Tag Archives: management

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

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tryout
 Tryout: a test of someone’s ability to do something that is used to see if he or she should join a team, perform in a play, etc. (Merriam-Webster)

 

We routinely help our chiropractic teams with the hiring process.

Getting the right players can make all the difference in whether you are a winning team or just a mediocre one.

 It is often difficult to find the right candidate for the job. The prospective employee is trained to be sweet at the interview and have an impressive resume and you are expected to ask her just the right questions that will evoke her true character. This is usually not adequate.

In addition to interviews, practical tests that challenge candidates for the job position can be included as part of the hiring process. Much like a “tryout” for any sport team, musical group, or an audition for a play, we want to see how the prospective new employee performs.

A good management motto is: “Look, don’t listen.” This definitely applies to hiring.

After the first interview, if you are still interested in the person, have them come in again for a practical interview. This is the “tryout” or audition. For the front desk position, present them with some challenging but common situations and have them demonstrate how they would handle each. Have them demonstrate as in role playing, not just tell you how they would do it.

 In the examples below, the doctor can be in the role of the patient, or prospective patient, or have another team member in that role.

For the Front Desk position, you can have the candidate take on the following situations:

  •  Appointment book is full. Patient calls in and wants to see the doctor.
  • Patient calls in and is in pain.
  • Calls but is skeptical of chiropractic
  • Calls, asks how much for an adjustment, and then says it costs too much
  • Patient is leaving after an adjustment, needs to be scheduled, and the phone is ringing.
  • Patient owes $37.67. Collect it.
  • Promoting upcoming talk, next Tuesday at 6:30 on “Spinal Fitness.”

Someone applying for Patient Accounts could role-play the following:

  • Perform a patient financial consultation on a new Medicare patient who also has a secondary.
  • Call for chiropractic benefits.
  • Receive a letter “not medically necessary.” What actions to take?
  • Promoting upcoming talk, next Tuesday at 6:30 on Spinal Fitness.

Other situations can be presented that are appropriate for your office, depending on the position, such as therapy, external marketing, etc. Be creative and keep it fun, but challenging.

You can give the candidate a few lines to help them, but tell them you want them to improvise to the best of their ability. It doesn’t have to be perfect and probably won’t be that smooth as they are new to your office.

What you are looking for is their ability to be genuinely interested in the patient. You want to see how much in command they are of the situation, their friendliness, compassion, and general quality of their communication.

If you want a winning team, when hiring, use “Tryouts.”

Pilot of the Wheelchair: The Girl and Her Passenger

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This short story may not seem at first to pertain to your chiropractic office, but it does.

In the hot afternoon Sunday traffic, in the right lane waiting to turn right, our lane had stop moving.

Crossing the busy six lane intersection heading toward us was a man in a motorized wheelchair.  His face was full but motionless and looked worn. I couldn’t be sure, but he had that straight-ahead look of someone who was blind. He was maybe upper thirties or mid forties with short hair, perhaps a wounded veteran who paid no mind to the antsy cars that waited for him and his wheelchair.

Sitting on his lap was a thin little girl. Maybe eight years old.  She was curled up, cuddled with one of her shoulders against one of his. As they were crossing the last three lanes, she stretched out her arm with an open hand as if to say “halt, please let us cross.”

She had the look of a girl who had not had an easy life but was happy to be with this person whose immobile legs she rested on.

Once they made it to the other side our lane started to move. The pair moved closer as I moved forward. It appeared as if she was acting as the man’s eyes and told him when to go. I had the sense that he was a family member, perhaps her father, by the bond they seemed to share.

As I passed them in my nice air conditioned car, I looked closely at the girl and waved to her and smiled. She looked at me directly as I drove by. She gave me a wave and beamed a big smile as if to say “Thanks. We just made it across a busy road and me and my pa are having a Sunday outing.”

In my mind, her face reminded me of pictures of Anne Frank, the girl in Amsterdam that kept a diary before being taken by the Nazis to her death in 1945.

I would have liked to stop and help her in some way. Or say “hi” to the man in the wheelchair who looked so stoic. Maybe there was something I could do for them.

But the fact is – they did something for me.

They set an example – of courage, caring and love. They had heart: For each other, for their goals, and seemingly for their adventure.

Not everything can be put into a mission statement or measured by statistics.  No “boot camp” can teach this, and even if all your policies and procedures were followed perfectly, you could still miss it.

Heart.

One office I know has so MUCH heart the whole town loves the office and the office loves the town. The fact that there is a 2-3 week waiting list of new patients is the biggest challenge the office has.

By training and professional experience, I have a bias towards procedures, organizational structure and production.  No doubt, without these, offices would experience anarchy or insolvency. But I have also learned that heart is more important.

We can all become discouraged at times. Emotions and confusions can affect your patients as they do you and this can put a barrier around our capacity to care.  This may be affecting you or your office now.

But this is only temporary and not the real you.

This is what the little girl gave me. Her wave to me was a “thank you for stopping to let us cross the road”, but also, “we are all in this together.”

