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Insurance Network Participation and Getting the Best Bangs for Your Buck

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Have you ever . . . Wished there was an easy way to make sense of the array of insurance networks out there? Should I be in? Should I opt out? Here’s a guide for you and your staff to follow to help you decide whether pursuing a specific insurance contract, and staying in, is worth your time and investment:

First, determine which companies you are in network with. Do you have a contract? What are your provider obligations? Are you getting reimbursed what the contract’s fee schedule says it will reimburse? Do you have a profile set up with the national Council for Affordable Quality Healthcare (CAQH) universal provider database and is the information current, and reviewed quarterly? There is no charge to create and maintain your profile in this credentialing database.

Second, make sure you know if you are currently enrolled in Medicare and if you are a participating or non-participating provider. Are you also currently enrolled as a provider in your state’s Medicaid program?

Third, audit your patient demographic. Run a report in your practice management software. What percentage of your reimbursement is coming from insurance? What percentage is coming directly from patients? Which payers are you mainly seeing patients from? Are you finding that patients are requesting you be in network with a certain company? Who are the main employers in your area insured with? Are you enrolled as a provider with the Veteran’s Administration in your area?

Fourth, develop a spreadsheet called “Insurance Networks” to help you and your insurance department keep the information organized and up to date.

Once you have a grasp on the above, you’re ready to determine if you need to pursue network participation with additional companies. Treating this like a sales or business venture, you’ll want to have insurance companies coming to you and requesting you be in their network. Remember, it is to their benefit and their obligation to keep their paying policyholders happy. Patients should feel free to call their insurer requesting you be on their plan. Patients have done this, and outcomes have been successful. Why? Because the worst phone call an insurance company can receive is from an upset policyholder who can’t afford to see their favorite doctor who is helping them (that’s you!) because the doctor is not on the plan.

Things to consider prior to enrolling in a plan include:

  • What is the reimbursement rate?
  • What percentage of the approved charges are taken out for contract discounts?
  • Is there a fee to join?
  • What are your provider obligations?
  • Do they want you to participate in their workers compensation, PI programs? (In our experience, opting in to the WC and PI products means no steerage to you, and cut reimbursements).
  • Are there pre-authorizations required prior to care? Is there a visit limit?
  • What is the initial credentialing and re-credentialing process?

Now, you are on all the plans that are making your pocketbook and your patient happy. What do you need to do to maintain your in-network status? You will need to notify a payer with updated clinic information anytime there is a change in information you submitted at enrollment. This includes phone number change, address change, adding a new provider to the office.

You will also need to make sure you are tracking re-credentialing timeframes for each insurance company. Typically, the recredentialing process for commercial payers is every three years but since your enrollments with each payer fall on different dates, your re-credentialing due dates will vary. Your Medicare re-credentialing is every five years. Re-validation with Medicaid programs is typically every three to five years, depending on your state’s standards. For example, it is every three years in WI and every five years in MI. Many of the larger commercial payers such as Blue Cross, Humana, United Healthcare/Optum Physical Health, use CAQH to approve your re-credentialing. Those who do not will send a written communication via mail or email letting you know your recredentialing is coming due and will include the applications and instructions. Make sure to track these dates in your insurance spreadsheet.

We’ve just touched the surface of network plans and credentialing. Email me for assistance with how these processes work for your practice. You may reach me at lisa@pmaworks.com
Happy Credentialing!

Lisa
“Increasing your collections through better billing and documentation”

The Best That Ever Was?

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Just imagine… imagine that you have SO many patients that you need to move to a larger office to accommodate them all.

A few years later, once again, you are seeing more patients than your office can hold, so you build the office of your dreams – a custom designed 19,000 square foot clinic. And the patients keep coming, so you bring on other doctors. Some days, you and the doctors see 600 visits.

Since patients travel to see you from all over the world, you build a motel next to your office. You also set up a limousine service from the nearby airport to your office.

Could you do this?

Clarence Gonstead did. Here, in Wisconsin, from the 1920s to the early 1970s

What made him so successful?

He was an expert. He was a master at his art. He was committed and focused on his craft and his outcomes.

A founder of a chiropractic college would later say that Dr. Gonstead was not a “commercial chiropractor.” He didn’t focus on management or marketing – just chiropractic. (As a management consultant, I can only wonder how expansive his operation would have grown had he had managers as dedicated and competent as he was!)

He was focused on results and said: “Our future will be our results.”

According to people who have studied exceptional performance, there are definite ingredients needed to become an expert, all of which are available to you. And by the way, “natural talent” is not one of them. Let’s look at each one:

  1. Deliberate practice.
  2. Coaching and training.
  3. Commitment to being an expert.
  4. Support from family and friends.

 

  1. Deliberate Practice. Knowledge is fine, but it is skills that are needed. Skills are acquired through a specific type of practice, which Anders Ericcson calls “Deliberate Practice.” This is not just going through the motions of hitting a golf ball, for example, if you are a golfer. It is going beyond your comfort zone and making mistakes and learning better methods.
  2. Coaching and Mentoring. Ericsson points to Tiger Woods for an example of the importance of coaches and mentors. Tiger’s father, Earl, an avid golfer himself, was a teacher of young boys and had a passion for sports. He started training Tiger at an “unthinkably early age.”
  3. Commitment. It is obvious but often overlooked, that to be an expert, you must want to be one. Deliberate practice and study require work and is not comfortable. Tiger used to train 13 hours a day, according to one of his coaches, Hank Hanley. (Golf Digest)
  4. Support from Family and Friends. Support can bolster individual efforts to succeed. Tiger’s dad was Tiger’s champion, as was Brett Favre’s dad, Irv, the famous football quarterback. Parents, spouses, and friends can play a major part in helping to bring about expertise in others.

It doesn’t matter what method of adjusting you use, or if you are a dentist or a chef or a cello player. It does matter if you are an expert. Achieving a high level of skill is not always fun or easy, but the rewards are worth it.

Tiger Woods was recognized as the world’s top-ranked golfer in the first 10 years of the 21st Century. He then fell into a slump with domestic issues and physical injuries. But with continued training, he came back to win his 5th Master title and 15th Major title at the Augusta National Golf Course just last weekend! (By the way, Tiger also praises chiropractic for his success!)

I have seen the ads, and I am sure you have as well, on how you can be a laptop chiropractor, travel the world, and make “six figures.”

