Capacity Constraints: Hidden Practice Barriers

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

Why Goals Work and How to Harness Their Power for Greater Prosperity

Goals are the 20%of efforts thatWhy do goals work?

We all know the obvious: they help keep you focused, and as Yogi Berra, the baseball catcher, said, “If you don’t know where you are going, you might wind up somewhere else.”

We have all heard about their importance.  But we may not have heard or understood WHY.

What is the underlying principle behind goals, and why do they work?  What gives them their power? And can you harness it improve your business and its bottom line?

Stick with me and find out…

==   ==   ==   ==   ==

It was one of those September days in the Midwest when the leaves were turning orange, and the wind was blowing.  I was in Chicago – the Windy City – where I attended a seminar downtown at one of its plush hotels.

The program was kind of out of my league – at least then.  The fee for three days was $7,000.  I was only attending the first day, which was $1,000 – still a lot of money.  But I was drawn to the subject, and I was familiar with the person who was putting it on.

There were aggressive young MBA types flying in from around the country and the world.  On the night before, at the hotel where the seminar was to be held, I saw several small groups in lively discussion around laptops – as if they were in the middle of inventing the next Big Thing.  I remember talking to one young man from Singapore and learning about the high-energy atmosphere of entrepreneurship there.

The seminar focused on building, buying, or overhauling a business.  The speaker was a self-made billionaire, a former management consultant, so his teaching fees did not come cheap.  This was not a seminar for dabblers!

The subjects discussed on the first day and, as I learned, on the other two days, were surprisingly uncomplicated.  They discussed the key ingredients to look for when deciding what business to build, buy, or grow.  These few key factors were introduced on the first day of the seminar and then expanded upon the other two days.

But it all started around one principle: the PARETO PRINCIPLE.

Many of you know the Pareto Principle and the Rule of 80/20.  This Principle has been used over the last 50 years by major manufacturing companies to improve the quality of their products.  The concept is easy to state but often difficult for entrepreneurs to apply.  It predicts that roughly 80% of valuable results come from just 20% of efforts.  In some cases, the ratio can even be more extreme so that 10% or even 5% produces 90% or 95% of the results.

Not all efforts are equal: there are the “vital few” efforts and the “useful many” efforts.  Workaholic entrepreneurs can struggle to put this concept into practical use.  We find that delegating a $20 an hour task is risky, so we will spend time organizing a bookshelf or driving to get office supplies ourselves instead of taking care of a potential $1,000 an hour task, or even a $10,000 an hour task.

As a non-business example of the 80/20 Rule, consider all the clothes in your closet.  I bet you wear just 20%, or less, 80% of the time.  Then, consider how you get to work – out of all the choices of roads to take, you use just a few of them.

Look at a winning athletic team.  Just a few players are responsible for 80% of its success.  This does not mean that the other players are not important – just not THAT important.

All efforts are just not equal or average.

How might this apply to your business?  Well, for example, 80% or more of customer dissatisfaction comes from 20% or less of your patients.  On the other hand, 20% or less of your patients account for 80% of your patient referrals.

As the CEO of your business, what are the vital few actions you can take that will produce the most results?  I suggest that defining the business’s goals, ensuring that your team understands them, and keeping these goals alive each week is key.

As Stephen Covey advises: “Begin with the end in mind.”  Goals are simply the end you have in mind.  On the higher end, they would include your mission, vision, and reason for them – your WHY.  They would also include the values you hold as standards of behavior and performance.

These greater goals would be manifested as products or outcomes.  For example, if your mission included helping people have healthy teeth, then a practical manifestation of this goal would be “Jim,” a patient, having his teeth cleaned today.  If your vision were a healthy and pain-free community, the practical outcomes would be 100 patients adjusted today.

As a doctor, what would be the 20% of your actions that account for 80% of your results?  I suggest letting the patient know that you understand their goals and work to help them achieve those goals at each encounter.

As the manager of your business, ensuring each team member knows the goals of their roles and helping them achieve these goals, with good coaching and communication, will produce 80% of their successful efforts.

It all goes back to goals.  

They are the leverage points that direct and amplify all your efforts.

But here is the truth you must understand:

A small amount of time consistently spent defining the goals of, and within, your business — and working out how to achieve them — are the vital few actions that produce most of your excellent outcomes.

Know before you go.

If you and your team routinely define and redefine your goals, both the higher ones and the practical ones, and work out how to better achieve them, you will have a more prosperous and stress-free business.

Get the goals right each day, and all else will follow in your favor.

Working towards a better future,

Ed

If you don’t have it yet, get my book to learn more about how to use goals in your practice. The Goal Driven Business.