That is the lesson I am left with.

There is heroism all around us. Simple and quiet examples of selfless caring and love pass us by daily if we were to notice.  People want to help others and want help as well. Why? Because we are all in this together. Because we care. Because we have heart.

Training on procedures such as the report of findings is fine, but your patients aren’t adversaries and neither is your community. They want to get better and they want to help others to get better.   Really care for them, really love them, be honest with them, and have the courage to always do this, and they will never leave you.

Whatever your office mission statement says, if you have one, it should say what is in your heart. And if you follow that, I am sure you can successfully pilot your team on its adventure.

#  #  #

Ed Petty

Finding the Right Mix for Your Chiropractic Promotions

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THE PROMOTIONAL RIVER

I sometimes receive emails and calls from chiropractors requesting a quick fix for their lack of new patients.   I often wonder if they ever got the idea of symptomatic care versus corrective and wellness care.

Effective marketing requires more than just a killer advertisement or long copy reactivation letter or a spinal screening.   It has been said that good marketing doesn’t depend on one promotion to get 50 new patients, but rather 50 promotions each generating one new patient.

Generating a high volume of new patients in your chiropractic office requires multiple channels of communication.   Consider how a river grows – through lots of tributaries. The Mississippi starts out like a creek, but then other creeks run into it and it grows and grows.

We call this the promotional mix – the blend of different approaches you use to communicate the benefits of your services.

On the following page, we have listed just a few important categories of effective promotions for your office.  Of course, there are others, but we have found that these work well and can act as a good foundation.

Mississippi

FOUNDATIONS OF PROMOTION

Effective promotion starts with individual and team motivation. It then should be entwined with all of your basic routines each day, from the way the phone is answered to the consultation and patient examination.

Beyond this, you can schedule specific health topics months in advance and offer them as workshops or “Awareness Weeks” where you provide a free screening exam and info.

Occasional special promotions should be scheduled, such as “Kid’s Day”, and community services should also be scheduled, such as screenings, relationship building with external referrals sources, and workshops.

Your presence on the Internet has to be constantly added to.

These are some of the main categories of your promotions, though advertising and public relations events can also occur now and then.

PromoMix(larger image)

KEY PROMOTIONS   

1.   Motivation.  You and your team’s desire to promote the benefits of your services create the energy to make your marketing work. Constantly nurture this.  Start with WHY?

2.   Basic Service and Chiropractic Care Procedures.   This is your foundation. Marketing is embedded in the heart of all the basic duties you do every day.  You should constantly review and try to improve on the marketing aspect of your procedures.  Be ever more cheerful, more genuine, more caring, and giving of extra-ordinary care and service.  Have “Present Time Consciousness.” It is helpful to have a checklist of these procedures to review.  Little things can slip aside and go unnoticed and a checklist helps flush everything out for inspection.  Work on a procedure or two every month so that you are constantly improving.

3.   Special Promotions. These are promotional events that can be internal, external, or both. For example, flowers to women on Mother’s Day, a Kid’s Day, Community Appreciation Day, Anniversary Day, etc.  They can be tied in with holidays, community days, parades, donation drives, etc. Most have an offer for a free service, but not all. These are IN ADDITION to the monthly education themes. Schedule these every other month or so. Promote these on the Internet and in newsletters.

4.   Community Education Program  (Monthly Health Themes) We have found that this program gradually builds momentum and if managed well, brings in more patient referrals, external new patients, and returning patients directly and indirectly. Here are some steps to make it successful.

a.    Select monthly themes around a condition or healthful topic. Can include headaches, kid’s health, motherhood, nutrition, cooking class, exercise, golf clinic, etc.
b.    Schedule a workshop time or “Awareness Week” (free screening exam last week of the month)  at the end of each month.
c.    Customize a poster. Samples on our Members site or make up your own.
d.    Do a YouTube video on the subject the month before. Post on Facebook, web site, YouTube channel and embed in your email
e.    Send out an email notice promoting the event, with a link to the video Health Tip, testimonial, etc.
f.    Send a hard copy newsletter with testimonials mailed to some of your patient files now and then (3 months) and all files every 6 months.
g.    Posters distributed locally and as statement stuffers.
h.    Press releases can be sent to local papers/electronic calendars.
i.    Ads are an option.

5.   Community Services. These are scheduled each month and include screenings, workshops and external referrals source development (MDs, businesses, DDS, auto body shops, etc.)

6.    Keep The Conversation Going: Internet And Newsletter.  Update your Internet presence and post new info regularly. Set a goal of how many hours it gets worked on each month, eg.  1 hr a week.  You could also use a checklist (we have one on our PM&A Members site). This would include Facebook postings, YouTube, directory sites (Yelp, Healthgrades.com. etc.), and search engines (Google, Bing, etc.).  And, of course, your website/blog.  Add patient testimonials, photos, and health tips. Keep posting – but keep most of the info local and “newsy,” just short of gossipy.  Also, send out electronic and hard copy newsletters with similar newsy content and notices for upcoming promotions, talks.

