a broad and open ended question. It takes the both of you through the quick-fix drive-through to get to, finally, what they really want.

If I have a painful tooth, I would see a dentist to at least treat it enough so that it wasn’t causing me discomfort. But if the dentist asked me what I really considered important about my dental health, I might say that I would like cavity free teeth that never caused me pain. I would like all my teeth and gums to be healthy and look good until I am at least 105.

The dentist would then repeat back to me what I said that was most important about my dental health so that we could agree that this was my goal — something I wanted. With this disclosed and agreed upon, we could now dig into my history and perform the exam to see what was going on that was causing the symptoms.

Once all this was done, he would explain to me not only what was causing my pain, but what I needed to do, in the long term to get my mouth 100%, which we already agreed upon I wanted.

I definitely don’t want or need a hard sell for something I am not sure I need.

But if you find out what I really want and let me know that you can deliver, you won’t have to sell me. I am already motivated.

Confrontational Anxiety

Confrontational anxiety is that stress you, and your patient, can feel when discussing the length and expense of your recommended treatment plan. But it melts away and evaporates if you work towards what the patient really wants.

There are many different approaches designed to help get the patient to agree to a more complete treatment plan, including scripted words or phrases for the doctor and staff to say. Ultimately, the patient must trust you. They will have to understand what is causing the symptoms, what it will take to get better, and the benefits to be had. In the end, you will want to work out your own procedure. (Give us a call, we can help!)

Realize that your new and prospective patient is just barely trusting you, as it is. They would like to trust you more. They hope for more than just a “pop and pray” (“…and hope that they pay”) treatment and adjustment from you. What they usually offer you, or present to you as a new patient, is a symptom that may have deeper causes. Their condition is probably not new. They likely have had it, or some aspect of it, for some time. Only when it becomes more acute do they come to see you.

The analogy of the iceberg is useful.

Your patient wants relief, but also wants everything in life that the pain hampered or prevented. This might include less recurring episodes of pain, the ability to resume their hobbies and sports, improved performance in life activities, stronger immune function, better balance, increased knowledge to improve their health, more happiness, better weight management, and more energy. You can and should make a list of at least 10 benefits that come from a patient completing their treatment plan.

I buy a new car not to just have a better ride, but to feel that I have a better life. I pay for a cleaning service because I want a cleaner house, but deep down, I really do so because I want a happier wife.

Patients are too often short-changed because of a culture that is fast and shallow. You don’t have to be – and you can give your patients complete and thorough care. This is what they want – once they understand their condition and what you can provide. And, once they trust you.

Be interested in your patient and go deep to find out about their health, their history, and what they really want. Then, educate them on how the both of you, working together, can best help them get what they really want — and what you want and can deliver.

© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the singularity. © 2017

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Tent Poster – Making Friends – Dale Carnegie

Posted on September 20, 2016 by Linda

“You can make more friends in two months by becoming interested in other people…
…than you can in two years by trying to get other people interested in you.”

~Dale Carnegie, How to Win Friends and Influence People

For a printable copy of this tent poster visit: Making Friends

Your Most Important Set of Chiropractic Office Procedures

Posted on January 18, 2016 by Edward Petty

An Introduction to the Practice Development Process of Continuous Improvement

A key difference between a successful and profitable chiropractic business and a roller coaster type practice can be traced back to procedures and systems.

Many practice problems occur because procedures are not established, consistently followed, and regularly improved. This has been the secret to franchising. Starbucks may offer new products and services now and then, but for the most part, they follow their checklists and manuals of successful procedures. The local New Age coffee shop down on the corner with the unemployed guitar player usually lasts for about a year before the owner’s savings and inspiration dry up, along with the last cup of coffee.

Of all the categories of systems in your office, what would you say would be the most important?

☐Patient Accounts (Billing/Collections) Systems
☐Marketing Systems
☐Front Desk Systems
☐Therapy and Clinical Support Systems
☐ Doctor Systems
☐ Business Systems (Payroll, Financial Planning, Taxes,)
☐ Leadership
☐Office, Practice Management Systems

My guess is that you usually keep most billing procedures in place as… obviously, you need to be paid. And, you will usually keep most front desk procedures in place. These deal with patients and patients are obviously in the office, or not. And you, of course, follow your clinical procedures.

Your marketing procedures come and go, at least they do in most offices. They are just not consistent. This is why I put together the Marketing Manager System in 2000. The biggest error in most offices with their marketing is that it simply isn’t done consistently.