I love the Internet and laptops and do travel the world and have nothing against being wealthy. But you are a doctor, a provider of service and outcomes, and if what you deliver is not exceptional and extra-ordinary, then the world will pass you buy.

There has been a great “shake-out” occurring in commerce. We have seen it happen with retail – where now the Internet and Walmart dominate. The store on Main Street is shuttered. This will be happening to the service industry as well. Only the very best will survive. Don’t fall for schemes that promise to get rich with easy effort.

What should you do?

You should become the best in the world.

You should work tirelessly, like Tiger Woods and Clarence Gonstead, to become the world class masters.

And as Clarence Gonstead said,

“Practice. Practice. Practice. Never stop.”

Sincerely,

Ed

PS
If you have the time, I encourage those of you who use Dr. Gonstead’s method, and even those who don’t, to come by his clinic in Mount Horeb and listen to some of the stories of those who worked with him directly.

And especially… bring your team.

“My Time with Clarence Gonstead DC”
4 Speakers who Learned and worked with Gonstead

Link to a poster on Facebook

Time and Place

  • Friday, April 26th, 6:30 PM (Free!)
  • Gonstead Clinic of Chiropractic
  • 1505 Bus. Hwy. 18-151 E, Mt. Horeb
  • (608) 437-5585

Also, during the weekend, the Gonstead Methodology Institute is sponsoring a “GCSS Knee Chest Extravaganza.”

Link to more information.

Goals, Games, and Groundhog Day

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It is a New Year and already we are knee-deep in its work.

But it is a NEW YEAR and it is important that you take time out to make new plans and then review them often.

Life Works in Cycles

Each year in Wisconsin, the leaves fall and then the snow falls. But by July the strawberries are ready for the pickin’. Every month, we can see the full moon. Each day, we can see the sunrise – if it is not cloudy.

In human endeavors, we seem to follow this natural rhythm of following cycles. After we finish the 9th grade, we are ready to begin the 10th grade. We are excited to finish when we get out of school for the summer, and then again, eager to start the new grade when we begin again in the fall.

These are all cycles.

What would happen if you stayed in the 9th grade, year after year? How would you feel?

Yet, in our work life we fall into the trap of doing the same thing over and over and over. This is not the first unique and special patient you have ever seen…this patient is a customer just like all the others — just another case. Today is not the first day of the rest of your life, it is just like yesterday which is the same as a long line of days that go on and on. And on…

We get beaten down by the tedium, working endlessly for some forgotten purpose, as if the assembly line we were on never stopped and was always the same.

This is a major cause of stress.

Groundhog Day Syndrome

You can’t do one thing forever, like in the movie “Groundhog Day.” In it, the main character visits a town in Pennsylvania where everyone watches to see if a groundhog can see its shadow. This is traditionally on February 2 (This year, it is on a Saturday.) The only problem is, for this character, the day keeps repeating and repeating, the same each day. It drives the character to suicide, but even that doesn’t work. Finally, he falls in love and wins the girl and has a new life.

Anything in life that begins, it seems, must end. It can start again, but it must end so that a new iteration can be created. It is the cycle of life.

Goals and Games

This is an important factor in what is called Gamification. With the advent of computer games, design elements are added in to make the game fun, challenging, and motivational.

But games are nothing new. Baseball is a game. It has a season and games and innings. It has cycles. Games have been part of human behavior since the beginning. The Olympics started in 776 BCE.

One aspect of games that can be overlooked is the fact that they are just an activity for play. Play is something we do naturally as toddlers. As we grow older, this activity becomes structured into organized sports and games, but at the core is the desire to have fun. To play.

We can lose this sense of play when what we do has no end and no beginning. Persistence is a good quality, but it can lead to an enforced dullness that buries our enthusiasm.

It is important to keep in mind that in business, as in sports, keeping the perspective of play is more effective than bearing down on one’s duties with serious gravity. Practices that incorporate some of the components of a game into their operations are more productive and have a better time.

What are your goals for 2019? For the 1st Quarter? For this month… or for today? Higher numbers? New team members? Community wide outreach program? New training and greater knowledge?

As soon as you make a goal, you start a new cycle and begin a new game. Try to win. But you could lose. Either way, don’t get too serious about it and just be grateful to be able to be in the game.

Set new goals and play. Play — to win. Have fun. Smile a little more!

Health Account Savings Plans: Assisting Your Patients To Stay on Their Treatment Plan

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Welcome to your best chiropractic year!

Commercial health insurance carriers such as United Health Care and Anthem BCBS can offer their customers, who are also your patients’ employers, two different health account savings options:

  • Health Reimbursement Arrangement
  • Health Savings Account

An employer can also directly offer the benefit of their employees signing up for a Flexible Spending Account.

Let’s dig into each one!

What is a Health Reimbursement Account? (HRA)

A Health Reimbursement Account (HRA) is an account that your patient’s employer funds to help the employee pay for covered healthcare services. The patient cannot put monies into an HRA, as the account is owned by the employer. This includes paying for services (chiropractic office visits) that apply to the patient’s deductible. The patient can begin using their HRA on the first day of the plan year. Since the patient’s employer controls the fund, the employer has the ability to make the rules on when and how the patient can use the money. Additionally, there are coinsurance-only HRA plans available, whereby the patient’s employer will pay only coinsurance amounts.

The patient does not have to pay taxes, state or federal, on HRA monies, so it is a tax savings. The HRA cannot earn interest as it is not a personal bank account.

How do you, Doctor, get paid? Once claims are submitted to the insurer, the insurance carrier will pay, as long as the patient has funds in the account. You will typically, but not always, receive two EOBs/remittances for the same DOS. This is usually due to that first charge going to the patient’s PCP and then getting denied and forwarded to the employer. Referrals from the patient’s PCP to your office is not a requirement tied to an HRA.

There is only one account set up for all covered dependents on a plan. The employee does not report the HRA monies to the IRS.

Takeaways:

  • Get in good standing with your community’s businesses and industries so chiropractic can stay included on their coverage and benefits, and you can get those referrals!
  • Billing Tip: Make sure you are posting to the most recent, newest remittance.

Health Savings Account (HSA)
A Health Savings Account is a savings plan set aside for taxpayers who enroll themselves in a high-deductible health plan. They can be offered by your patient’s employer as an employee benefit, or the patient may elect to sign up independently. The benefit here is that the funds are not subject to tax liability upon deposits. Moreover, if there are monies left in an HSA, they can roll over into the next year. When your patient’s health plan offers this type of plan, they are provided with a debit or credit card to make their eligible health service purchases. Both the patient and their employer can contribute to the fund. The patient must report this account to the IRS when they do their taxes.