7.   Public Relations and Advertising.  Radio ads and print ads promoting specials events can be helpful now and then. Public relations such as press releases and donation drives can add long term good will and should be done a few times a year

3 Month Marketing Planner [Link]

The Chiropractor Versus the Chiropractic CEO

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There is a constant struggle in your office.

It is a battle between you as the doctor and you as the CEO.

As the CEO, you want to grow your business. You want it to be profitable, smooth running, and systematized.  You want it to be efficient and providing excellent service.

As the doctor, you want to focus on each patient and their unique treatment program. You really could care less about administrative concerns as these are usually just distractions to your patient care.

Who wins this war between the doctor and the executive manager?

Unfortunately, in most cases, no one.  Usually, the doctor’s duties blend in with the executive duties and the services get watered down and the growth of the office never reaches its full potential.

Without a doubt, the biggest dilemma in practice management is just this:

How can you be the best doctor you can be
and also run your office?
If you had the time (and perhaps the training, but that too just takes more time!) you could take your business to the next level.  But there just isn’t the time. You are too busy as it is.

This was the theme of Gerber’s book, the E-Myth, wasn’t it?

You know you should “systematize” your office procedures, but that still takes time. And maybe this systematizing stuff hasn’t worked all that well for you.

It comes down to roles: how can you be a compassionate and dedicated doctor while at the same time being the CEO of a growing small business?

This Thursday, October 18, 12:30 pm Central to 1:20, we will show you how –

Learn how you can, in 5 hours or less each month:

*  Drive your business to the next level
*  Improve communication with team members
*  Help each staff member be more goal oriented
*  Help create a stronger team that is more goal oriented
*  Have more fun in practice
*  Achieve more of your clinic goals

As the doctor, you are taught patient management procedures. You need them and patients benefit from them.

But as a business owner, you also need practice management procedures. Done properly done, your business will benefit.

We will show you how to do it in just over 1 hour per week, on average.

You won’t find this anywhere else. (Hype alert.) This is a culmination of our Marketing Manager System (2001), 3 Goals Management System (2008), and three other management systems which we have incorporated into our consulting over the last 25 years.

Because we feel this process is so important for your practice, we are waiving the fee for this webinar.

That’s right, this is one is FREE. It should be three times the usual price but we want to get it out to you now and fast. We want to help you get a head start on 2013.

But you have to register, so go HERE to do so.

Best regards,
Ed

PS This webinar is for doctor owners only and the office manager or administrative/office coordinator.

 

5 Levels of Administrative Support in a Chiropractic Office

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Someone in your office needs to be responsible for the administrative duties that fall outside of the usual functions in a chiropractic office of:

  • Front Desk
  • Patient Accounts
  • Hallway/Therapy.

This someone is usually the chiropractor – at least at first. But as the practice grows there is more administrative work to do. The doctor can do it, of course, but he or she should be spending time on adjusting patients and building the office.

The smart doctor knows this rule:

Do what you do best,     
And delegate all the rest.

Some offices have a chiropractic assistant that is called an “office manager.” The role of the office manager is often vague and the duties are varied.  Usually the “office manager” has had very little, if any, management training.

The growth of the business will eventually stall because of this.

Most chiropractic team members are bright and industrious and whoever is assigned the role of office manager usually does her best for the office. Unfortunately, this is not enough in most cases for the office to achieve its capacity and goals.

In 2013 we will be launching a number of new office manager training programs to help doctors and office managers achieve their full potential.

In the meantime, the chart below may help clarify the general range of duties of an office manager. It lists an approximate hierarchy of responsibility for someone delegated by the doctor to perform administrative functions.

A staff member who has another job in the office, for example, front desk, may take on a part time role of Administrative Assistant. As the office grows, she could take on more responsibilities as the Administrative Coordinator, and then finally as an Office Manager. She may have to delegate some of her front desk duties to give time for the extra admin work she now has.

The titles below are intended to demonstrate that there are different levels of administrative responsibility and are not exact.  Your office might just need an admin assistant.

However all doctors need to delegate their management and administrative duties and more offices than not, suffer for lack of well trained and effective office managers.

5 Levels of Administrative Support

Administer = from Latin administrare, from ad- + ministrare to serve, from minister, servant

5. Practice Manager – Similar to a general manager. This role is for a larger office with 15 or more staff.

4. Office Manager –  About 5 hours per week or more, but takes on a majority of the administrative duties and some of the management functions. Supports the staff and the doctor to give better service. Is accountable for office growth and performance.

3. Office Coordinator – Works 5 hours a week on administration. Helps the doctor with management duties, including human resources (hiring, training, etc.), marketing, coordinates with the staff on training, marketing, and other special projects.

2. Administrative Coordinator – Works about 3-5 hours a week on administration. Clerical duties, some important. Helps the doctor with management duties, including human resources, marketing, etc.