But the most important category of systems is not so obvious. These are the management procedures and systems. Why are these most important? Because they keep all the other procedures in place and are continually being improved upon.

Why do you think CEO’s are paid so much money? Because they are in charge of the management of a business and are able to increase its bottom line by the millions. They have procedures that they follow and insist that others do as well. These procedures all add up to systems.

Over the years, Petty Michel and Associates has been very successful at increasing the revenues of practices. One of the reasons is that we implement what we call the Practice Development Process. It is a monthly system of management that gradually works to objectively improve the business, repetitively over and over. It integrates into your current systems and does not take that much extra time. But in the end, it saves you a great deal of time, extra work, and lost revenue.

To learn more about the 3Goals Practice Development Process: 3Goals PDP

The 3Goals Practice Development Process for Chiropractic Success

Posted on January 18, 2016 by Edward Petty

Four steps to continuously develop and improve your practice

The Practice Development Process is a simple, yet powerful practice building system that can help take you and your business to its full potential of a systematized, team driven and profitable business.

It transforms your practice. Month by month, it helps move your practice to a more profitable service oriented business that runs at near full capacity – with less ups and downs that demand your time and extra work.

It is based upon the idea of constant improvement.

The principle of constant improvement in management science has been a major factor in the success of large manufacturing corporations around the world. The success of the Japanese automobile manufacturing rests heavily on a process of constant improvement called Kaizen (kai = change, zen = good). Motorola developed its own program called “Six Sigma”, a process of continuous improvement.

We have adapted these processes to be applied in practice management and call it the 3Goals Practice Development Process (PDP).

The Practice Development Process has four steps:

Access
Plan
Supervise
Document

Integrate This Process As Part Of Your Team Meetings. The first two steps, Assess and Plan, are usually done before or during the first staff meeting of the month. Supervision goes on during the month to ensure that the plan gets completed. At the end of the month, successful procedures are documented in a practice playbook for future training and assessments.

Your Consultant and Coach. This process is best done with your practice and business coach. Each month, the two of you should work through step 1 and 2. During the month, your coach may also be able to help with the implementation of the plan.

THE 4 STEPS OF THE PRACTICE DEVELOPMENT PROCESS:
1. Assess and Review. At the end of the month, look over the statistics and note what areas improved and what areas didn’t. Then check what was actually done, or not done in each area. Use your departmental checklists from your Practice Playbook if you have started this.

Many business owners still manage without looking at objective indicators. They manage by emotions, mistakes, fear, “bright ideas”and other flighty factors that ultimately hold a clinic back, or often just burn it out.

Effective clinic managers, like an athletic team coaches, base their actions first on actual outcomes and performance monitors. These are your daily, weekly, and monthly practice statistics. PM&A has developed a specialized form of review which is called Practice Analytics System which we display on our client’s personal Practice Dashboard’s.

This assessment also includes reviewing checklists of the key procedures and whether or not key duties were done.

2 Plan. Work out the key areas you want to work on in the next month. Pick just one or two areas that will make the biggest difference and make a list of a few action steps that will help improve the area in your office you have targeted. Get the actions assigned with a date on when they should be done.

3 Supervise. Regularly monitor the implementation of the action steps with yourself, your team, and your consultant. Provide help where needed to get them done.

4 Systematize. You do not want to keep inventing the wheel, so at the end of each month, document any procedure that worked well.

List all successful activities for each department and “lock them in” as standard operating procedures. Keep what works, throw out what doesn’t. Start with just a checklist of key procedures. Later, you can write or videotape a description of each procedure. It is from this that you will do your training and “coaching reviews.” Use your playbook often: refer to it and practice.

Gradually, you should have your own system of practice management and patient management and have it outlined simply in your Practice Playbook. For example, the “Smith Chiropractic System of Patient Management.”

IMPLEMENTATION SCHEDULE
Week 1. First Week of the Month: Do Steps 1 & 2 – Assess and Plan
Week 2. Supervise. Coordinate upcoming activities. Study and Train. (Optional: Separate Marketing Meeting)
Week 3. Supervise. Coordinate upcoming activities. Study and Train.
Week 4. Supervise. Coordinate on upcoming activities. Celebrate and party for a great month! Add to Practice Playbook.

REPETITION
Do The Practice Development Process Every Month.
The success of this process derives much of its power from a simple principle from Aristotle.

“We are what we repeatedly do.
Excellence, then, is not an act, but a habit.”

