Tag Archives: michel

Going Public or Going Purpose

Posted on by
Reply

Be like a juvenile delinquent!

The chiropractic model for care follows three main stages, according to many patient educational articles. These are 1) Relief, 2) Correction and 3) Maintenance and Wellness.

I am sure it could be nuanced into other levels or worded differently, but these three make sense to me — so much that it inspired me to write a book – The Goal Driven Business.

But I had another inspiration.

I read a book about a young French-Canadian rock climber who lived in Southern California and was not finding the equipment he needed. So, he became a blacksmith and started making his own. In the late 1950s and ’60s, he started the Chouinard Equipment Co and made climbing gear for other climbers. He also wanted better outdoor gear, and so founded Patagonia, a clothing company.

The name of the book was Let My People Go Surfing. It was by Yvonne Chouinard and tells the story of how he grew Patagonia.

Patagonia, now a 50-year-old company, has done very well financially. It has also done very well for the quality of its products and services and its employees. But it is also driven by the goal of making Earth healthier.

Patagonia demonstrates three goals I believe every business has: 1) profit, 2) expert service and people, and 3) higher purpose. In my book, I reference examples of how the best companies focus, knowingly or unknowingly, on these three goals.

The best offices I have worked with over the years have also been committed to these three goals. They cared about providing the best service to their patients, but also to their staff. They were committed to helping as many people as possible be healthier. And, of course, they insisted on profits.

Chouinard, with his family, own Patagonia.

That is until this month. Valued at 3 billion dollars, Chouinard announced that they are giving the company away. He could have sold it to … Amazon, for example, or they could have made it a public company. Instead, he donated it to a fund called the Patagonia Purpose Trust. He says, “Earth is now our only shareholder.”

“Instead of “going public,” you could say we’re “going purpose.” Instead of extracting value from nature and transforming it into wealth for investors, we’ll use the wealth Patagonia creates to protect the source of all wealth.”

I encourage you to look into Chouinard’s lessons on business, which he acquired through trial and error as we do! I have some links over on the blog (see below.) There are many business lessons to learn by studying the trials of other business owners in different types of businesses.

But I guarantee you that if you commit to these three goals, in the long run, just like with your patients, your business and your life will thrive.

And one other note!

I think ol’ Yvonne would have been a natural chiropractor. He reminds me of you guys. In an interview in 2017, he says:

“One of my favorite quotes is if you want to understand entrepreneurs, study the juvenile delinquent because they’re saying, you know, this sucks. I’m gonna do it my own way. And that’s what the entrepreneur does. They just say this is wrong. I’m gonna do it this other way. And that’s the fun part of business actually.”

So, have fun, and seize the future,

Ed

For links and other references, go to our blog here: Goal Driven

Ed Petty in front of Chouinard Equipment Company, Ventura California

 

Patagonia home page
https://www.patagonia.com/home/

Interview with Chouindard
https://www.npr.org/2018/02/06/572558864/patagonia-yvon-chouinard

News articles
https://www.reddit.com/r/climbing/comments/xebzib/yvon_chouinard_gives_patagonia_to_charitable/

https://www.inc.com/yvon-chouinard/patagonia-ceo-let-my-people-go-surfing-why-company-mission-is-not-profit.html

Book
https://www.barnesandnoble.com/w/let-my-people-go-surfing-yvon-chouinard/1124064053?ean=9780143109679

Are You Ready For Flu Season?

Posted on by
Reply

Are ready for flu season?

Big Pharma is.

If you haven’t seen the ads yet, you will soon. And so will your patients and potential patients.

It’s just business. “The global influenza vaccine market size was valued at USD 7.02 billion in 2021. The market is projected to grow from USD 7.54 billion in 2022 to USD 13.58 billion by 2029.” (Market Research Report, Fortune Business Insights, Sept 2022)

So, what does this have to do with practice and business development?

Your Unique Selling Proposition

In a practical sense, you are the uncola of the cola healthcare world.

You are health doctors – not disease doctors or drug doctors. However you want to frame it, you can define what you do as different than the pharmaceutical alternatives in such a way that you stand out from the crowd.

Remember, it is not necessarily what you do that counts. It’s what you stand for.

You stand for natural health. As Simon Sinek reminds us, “People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”

Better Service and Better Health

In my book, the Goal Driven Business, I reference how consumers want more information about their services and products. Especially in this age of abundant and ready information. Patient education is not a chore, it is a service that, if it is well presented, patients appreciate.

But even more, you know about the immune system and what improves it. But natural approaches to boosting the immune system are not emphasized by the medical “information” that is promoted and posted. But you know better: adjustments, exercise, vitamin D, C, and all the rest. Acupuncture too!

It does take a little more time to educate your patients and community. But think of it as a clinical service that makes you unique and special. Think of it also as a marketing expense.

Pride and Purpose

There might be another reason to educate your community on natural approaches to viruses, one that is more personal.

You might feel that your patients and neighbors are being misled and that vital information is being kept from them. You may want to right this wrong!

And lest anyone tries to reframe you as unscientific, the leading cause of death is errors in medicine.(2)

So… the Flu Season is on its way. Go for it!

Enter the race and position yourself and your team as the good guys, the Natural Health Clinic that gets results. And by the way, don’t overlook that you all need to practice what you preach!

There is a very large portion of the population that is seeking a more natural lifestyle. Google search terms show strong interest in natural remedies. You will appeal to them — they are just looking for a health-oriented team to help them maintain and improve their healthy lifestyle.

Seize Your Future,

Ed

Links to the above references and others on the blog, here:

Learn how to create a Goal Driven practice that is more profitable and fun – get The Goal Driven Business

Preparing for Autumn

Posted on by
Reply

“When you fail to prepare, you’re preparing to fail.”

John Wooden (QuoteInvestigator)

September is upon us, and Autumn is just ahead.