1. Administrative Assistant – Works about 3 hours a week on administration. Mostly clerical duties.

Why You Shouldn’t Have Promotions

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As a chiropractor, there are many reasons why you shouldn’t have practice promotions.

Hundreds.  You can come up with 10 right now. Your staff could think of more. So could your family!

Most of them would have something to do with not enough time to do them, or too much of a hassle, or it might cost too much. Then, there is also:  not sure if they would work, or what do we do and how do we do it?  Maybe you are really too frightened, embarrassed, or burned out to promote.

Now, you could say:  “Hey, I already have more patients than I can see.”

Yes, maybe you could.  But then you would have to ask yourself: “is everyone in my town getting proper chiropractic and natural health care?” “Is anyone in my neighborhood receiving unnecessary drugs, surgery?”

On the other hand there are only a few reasons you would want to have practice promotions. These would include:

  • Help more people
  • Fill up your office
  • Make more money
  • Make your services and those of chiropractic more popular

In terms of traffic lights, promotions are GREEN.

 In your office, what light is flashing? Yellow, red, or green?

Green means GO! Promotion = pro + motion. The word comes from “forward motion.”

Ultimately, there are three basic reasons for not promoting:

3. Not knowing what or how
2. Lacking the motivation
1. Lacking the organization

In our upcoming webinar, we cover the what and the how and the why to get your promotions going, fill up your office, increase your revenue, and make your services more popular.

Hope to see you there.

Best regards,

Ed

 

July Webinars- Positive Job Reviews and Practical Chiropractic Patient Education

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This month, we have 2 webinars designed to help you grow your practice and provide better service to your patients. These are in addition to our world class expert consulting and coaching, our free articles on our web site and those especially for our clients in our PM/A Members Library.

These are short discussions with plenty of slides and examples, along with follow up summaries.

Register now. Keep training!

  •  Office Management –  How to Do An Employee Job Review For Your Chiropractic Office So That Everyone Wins.
    Are these job reviews really necessary? Do employees get raises automatically every year? Employee reviews are often neglected, or are dreaded by both employee and doctor. This webinar covers the basic steps to make them effective and positive for all concerned.Thursday, July 12, 12:30pm   Registration
  • Marketing Management – Educating Your Chiropractic Patients – 6 Programs that Work.
    Does patient education work? How much of it just a sales pitch by companies to get you to buy their brochures and videos?  Even if it does work, what are some practical steps you can use in our office? We will discuss 6 simple programs that are working to help increase patient referrals and retention.
    Thursday, July 19th, 12:30pm  Registration

****To view the calendar and/or register  for our other webinars as an active PM/A client or guest, please go here: LINK 

Chiropractic Principles, Chiropractic Infomercials, Management by Numbers: 3 New Webinars in June

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June, 2012
Milwaukee, WI

A tidal surge of politics rampages across this state with a big recall election for our standing governor taking place. But this surge will no doubt continue across this country for the rest of this year. Like massive tectonic plates shifting, the forces will be widespread as more people become involved in current events.

No matter what side you take in politics, if any, and there are more than two sides, there is only one side when it comes to taking care of your patients. That decision is already made for you by virtue of being a chiropractic doctor and chiropractic team member. That side is simple: deliver the highest quality care and service possible for your patients.

You must always do what is best for their health. That is never an issue.

Similarly, you must always do what is best for the health of your business that provides this care. It too must be strong and healthy so that it can provide the facility that allows you to give provide for your patients.

We encourage you to stay informed on all sides of the issues that concern you, for there is usually some truth to be found  in every corner of an issue.  But even more, we encourage you to consider voting with the quality of your clinical care and the quantity of your chiropractic services.

Yard signs for your cause or candidate are fine. But even louder should be your voice for the health freedoms of your patients – freedom from toxins in their water, food, and air.  Freedom from misinformation about chiropractic care.  Freedom to be healthy without drugs or surgery.

In addition to our world class expert consulting and coaching, our free articles on our web site or those especially for our clients in our PM/A Members Library, this month we have 3 “kick-gluteus maximus” (management term for kick-ass) webinars.

  • Office Manager Training: How to Motivate Your Team and Keep Them Motivated With Chiropractic Principles and Philosophy. With Phyllis Frase (Date, Time. More info below.)
  • Marketing Manager Training: The New Infomercials For Chiropractors That Work and Are Inexpensive, Fun, And Effective. Learn How. (Date, Time. More info below.)
  • Executive Management: Why You Shouldn’t Manage Your Practice by Statistics…And Why and How you Should. (Date, Time. More info below.)

Attend these webinars and VOTE WITH YOUR CARE.

Think global, but act local and make your voice heard by setting an example of the best health care provided in the best run health care business in your town.

Webinars for June, 2012 from Petty Michel and Associates

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

OFFICE MANAGER TRAINING

How to Motivate Your Team and Keep Them Motivated

This webinar will provide your office manager with the tools to motivate your team by using the key fundamentals of chiropractic philosophy.