***New Training Program***

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. A Goal Driven Business is a team of Goal Drivers. That is what this program will teach you to create. (What is a Goal Driven Business? )
If you are interested in taking the training program on the Goal Driven System, for you and 1 team member, please go here to schedule a time to learn more about it. Schedule a meeting with me.

Goal Driven.com
Petty Michel & Associates

Time to See the World and Your Future Anew

See the Word AnewI have been in touch with most of you and, for the most part, you all are doing relatively well during these days of COVID-19. Of course, the keyword here is… relatively.

Whatta time, eh? Historic, that is for sure. It will change our society and our world as nothing has since, perhaps, WW 2.

The Lighthouse in the Storm

Your role, right now, is so very important. Perhaps more than you know.  Your patients have fears, questions, and doubts. Their parents could contract COVID, perhaps they could. They are out of work or soon will be, and there is the apprehension that all of this is a government plot towards totalitarianism.

With all the communication regarding our current situation, you have to remain as a calm source for sound, researched data that provides comfort and solutions. You will have to be a lighthouse in this storm.

YOU are independent. You do not work for a drug company, and you are not beholding to a boss that works for a hospital or a government agency. Therefore, when patients come to you with worries and questions, they trust that what you tell them is unadulterated, unbiased, and accurate information.

And even more, they hope that you genuinely care.

Time to See the World Anew

In some sense, the world is experiencing a big “Time Out.”

Perhaps we can all take this time to become closer to our families and friends. My daughter is cooking more, my son is homeschooling his kids, and I am practicing guitar tunes from my old 1960’s book of folk songs!

I notice on my walks and runs that here, in Milwaukee, the air is fresher, cleaner, and the sky is bluer. Less smog from our southern neighbors and nearby freeways and overhead airplanes. The difference is striking and one can only imagine what we have been breathing in all this time!

It is spring, you have a family and friends, and you have your own self. COVID-19 doesn’t change this.

Good to Great: Redesign your NEW Business.

But what I am most looking forward to is the NEW.

Right now, you have a unique opportunity, during this temporary slump, to reimagine and redesign your business.

You’ve had a good, perhaps a very good business before. But as Jim Collins explains in his book, Good to Great, good can be the enemy of great.

The Good is now the Old, and we have this moment to review our goals and engineer better pathways to them.  Now, you can create the Great!  This will be your new version of your business based upon all you have learned as a professional and as a business owner or stakeholder. This new version can be your best creation ever.

Over the next few months, we will be discussing this, and I and all of us at PM&A, look forward to helping you and your team create the business of your dreams.

Looking forward to the future,

Ed

PS Happy Earth Day!

Monthly Goal Setting for the Chiropractic Team

Chiropractic Team Goal Setting

At the beginning of each month you want to see that your team sets new TEAM GOALS.  You can also set individual goals privately at a different time, but TEAM goals are most immediate and important.

Each goal setting session always begins with a REVIEW of the past month. This gives the opportunity for the group (or individual in individual goal setting) to explain how they did and how they did it. And it gives you the opportunity to listen and then give some feedback. The feedback could be praise, or otherwise.

After the review, set the goals.   Group goals should be simple, usually just Office Visits and New Patients, though Collections can also be included. IMPORTANT: Let the group set the goals. You should negotiate the goals, but it has to be theirs.  Once these goals are set, ask the group (or individual) how they/we plan to achieve these goals? Get at least 3 action steps.

The last goal should include a “greater purpose” goal or two. This could be a party at your house next Thursday night, Betty, the Front Desk Coordinator will give a book report on one of the books in the Lending Library at next month’s Team Goal Setting meeting, and a check to see who is going to volunteer for working at the food bank next Saturday evening.

Why? You should also spend some time discussing why you have these goals. This takes you back to your MISSION.  Numbers for numbers sake is a soulless and goalless pursuit.

 In sum:

  1. Review last month’s numbers. Were they up or down from the prior month?  Ask.
  2. Then, ask why? Get the team to figure it out. Let it be a brainstorming session if possible.
  3. Let them tell you and you listen and question as needed.
  4. Acknowledge. Praise or show disapproval, as appropriate.
  5. Then ask for action steps to achieve goals.
  6. Then, get a few “greater purpose” goals.
  7. Then, continue with the rest of the staff meeting, such as announcing upcoming events, miscellaneous, etc. Include some discussion about WHY these goals are important.
  8. Do the same for individual team member’s right after the Team Goal Setting, or soon after.

 For more information on how this procedure is done, refer to the webinar called the Fast Flow CEO.