This often referenced quote is from a series of lectures he was to have given at the Greek Lyceum on ethics (300 B.C.). We could say, then, that continuing to do the Practice Development Assessment, and all of your procedures and systems, is ethical and leads to excellence. The contrary would also be true.

GOALS AND CONSTANT IMPROVEMENT
It is important to keep in mind WHY we are doing the PDP each month.

It is assumed we all want to improve, that improvement is possible, and that we have higher purposes and goals. Our patients do. That is why they see us and we help them improve and get closer to their goals at each visit.

By consistently working the 3 Goals Practice Development Process each month you, the practice, and each team member will also get closer to the higher goals each of you share.

10 Practice Development Strategies for Chiropractors in 2015

Posted on December 31, 2014 by Edward Petty

[If you think that you could make more money selling pharmaceuticals, injecting patients with vaccines and promoting flu shots in front of your office, these recommendations are not for you. For those matters, you might want to ask Palmer Chiropractic College or the Wisconsin Chiropractic Association for their opinions.]

What strategic moves should you be taking now to make sure that you have a better year in 2015 and in years to come?

After reviewing current literature and statistics, and based upon my observations and experience, I have put together a report which makes a number of recommendations that can be helpful to you. I have also included an extensive list of references for your further study.

The report contains a lot of information and so it is only for the serious practice executive. It will be a useful resource for you to refer to while you implement some of the suggestions I offer. Reading time is about 15 minutes. It offers new views on practice marketing, management, and leadership, with 25 specific recommendations. To go straight to the main course, go here:

Here is a shorter version:

Executive Summary – 10 Strategies to Prosper and Flourish in 2015 and Beyond

1. Know Your Environment. The Medical-Pharmaceutical industries are spending more to dominate the market place. Their efforts are becoming more pervasive in reach and more covert in manipulation. At the same time, wellness statistics continue to grow. More people are turning to organic foods and are focused on wellness.

2. Marketing Positioning. My recommendation is to embrace the popular movement towards natural health and own it. Be its champion. You are the Healthy Life Doctors. This is your niche.

3. Unique Selling Proposition. Stay committed to your core services, but articulate your Unique Selling Proposition to your specific market niche(s). Not everyone is your patient. Select certain markets that are already reaching for your type of services: people fed up with drugs, baby boomers who want to stay healthy, mothers who want to avoid drugs for their children, athletes, employers who want healthy employees, etc.

4. Get More For Less. Watch your economics but don’t get stuck in a scarcity mindset. Central to economics is a return on investment -ROI. Invest in yourself and especially in making your support team expert professionals. Learn and apply the Pareto Principle (how 80 percent of your results come from just 20% of your efforts).

5. Insurance or Cash? Yes! Take insurance but don’t kowtow to the Insurance Cartel. There are millions of people who want help and can pay for it and are just looking for a solution. You have to let them know that you have their solution.

6. Shift from Personality Driven Practice to Team Driven Business. The successful offices of the future will be team driven and systematized. Each team member has to be an expert as a specialist, as a team member, and as a marketer. And each should try to achieve this as well. The doctor will delegate most marketing and administrative details to others.

7. Shift from Solo Practice to Group Practice. For those of you who are ready, you should join forces with other doctors in a group practice. This has not had a lot of success in the chiropractic profession as it has in other professions, but the time is right now to band together synergistically as brothers and sisters. There are many good reasons to do this now. However, it has to be set up — and maintained — correctly.

8. New Role: CEO and Leader. Why do CEO’s get paid so much? Because they can make such a positive difference in the business. Up to now in your career you have taken on administrative and marketing projects mostly from the role of doctor, or perhaps owner. The CEO role probably has not been emphasized. Shifting to the role of CEO changes everything. Growing a business becomes easier, you have more time available, and you make more money.

9. Seek Out and Integrate Your Greater Purposes with Your Business. The power for your office, and you, comes from those things that mean the most. This would include your family and your spiritual pursuits. But our world is smaller and we live in a networked economy and culture. Your office, in its own right, has to be a leader in your community and environment and contribute in some way beyond its walls. This also includes having a voice in your professional organization. Your greater purposes also include your personal hobbies. Since you are not working on an assembly line, many of these purposes should be integrated into your work.

10. Get an Executive Coach. Why does corporate America spend over a billion dollars on executive coaching? Because the return of investment proves to be at least 7 times, and in some cases, 10-49 times cost. Executive coaching doesn’t cost – it pays.