The webinar presenter will be Ms. Phyllis Frase, an internationally known chiropractic team trainer. As a team teacher with the Parker Seminars since 1998, she also has taught across the country at many state conferences, and as far away as the New Zealand Chiropractic College.  She has been a PM&A consultant and coach since 2007.

An outstanding speaker, she is also a hard worker and gives her all to her client’s success.

45 minutes with Question and Answer available. Excellent for all office managers and doctor/owners.

Thursday, June 14th, 12:30 CDT. Registration

 

MARKETING MANAGER TRAINING

The New Infomercials for Chiropractors That Work

Whatever happened to Infomercials? They’re still around and they still work. And you can do them very inexpensively. You just need to know how.

This webinar will give you practical examples and include forms for you to use in producing your own amateur and informational marketing that can help you create more new patients and keep the ones you have.

Ideal for the doctor owner, marketing manager, and anyone involved in practice marketing.

45 minutes with Questions and Answer Available.

Thursday, June 21st, 12:30 CDT Registration

 

EXECUTIVE MANAGEMENT

Why You Shouldn’t Manage Your Practice by Statistics…And Why and How you Should

C.A. Reports have been around for a long time. Every management company seems to require you to report your numbers. But is this a good idea? What are the hidden downsides of doing this?

Even if you have the numbers, what do you do with them? How do you use them. What about ratios? And then there are those financial reports your accountant sends you – like they should. What should you do with these other than just file them?

The fact is, IF you know how to use the numbers of your practice your life will suddenly be much easier. Practice “noise” will dissipate and the time spent as a CEO will be less, AND more effective.

This webinar will give you both the benefits and risks associated with using statistics to manage your business, with follow up materials to use in your office.

A must for Practice CEO’s. We also encourage you to include your office manager to participate in this webinar.

45 minutes

Thursday, June 28th, 12:30 CDT. Registration

The Theory of Constraints: How Bottlenecks Can Suffocate The Growth Of Your Chiropractic Practice And What To Do About Them

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Do you work hard but you just don’t get as far as you should?  The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth.

Here is an example: One doctor we worked with a few years back had a small office of about 1000 square feet. He was seeing about 140 visits week but wanted to see more. He felt the problem was not enough promotions generating more new patients.

We visited his office and noticed that he already had a decent amount of marketing underway and he was getting external new patients. While his marketing could have been more effective, it wasn’t that bad.

We noticed that the reception area was tiny and mentioned this to the doctor and suggested he move to a larger office. He had his mind made up.  He did not want to get a larger office because he had heard of doctors seeing 300 O.V.’s per week in 1000 square feet with very low overhead and he wanted to do the same.

So we set up a special focus group and personally interviewed his patients. The primary complaint was that the reception area was too small. The patients interviewed said that during peak hours there was no room for them to sit. They said that they felt that he must be too busy and therefore they would not come in to see him because he was full, and that they referred their friends to other offices.

Well, with this information, the doctor finally decided to move into a new office with a larger reception room.  Shortly thereafter, his office visits shot up to an average of 225 per week.

There are a number of lessons to learn from this story. One being not having a fixed opinion of how things should be based upon hearsay, or what may work for one doctor may not work for you. But the biggest lesson has to do with capacity. And, there are many examples of capacity restraints that we often uncover in our consulting and coaching work over the years.

Bottlenecks can occur at the front desk, in the therapy area, and in the insurance department. They can occur with the patient flow, with paperwork or in doctor time.

The theory of capacity management, as expounded by Eli Goldratt and explained in his books, including the best selling The Goal, discusses the theory of capacity constraints as applied to a manufacturing environment.  The same principle applies to a health care facility.

According to Goldratt:“Capacity is the available time for production.” A bottleneck is:  “what happens if capacity is less than demand placed on resource.”

 

SOME CHIROPRACTIC EXAMPLES:

  • Peak Periods. Between the 4-6 pm slot, where there is extra traffic, additional staff or increased capacity is not always provided. If staff feel that patients are waiting too long, or that they are not able to handle all the traffic, they may unconsciously hope the phone does not ring or another patient walks in. In turn, should someone new call or walk in, the quality of service may be poor.
  • Paperwork.  Older forms may not meet the current needs, be redundant or even hard to read.
  • Poor scheduling of patients: (not cluster booked, not booking for NP or paperwork)
  • Doctors waiting for therapy patients. (No therapy staff or therapy after adjustment)
  • Front Desk doing insurance and scheduling at each visit (no multiple appointment plan or Prepayment plan)
  • Not enough exam rooms
  • Clutter in front desk/insurance area
  • Quitting time. After a long day, all staff and doctors are looking forward to leaving and really don’t want extra patients to call or come in.
  • Backlogs. Undone reports from two summers ago, partially completed projects, cluttered desks or office space, all discourage an increase in production. You only have so much mental capacity, and if it gets frittered away on projects that are not completed, you will have “too many irons in the fire” to add any more
  • Doctor talking too much. “Table talk” should be about chiropractic, the patient’s need for care, their progress, and referrals.  Now and then, a few questions about the patient’s personal life to demonstrate your genuine interest is good. Aside from that, there is no need to justify your services with lots of talking. Keep it moving.
  • “Difficult people”. Some staff, or patients, will seem to drain you of your energy, or consume too much of your time trying to keep them happy. This can “clog” up your day.
  • Doctor too busy doing administrative tasks and micro managing. This distracts him from the work that he needs to do.
  • Doctor’s mind “filled up” with lots of experience and no longer curious or interested in practice.