I encourage you to be thinking about your practice development plans for the last quarter of this year – October, November, and December. Let’s start with some fast ideas on promotions:

  • October is National Chiropractic Month (Used to be National Spinal Health Month). October 16th is World Spine Day. Not sure who comes up with these “Observances,” and I don’t really care. Don’t think it makes much difference… You can call October “National Get Your Rear in Here Month” if you want. I like to use the word “national” as it seems to imply that everyone now must comply and “report in.” It’s official, at least in your office.
  • November is a good time for “Cause” promotions. These are promotions that are linked to a worthy charitable cause that you feel genuine about. Word of warning: Don’t fake it. TV stations that promote “Toys for Tots” are so obviously insincere that I can’t believe they still do them. Find a charity that you and your team, and patients, want to support. Done right, you’d be surprised at how popular these promotions can be.
  • December is an opportunity to hunker down with all your patients, active and inactive. Parties, events, showing some gratitude and best wishes for the New Year.
  • Improvement Goals. Look at what you can do to improve clinic performance, including:o Continuing education for you.
    o C.E. for your team. Seminars, webinars, podcasts, books!
    o Team trainings in the office.
    o Individual team member training in the office.
    o Procedures: “How can we do this better?”
    o Software updates
    o Backlogs eliminated
    o Decor

• 2023 Sometime in November, you should also look at your plans for January. The New Year also approaches fast.

All this may seem a bit much to consider, but time waits for no one.

Schedule a couple of sessions this month with your team and do some planning.

GET PREPARED

And Seize the Future,

Ed

You can find links to references in this newsletter and more on our blog here:
https://www.worldspineday.org/

https://www.chiroeco.com/plan-now-for-national-chiropractic-health-month-2022-theme-announced/

https://pmaworks.com/observations/chiropractic-practice-marketing-ideas-for-fall-2016/

Staff as Support Professionals and Experts

Posted on by
Reply

staff experts as professionals“No company, small or large, can win over the long run without energized employees who believe in the mission and understand how to achieve it.”
Jack Welch, former CEO Boeing

There is a direct relationship between motivation, skill, and the outcomes achieved in your practice.

One doctor we work with told me that, after being in practice for over 30 years, he is now getting better results than ever before. I have watched him continue to train, study, and practice his skills over the years. As a result, he feels he is on a whole new level of expertise. He has discontinued most of his external marketing efforts. He routinely sees 100 visits per day and has brought in another doctor to help.

But you, as the doctor, are only ½ of the equation. The other half is your staff. Even if you are the best in your state, if your team is not equally as skilled and motivated in their areas, the quality and quantity of your services will be impacted.

You want everyone on your team to be professionals on the road to becoming experts.

They may not know that this is what is expected. Perhaps they consider their job is, well, just a job. Some doctors refer to their staff members as secretaries or girls. I know! The early 1960’s still lingers.

A Big Shift from Employee to Expert

Make a shift in how your employees view themselves and how you view them as well.

I have been recommending to doctors that when they interview potential employees, they let them know that in 1 year, they are expected to give part of the lay lecture to patients on health care.

I also recommend that staff study and report what they learned at staff meetings. This lets them know that they ARE professionals, should be knowledgeable and need to take responsibility for what they know.

Also, teaching is another approach to learning, as in the adage: “To teach is to learn twice.”

To stress the importance of training, I sometimes ask a staff member to answer some basic questions about chiropractic when I am at a team meeting. For example, I might ask them to define “subluxation,” or “what are the effects of a subluxation,” or what does “pain is the last to show and the first to go” mean? Often, the staff member stumbles or can’t answer. After a tense moment, I lower my head and look at the doctor. Then, I help the staff member with the answer so they don’t feel bad.

I teach a specialized exercise program part-time. Have for years. I have learned that the student’s performance is directly linked to how well I have taught them.

Your Employees are Your Students

Your employees are your students. This is often overlooked by clinic owners and here is why: they are focused on just 2 roles — doctor and owner/entrepreneur.

However, there is a 3rd role most doctors are reluctant to fulfill, which is the manager or CEO.

As CEO, you are responsible for the training and coaching of your team and hence, their performance. This is a style of management sometimes called Servant Leadership or Servant Management.

You want and really need an expert support team. A team of experts support the doctors will greatly improve the quality and quantity of services and make your life much easier. To achieve this, you’ll need to take on the CEO role. At first, this may seem to add extra work to your already busy week. But in time, things improve.

Done right, you will have a Goal Driven Practice driven by a Goal Driven Team. Still, there are real barriers to becoming a Practice CEO and creating a support team of Goal Driven experts.

Look for our new program in 2023 where I will teach the Fast Flow CEO System as part of several Goal Driven trainings for next year.

And if you haven’t purchased The Goal Driven Business yet, do so. Required reading!

Seize your Future,

Ed

If you are interested in being part of a limited number of offices trained in Goal Driven Management and the Fast Flow CEO System, click here for updates in the months to come.[ special email category]

The Value of Creating a Practice Community

Posted on by
Reply

Where everybody knows everybody else’s name

Do your patients consider your practice so cool that they want to hang out with you more?

Do they come in early just to soak in the vibes and chat with other patients?

Do you have a practice club?

There are sizable benefits to creating and sustaining your own practice community. The fact is you probably loosely have one already. It is a rich resource that, if better organized and cultivated, can improve patient retention and referrals.

People want to be part of something larger than themselves. This includes belonging to a group whose values they share. Edward Deci, Ph.D., says it is an intrinsic, innate motivation we all have.

A practice club, or organized community relations program, strengthens your connection with each patient. But in addition, it builds relationships between your patients and even non-patients who are supportive of your practice.

I grew up in a small farm town. We had a very busy barbershop. It was always full of men, smoking cigarettes and talking to the barbers – and each other – about the comings and goings of our small town. I think my dad dropped in at least every other day. The barbershop had created its own interactive and slightly exclusive club.

As a more organized example, the motorcycle company Harley-Davidson established the Harley Owners Group, nicknamed HOG. You must own a Harley motorcycle to belong, and then you are eligible to attend many events the company sponsors and receive discounts on all its products. I know a few HOG members, and they are loyal to the brand and share a bond with each other. And they are active, servicing their bikes and using Harley products.

Organizing Your Community

You can sponsor your own “rallies” and probably have. Patients attend, see you and your staff outside the office, and get a chance to talk. But even more, they can connect with other patients. This is how your practice network strengthens.

You can better organize your community by delegating someone to be your Community Services Coordinator for a few hours every month. They would plan and implement various events, with everyone on staff would participating.

In addition, they could start an online club, such as a private Facebook Group. Your patients would be invited to join, as well as local businesses who share your values.

In my experience, most community-building efforts rarely amount to much because there is no one in charge to keep the group energized. Events are “one and done,” with little follow-up. This contributes to the Practice Roller Coaster effect. They do work at generating referrals and improving retention, for a while, but the energy created ebbs away.