An executive coach is different from a clinical coach. An executive coach will help you be a better CEO – a better leader, marketer and manager who builds a team driven business which allows you to delegate most non clinical duties. He or she will help you sort out what tasks will produce the greatest positive effects for your business, and help you get those tasks done. He or she will be your partner, counselor, confident, coach, teacher, drill instructor, and friend.

The future has never looked brighter, but the challenges are not slight. This makes your success all the more important – and sweeter.

Ed Petty

The Most Cost Effective Tool You Have to Build Your Chiropractic Practice and Help Your Patients – and you probably are barely using it!

Posted on October 22, 2014 by Edward Petty

what if I told you copy

Forget about the roller tables, stretching bands, balance boards, traction devises, taping, decompression, protein powder, vibrating platforms, laser, lipo body sculpting, ultrasound, stim, tens, supplements, orthotics, etc.

Any or all of these may or may not be appropriate for your practice, but they should not be your first choice in providing a modality or ancillary service to your patients.

Think about this: what could you do for your patients, in addition to your adjustments, that would help them improve their health the most?

EDUCATE THEM

The more the patient knows about how chiropractic works – and how your services help them – the more motivated they will be in following through with their health care plan.

People don’t know about subluxations just like they really didn’t know about asbestos or cigarettes. It was a while ago but advertising was rampant on television and in print promoting cigarettes. MD’s were often used to legitimize the use of cigarettes.

Today, your patients are also being inundated with propaganda about food, drugs, and basic lifestyle choices that are not healthy, let alone not true. They are told that drugs are safe solutions for headaches, back pain, and other ailments when in many cases they are found to be poisonous. (Vioxx, Accutane, Cylert, Darvon & Darvocet, for example.) Nearly all the food they eat has various toxins, from aspartame in diet food to herbicides that linger (glyphosate, used in “Roundup” and sprayed on your kid’s schools playgrounds).

Educated patients are better equipped to keep to their treatment program and continue improving their health. Isn’t this what you want?

This is your #1 ancillary service.

#1 Marketing Tool
Educated patients are more motivated to refer those they know to you and to help you set up external events. They can become your ambassadors, field representatives and sales force. They know that someone with headaches, low back pain, or other odd symptoms may be helped by chiropractic and your services. They may be able to refer them directly, or you can help them by providing special workshops, special events, and opportunities for external programs at their place of work.

#1 Team Management Tool
All of this also applies to each of your team members as well.

We are all “numbed down” by a conventional lifestyle and a culture that is greatly manufactured by just a few large industries such as Big Pharma and Big Food that use media and government to achieve its ends.

And, frankly, we tend to take what we do for granted. Imagine a patient who had a headache for years and after your care is now pain free and can get a full night’s sleep and her relationships with her family have improved., etc. Amazing, right? But for us, pretty routine. We can end up being more concerned about billing her secondary or supplement insurance or keeping her scheduling than in just celebrating with her.

Almost anything you know about health care will be “new news” to your patients and probably many of your staff. Plus, we all tend to forget what we once knew.

What is the big difference with you from when you started chiropractic college and after you graduated (Besides debt) . THE difference was and is that you were motivated. And you were motivated because… you were educated and even more, you were enlightened. You were able to see things in people’s health conditions that you never saw before. And with all this understanding, you were now more motivated.

But in time, awareness can dim and so can motivation. New patients start dropping off, treatment plans get shorter, and the quality of staff performance erodes. The solution is to keep educating patients and team members so that they stay awake and motivated.

In other words, WAKE THE FLOCK UP!

Patient and staff education provide the best ROI of any activity you have. Modalities and extra services have many overlooked costs such as staff time to account and bill for the therapies, extra staff to apply the services, someone to take inventory of the products and to sell them, etc. Patient education is pretty much a no cost proposition. How much does a care class cost? Watching “Doctored” or “Food Inc. ” or “Bought” with your staff and then discussing it afterwards (that is very important), it is much cheaper than flying to Las Vegas.

And if you do it often and effectively, you will be able to afford that next seminar in Hawaii.

As the doctor, you are the CEO, the Chief Evangelizing Officer. I first heard this term from Guy Kawasaki, who was called this when he worked for Apple when the Macintosh was first launched in the early 80’s. Macintosh was trying to win over users from IBM computers to the Apple Macintosh.

You are creating converts to a chiropractic and natural health lifestyle.

Remember that education, both staff, patients, and your own education as well should cover not only what your services do, and how they do it, but WHY you provide these services. In fact, your emotional connection to the reason you do your services communicates the strongest.