Takeaway:

Health Savings Accounts are not owned by the patient’s employer. All taxpayers with high-deductible health plans are eligible and must report this account to the IRS when doing taxes.

Employer-based Flexible Spending Accounts (FSA)
An Flexible Spending Account is a special account the patient puts money into to pay for certain out-of-pocket expenses such as medical related, dependency related, and a limited dental and vision plan. This arrangement also has a tax-free benefit. The list of all eligible expenses can be found on the IRS website at: https://www.irs.gov/newsroom/irs-plan-now-to-use-health-flexible-spending-arrangements-in-2019

The employer owns this account.

A frequently asked question I get is, does an FSA cover massage?
Answer: Yes, it does with the ordering physician (chiropractors included) writing a note of necessity for the massage therapy.

When there are monies left over in the account at the end of the year, the employer has two options they can offer their employees:

  1. The patient can set aside the monies and use it up to two-and-a-half months into the new year, or
  2. The employer can allow the employee to carry over up to $500 from one year to the next.

Takeaway:
There are several eligible out of pocket expenses that an FSA will cover. Click on the IRS link for more information: https://www.irs.gov/newsroom/irs-plan-now-to-use-health-flexible-spending-arrangements-in-2019

SUMMARY
If your patients struggle to keep their appointments due to financial concerns ask them if they have one of these savings accounts that might be able to supplement payment of their care and keep them on their treatment plan.

Oh, one further heads-up to our profession just finding its way down the pipeline . . . you may have or will be receiving a letter from a TriWest Family Alliance group out of Arizona promoting their billing services on behalf of VA offices. This letter is being distributed nationwide. Please note we have researched this, and credentialing and contracting with this group is optional. If you already have a contract with your VA, you may continue treating VA patients as usual. There is no change in their referral of patients to you, or the preauthorization process.

If you have any further questions, don’t hesitate to reach out to either myself or Dave.

Please feel free to forward this article to your insurance department.

Adios for now!
Lisa

“Increasing your collections through better billing and documentation.”

Yearly Goals…Be a Homesteader

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Practice and Business Goals Petty Michel

Sometime back in the late 1800’s, my great great grandfather homesteaded land in Oregon. The way I understand it, he found a plot of land he liked in the southern part of the state. This was his goal. He and his wife then settled on it.

You too can be a homesteader.

You have a chance to stake out your own plot in 2019. You can define where you want to be in the future… and then work it so that it is yours. And if you don’t, well, you will still be somewhere, just not where you want to be.

Life is this river and it just keeps rolling, and we are on it. We are not leaves floating rudderless. We have some choice about where we want to be 12 months from now. We can set a course and navigate and sail or row or jump out and paddle ourselves to where we want to be.

This is why we set goals and a course of action. We don’t want to wind up broken and dead on the rocks, or stuck idle in a rancid stinky lagoon that goes nowhere!

But when you do set goals for your business, or even for your career, they are often too lop-sided. They are not holistic. You might say that they are symptomatic. We may only shoot for the amount of money we want to make. This isn’t bad, it just isn’t enough. It is too superficial.

If you want to make more money, you have to see more people. If you want to see more people, you have to take better care of them. To do so, you have to improve your services. To do this, you have to improve your expertise and the expertise of others who see your patients. Lastly, you can’t be an old grouch, unhappy with a poorly managed personal life.

You are in the business of improvement! To improve people, you also have to improve your business. To improve your business, you have to improve the professional skill of each member of the business. Lastly, each member of the team has to work on self-improvement.

Make these into your goals.

DRIVE each other to achieve these goals.

Be GOAL DRIVEN!!

IF this is done, how could you – or anyone lose? Everyone wins.

So, to keep it simple, see the attached worksheet. Set your goals for each area, and every three months, ESCAPE to a place where there is no interruption, your “laboratory,” to confront how you did and make any necessary adjustments to your plans and continue your journey to your yearly goals.

Yearly Goals Worksheet — Link

Set aside 2 or more hours at the beginning of the year and the beginning of each new quarter (3-month period) to review your past and set new goals.

To do this, you must get away. Turn off the phones and remove ALL distractions. You are going to your Goals Laboratory and humbly review the past and boldly make new plans for the future.

You will fall off the rails, so every three months, you will have already scheduled time to review your failings and triumphs and reset. You can now get back on track and re-plan and go forward to the next three-month marker.

Use the worksheet to help you have a Goal Driven year.

Good travels and Bon Voyage.

— Ed

Yearly Goals Worksheet

Medicare, Yada, Yada, Yada: Fraud, Waste and Abuse Training.

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OK, I admit it. Medicare is not the most glamourous topic to write about, nor does much of it pertain to our world of the chiropractic profession as we know it. However with that said, I am doing due diligence for you and fulfilling my duty to inform you of the necessary requirements a Covered Entity must follow (that’s us included!) to keep the Office of Inspector General off our backs and to help you take preventive measures so you’re not sending back reimbursement money you earned from providing patient care.

Because . . . based on my observations in the field – and this is a review for those of you who read our PM&A articles and utilize our library- how many of you know, for example, what a Part C Medicare plan is? How many of you know that all Part C providers are required to undergo annual Fraud Waste and Abuse training?

Second example: How many of you are aware that Medicare, starting in April of this year and going into April of 2019, is sending all of their beneficiaries new ID cards in an effort to do away with social security numbers for the sake of safeguarding identification?

So how do my two examples above directly impact you, your practice, and your bottom line?

Let’s circle back to the first example. A Part C Medicare Plan is known as a Medicare Advantage Plan. It oftentimes covers more services than a straight Medicare plan does. HMO/PPOs such as Humana and Blue Cross Blue Shield have developed their own Medicare Advantage Plans and offer them to their policyholders, your patients. A patient who signs up for an Advantage Plan must also be enrolled in Medicare A (hospital), and Medicare B (outpatient provider services). Medicare Part C providers to date have been required to, annually, undergo what is called Fraud, Waste and Abuse Training. Let’s take each of the three words and define them from the Medicare and Medicaid world.