 

SIX CATEGORIES OF CAPACITY IN A CHIROPRACTIC OFFICE:   We can break practice capacity constraints into 6 categories.

  1. Physical. (For example, not enough rooms, rooms too small, or just too cluttered.)Doctor. (For example, doctor doing billing, answering phones, and micro managing. )
  2. Procedural. (E.G. making 4 copies of each EOB rather than making an electronic back up)
  3. Equipment. (For example, using hand feed copier rather than an automatic feeder.)
  4. Personnel. (Not enough staff, poorly trained staff, barely competent staff preventing you from hiring superior staff, and negative staff, etc.)
  5. Doctor. (For example, doctor doing billing, answering phones,  micro managing, head “filled” with “krap!” )

 

REMOVING PRACTICE CONSTRAINTS

Here are some steps to take to remove bottlenecks.

First, start by determining what is the maximum number of patients that could be seen by the doctor if all he or she did was adjust or treat them.  What is the doctor’s capacity in terms of visits? E.G. 250 visits per week – if all she did was adjust, do SOAPs, exams, and report of findings, with 6 New Patients and 5 returning or re-injured patients.

Then, look at what eats up the doctor’s time.  Then, consider the flow of patients, of paper, and anything that slows it down or gets in its way. Consider patients waiting, paperwork waiting, and any times of the day or days during the week where there is a slowdown or backlog.  Honestly check each category below.

Once you do this, have a staff meeting, explain the concept, and get responses from the staff.

  1. Doctor’s time: What does he do other than adjust patients? Can it be delegated? Can scheduling be improved so that the doctor never waits? Does she have any redundant tasks that can be made into a routine template?
  2. Procedures: Are there redundancies? Is something being done that could be done faster?
  3. Personnel: More training needed, more staff needed, better attitudes needed?
  4. Physical space: Do you need more space? Could things be arranged differently for greater efficiency?
  5. Equipment: Could a new piece of equipment speed things up? Does anything need fixing?

Once you have done this, give yourself 30 days to fix the biggest capacity constraint. Then, reassess. If the constraint is fixed and the flow is improved in that one area, it may have migrated to another area.

For example, a doctor was doing all of the x-rays which took extra time and she was also waiting for patients because they were not “cluster” booked. Solution: staff did all the x-ray work and the doctor just came in, checked, and “pushed the button.” The front desk booked the patients tightly so that the doctor did not have gaps in her schedule. Visits increased by 40 per week, from 160 to 200 for the week because now there was more “room.”

However, now that this was fixed, the bottle neck may “migrated” to another part of the office.  Now, the insurance department can’t keep up with the extra work and a backlog starts to build up in this area.   If this does not get fixed, then the insurance department’s traffic will slow down,  like a traffic jam,  and the office visits will eventually go back down to 160 per week.

 

When your business is not expanding like you feel it should, you may have bottlenecks or hidden logjams choking and stunting your growth. Fixing these and opening up the flow, even at extra cost, will usually greatly increase production and income and be worth it.

If it doesn’t get fixed soon, give us a call.

Sometime

(copyright Petty Michel & Associates 8/27, 2007. Revised 2012. CHMS, Inc.)

A Short History of How Everything Else Has Cost You Hundreds of Thousands of Dollars and (nearly) Killed Your Dreams as a Chiropractor

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When you started your chiropractic practice, you took on 2 roles: “Doctor” and “Everything Else.” As your practice grew, you became busier in your role of doctor. That is what you wanted. That was good.

But as your practice grew, your role of “Everything Else” also got busier. This was a distraction from your role of doctor, so you delegated front desk, billing and therapy duties. You still kept the role of “Everything Else.”

As your practice continued to grow with more staff – your role of “Everything Else” expanded geometrically.  This concerned you.

You didn’t think about it much because you enjoyed being a chiropractor and loved your patients, but when you were very busy, you made more money. You could take a vacation with your family, put money aside for your kid’s education, and pay off debts.  Sometimes, you could see yourself producing even more, helping more people, and being even more prosperous.

These dreams didn’t last long. Your role of “Everything Else” became more demanding.  There were more “everything else’s” crying for attention.  There was too much to do and soon you saw your patient volume dropping. Patients were dropping out of care and new patients became scarce. You had lost control.

Other doctors who were experiencing lowered income blamed insurance companies. Or the economy. Or the modern culture.  All you knew was that it wasn’t fun anymore and there was just too much work to do. Work that wasn’t chiropractic.