Authentic newsletters, events, phone calls, a social media group, success stories, and special bonuses help keep the community humming along.

Network Effects

Network Effects is an economic term. It simply means that the more people use a company’s product or service, the more valuable it becomes. The larger your network becomes, the better the service improves. And the better your services improve, the larger your network becomes.

It is momentum related. Think of a flywheel or pushing a car with a dead battery. (ugh). Once you get it going, the going gets easier.

From my favorite HOG advertisement:

“It’s a free country. Live like it.
Screw it, let’s ride.”

And also,

Seize your future,

Ed

Want to improve your community building? Schedule a call and we can look at options. To schedule, go here.

In the Sierra’s

The Phone Experience and Your New Patients

Posted on by
Reply

I just read about a new study sponsored by a tech company (Invoca.com*) that sought to understand the buying habits of consumers better.

It revealed that as inflation increases, the expectations of customers do as well.

It pointed out that inflation has consumers rethinking their more expensive purchases, including health care. However, almost two-thirds (63%) report that they’re still willing to pay more to get better customer service.

While consumer shopping is based on price, they’re also demanding better experiences. The survey found that more than three-quarters of respondents (76%) said they would stop doing business with a company after just one bad experience.

When respondents ranked the possible reasons why they would stop doing business with a company, a bad phone experience was second only to high prices.

Another interesting fact I noted was that most consumers ranked the phone as their preferred channel when they needed help regarding a purchase. They may go to your website, but the vital moment occurs on the phone. Not texting, emailing, or even visiting the office in person, but the phone call is the preferred method of contacting you.

And the preferred use of the phone in the 2022 survey was up 8% since 2021.

How your patients and potential patients are treated on the phone has an enormous impact on your weekly practice numbers. I would estimate that up to 20% of your volume could fluctuate based upon the great experience or poor experience someone has with your front desk.

The ebullient nature of the staff person you have plays a key role, but so is that staff member’s experience while working in your office. For example, I have seen visits go up when a new happy-to-be-hired front desk staff member takes over the front desk, only to see the numbers dip after they become discouraged a few months later.

The front desk is the most demanding role you have in your office. They need to always be “on,” eager, and interested in phone calls while at the same time checking people in, collecting money, and chatting with patients as they can.

I have spent occasions rehearsing with the front desk on answering the phone. It is simple, but done correctly, it is an art.

Even if your front desk team are pros, positively rehearse with them now and then – tell them even the experts practice daily!

Constant improvement is the road to excellence, and excellent service is needed in our post-Covid world.

And in the end, all this study points to is that common courtesy, genuine interest in and care for each other, being authentic, and kindness are more valuable than ever.

Ed

*https://experience.invoca.com/2022-invoca-buyer-experience-report/p/1

Just Gabbing

Posted on by
Reply

 

I was once hired by a dental clinic years ago. Numbers had been headed the wrong way (down). Visiting the office, I discovered that no one talked to one another. This was the doctor’s policy. The staff didn’t talk to each other, or to the doctor, and the doctors only talked with the patients. Patient communication was limited, short, and almost brusk.

For about 3 months, I worked with the staff and two doctors to get them together and communicate. No marketing, no policies, no strategies… just gabbing. They got to know each other better. They also discussed issues in the office and started having ideas for improving things.

Also…stats went up!

The doctor was not happy and accused me of not working, just talking! Despite my urging, he didn’t manage by the numbers, just by some old-school idea of working on an assembly line where no one was allowed to talk.

The work ethic of the Industrial Age was that you “clock in,” leave your life behind you, work like a machine for 8 hours, and then “clock out.” You worked at a machine as a machine.

But people aren’t machines.

Minor confusions and then disagreements can accumulate in any relationship. Imagined or real offenses occur. It does in any family, for example. Relationships stiffen when this happens, like a hose in winter with summer’s water frozen.

Relations can be warm and friendly or deteriorate to a cool façade. The internal relationship within the office team ultimately affects both the quality and quantity of the clinic’s performance.

Relationships can be difficult, no doubt. People are complicated, and life is constantly throwing each one of us different curve balls. This is why relationships need regular maintenance. Your family relationships, for example, require time for communication and working things out when there are differences. Planning vacations, reviewing budgets, children’s school and sports activities, and much more takes work.

The same goes with your office family.

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

I have used this definition for years. I am sure there are other definitions, but this has worked.

This definition applies to your patients. Give them great service, engage in meaningful and empathic communication. They will get better, and they will stay with you longer.

This definition also applies to generating new patients: Expand your network. Get people to know you and how your services can help them.

But this definition also applies to your staff: create and maintain a great relationship with your teammates – and support them.

You must schedule time each week for each other. Staff meetings, training sessions, marketing meetings, lunches, one on one meetings, square dancing (good exercise!) – whatever the venue, make the time to communicate and support each other. This simple act with your staff will help you provide the best service and outcomes to your patients. And help you reach and stay at full capacity.

Keep dancing and …Seize your Future,

Ed

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

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

Medicare Providers Re-validation Update Announced

Posted on by
2

UPDATED FROM JANUARY 24th, 2022

Dear Chiropractors, Office Managers, and Insurance Personnel:

“The Center for Medicare & Medicaid Services is continuing to populate providers’ re-validation due dates from a ‘TBD’ date to an actual due date.

Per CMS (data.cms.gov):

  1. The re-validation data was last refreshed on August 01, 2022.
  2. ‘Adjusted’ Re-validation Due Dates for October 2022 have been added.
  3. The next data refresh is tentatively scheduled for September 1, 2022.
  4. Affiliations now include reassignments as well as Physician Assistant(PA) employment relationships.”

https://data.cms.gov/tools/medicare-revalidation-list

=====

January 24th, 2022

As you may be aware, the Center for Medicare and Medicaid (CMS) made an accommodation during the pandemic regarding your doctor re-validation due date with Medicare. As such, CMS will be adjusting doctors’ re-validation due dates in phases starting this quarter. The Medicare Enrollment online tool, PECOS, has shared information on their homepage that enrollment re-validation has resumed in a phased approach for active providers.