  • Fraud is known intent to deceive in order to collect money from the Medicare program illegitimately.
  • Waste is overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the healthcare system, including the Medicare and Medicaid programs. It is not generally considered to be caused by criminally negligent actions, but by the misuse of office and/or practice resources.
  • Medicare Abuse includes practices that result in unnecessary costs to the Medicare program such as over or underutilizing services. You are probably familiar with the Quality of Care initiatives such as MIPS/MACRA and the EHR incentives, implemented to help combat abuse. Common types of abuse include:
    • Billing for unnecessary services
    • Overcharging for services or supplies
    • Misusing billing codes (upcoding) to increase reimbursement*

*Downcoding is also a misuse of billing codes. Stop doing it. Although not intended to increase reimbursement it is a red flag to Medicare, and your services will be questioned as to if they were “medically necessary.”

Back to the training . . . I urge you now to complete this training by the end of December. It is intended for doctors and staff. Download the PowerPoint below, read thoroughly and after completion have each staff and doctor sign off to attest, they read through the PowerPoint. The sign-off can be as simple as logging signatures and completion date in a notebook or a spreadsheet. It is not necessary to print out the PowerPoint. Oh, and many insurance contracts require this training as a contract obligation to be part of their network as well. You can access Medicare’s training PowerPoint here: Fraud, Waste and Abuse

Referring back to the second example of new Medicare cards. You can review our previous article and checklist here: New Medicare Beneficiary Indentifiers to be Assigned Your Patients

Your staff should be asking Medicare patients for their new cards, making a copy, and making sure the address in your practice management program matches the address the Social Security office has on file. If there is a mismatch like the patient has moved and not updated their address, you will have problems getting reimbursed. Make sure your Insurance Profiles in your programs have the new Medicare IDs.

Stay tuned for more helpful articles like this. If you have any questions on the above, contact me! I’m here to help.

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

And remember . . .
“The Future Will Be Our Results” (Clarence Gonstead, D.C.)

How to Deliver Goal Driven Extra-Ordinary Customer Service (Part 2 of 2)

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“Our future will be our results.”     Clarence Gonstead, D.C.

How do we overcome these barriers to extra-ordinary service?

Let’s first define “service.” Service in a professional service firm or professional practice includes two categories:

A. Outcomes. These are the results from the provider.
B. Customer experience. This comes from what the customer experiences as they move along their pathway through your business.

Let’s begin with your goals.

1. Define and Commit to Your Highest Goals.

To create world class outcomes and service, you first need to review your most senior goals. Then, you have to ensure everyone understands them, agrees to them, and commits to doing everything possible to achieve them.

Setting purposeful goals over a lunch meeting does not take into account the sacrifice and effort that will be necessary to achieve them. You may commit to your own goals, but like New Year’s resolutions to go to the gym, you get distracted and discontinue after a few weeks. Some of your team may say they understand the goals – even agree to them – but in fact are only passengers along for the ride.

So, you should review and recommit to your goals each week. Be insistent, allowing for shortfalls now and then, but not compromising in the long run. Be true to your goals or make new ones. Spend time on these three:

a) Mission
This is the purpose of your office. It should be short and to the point and should include something about excellent service and outcomes and helping as many as possible.
b) Core Values
These are the standards for professional behavior and performance. List what values you consider most important in providing health care.
c) Patient Outcomes
Define where you are taking your patients. Relief care only? Or are you taking them further to better health and wellness?

Be true to your goals.

2. Outstanding Outcomes Come from Expertise

Because of your clinical skill, you can produce wonderful outcomes. But can you do even better? Here are some masters in their field as examples of professionals that never stopped improving their craft:

Music: Pablo Casals

Pablo Casals was a cellist – regarded as the best that ever lived. He was born in 1876 in Catalonia, Spain. In 1963 he was awarded the Presidential Medal of Freedom by President John F Kennedy, and in 1971, two months before his 95th birthday, he performed for the United Nations and accepted the U.N. Peace medal.

Casals was talented, but he practiced daily. There is a story about Casals and his training regimen:

He [Casals] agreed to have Robert Snyder make a movie short, “A Day in the Life of Pablo Casals.” Snyder asked Casals, the world’s foremost cellist, why he continues to practice four and five hours a day.

Casals answered: “Because I think I am making progress.”

Food Preparation: Chef Jiro Ono

If you want and value good sushi, Chef Jiro Ono is your guy. He was 92 at the time of this writing. He still works in his small restaurant in Tokyo that holds only 20 people at a time. The waiting list can be over a year. Still, at his age, he works on perfecting every aspect of the sushi, from selecting the exact right fish early at the fish market, to the exact texture of the rice. And every night he considers how he can improve on that day’s production. He is considered the foremost sushi chef in the world. (Jiro Dreams of Sushi, David Gelb 2011 documentary, Wikipedia)

“Once you decide on your occupation… you must immerse yourself in your work. You have to fall in love with your work. Never complain about your job. You must dedicate your life to mastering your skill. That’s the secret of success…… Even though I’m eighty-five years old, I don’t feel like retiring.” Jiro Ono (Jiro dreams of sushi, 2011)

Health Care: Clarence Gonstead

Clarence Gonstead was a chiropractor, born in 1898 and grew up in Wisconsin. In 1923, Dr. Gonstead graduated from Palmer Chiropractic College and began practicing. In 1939, he built a new chiropractic office in Mount Horeb, Wisconsin.

Because of the growth of his practice, a new Gonstead Clinic of Chiropractic was completed 1964. It was a two-level facility with 29,000 square feet. In 1965, adjacent to the new clinic, a full-service motel was built. Gonstead’s reputation as a remarkable chiropractor had spread beyond the United States and he had patients flying in from all over the world. To assist these patients, he set up a limousine service between the Madison, Wisconsin, airport and the Gonstead clinic about 30 miles away. Patients with their own private planes could fly in and land at Gonstead’s personal airport located next to his home on the outskirts of Mount Horeb.

With no marketing, his practice grew so that that he was seeing over 250 patients per day, working six-and-a-half days a week. He often treated his last patient at 2:30 in the morning.

Gonstead studied and improved his craft. He was not, as a founder of a chiropractic college would later say, a “commercial chiropractor.” He was focused on results and said: “Our future will be our results.”

Eventually, he began teaching others his system which is now recognized around the planet as one of the most effective and popular forms of chiropractic technique. He encouraged other chiropractors to study and to “Practice. Practice. Practice. Never stop.”