The fact is, you were never too sure of this role of “Everything Else” and never really liked it all that much. You didn’t have any training in it like you did as a doctor.  And when all of the “everything else’s” starting coming at you, you felt like things were getting beyond your command.

You experienced some staff turnover and now with patient volume down, you didn’t need as many staff. Gradually there was less to do in your role of “Everything Else.”

This cycle may have occurred to you a few times: numbers up, then more stress, then back down. A roller coaster.

  MONTHLY OFFICE VISITS And here is where you may be now.

If you were to add up the amount of revenue you could have made had you stayed at your highest level, or been able to go even higher were it not for your role of “Everything Else”, you might be surprised how much this “Everything Else” role cost you. Hundreds of thousands of dollars.

= = = = = =  =

If this is your story so far, don’t go away. The last chapter hasn’t been written. In fact, your next one might be completely different. Here is an introduction to it:

You read about the chiropractic Executive Freedom Package and started it.

You discover that the “Everything Else” role is really the role of the business executive. It is the role of the CEO.

You realize that all major businesses have an executive and that there are certain skills and tools as a CEO to be learned. These skills have to do with leadership, management, and marketing.

So you learn these skills and get coached on them.  In time, you get better and better at applying them.

You find a staff member and give her the role of chiropractic office manager. You get her continuously trained and give her lots of your less important CEO duties. As she gets better, you give her more.

You get someone to help you coordinate all the marketing. You give him continuous training.

You have staff meetings and get the team on board with managing the office.

All the “everything else’s” are organized into systematized procedures and delegated to your team.

Numbers go up. Your team continues to improve. They are happy about this as they are sharing in the management of the office and its success. Now that all the “everything elses” are packaged up into nice neat systems, you have time to focus more on patient care, future planning,  personal studies, and other pursuits.

You are now a better leader, better manager, and a better marketer, and your business continues to grow. Your team is happier, more people are getting served, and you make more money.

If someone had only told you about the role “Everything Else” and what it really was all about years ago you would have avoided losing so much money and wasted time.

On the other hand, now that you know what the secret is, you are on your way out of the rut you have been in and on your way to greater freedom.

You can learn more about the “Everything Else” role and how to create the business structure that puts you in command with our new chiropractic business Freedom Package here.

 

Improving Team Performance and Developing Community Services for a Chiropractic Office

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This month we cover a couple of import topics, both of which can bring you more income if managed correctly: Chiropractic Staff Performance and Community Relations Marketing.

TEAM PERFORMANCE

How well does your staff perform their duties?

Studies show that there are 3 primary methods to improve performance:

  • Deliberate Practice
  • Expert Coaching
  • Family and social support.

Natural talent is a factor, but is never enough by itself and is often overrated.

So, how well does each member of your team perform?  Are they experts? Are they ready to teach their own seminars?

And how about your how team? How well do all of you work as a team? Will they go to the Super Bowl or World Series this year?

Your office responds to training like any athletic team or musical group. If the scoreboard shows that the numbers aren’t where they should be, then individual performance or team performance is a likely reason why.

What is the fast and economical solution? Training. Coaching.  This is something you and your office manager, and each team member can learn.

Team training is not done by just one person; it is done by the team. One member helps the other member, and back and forth until both improve.

Our webinar this week covers just this topic.

 10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8th, 12:30 CT

Don’t miss it. Excellent for Clinic Owners (CEO’s) and Office Managers.

 ===============

 COMMUNITY SERVICES: External Marketing

We all live in caves.

We live in a cave house. Then we get into our cave car and drive to our cave office and stay in our cave rooms.

Meanwhile, there is a whole world out there with thousands of people that need your care, but don’t know it.  And the main thing you have to do is to just … SHOW UP and do something.

What’s so hard about that?

You all have done screenings and you all have done some kind of external events: workshops, school presentations, visiting medical offices. The hard part is not the presentation. The most difficult (and it is not difficult) is getting these events scheduled.

Ideally, you should have your community services calendar scheduled with a few external events of one kind or another every month.

This is the subject of our next marketing webinar.

 Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

Thursday, March 15th, 12:30 Central Time.

 

How to Register

For guests, you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

Last Seminar/Next Seminar

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We just finished our 10 classes in 1 day seminar in Minneapolis – our “10 in 1.”  From what I heard and saw, everyone had a great time. I know we did. And for my money, I think we had some of the best professionals in the country giving presentations – as well as attending!

Dave Michel at 3Goals Seminar in Minneapolis
Dave Michel at 3Goals Seminar in Minneapolis

In addition to great presentations by Phyllis Frase on chiropractic philosophy and procedures for staff, Dave Michel on insurance, and myself on marketing and practice building, we had two guest doctors.

Dr Tom Potisk at 3-goals Seminar in Minneapolis
Dr Tom Potisk at 3-goals Seminar in Minneapolis

One was Dr. Tom Potisk who went over how he maintained a joyful practice for 25 years in a multi-doctor setting with 2 associate doctors.