What this means for you: It is critical that you check your re-validation due date and re-validate your Medicare enrollment prior to your due date. If you don’t re-validate, claims will most likely deny when their software program catches a mismatch to enrollment due dates, and you may lose your billing privileges. If you reassign your benefits to your group/Type 2 NPI, you will need to re-validate the group enrollment as well. The re-validation requirement holds regardless of if you are a participating or non-participating provider. There is no fee to re-validate.

CMS has stated they will notify providers via email on file, or mail, approximately three to four months prior to their adjusted due date. You can check your re-validation due date here:
https://data.cms.gov/tools/medicare-revalidation-list

Once you open the page, you will see two due date boxes. You may disregard the original due date shown on that page. The box to pay attention to is the “Adjusted Due Date”. If it states TBD, keep checking every couple of weeks to see if that field has been populated to show your adjusted due date.

How do you re-validate? Use online PECOS (the preferred method), linked here: https://pecos.cms.hhs.gov/pecos/login.do#headingLv1

Or submit a paper 855i application, found here: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms855i.pdf

References:
Please see the initial communication here:
https://pecos.cms.hhs.gov/pecos/login.do#headingLv1

Additional related links:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Revalidations

https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf

Contact us if you have any questions – we’ve got you covered!
(This includes if you can’t get into your PECOS account because it’s been so long, or because of staff changes, or because you forget your password, call us and we can help you.)

Lisa Barnett
920-334-4561
Petty, Michel & Associates

Email: lisa@pmaworks.com, dave@pmaworks.com

Brutal Economics: A hidden expense.

Posted on by
Reply

You have more expenses than you’ve probably considered.
 
Your biggest expense, like that old poster you have had in your reception room since 2012, has become invisible.
 
What is this big expense?
 
Well, one of the goals we work with in the Goal Driven System is the Full Capacity Goal.
 
This goal can be easily overlooked as we are focused on patient care, reimbursements, staffing schedules, vacations, and a thousand other tasks that require our attention.
 
The reason the use of goals is so effective in practice management is that they help you see the Vital Few from the Useful Many. (These terms are often used in reference to the Pareto Principle of 80/20.) The Vital Few are those factors (20% or less) that produce 80% (or more) of the results.
 
If you are not operating at close to full capacity, you are wasting money.
 
For example, if you could see, 160 patients in a week, given your schedule and good support, at $65 per visit, that would equal $10,400 per week. On a monthly basis, this would work out to be 640 visits and about $41,600 in revenue. This would be 100% Full Capacity.
 
You know from experience that your expenses are a lot higher than most realize. First, there are fixed expenses that you must pay out regardless of the performance of your business. And after everything and everyone is paid, after all accounts are settled, what is left over is yours.
 
At 70% capacity, that is not much. At 50% capacity, that is nothing.
 
Of course, you don’t focus on stats and money when you deal with patients as a doctor and as care givers.
 
But as a business owner, you must.
 
Numbers, analytics, Key Performance Indicators –– these make up your scoreboard and give you the best feedback to help you manage the performance of your business.
 
We carefully analyze our clients’ numbers each month and encourage they do the same. We also plot them on graphs and charts to notice trends. These are our x-rays.
 
Lately, we have realized that there is one number that gets overlooked in the hustle and bustle of business management. That is to what degree the office is operating at its full capacity.
 
In Goal Driven Analytics, we have been testing a “business capacitometer.” It displays, much like a speedometer or tachometer, the percentage of full capacity that the business is operating.
 
But you can easily do the same. Here is how:
 
  1. Weekly Visits. Determine the maximum number of visits you could see comfortably each week if you were reasonably supported with software and staff. ______
  2. Full Capacity Goal. Multiple this by 4 (I know, 4.3 is more exact): ___ This is your Full Capacity Goal.
  3. Percent of Full Capacity. At the end of the month, divide the number of visits you saw by your full Capacity Goal and you will get the percentage that shows you how the efficiency of your practice. E.G. You FCG is 800 and you saw 600 = 600/800 = 75%
Work towards maintaining 90% or above. Find the capacity constraints and remove them.
 
This is also very helpful if you have multiple providers – other associate chiropractors, massage therapists, other services, even your rehab or therapy departments. After agreeing on what volume would be full capacity, each month they can see their level of performance.
 
Last note: It is not about the statistics. While stats are your best indicator, remember … it is not the stat that is important — it is what they represent. A helped person!
 
Seize the Future,
 
Ed

 

Take a Stand: Define and Promote Your Brand

Posted on by
Reply

Using your brand to generate more patients, increase retention, and recruit top talent!

Promoting your brand has not been an important or even viable method of marketing for most chiropractors.

But that is no longer true.

Brand marketing needs to be part of your marketing mix. I will tell you why, but first, let’s define our terms:

Brand marketing is different from direct response marketing. Brand marketing focuses on generating awareness of your office, while direct response aims to generate new customers.

A smaller business with limited resources must focus on direct marketing rather than brand marketing. This is especially important when you begin.

Once your practice is maturing, your patients know you. You are the brand. You probably don’t plan on growing the business any further so there doesn’t seem to be any real need to promote your brand in the community.

But now there is.

More competition for patients

Franchise health companies are stepping up their activities. For example, the Joint Chiropractic, which filed with the SEC for around $35 million 10 years ago, and is a public traded company, acquired an additional 7.5 million in funding just two years ago. Their website says they have more than 600 locations, and I have seen their marketing activities in Wisconsin.

Physical therapy franchises are spreading, such as FYZICAL. According to its website, it has grown to more than 448 locations in 7 years as of 2021. In addition, acupuncture franchises, massage franchises, and dental franchises are on the rise.

Competition for Qualified Employees

You can also see increased competition if you have been recruiting doctors, providers, or support personnel lately. Job seekers can acquire a startling amount of information about you and what it is like for employees to work with you. They are interested in your culture, benefits, and values – which are all part of your brand.

What Makes You Different and Better

It could be said that your brand is: what makes you stand apart — and better – from all the comparable alternatives.

It is your Unique Selling Proposition.

A well-defined and promoted brand will help you:

  • Generate pride and loyalty in your patient base
  • Encourage more patient referrals
  • Improve team morale
  • Generate referrals from external referral sources
  • Improve marketing recruitment efforts for top employee talent

How to Define Your Brand

Once again, it all goes back to goals. (Doesn’t everything?)

What is the mission of your office? What are its values? What are its valuable outcomes?

This Is a Distillation Of Your Story: why you are a doctor, why you are in business, and what brings you joy daily?