So, be like Jiro, Pablo, or Clarence! Use “deliberate practice” and look to see how you can improve your skills and methods so that your customers can achieve their goals faster and better.

Never stop improving your craftsmanship.

3. Delegate Administrative Duties to a Goal Driven Team

It is almost impossible to focus on excellent patient outcomes and run a growing business at the same time. You need a strong support infrastructure. This means professional team members that are trained and motivated to apply procedures that are both simple and effective.

Chiropractic works. Not having a smooth-running support structure is the primary element that is in your way from developing your practice to its full potential.

This has been the major focus of our work over the last 30 plus years. We have found that the better the support, the better the outcomes and the happier the doctor and staff.

Improve your people and systems.

4. Create an Upbeat and Supportive Work Environment

“If you go into any organization that’s customer-facing, you can tell in five minutes when the employees are feeling abused. They retaliate on the customers.”   Jeffrey Pfeffer, professor at Stanford University

The way the employees are treated directly affects the service that they will provide to the customer.

Sure, work can be stressful at times. Maybe someone snaps at someone else. This happens in any high-performance activity. But as long as we all share the same mission and values, we can address our personal slights to each other and move on.

It is everyone’s responsibility to create a cheerful work environment for each other. If you are having fun, so will our patients.

Smile more — and make work fun!

5. Give Your Patients Information. Educate Them!

“If I’d asked customers what they wanted, they would have told me, ‘A faster horse!’.” Henry Ford.

Of course, you give people want they want – what they consider urgent and important.

But people didn’t want a faster horse, they just wanted faster transportation. Horse, car, airplane… they wanted to get to where they wanted to go – faster. They just didn’t know about how simple, fast, and easy a Model-T was.

You must show them through education that you have what they want and need.

Most offices provide relief. That is what the patient is aware of and willing to pay for. But since you are providing a product that is not tangible using procedures that are invisible, your customer may have a difficult time understanding anything beyond the “quick fix.”

They may know they want more but lack the understanding of what is available.

I know I need to pay my taxes, but what I really want is to pay as little as possible. I also would like to contribute to my children’s education. With some education, my accountant could make me aware of different strategies that would take me to my full goal.

“Customers are thirsty for more information and knowledge,” according to studies by ThinkJar, a customer strategy consultancy.

To deliver your best and complete outcomes, you need your patient’s motivation to do so. It is a path and a partnership that you travel together.

The better that they understand their condition and your unique remedy, the easier it will be for you to help them achieve the best outcome possible.

The more they know — the further they’ll go!

6. Making the Patient’s Experience Extra-Ordinary

Making the patient experience “WOW” takes a team effort.

If studies show that customers discontinue a service mostly because of a lack of interest on the part of the service provider — and your own personal experience validates this fact, then the solution is simple. Just be genuine and interested in your patients. Be empathetic. Take the time to be totally present, in the “now,” and have “present time consciousness.” You only have 1 patient, and that is the one you are with, or about to see.

Then, when you practice with your team at team meetings, focus on this: the level of honest interest, curiosity, and care.

Practicing scrapes off the “barnacles” that attach to us all as we soldier through our work days. Here are some training tips for working on improving customer service with your team:

a) Review the Customer’s Journey

Lay out the pathway to and through your services. Do this with your team.

This begins even before your patients contact you. Who are they? Mom’s, seniors, kids? What brings them to you? What other solutions have they tried before they came to you? Get to know them and empathize with their condition.

b) Flow Chart

Then, list the sequence of actions, or a flow chart of what occurs from first contact through their first service and leaving. Drawing this out with your team will expose many areas for improvement.

c) The Walk-Through

Against this flow chart, you and your team can now look at where you can add more benefits for your customers.

I have found that practicing a “walk-through” reveals many hidden plusses – and embarrassing weaknesses, in service. The doctor or a team member takes on the role of a customer. They then travel some portion of the patient pathway with the usual team in their roles, acting as if they are dealing with an actual patient.

You are guaranteed to find areas where service can be improved.

d) Add More Value

Bain Consulting, an international management company, identified 30 different elements of value relative to consumer needs in an extensive study. They categorized these customer values into four categories:

    • Functional values, such as quality, variety, time efficient, simplicity, reduces effort, and reduces cost.
    • Emotional values, which included entertainment and fun, aesthetics, rewards, and attractiveness.
    • Life Changing values which included affiliations, community, and greater purpose.
    • Social Impact. An industry example was Tom’s shoes, a shoe company that donates a pair of shoes to underprivileged for every pair purchased by a customer.

In their research, Bain noticed that the companies that had the highest ratings on the most values had more loyal customers than the rest. They also found that these companies had faster revenue growth than others.

Good service pays. Great services pay even better!

With this in mind, look again at your flow chart and notice where you can add more value to your services. Start with the direct service to your customer, the “functional” areas of your business. For example, how could your customers receive their services:

  • Faster
  • More conveniently
  • Less expensively
  • With less effort
  • With greater simplicity
  • Receive child care while in the office
  • And also acquire a understanding their condition and their care program

In the next category that Bain used, what kind of “emotional” values could you add, including:

  • Fun and entertainment
  • Rewards
  • Design/Aesthetics
  • Attractiveness
  • Reduced Anxiety

The next two categories relate to higher purposes. “Life changing” and “Self-transcendence,” including:

  • Affiliation/belonging – Create a wellness or health club, have patient barbeques and get togethers.
  • Social Impact – Schedule yearly events to help the less fortunate, clean-up drives, and health and environmental causes.

In the years to come, Customer Service will take the lead in all your marketing efforts and will be the factor that sets you apart from comparable alternatives.

Edward Petty

Goal-Driven Customer Service (Part 1 of 2)

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“Your customers are only satisfied because their expectations are so low and because no one else is doing better. Just having satisfied customers isn’t good enough anymore. If you really want a booming business, you have to create Raving Fans.” Ken Blanchard, Raving Fans

Customer Service is one of the 5 Power Drivers of your business.

It is the least expensive form of marketing you have and will be your surest guarantee to profits in the years to come.

But in my work in business development, and my experience as a consumer, most service is just adequate. It is “nice.” If it was any less, there wouldn’t be any service at all. Most service is just good enough to get by.

The most common examples of poor service I have witnessed were encounters by the provider that were so routine as to become rote and even superficial. Services were provided as part of a checklist, almost robotically. Even with all the smiles and friendly chatter, this customer was just like all the others before – nobody special. Added to this, the support staff were disengaged, bored, or even irritated at the customer for the interruption.