WHAT TO DO
1. First, keep yourself aware and amazed at the innate healing power of the body and the great affects your services provide. Provide an hour or two of study for yourself each week. Just like you work IN your office, you have to work ON your office – and that includes yourself.

2. Let yourself get emotional about what the FLOCK is going on! Don’t be “correct”, well heeled and a good little domesticated “provider.” It is natural that you become somewhat “riled up” about the injustice that your patients and their family and friends experience in receiving “health care” or at the misinformation “fed” to people about healthy living.

3. Educate your team. Watch a movie with them and then have a discussion period afterwards. (The discussion is very important as it helps get everyone engaged in the process.)

4. Staff Meetings. Go over a case history or two.

5. Patient Care Class. There are many different names for this, but all patients get better, faster, and stay healthier longer if they know more about chiropractic and health. Make it a part of their treatment plan and bribe them with food!

6. Start a Lending Library and position your office as an educational facility. Even if you lose a few books or DVD’s each month, it is worth it as your patients will see that you are serious about health and health education. Give each staff member a bonus for a book report presentation at a staff meeting.

There are many ways to educate yourself, your team, and your patients. Done right, education turns into enlightenment and this will produce a greater return than many other activities you do.

# # #

Your Biggest Chiropractic Bill Each Month

Posted on January 23, 2014 by Edward Petty

You may be overlooking your biggest bill. Most chiropractors do.

What is it? If you are in the upper Midwest or Eastern part of the US in the winter of 2014, it might be your heating bill. It has been pretty cold.

How about personnel or marketing? Your lease? Staff benefits? How about your pay? (Probably not, I would guess.)

In running a chiropractic business, many doctors try to maximize the profit of their business by reducing expenses. They often get this idea from their accountants, and, from a certain perspective, it is a good idea. But accountants are trained such that their primary function is reporting income for tax purposes and not managing business finances.

You definitely need to review your Profit and Loss and Balance sheets regularly. Sometimes you can get carried away with expenses, not noticing that things are getting out of balance when you have 4 x-ray units, 15 computers and only 1 staff member.

But what your financial statements don’t show you, and what your accountant isn’t trained to see, is your ROI – your return on your investment.

And what is your biggest investment? (Pause while you consider this question….)

It is YOU.

And what is your biggest bill? What is your biggest expense?

It is the income that you could and should be making that you aren’t.

Your biggest bill is the amount of money you could be making if you were operating at your full capacity but aren’t.

Here is an example: Let’s say you are relatively healthy and are capably of seeing 200 patient visits per week comfortably. This excludes new patient visits. This averages out to about 860 visits per month. Let’s drop it down to 820 visits for vacation days, etc. Now, let’s say you collect only $40 per visit, average. This would mean you would be collecting $32,800 per month.

Let’s leave aside the possibility you could collect more per visit and imagine that you are seeing 150 visits per week, or 645 visits per month, or 605 if we take out a few visits for vacation days (40 visits per month). At $40 per visit, this leaves you with $24,200 per month, or $8,600 LESS than you should be making each month.

In other words, if you could and should be making $32,800 per month and you are only making $24,200 per month, you are essentially writing a check for $8,600 EACH MONTH, payable to “Inefficiency, Inc.”

You are wasting that much each month as a negative return on your investment on yourself.

This is so brutal to face that most doctors would rather look the other way. But whether you squint at it, or not, the reality is there: you are wasting your hard earned cash each month that you are not operating at full capacity. You are throwing away a portion of the time, training, and sacrifices you have made to get to where you are now.

It is as if you are writing a check, each month, for the amount of money you should be making, but aren’t.

Savvy CEO’s and large corporations understand this. They need to get the full measure out of their investments. As a result, they invest heavily into solutions that improve production and services so their business can achieve full capacity.

One investment that shows the greatest return is corporate training and coaching. This is a huge industry: corporate training grosses $138 billion yearly in North America and executive and business coaching is at $9 billion a year and growing.

Various studies show that executive coaching brings back a return of 5 to 8 times the investment.

Obviously this speaks to our services, but beyond us, coaching and team training help you get the most out of your biggest investment – you.

Read a book, go to a seminar, watch a webinar, participate in 4 Mastermind groups, and get an executive coach to help train and guide you. Invest in yourself so that you can take the necessary actions to reach your full capacity.

In today’s economy, you need to get more out of what you have.

Quit wasting money. Invest in yourself. You can afford it.

Ed Petty

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