Answer this for yourself, and then ask your staff:

What makes us special?

Survey a few of your patients: what makes us special from other providers? Why did you choose us?

Your brand showcases all this into an identity that people can know, like, and trust.

It can be somewhat symbolized with a logo and tag line, like the Nike “shoosh,” and the tag line: “Just Do It.” It can be represented in your newsletters, your office decor and cleanliness, the appearance of you and your team, and in all aspects of your promotions on social media.

But primarily, it must be demonstrated each day by you and your team living up to your values, your commitment to your mission, and providing world-class service and outcomes.

The world is moving faster, and we all have to work to stay ahead. And if we do it right, not only will it be rewarding but also fun.

Carpe Posterum (Seize the Future)

Ed

Need help with your branding strategy? Schedule a call and let’s have look at the best strategic options
SCHEDULE NOW

 

Capacity Constraints: Hidden Practice Barriers

Posted on by
Reply

Fixing the weakest links.

Your practice should flow smooth, fast, and uninterrupted, like a clear mountain stream.

Most offices, unfortunately, have hidden dams that slow or even block the flows within their office. This limits growth and increases stress.

For example, I have often seen the front desk so clogged with paperwork that new and active patients were inadvertently discouraged from coming in.

Every department and function of your practice is vulnerable to innocuously seeming events that add friction that choke production. Interruptions in the billing department, poor note-keeping systems for doctors, too many therapies to choose from, insufficient space, staff unclear of their goals, staff driven into apathy by being micromanaged… there are many potential opportunities for roadblocks.

Generating more new patients to increase your patient volume is usually a good idea. But often, the increase in volume is short lived because the office had too many hidden log jams and wasn’t set up for the higher patient volume. Even the doctors, while saying they want more new patients, can become fatigued by the end of the day and privately look forward to lighter days.

There are several remedies for these clogged flows.

First, clear up the goals and outcomes of each department. For example, the goal of the front desk is not “completed paperwork.” (A “Fully Scheduled Day” would be better!)

Second, you can review and refine the flow of patients into, through, and out of your practice. Draw a patient flow chart. Start with your new patients. List the sequence of actions your new patient goes through on their first day at your office. Later, you can do this for their second and third day. You can later work out a flow chart for reactivated patients, re-injured patients, and different types of cases.

Then, you and your team can rehearse the entire sequence to see what is missing or what needs to be eliminated.

I cover this in The Goal Driven Business:

Broken flow patterns that remain invisible “clog up” the system and slow down everyone’s best efforts to produce valuable outcomes and excellent service. These are bottlenecks. Discovering and eradicating them is a significant function of the Goal Achievement Process.

In his 1984 book, The Goal, Eliyahu Goldratt introduced what has come to be known as the “Theory of Constraints.” By making a chart outlining the flow of your customers, for example, you’ll better identify “leaks” or constraints which lessen your ability to achieve high quality and quantity customer outcomes.

As Goldratt states, “Since the strength of the chain is determined by the weakest link, then the first step to improve an organization must be to identify the weakest link.”

Every three months or so, do a “walk-through” with your entire team, where someone takes on the role of customer. This rehearsal will bring to light many duplicated or omitted functions. You’d be surprised to discover that many of the tasks you assume are done for your customer are actually skipped or poorly linked in. Sometimes you find tasks from decades ago, that no longer apply, are still being done.

Be an engineer to your goals and discover the constraints holding your office back, and remove them.

Be…… A Goalineer!

Ed

PS For those of you who have purchased my book, The Goal Driven Business, you are welcome to schedule a no-charge consultation to see how you can remove your bottlenecks and achieve your goals. SCHEDULE NOW

If you haven’t purchased the book yet, please do so here.  BUY THE BOOK

Health Screenings in 2022

Posted on by
Reply

This past weekend, outside our local grocery store, the Village (what they call a suburban town out here) closed off the main street and had an art fair. So I took a few minutes to look around before I headed home with my organic veggies!

There were maybe 30-40 10×10 tents with various artists displaying their works. The day was hot, and I was in a hurry. Suddenly, I stopped when I saw an old familiar sight, one that I hadn’t seen for a few years. There it was-a chiropractic health screening booth.

That’s right… s c r e e n I n g s!

The signs said, “Spinal Health Screening” with the name of the corporate chiropractic company which now has offices in a few states in the Midwest and in WA, according to their website.

Now, for the most part, I like screenings and, if done right, recommend them. I would not be overstating the fact that we have personally participated in hundreds of screenings in hundreds of venues over the years. (I still have a couple of PVC Posture Analyzers in my garage.) We have personally trained well over 50 “Screening Technicians” and hundreds more in seminars and via our marketing manuals. We used screenings when we opened up our 24 offices here in Wisconsin.

Now that people are less in fear of being murdered by one another for carrying the COVID, outdoor events are resurfacing.

Here is a short list of benefits of screenings:

  1. Generate new patients.
  2. Reactivate former patients.
  3. Create new external referrals sources
  4. Create goodwill and good publicity. (We won an award for our booth at a county fair once which was pictured in the local paper.)
  5. Meet people in your community.

Here are 5 essential ingredients to help you achieve these benefits:

  1. Friendly. Whoever is in the booth should be friendly, casual, and having fun. Therefore,
  2. Short shifts. It should not be an endurance contest—a few hours at most. Get in, greet people, talk with them, screen the interested few, and get out.
  3. Training and positive experience. If you have a non-doctor in the booth, for Pete’s sake, train them. Ideally, they could be a staff member who already knows the excellent outcomes you produce and can easily recommend you.
  4. Be interested in people. Are they in pain? Have they seen a chiropractor, acupuncturist, P.T., M.D. for their issue? Where do they work? What do they think of the Milwaukee Brewers Baseball club’s chances this season?
  5. Unserious. As B.J. Palmer said in Rule #9, “Don’t take yourself too damn seriously.” (to get a copy of Rule #9)

Get out there with your people… they need you!

Ed

PS BY the way, just curious… please reply if you would like a short webinar on what we have seen works best for screenings.

Posted on by
Reply

Here in the United States, July 4th is a date we celebrate each year, commemorating the independence as colonies from Great Britain.

And I can’t help but see a parallel between those hardy souls in the American colonies that wanted their freedom and, well, you! Chiropractors and their teams.