I have done enough customer interviews to know that most of those who give online reviews, for example, do so out of a sense of friendship and support, rather than from their exuberant advocacy. They are sincere, but just not that excited about the services they received.

For example, how would you compare your last visit with your attorney, dentist or accountant? They got the job done, right? But, it wasn’t “WOW… I just saw my dentist and it was awesome!”

You wouldn’t stand in line to see your accountant all night like people do to get a new iPhone or tickets to a favorite rock concert.

But this is the value customers will need to place on your services inorder for your business to thrive in the next ten years and more

Why Customer Service is SO Important

Customer Service Now

There are dozens of books and studies that document why customer service is vital to the health of your business. Every year there are new studies that show the importance of excellent customer service. I am sure that you have seen them.

Some highlights:

  • Americans continue to reward companies that get service right. US consumers say they’re willing to spend 17 percent more to do business with companies that deliver excellent service, up from 14 percent in 2014. As a group, Millennials are willing to spend the most for great care. (21% additional), (American Express 2017 Customer Service Barometer)
  • Maximizing satisfaction with customer journeys can increase customer satisfaction by 20%, lift revenue by 15% and lower the cost of serving customers by as much as 20%. (McKinsey & Company)
  • 86% of consumers are willing to pay more for an upgraded experience. (ThinkJar)
  • One happy customer can equal as many as 9 referrals for your business. (American Express)
  • A 2% increase in customer retention has the same effect as decreasing costs by 10%. (Leading on the Edge of Chaos, Emmet Murphy and Mark Murphy)
  • One happy customer can equal as many as 9 referrals for your business. (American Express)

On the down side:

  • A typical business hears from 4% of its dissatisfied customers. (“Understanding Customers” by Ruby Newell-Legner)
  • 85% of customer churn due to poor service was preventable. (ThinkJar, Inc.)
  • 89% of consumers have stopped doing business with a company after experiencing poor customer service. (Rightnow Customer Experience Impact Report)
  • Depending on which study you believe, and what industry you’re in, acquiring a new customer is anywhere from five to 25 times more expensive than retaining an existing one. (Harvard Business Review, 2014)

Customer Service in the Future

As we move into the 2020’s, the quality of your service will be more important than ever before. It will be the distinguishing factor between your business and others that provide comparable services.

A recent report from a survey by Microsoft stated: “As customer expectations continue to climb, it becomes more challenging for brands to set themselves apart from the competition. Markets are increasingly crowded, and both price and product are being steadily overtaken by customer experience as the number one brand differentiator. (2018 state of global customer service report (Microsoft))

Research by Walker, Inc., predicted that by 2020 customer experience will overtake price and product as the main differentiator.

Your Replacement Is Being Shipped Now

Artificial Intelligence is coming for you.

By 2029, machines will be able to match human intelligence. This is a prediction by Ray Kurzweil (co-founder and chancellor of Singularity University and Google engineer and author of The Singularity is Near). Kurzweil, along with other futurists, predict that computers will be building computers faster and smarter than humans – and this would create a technological singularity – where the speed of technology development of increases infinity fast. According to Peter Rejcek – there is serious investment based upon these predictions. (Singualrityhub.com, March 31, 2017)

How will A.I. impact the professions? How will this impact you?

“Whatever terminology is preferred, we foresee that, in the end, the traditional professions will be dismantled, leaving most (but not all) professionals to be replaced by less expert people and high-performing systems. “(The Future of Professions, Susskind and Susskind, Page 303, 2015)

The Future Belongs to Those Who Provide the World Class Service

This is the writing on the wall and those smart enough, will heed it.

I truly hope that this is you.

If you are not the best in your niche, the time will come when you will be left behind – like an abandoned roadside fruit stand bypassed by a newer and faster road.

I want to give you some insight and actions steps so that you will be a winner and a profitable leader in your profession well into the 2020’s.

But beware — there are booby traps and thieves along the way that can rob you of your success. So, let’s look at these villains hang out so that you are prepared and able to create World Class service and dominate your niche.

Six Barriers to Extra-Ordinary Service

1. Organizational demands eventually wear down the provider into mediocrity

How can a provider become a master at their craft and focus on creating great results while at the same time trying to run their growing business? There is just too much to do. All this work finally hobbles excellent service and outcomes.
There is just too much to do – too many roles to assume, too many hats to wear.

2. Hubris

To achieve any success at all, you have had to persevere and breakthrough many challenges. You have many reasons, therefore, to feel that your way is a winning way because, obviously, it has worked. At least up to now.

But great service is not about you, it is not about your business or philosophy or religion or any of your bias’. It is solely about your customer. It is their goals, not yours and not those of the business, that must be achieved.

You must have humility to review the outcomes of your work and question how you can improve as a provider – and how the actions of your support team can also improve.

3. You and your team have lost sight of the value of your services.

The business of providing service to your customers can begin to overshadow the benefits they receive. At some point, the people you care for become “cases,” and their individuality blurs with everyone else’s.

Sometimes the “negative few outweigh the positive many,” and we can’t see or appreciate all the good our services have done for our customers, their families, and even the community.

The joy of helping others and the victories of seeing your customers overcome their issues no longer make you smile or fill your chest with confidence and pride.

4. Culture – Our Shallow World

We live in a fast-paced world that does not seem to have time for understanding, empathy, or thorough results.

We are all in a hurry, and for the most part, don’t expect, or demand, much from our providers.

There also still lingers an assembly-line culture of receiving a manufactured template from our providers, or at least their support team. And, as providers and support professionals, we can fall into the assembly-line mode of just seeing “another case,” with all their problems, idiosyncrasies, and often confused rudeness.

We end up short-changing our customers on the benefits that they could be receiving.

5. The Invisible Product

You are selling and delivering a product that is invisible.

It is not like buying a refrigerator, a car or a kite.

But customers don’t always know what criteria they should use to judge their results. They don’t know the process that is undertaken to deliver the outcomes they want, or even what the potential outcomes are.

So accustom to the objective criteria of your services, you may not appreciate the customer’s lack of understanding about the nature of their situation. As a result, the customer doesn’t know if they had a minor service or a complete one.

Standards become foggy, outcomes become poorly defined. Customers leave unhappy or confused and the provider is dismayed.

6. Not Yet a Champion

There really is a difference between a rookie and a master.