Dr. Shane Walker at 3-goals Seminar in Minneapolis
Dr. Shane Walker at 3-goals Seminar in Minneapolis

Then, as a special guest, we were pleased to have Dr. Shane Walker who is the president of the Federation of Straight Chiropractors. He lit the room up with passion, statistics, and purpose and reminded everyone about the power of chiropractic, as well as it’s importance in society today.

So, just a reminder:

Our Milwaukee seminar is coming up soon.

Dave, Phyllis, and myself all have new material covering C.A. training, insurance and reimbursement procedures, and marketing and practice building.  Our presentations are all based upon the work we do each week in offices across the country – and what we see working, and not working.

For our Milwaukee seminar, we are especially pleased to have two exceptional doctors giving presentations on Thursday, May 20th.  Both are highly qualified and successful doctors that set great examples for excellence in their practice, business, and life.

We will be sending info out on them soon, but you can find out more here.

Hope to see you all in Milwaukee.

Economic Factors

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We all know or have heard that the number one reason that a patient drops out of care, based on surveys, is that they experienced an “attitude of indifference” on the part of the doctor or the staff.

Most offices nod knowingly and are assured that their office cares about the patients, that their staff show concern, that their doctors have the patient’s interest at heart.

But what is an “attitude of indifference?” How does it manifest in a clinic? What does it feel like to a patient?

A patient experiences an attitude of indifference when they feel they are the 38th visit on a 60 visit day. They experience an attitude of indifference when they feel like they are on visit 15 of a 36 visit treatment plan and that everything is the same as the last 13 visits.

They feel an attitude of indifference when the doctor says, during the ROF, that he will give them some home exercises, and then doesn’t. Or when the doctor instructs them to attend the spinal care class as an important part of the treatment plan and no one schedules them for it, or when the front desk says they will order a supplement for them and a month goes by without the order, or the doctor says she will do a re-exam and then keeps putting it off, or when the doctor is running 5-10 minutes behind each visit or worse, comes in late.

Normally, you may still get that patient to follow through. But put yourself in the patient’s shoes. They are feeling better, even feeling “healthy” now, they have a $30 copay twice a week, and they have just heard that the company their husband works for may be laying off some people.

90% of the population right now, according to USA Today, is worried about the economy. Many have been affected, and many more are concerned – they are uncertain. When will things get better? Are we heading down farther? Am I going to have any money left?

When people are uncertain, the decisions they make are either “no” or “maybe” (which isn’t a decision but a postponement). They don’t decide that now is a great time to spend more money. Not on cars, not on restaurants, not on healthcare.

Expressing an attitude of interest is an “every visit” manifestation. That patient’s visit is not the 38th of the day or the 15th in their treatment plan – it is a singular, unique moment in time that will never occur again. It is a one and only opportunity to make an impact and a difference in that patient’s life. When you talk to them about the weather (“gee, cold out today, isn’t it?”) or tell them a joke in the treatment room or bs about the Packers – and if that is ALL you do that visit, you are just more white noise in their life, just another piece of spam in their mental inbox.

You have to manage a patient’s care EVERY visit, you have to work to make a difference in that patient’s life EVERY visit. If you don’t, that is an attitude of indifference. There is no other way to put it.

There are four critical factors that go into growing during a recession. These are:

1)    Great customer service. During a recession, other businesses cut back on the front end. People want and need good customer service. They deserve it from your office.

2)    Excellent patient financial plans, well communicated. The first response in some clinics when times get tight is to tighten up your financial plans. “All patients have to pay their copay before they see the doctor. No copay, no visit.” Do this and watch your practice drop by 50% (actual case).

3)    Step up your marketing. Great customer service and flexible financial plans don’t mean anything if no one comes in. Marketing is a variable expense and one of the first areas businesses cut. There were over 650 auto makers in the US before the great depression. After, there were six. Clinics are closing, going out of business right now. You can pick up market share.

4)    Increase your patient education. Patients aren’t going to blindly come in “because you said so”. Educating patients on wellness, having a wellness report of findings, and a “can’t resist” wellness financial plan are keys to building your practice.

Following the 3-Goals principles, review the above four points. Implement them personally. Review them with your staff and see how they can implement them further. Review them again and refine them.

There has never been a better time to grow your practice.

Getting Away – Rule No. 9

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Sometimes you got to get away.

It could be for an hour, fifteen minutes, a week, or more.  To be fully engaged in your chiropractic practice, studies have confirmed, you also have to fully disengage every now and then.

One of my favorite books on this is by Dr. Jim Loehr and Dr. Jack Groppel, The Power of Full Engagement.  Disengaging from work, and engaging in other activities, adds more power and insight when you return to it.

More than 80 years ago, this subject was discussed by B.J. Palmer, known as the Developer of Chiropractic, with insight and character. His advice is completely supported by modern research and is worth reading and applying today.

Rule No. 9 ( PDF version to download.)

(720 words; about a 4 minute read)