To colonize means to “take control of a people or area, especially as an extension of state power… to take or make use of (something) without authority or right.” (Merriam-Webster)

It could be said that the profession of medicine has been colonized by a few corporate interests. Same has been happening with other professions and industries. A few large corporations own and control more and more businesses that were once independent.

But for the most part, chiropractic as a profession has remained independent.

It hasn’t been easy, what with the AMA and Pharma coming after you, as was disclosed in the Wilk’s trail. (That was just a speed bump for them!) But Team Chiropractic has won its independence and freedom due to the courage of those who have come before you.

And it also comes from your continuing courage today.

So, this Fourth is also about your independence and your continued efforts to do the BEST for your patients and your communities.

Celebrate this!

Yes, it is just another day at the office. But this weekend, have an extra cool drink and recognize your leadership and courage in standing up for the true health of your patients and your community.

Stay free, and help others do the same.

Ed

Where Everybody Knows Your Name: Creating a Chiropractic Community

Posted on by
Reply
Used to be a popular TV program called Cheers back in the 80’s. It was modeled after a bar in Boston with the same name. As a situational comedy, Cheers presented a familiar group of customers who came to the bar to have a drink, but also to relax, socialize, and have good cheer.

 

Patients come into your office to improve their health and find relief from discomfort. But they are also looking for something more.

 

Remember that a practice is a network of relationships created and sustained through communication and service. That’s my definition. There are other definitions, I’m sure, but at the foundation, communication is critical.

 

It can be a lonely world where there seems little time for real communication – or friendship.

 

You are more than a doctor, and your staff are more than just support professionals. You and your entire team are part of a caring family, a community of like-minded people who are committed to health and helping each other achieve it.

 

Creating a community is a big deal in businesses now. For good reason… Belongingness has been identified as an intrinsic motivation we all have, according to Self-Determination Theory. But it can be contrived and gimmicky if it is not genuine.

 

In the best offices I have visited, staff and doctors formed a work family… genuinely caring for each other as well as for their patients. The patients were also included in the family. Sometimes, I would see them spending too much time gabbing at the front desk or bringing fresh produce for the doctor from their garden. I would even see patients just stop by the reception area to chat amongst themselves, catching up on shared concerns and local news.

 

Yes, the best practices have policies and procedures. These are the systems that help ensure fast and efficient service in high quantity with high quality.

 

But procedures cannot take the place of a real person interested in and caring for another person.

 

In very lay terms, the spine is the structure that supports and protects the function of the spinal cord. It is the function that counts, that comes first.

 

Many offices have their function impeded by tangled up, omitted, or unfollowed procedures and policies. You definitely need a strong infrastructure to have a prosperous low stress business. But the reason, the goal for good systems includes having good communication with your patients and each other.

 

There are many troubling issues we all face. Make your office a place where people want to go for better health and better friendship.

 

A place where everyone is glad you came and where everybody knows your name.

 

Ed

 

Theme from the sitcom Cheers
“…Making your way in the world today takes everything you’ve got.
Taking a break from all your worries, sure would help a lot.

 

Wouldn’t you like to get away?

 

Sometimes you want to go

 

Where everybody knows your name,
and they’re always glad you came.
You wanna be where you can see, our troubles are all the same
You wanna be where everybody knows
Your name.”

 

Carpe Posterum (Sieze the Future)

 

Ed

3 Effective Methods to Amp Up Your Team’s Motivation

Posted on by
Reply

Do you sometimes feel that you are just reporting in on Mondays to work on the assembly line? Has the eagerness to achieve your goals been replaced by an attitude of “now I have to go to work.”

How about your team members? Do you suspect that they sometimes disengage from their work when you are not looking?

It happens.

Yet, the level of any team’s motivation directly affects its level of success.

Here are three keys to improving motivation:

1. GOAL ALIGNMENT

The outcomes of any job need to be matched with the mission of the job.
For example, let’s take the front desk. Many front desk new hires are trained on the appointment procedures for patients but omit teaching them on the mission of the front desk.

The mission of the front desk is to assist the patient in becoming healthier by helping them keep to their health and treatment plan. That would be its mission or higher-level goal. The lower-level, or practical, goals would include every patient keeping their appointment, or 100% kept appointments!

If the front desk is primarily busy working on insurance paperwork, their work is not in alignment with the mission of their job. This is a misalignment of goals.

“The psychologists Ken Sheldon and Tim Kasser have found that people who are mentally healthy and happy have a higher degree of ‘vertical coherence’ among their goals — that is, higher-level (long-term) goals and lower-level (immediate) goals all fit together well so that pursuing one’s short-term goals advances the pursuit of long-term goals”. (The Happiness Hypothesis – pg145)

In the Goal Driven System, we have found that everyone works more efficiently and with a better attitude if the mission of the job is connected to its outcomes.

You, as the doctor, come to the office to work with patients, yet much of your work involves getting administrative tasks completed. Your higher clinical goals as a doctor do not line up with all the admin chores needed.

Here is a sample chart showing higher-level goals and lower-level goals.

Action Step: Regularly review the mission for everyone’s job, including your own, with the outcomes it needs to produce. Keep higher-level and lower-level goals connected.

2. TEAM INCLUSION
Your employees will be more motivated if they are included in the progress and direction of the business in which they work.

“Motivation requires that people see a relationship between their behavior
and desired outcome…” (Edward L. Deci). (Why We Do What We Do, Deci, page 59)

Action Step. Keep your team updated on the progress towards your goals, as we discussed in our last newsletter.* Do this in regular staff meetings to monitor the progress in achieving lower-level and higher-level goals.

3. COACHING AND ACCOUNTABILITY
Several studies indicate that people are more likely to achieve their goals with accountability and support.*

This is one reason why weight-loss programs do so well – there is someone you must answer up to who also guides you, supports you and keeps you on track to your goals.
There are many barriers that can cause us to lose our enthusiasm to achieve our goals and settle for substitutes. Owning and growing a business as a doctor is very challenging and sometimes a lonely endeavor.

Action step: The solution is to recruit trusted advisors – colleagues, and professionals for accounting, legal, and practice development (our specialty.)

Carpe Posterum (Seize the Future)

Ed

This is covered more thoroughly in my book, the Goal Driven Business. Buy it here.