The idea of mastery is a dominate value in sports, music, and in some of the professions. But we live in a commoditized world and we want our gratification fast.

Employees don’t see their roles as a journey to becoming experts, and neither do many providers of services. Everyone works hard and gets results. Isn’t that enough?

No. It isn’t.

Plain and ordinary service will not grow your business. If you and your support staff are not working hard on becoming masters in delivering World Class service, your customers and potential customers will be seeking businesses that are.

# # #

Stay tuned for Part 2: How to Create World Class Outcomes, Provide Extra-ordinary Service, and Raving Fans!

Tent Poster – Mental Toughness – Goggins

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

— David Goggins

 

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

It Pays to Be an Expert. Are You One?

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Hi and Summer Greetings!

A vital component in our 3 Goals System is the importance of becoming an expert.

I’ll cut right to the most immediate reason:

Research shows that experts in any field or role make more money.

In high complexity jobs like professionals, the top 10% produce 80% more than average and 700% more than the bottom 10%[i].

But this is also true in less complex jobs, where it was found that the top 10% of workers produce 25% more than the average, and 75% more than the bottom 10%.

Aside from high school interns that help file and run errands, all the roles in your office are high complexity.

So, how do you become an expert?

A Desired Goal
Becoming an expert must be a goal that is desired to be achieved. It should be a core value. There must be a commitment to be an expert.

From the book, the Talent Code[ii]:

With the same amount of practice, the long-term-commitment group outperformed the short-term-commitment group by 400 percent. The long-term-commitment group, with a mere twenty minutes of weekly practice, progressed faster than the short-termers who practiced for an hour and a half. When long-term commitment combined with high levels of practice, skills skyrocketed.

 

Most employees in offices do not intend to become experts. It has never been a requirement for any job they have ever had. Plus, it is characteristic of modern culture to not value mastery. Why go through the long and uncomfortable task of becoming truly skilled and produce quality outcomes when it has never been expected of them?

Plus, I believe that through advertising we have been encultured to think in terms of instant gratification – I can get a “meal” through the drive-in at McDonald’s and replace that broken appliance through Amazon Prime.

And providers… you too are often so distracted by organizational issues that, well, good enough is good enough. You get fine results, right?

But I will remind you of Clarence Gonstead.

He continually worked at developing his skills and methodology. Everything else followed, including thousands of patients, so many in fact that he had to build a hotel next to his clinic for those coming from out of town.

Deliberate Practice
Keep your own checklist of procedures and work on them. Find how you can improve the manner in which you perform the most important tasks – and then improve some more. Much like you were practicing a musical piece on the piano or working out how to run the high hurdles faster – practice.

And the key is deliberate. Take some aspect of your job and work – deliberately. You might be surprised on how you might have taken some procedure for granted as working but when you examine it, you discover that there is a lot of room for improvement.

Research shows that doctors who have been in practice for twenty or more years do worse on certain objective measures of performance than those who are just two or three years out of medical school.

The reason for this is that doctors working day-in and day-out can begin to go on automatic because their work no longer pushes them out of their comfort zones[iii].

Find a Coach – Be a Coach
Coaching others will help you master your own skill. An old phrase applies:
“To teach is to learn twice.”
Seek out a coach, or coaches and mentors and learn from them. Have a “beginners mind,” or “Shoshin” — a term used in Japan meaning no matter how much you already know, always train as if you are beginner.
Schedule Training Time
Whether it is watching a webinar, reading a book, coaching a teammate, or reviewing an x-ray with a colleague, block out the time and interruptions. This is sacred time. Just a few minutes each week can produce definite results.

I know… I talk about this all the time …and will continue to do so as it is one of the least expensive methods to improve your business and increase income. And I know you also know this! So, this is just a friendly reminder to train and encourage your team to become experts.

I suggest your goal is to create a team of experts, and… and Expert Team!

Training Sayings
I have been keeping a list of “training maxims,” or aphorisms. I have listed a few on the next page.
Just for fun, could you offer others?
Stay curious and keep training!
Ed
References

[i] Hunter, J. E., Schmidt, F. L., Judiesch, M. K., (1990) “Individual Differences in Output Variability as a Function of Job Complexity”, Journal of Applied Psychology

http://psycnet.apa.org/index.cfm?fa=fulltext.journal&jcode=apl&vol=75&issue=1&page=28&format=HTML

https://80000hours.org/2012/09/how-good-are-the-best/

[ii] The Talent Code: Greatness Isn’t Born. It’s Grown. Here’s How. by Daniel Coyle

[iii] Peak: Secrets from the New Science of Expertise by Anders Ericsson

 

Ed’s Training Maxims

I am working on some sayings, or aphorisms on training and study. I have come up with a few.

Don’t cringe…!

Can you add any?

  • Educate – Don’t Terminate.
  • Don’t Complain – Just Train.
  • The more you learn — The more you earn.
  • Don’t Curse – Rehearse.
  • Don’t fight – Enlight!
  • To attain — You gotta train.
  • Don’t be on the dole — Be an expert in your role.
  • Become unchained — Go get trained.
  • Don’t choke your team! — Just provoke the dream.
  • Some will see it — Others will flee it.
  • Live the dream – Create an Expert Team

Not mine, but good ones:

  • To teach is to learn twice
  • “I hear and I forget. I see and I remember. I do and I understand.”

Driven to Excellence – Happy Father’s Day

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I’m facing the “BIG 60” in just a couple of days.  With that, back in April, I decided to take on the Great Cycle Challenge, which is a bicycle challenge during the month of June for Children’s Cancer Research.  My goal was to ride 60 miles during the month of June with 60 friends sponsoring me at $10.00 each to raise $600.00.

This challenge has been more eye opening than I had anticipated.

I haven’t really done much bike riding in probably 35 years.  The peaceful rides through the countryside along the White River Trail in Lyons have given me time to reflect on much more than raising money for Children’s Cancer and/or the fact that I’m turning 60.

Each day, while riding, a thought would pop into my head of someone I knew that has had to face cancer.  When my (ars) began to pain me…. I would think of those going through treatment and the challenge they face each day of their cancer treatment journey.  I would think of the challenges each family faces as their loved one struggles through the pain and how it really affects the whole family when one is afflicted.  I would think of those that have lost the battle to this horrible disease.  This was motivation enough for me to continue the ride returning to the comfort of my home.