Chiropractic Practice Management, Marketing, and Leadership Recorded Training Webinars

This is a list of our practice development recorded webinars.

Each is a recording of a slide show driven lecture, each filled with an abundance of practice information derived from in the field work – and plenty of slides!

Currently, you have to be active on a PM&A program. By this summer, these will be available on and individual basis for a small fee.

 Chiropractic CEO Webinars

 Creating your Dream Team Summary and VideoA virtual “live” interview with the doctor and staff of a true chiropractic dream team. Find out what they do to achieve high numbers, profit, and fun.

 The Fast Flow Practice CEO  -55 minutes webinar video and summary.
One of the biggest challenges in running and growing your business is the time it takes you away from seeing patients and from your family.  We have solved this with what we call the Fast Flow Practice CEO System.   A new system derived from old principles.
Management by the Numbers: 44 minutes – Summary and Video
Management is a subject that has techniques to help you go from where you are to where you want to be.  Management By the Numbers (MBN)  can be faster and more accurate than other forms of management, and help build staff morale and make it more self directed.

Capacity Constraints : 33 minutes – Summary and Video
Do you work hard but you just don’t get as far as you should? The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth. This is the subject of Capacity Constraints.

How to Be an Effective Practice CEO  Video
If you are struggling with the ups and downs of a stressful practice, or have finally “settled” into a comfort zone producing much lower than you know you are capable of, this program is for you.

~~

Chiropractic Office Manager Webinars

 Chiropractic Manager Webinar – Roles and Goals  Summary, Video and Study Guide
What Are The Key Roles In Your Office? A hidden barrier in many offices has to do with confusing roles and job duties. Clear these up and see how much smoother patients and paper flow, and happier the team becomes.  Small office or big health business, clarify these 8 roles and the numbers will go up.
 

Chiropractic Manager WebinarJob and Performance Reviews    Video
Employee reviews are often neglected, or are dreaded by employee and doctor. This webinar covers the basic steps to make them effective and positive for both doctor and employee.  Approx 37 minutes.

Chiropractic Manager Webinar – Motivating Your StaffVideo  Ms. Phyllis Frase shares 5 secrets to keeping yourself and your staff motivated.

 Chiropractic Manager WebinarTeam Meetings   Summary, Video and Study Guide. This is an overview of 8 essential actions to help you improve your meetings and make them faster, more fun, and more effective. Plus, different types of short meetings that your team can grow.

 Chiropractic Manager Webinar –  The Office Manager Job Description  Summary, Video and Study Guide. This class covers 17 essential duties of the office manager. Both the doctor and the office manager should watch and discuss these duties.
 

Chiropractic Manager Webinar-  How to Best to Train Your Staff  Summary, Video and Study Guide This webinar covers eight tips  to improve the performance of your team.  Training plays a big part in team building.
 

Chiropractic Manager WebinarHow to Hire the Right Team Member   Summary, Video and Study Guide.
This webinar  covers eight priniciples for hiring the right team member from knowing when to hire, who to hire and how to hire.
 

Office Manager Webinar – It’s All About the Patient, the Doctor and the MISSION [Summary, Video and Study Guide]
There are procedures to help the patients and procedures that help the doctor help the patient and then there is Everything Else.  Tips on how to deal with Everything Else. (30 minutes)

Office Manager Webinar- Part IITips and Tricks to make the office more efficient[Summary, Video]
Part II reveals tips and tricks of what an office manager can actually do in the office on a day to day basis to make things run smoother and  significantly improve the volume and quality of services. (55 minutes)

 Office Manager Webinar- Part I – Fundamentals of Practice Management [Summary, Video]
Part I covers the fundamentals of Practice Management (55 minutes)

 

Chiropractic Marketing Webinars

Innate Marketing  (55 minutes) – Webinar plus Summary.
There are stories that float around every now and then about how some offices can simply “think”  “New Patients” and they come in.
Are these stories an urban legend? A myth, or a fact? Can staff or doctors “concept” new patients in the door. Is this true? If so, how can you do this?  10 steps to help you generate more patient visits through “concepting.”

Chiropractic Special Promotions  (55 minutes) – Webinar plus Summary.
This webinar covers different promotions by month. You will learn 2-4 different practical promotions for each month of the year. More importantly, you will learn how to organize them so that they are time effective and productive.

Patient RetentionSummary and Video
If you understand the underlying basics of patient retention your appointment book should always be full.  Covered in this webinar is: Patient retention should be based on Principles – not gimmicks. Where are we you taking your patients? Why they quit?  The cost of not getting them there.