*Last Goal Driven Newsletter: https://www.goaldriven.com/post/those-numbers-do-you-manage-by-emotions-or-by-goals

* Study on Accountability. Psychological Bulletin © 2015 American Psychological Association 2016, Vol. 142, No. 2, 198 –229 Does Monitoring Goal Progress Promote Goal Attainment?

Those Numbers: Do You Manage by Emotions or by Goals?

Posted on by
Reply

scoreboard for statistics

It’s Monday morning. The staff is getting the office ready for the new day. And while doing so, they are wondering… “How is the boss’s mood going to be today?”

They are taking their cues on how the day will transpire based upon, at least in part, your emotional state.

Your team, as well, will often be tempted to manage their roles in the office emotionally, based on the circumstances in their personal lives.

There is nothing wrong with positive emotion. Emotion is a feeling “a mental reaction subjectively experienced” (Merriam-Webster). Some are more positive than others, such as joy, delight, cheerfulness, and others are more negative, such as anger, grief, and fear.

But emotion is reactive. Setting your sights and working for goals is proactive.

Your Scoreboard

Your practice numbers show you if you are headed towards your goals or away from them.

They can predict what needs to be done to improve your business and achieve your goals. They also keep everyone on your team informed on the status of the practice and included in its management.

There is a right and wrong way to use your numbers to help you achieve your goals.

There is, in fact, an entire methodology on how to use statistics to improve business performance.

Large companies use analytics to manage and improve their production in formal processes such as Kaizen, Six Sigma, and Total Quality Management.

In the Goal Driven System, we use a simplified version called GAP, the Goals Achievement Process, which works just fine.

At the beginning of each month:

  1. Review. Review your key numbers monthly at staff meetings. (This can also be done weekly to check on your progress.)
  2. Notice and support. Notice where the numbers went up. Then, plan a couple of action steps to support the areas that went up.
  3. Notice and fix. Notice where the numbers went down. Then, plan a few action steps to fix the areas that were down.

Remember that numbers by themselves are nothing. They are symptoms or representations of the quality and quantity of your outcomes. Don’t get so caught up with the “stats” that you lose sight of what the numbers represent. Expecting the numbers to improve without confronting and enhancing the factors causing the numbers is at best ineffective and, at worst, can be abusive.

But numbers can assist you and each team member to stay focused on the goals: your office mission, its values, and its outcomes.

In a Goal Driven office, your team takes its cues from the office scoreboard.
There is an art and a method to capture, display, read your statistics and apply what they tell you. This is not adequately taught to most doctors in business – or to employees. Yet managing by numbers is a fast and very effective method to keep your business improving.

We are creating a short training course to remedy this called Goal Driven Analytics for the Chiropractic Practice. Subscribers to this newsletter (you!) will be the first to hear about it.

In the meantime, stay true to your goals, and use your scoreboard to help you do so.

Seize the Future

Ed

The SPARKLING Practice and How to Achieve It: Synergy is the Key

Posted on by
Reply

We just awarded a two-doctor chiropractic office employee the SPARKLE award for outstanding service to patients and team members for 21 years of service.

Why a SPARKLE award? Well, that was the term most frequently used to describe this team member.

The clinic owner said: “She has dedicated almost 21 years (7,440 days!) of her professional (& personal, let’s be honest) life to our practice & the pulse of our family and pediatric practice. Over those years we have walked many of life’s journeys together, and she has formed meaningful connections with our patients. We have shared laughter (SO MUCH laughter!), tears and everything in between. She has changed many lives in her nearly 21 years.”

sparkle award for teammateWhile she indeed does “sparkle,” so does the entire practice. And the sparkle of this office is a byproduct of its synergy.

I even feature their practice as a positive example in my book, the Goal Driven Business.

The owner, the doctors, and the staff are all committed to the goal of providing the best service possible to each patient. But their goals also include supporting each other.

According to Merriam Webster: ” ‘The whole is greater than the sum of its parts,’ expresses the basic meaning of synergy.”

In his 7 Habits of Highly Effective People, Steven Covey refers to synergy as Habit #6.

“Synergize is the habit of creative cooperation. It is teamwork, open-mindedness, and the adventure of finding new solutions to old problems. But it doesn’t just happen on its own. It’s a process…”

Much of the Goal Driven Business draws upon Covey’s work as I have seen his concepts help create a business that runs at full capacity smoothly.

His preceding two habits particularly apply:

  • Habit 4. Think win-win.
  • Habit 5: Seek to understand first, then get understood.

This chiropractic practice has formal communication systems, but they also communicate abundantly informally. And each team member has the goal of helping each other and the patients “win.”

In the end, it all goes back to goals. It always does. The owner keeps the goals, including the mission and core values, at the forefront of the team each week. Further, she sets an example by living these goals professionally and personally.

And as a result, staff are happy, patients are happy, and the office runs at full capacity, profitably and smoothly.

You can generate synergy in your office by improving communication and focus on win-win goals for the patient and for each other.

And make your practice SPARKLE!

Ed

PS. For help in creating a synergistic and sparkling practice, contact us!

Improve Patient Retention Through Onboarding and Gamification

Posted on by
Reply

It all comes back to goals – helping patients achieve theirs.

Onboarding and Gamification. Now there are a couple of terms you didn’t hear way back in the last century of practice management.

While these terms are new, what they define have been used for years. I do think they more clearly express very useful procedures that can help fill up a practice and help more patients achieve their goals of better health.

Let’s take a look at each:

Onboarding

Onboarding refers to the process of bringing a new employee, or in this case, a new patient, “on board,” as on a boat. According to Merriam Webster, “companies want to onboard their clients and customers too—to get them fully fluent in their products and services, so that they can get the most out of them.”

Onboarding a new patient would include all the basic procedures you do over the first few days of care, including consultation, history, exam, imaging, financial arrangements, and explanation of the application of first services.

There are probably 8-10 essential actions you can take with every new patient, or returning patient, that will make their experience so exceptional that they eagerly continue with their care. However, like most offices, when you are busy, you may take a few shortcuts and only do the bare minimum of procedures to get by, vowing to complete them later.

But later rarely comes. Staff turnover, new regulations, and other disruptions all discard the best laid patient service procedures. Finally, only the very minimal is done.

I call this “Procedural Atrophy.” It happens. It is a “thing.” It happens to all of us. This is why checklists are so valuable. They remind us of all the steps that should be taken to produce the best outcome possible.

For many years, we have integrated a checklist for new patients on our New Patient Log.