Usually allowing a day in between rides to rest and rejuvenate today was different… I rode 8 miles yesterday and set out for 8 today.  Passing the half way mark the ride again became uncomfortable to say the least.  Again, I tried to focus on something other than the pain.

Immediately,  “DRIVEN” came to mind.  My mind pondered that word for a moment…thoughts racing to my head.

  • Driven… I recalled a recent article written by Ed Petty referencing David Goggins* with goal setting and being driven as a way to reach our goals. Moving out of our comfort zone through the pain and on to greatness.
  • Ed…I first met Ed Petty approximately 30 years ago. I was working in a Chiropractic office in Lake Geneva, WI for Dr. Culp(another great mentor might I add).  Ed had just moved to this area and was seeking out clients.  Little did I know that fast forward to today I have been working with him for almost 17 years.

When I have a birthday I often reflect on the past, where I’ve been and where I’m headed.

Ed has been an instrumental piece in my life providing me the motivation, knowledge and guidance to become a better person both personally and professionally.  He has helped me develop good communication skills, encourages a healthier lifestyle, and is there to listen when faced with a personal challenge.  Ed was one of the first people I was able to reach when my husband was killed at work just over 7 years ago.  I’m sure my call came to him as a shock as much as the call I received did however during that brief call he calmly presented me with two options.  “You can choose to wallow in your loss and look for sympathy from those around you or you can face the challenge and move forward.”  Again, that “driven” attitude to move outside our comfort zone at the forefront.

  • Father’s Day…. Ed while he is not my father, and really knows nothing of my childhood, has been a guiding light in my life for the past 30 years. Encouraging, teaching, coaching, and mostly being a friend. Ed has “DRIVEN” me to Excellence. And I am eternally grateful!

Happy Father’s Day to all those that Drive you to Excellence!

* https://pmaworks.com/observations/goggins/

 

 

 

Goal Driven: Faster to Your Goals!

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David Goggins

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

It doesn’t happen too often.

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

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

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

Sincerely,

Ed

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

Links to interview:

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

  1. 57 minute version: Search David Goggins on Impact Theory, With Tom Bilyeu. https://www.youtube.com/watch?v=78I9dTB9vqM&pbjreload=10
  2. 23 minute version: Abridged version: The Most Motivational Talk EVER! – David Goggins
    https://www.youtube.com/watch?v=oIrT1eHs1b0 
  3. 10:30 minutes How to Conquer Your Mind and Embrace The Suck  

May is Good Posture Month

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May is Good Posture Month.

I am not sure who claims this … the ACA (American Chiropractic Association) and ICA (International Chiropractic Association) used to, but after a fast look at their websites recently, it doesn’t look like they do anymore. Plenty of other websites do, however.  See below, for examples.

Posture is a big deal, apparently, from a clinical and health point of view. Patients should know this.  But patients are also concerned about their appearance and no matter how much you spend on your clothes, nothing looks good when you have poor posture. There are also mental ramifications to poor posture as well. So… lots of good material here to promote and help your peeps!

Use this event as a reason to encourage your patients to bring in their family and friends. You can change the flier to a community ad for anyone to come in. Use the sample poster and edit to suit your needs. Hang it in your office, fold and include in patient statements, include in your newsletters.  Use the promotion all month, or just for one week to make it more “special.”

Attached is a sample poster flier in Word and in PDF format, also an article I wrote on this event some years ago for some more ideas.

Carpe Diem (Seize the Day…and the month of May!)

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

Useful links:

http://posturemonth.org/posture-month/

http://www.whathealth.com/awareness/event/correctposturemonth.html

http://www.straightenupamerica.org/

Sample Poster (PDF)

Sample Poster – Customizable (Word – active clients)

Science Facts on Posture

Chiropractic Wins in Wisconsin

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On April 16th, 2018, Governor Walker of Wisconsin signed into law legislation that removed the arbitrary, higher National Board of Chiropractic Examiners scores and in the process completed the six-year project by the members of the Chiropractic Society of Wisconsin to end the efforts to block young chiropractors from entering Wisconsin.

The higher exam scores were enacted in 2012 in Wisconsin. The National Board of Chiropractic Examiners’ passing scores were 375 on both parts in 2012. But applicants in Wisconsin now had to get a score of 438 on the third part and 475 on the fourth part. Maryland required 438 on the third part, and North Carolina and West Virginia require 475 on the fourth part, but no other state requires both, said Horace Elliott, executive vice president of the national board, according to Dave Walburg of the State Journal in Madison (See link below) .

Under the guise of raising standards, the higher scores were initiated by the Wisconsin Chiropractic Association.  The result was to discourage new chiropractors from practicing in the state. With no real marketing to bring more chiropractors into Wisconsin by the WCA, it is obvious that the intention of the WCA was to limit chiropractic utilization. And it worked. New chiropractors being licensed in the state decreased.

Quoting from their press release, Steven Conway, D.C., the Executive Director of the C.S.W. said: “I personally believe the most important moment of this six-year project for the entire chiropractic profession in Wisconsin can be summed up with one of the key and deciding moments related to the first efforts by the CSW to remove the Wisconsin exam.

“I vividly remember a meeting with our legislative champion. The WCA had put on a very successful, full court press using all of their resources to stop the CSW’s efforts. I was told that the game was essentially over as the WCA had convinced the legislative leadership to keep the flawed Wisconsin exam and that the CSW should stand down. However, I knew that as an organization we could not quit on these young doctors or quite frankly our profession, so I let him know that the chiropractors associated with the CSW never quit on what we believe in and instead of folding we did just the opposite and increased our efforts.  At the time, we didn’t know how we were going to win; we just knew that losing was not an option we could accept. That underlying purpose to fight against all odds resulted in a victory for the chiropractic profession and the hundreds of young chiropractors who had to suffer through the failed Wisconsin exam.” (Link below.)

All members of the CSW should be congratulated for their dedication and hard work in achieving this win for chiropractic. In this time of increased opioid use, non-drug solutions are more important than ever before. Chiropractic has always been a popular and effective choice for the residents here in Wisconsin and the CSW has done them a great service helping to bring more chiropractors to the state.

Of special note is own Mr. David Michel for his generous work in personally working with the CSW as a member of its Board of Directors. I know he has unselfishly put in long hours over the years to help and all of us at Petty Michel and Associates commend him… with pride! Yea Dave!

Below are some links to more information about the history of this fight.

CSW press release

Report from State Journal in Madison, 2013