 Chiropractic Patient EducationSummary and Video (45 min)
We go over 7 basic strategies that cover the entire horizon of patient education and explain why it is so necessary to educate your patients if you want them to be healthier.

 Infomercials.Summary and Video .
Whatever happened to Infomercials? They’re still around and they still work. And you can do them very inexpensively. You just need to know how. This webinar will give you practical examples and include forms for you to use in producing your own amateur and informational marketing that can help you create more new patients and keep the ones you have.

 Internet Marketing and Social Media. – Summary and Video . This webinar covers some fundamentals regarding social media, Facebook, and general Internet marketing. (35 minutes) (not yet posted)

 The Art of Spinal Screenings.Summary and Video . Spinal Screenings – The Queen of External Marketing.  Everyone has done at least a few  spinal screenings. You have probably had some success with them. But how much better could you do if you knew the fundamentals of this time tested external marketing activity?  This is a three part series on spinal screenings. This session we will review the most fundamental principles of screenings. Get these, and all else will follow.(45 minutes)

 Scheduling Screenings and other External Events Summary and Video .  How to Schedule External Events And Create External Referral Sources.  Types of events, Outcomes, Purpose. How to plan the events and get them scheduled.(30 minutes)

Marketing Tips: Earth Day, Spring Promotions, and other TipsSummary and Video This webinar covers: Powerful internal marketing script, Report of findings referral procedure,  upcoming spring promotions, with special attention to utilizing Earth Day as an opportunity to promote your services.

Short Overview of Chiropractic Marketing Management with Some Marketing Tips Summary and Video   This is a short version of marketing management and some tips for the upcoming months. What are the three levels of marketing?  What part does communication have in your marketing?  How to engage your patients in your marketing efforts.  Upcoming special promotions. (30 minutes)

Marketing Management, Part I and Part II – This is the longer version of how to manage your marketing, and why.

Chiropractic Marketing Management – Session ISummary and Video The Why, What and How of Marketing. Getting your Marketing off the Ground. (55 minutes)

Chiropractic Marketing Management – Session IISummary and Video  Specific Marketing Manager Duties – Your Job Description.  General Overview of the Most Effective Marketing Procedures in Each of the 11 Marketing Categories (55 minutes)

 

Fall Marketing Ideas

Fall is in the air….. and it’s time to get that fall marketing calendar filled with activities.  To get the ball rolling, we have put together a few topics and suggestions to make your events fun and effective.

For our PMA members, we have more information about each topic, including ready made posters, handouts, and descriptions. For more information, please go to our PM&A Members site here , log in, and go the section called New Stuff on the top navigation bar.  You will find the article called Fall Marketing Ideas.

September:

  • National Backpack Awareness Day – Sept 19
  • Woman’s Health Week – Last week of September
  • Neuropathy (or Headache,etc. ) Awareness Week  (Pick a week to promote a free screeing exam for a specific condition.)
  • Crazee Dayz (For example, Thirsty Thursdays — offer a different type of drink each Thursday. Have patients make suggestions: organ apple juice in Sept, Egg nog in December, etc.)

October:

  • National Spinal Health Month (now called National Chiropractic Month).  Make a banner and use this as a motivation to have patients bring in their family for a free spinal fitness screening.
  • National Chiropractic Month. Use this as a reason to sponsor: Chiropractic Opportunity Week:  The doctor is having a “COW”
  • Hair Dresser/Beauty Salons/Spas – provide massages, screenings, and lectures.
  • Local Health Fairs at businesses.
  • Kid’s Halloween Party

November:

  • Thanksgiving Turkey Drawing Poster
  • Donation Drives
  • Deer Widows Week
  • Girl’s Night Out

December:

  • Holiday Coupons – Gift Certificates
  • Poinsettia Give Away
  • Saturday with Santa
  • Appreciation to External Referral Sources

Chiropractors: Never Work Another Day in Your Life!

Did you know that 73% of chiropractors can make all the money they want without ever working?

This is proven by 83% of studies.

Yes, that’s write. You two can make all the money you want, and even more, without even working.

Honest.  No more talks, letters, or yellow pages or even internets.  You don’t even have to sea patients.

moneyman

With this SECRET system I was able to make lots ‘o bucks.  (Doctre Phulo Vit)

Am I talking to you?  Yes, we are.

I have just discovered 6.3 steps on how to make all the money you want with out hardly working ever and getting all the love you need.   Honest.

Yea. Baby.

So, call us now at 800 APR-FOOL

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Don’t be fooled.   Get the real stuff.   Come to our seminar in Minneapolis and Milwaukee this spring.

See you there.

Happy Easter to you all.

Love,

The PM&A Team