When a new patient comes in for their first appointment, their name is manually written on a sheet. At each step along the way, the sheet is checked off as completed. This helps ensure that no step is missed in the onboarding process.

In some offices, we have even added columns for future visits, such as Progress Exam, Progress Report, Completed Care Program. We have then assigned a team member, usually someone in the therapy department, the role of Case Completion Coordinator. Their goal is to coordinate services to help ensure that each patient gets the care they want and need and completes their program. We also assign the Case Completion Coordinator statistics to help them monitor their effectiveness.

Retention is helping your patients achieve their goals of better health. The same would apply to any type of service business.

It is all about goals, yours and especially theirs.

I’d like to keep these newsletters as brief as possible, so next week we will cover how Gamification is yet another tool to help your patients achieve their health goals.

In the meantime, seek your future and stay true to your goals.

Ed

P.S. Reply to this email With Please send me the New Patient Log and Checklist if you would like a customizable Word copy of a sample New Patient Log and Checklist

PSS ALSO, get the Goal Driven Business plus 10 practice building tools –HERE!

Call Your Mom: The most important person in your practice

Posted on by
Reply

mom, mother, daughter, hugging, petty, michel, goal, driven, love“Call your mom!”

When we dropped off our son at college as a freshman that late summer day years ago, I told him: “Call your mom!”

And he did, but not often enough.

The fact that moms are extraordinary is an understatement. They are not ordinary people.

Motherhood just isn’t giving birth or the nine months before — if that wasn’t miraculous enough. It isn’t just the diaper months, the nursing, the crying, or the “terrible twos.” It goes on through all the stages of their child’s life – preteen angst at discovering their identity, infatuation break-ups, finding their social tribe, and all the challenges growing up leads us through.

Mother is always there.

And motherhood never ends. As long as she lives, our mothers are there throughout our lives.

Motherhood is a magical cape that certain women wear, your mom, for instance, that at one time protected you and at another helped you fly. Often without your gratitude.

Yea, dads are around too, often in the background. But moms are the first line of comfort and care, someone who loves you more than themselves.

And if moms are so vital in our lives, they are too in our practices.

Always show special gratitude to the mothers in your office.

This Sunday, May 8, is Mother’s Day. Do something special for all the mothers in your practice. Not as a gimmick but as a sincere act of gratitude and respect. Some offices give a flower to every mother that comes in on Friday or the days before. You can always provide some organic chocolates, a scented soap, or tea.

Yes, there is a marketing aspect to this, but excellent customer service is marketing. In most cases, women see doctors more than men, and mothers are often more dominant in determining and advocating for better health in families. (1,2) They are probably your better patients, and your better referral sources as well.

What if you don’t know if they have children? Well, first of all, you should. You are creating relationships with your patients. But if you don’t know, you can always politely ask them – and you will get to know them even better and strengthen your relationship.

For those who are not mothers, give them a flower to give to their mother. Then, have them post the photo on social media, and you can reward them with something.

So, Call Your Mother, and do something special for all the mothers in your life.

Ed

1. https://www.cdc.gov/mmwr/volumes/66/wr/mm6602a12.htm
2. https://www.huffpost.com/entry/why-men-dont-go-to-the-doctor_n_5759c267e4b00f97fba7aa3e

Chester Wilk Was Not to Be Bullied

Posted on by
Reply

A chiropractor that stood up for chiropractic.

chester wilk: a chiropractor that stood up for chiropractic

THIS IS A SPECIAL NOTE OF THANKS and a tribute to Chester Wilk, D.C., who passed away just a few days ago.

Dr. Wilk was the Wilk in Wilk versus AMA, the case where a federal judge ruled in 1987, based upon evidence, that the American Medical Association had been attempting to “contain and eliminate” the chiropractic profession.

Dr. Wilk and four other chiropractors first filed the suit in 1976. Doggedly pushing it along, Dr. Wilk, colleagues, and attorneys had to keep fighting even after the ruling against the AMA. From Wolinsky’s book, Contain and Eliminate:

“Wilk had earned a reputation as a street fighter. In 1974, he’d written a book of his own, Chiropractic Speaks Out: A Reply to Medical Propaganda, Bigotry, and Ignorance. In it, Wilk made a case for the validity of chiropractic based on scientific research, and he attacked the AMA for trying to stop chiropractic education and block insurance and Medicare reimbursement for chiropractic services. “Chiropractic is not a cure-all, but neither is medicine,” Wilk said.”

“The case was finally settled in January 1992. The amount of the settlement is under court seal. The settlement went toward attorney fees for Wilk et al., plus additional funds went to support a center for disabled children run by a chiropractor in Kentucky and the chiropractic schools with a request from the National Chiropractic Antitrust Committee led by Dr. Chester Wilk, which raised funds for the suit, that the colleges earmark the windfall for research. Not all did.” (Wolinsky)

I had the honor of having lunch with Dr. Wilk and his wife many years ago in Chicago. Later, in 1996, we both presented at a seminar hosted by Petty, Michel, and Associates to doctors and staff here in Milwaukee.

He was not flamboyant and seemed unassuming, but to me, he had a steely commitment to chiropractic, and I could see that he was not someone to be bullied.

Were it not for Dr. Wilk, and many others that worked with him to defend the profession of chiropractic from the illegal acts of the American Medical Association, you might not be where you are now.

The story about the Wilk’s case is a lesson for us all and an example well set.

And whether you are a chiropractor, work in the chiropractic field, work in any health field, or pursue healthy solutions for yourself and your family, no one or no organization has any right to suppress health information from you.

Dr. Wilk was not to be bullied or silenced, and neither should any of us. He stuck to his goals through thick and thin.

Please take a moment to pay your respects to this humble man and how we can continue his work.

Seize the Future!

Ed

PS links:

Dr. Chester Wilks Book: Medicine, Monopolies, and Malice
https://www.amazon.com/Medicine-Monopolies-Malice-Chester-Wilk/dp/0895296470

Wolinsky book: Contain and Eliminate
https://www.dynamicchiropractic.com/mpacms/dc/o2.php?f_id=34

More info about Dr. Chester Wilk https://chiro.org/Wilk/

Dr. Chester Wilk at Petty, Michel and Associates seminar discussing the Wilks vs AMA trail in 1996

Mr. Ed Petty at Petty, Michel, and Associates seminar discussing practice development.