Let’s Hear It For Chiropractic and Kid’s!

Posted on January 15, 2024 by Edward Petty

Petty Michel and Goal Driven Donation to Wisconsin Chiropractic for Kids How to support the health of our children

“History will judge us by the difference we make in the everyday lives of children.” Nelson Mandela*

Here in Wisconsin, the Chiropractic Society of Wisconsin, the primary chiropractic association, is sponsoring a Kid’s Day next week, which we are supporting.

Also, I am supporting it with donations from the sales of my book. Please consider contributing directly to the C.S.W. or buying my book (or 20 of them!).

If you look into it, how we treat our kids in the 2020s is probably worse than in decades past. The Styrofoam-like food, the toxins such as Glyphosate and Phthalates in our breakfast cereal, the nano plastics now in our blood, the sugar and seed oil, the escalation of Pharma drugs and shots, the social media, the list goes on and on.

Just look at the stats for health care in America, those that you can find. They are abysmal and getting worse. (I have links to some listed below.)

There are plenty of sources to learn about how we treat our kids, but as you can imagine, they are hard to find on regular internet searches. It’s a little like trying to find the truth about cigarettes or asbestos in the 1950s — you almost have to search out whistleblowers to find out what is truly going on. An e-book that was published in 2018 called The Sickest Generation, by Children’s Health Defense, is a good place to start. (Link below)

People in your community aren’t going to hear too much about this from the media or most corporate-paid doctors – though more independent physicians seem to be speaking out. This is why your work is so vital.

As a side note, promoting health care for kids can build your practice. Helping children get healthier is a great marketing and practice-building strategy.

But first and foremost, the primary reason to see kids is to help them stay healthy.

Chiropractic care can help young children with the bumps and tumbles they take as they grow. Young athletes especially benefit from adjustments. Other independent and naturally oriented health providers, such as those practicing acupuncture and Traditional Chinese Medicine, and functional and integrative medical providers can also be of great help.

But beyond chiropractic adjustments, education and support for a healthy chiropractic lifestyle is fundamental. Educate the parents and help the kids.

Consider contributing to the C.S.W. Kids Day program.

Also, consider encouraging your state association to develop a kids’ program, and if they already have one, please contribute to that.

Ed Petty

Link to Chiropractic Society of Wisconsin: https://www.chiropracticsocietywi.org/chirokids-day

Link to The Sickest Generation published by Children’s Health Defense, https://childrenshealthdefense.org/ebook-sign-up/ebook-sign-up-the-sickest-generation/

From The Sickest Generation

American children have never been sicker. Over half (54%) are suffering from one or more chronic illnesses.

The “4-A” disorders—autism, attention deficit hyperactivity disorder, asthma and allergies—have experienced meteoric growth, affecting children’s quality of life and contributing to premature mortality.

U.S. children are far more likely to die before their first birthday than infants in other wealthy countries and life expectancy is falling, driven largely by rising death rates in adolescents and younger adults. Suicide is the second leading cause of death in teens, half of whom are reported to have at least one mental, emotional or behavioral disorder.

The proportion of public school children using special education services is skyrocketing, with estimates ranging from 13% to 25% of school populations.

Mystifyingly, there is almost no outcry in medical, public health or government circles to find answers and solutions.

A Million-Dollar Chiropractic Healthcare Practice — and More in 24

Posted on January 9, 2024 by Edward Petty

When in doubt, paddle out!

We have been refining our Goal Driven System of practice development.

After our management training program completed with outstanding practice managers, it is clear to me that most offices can achieve 6 figures in income.

But why aim for a million dollar (or more) chiropractic practice? Good question!

Because you can. Because it is a challenge that you are worthy of.

Because, in the pursuit of this goal, you and your team will demonstrate your competence. And competence is an internal goal and a need we all want to demonstrate.

Behavioral Science in Practice Management

I cover the concept of Self-Determination Theory in my book, the Goal Driven Business. Much research has been done on what drives us and motivates us to achieve our goals. According to work done by Edward Deci and others, there are three motives we all have:

Autonomy (Independence and self-governing.)
Competence (Skill and effectiveness at getting something done.)
Relatedness (Being part of something bigger.)

These internal needs motivate us more than our motivations to receive external rewards or avoid punishments. Despite conventional “management” practices, external “incentives” only work in the short term. In fact, the promise of extra money and bonuses, like threats, can be detrimental to performance.

There is a right way to provide bonuses — we cover this on our Goal Driven Programs.

Competence in your Chiropractic Team

I want to focus on competence, though autonomy and relatedness are as powerful.

Here is a quote from one of Deci’s books:

“Decades ago, the personality psychologist Robert White wrote a compelling paper about “The Concept of Competence” in which he argued that people yearn so strongly to feel competent or effective in dealing with their environment that competence could be thought of as a fundamental human need.

“People, impelled by the need to feel competent, might engage in various activities simply to expand their own sense of accomplishment. “* (My emphasis.)

What does this mean?

We all want to demonstrate what we can do and even test the limits to see if we can do more. Look at children and the explorations and exploits they attempt. Think of your own crazy youth and all the dumb dares you accepted!

But we become domesticated as we enter adulthood. We censor our drives, curb our enthusiasms, and our purposes ebb.

But the intrinsic drive is still there – an ember that can be stoked.

Getting Stoked

Like the surfers say, the feeling of being stoked is exhilaration and joy. The feeling is worth the effort and losses.

Demonstrating your competence results in the Stoke. But you can’t demonstrate your competence or feel the Stoke if you don’t set big goals and then go for them. You enter a challenge, a contest that pits you and your team against the obstacles to your goals.

Paddling out to catch a wave, a surfer exerts tremendous effort. As they struggle to get out, they need to go through wave after wave crashing in on them until they are finally out far enough to wait to catch the right wave. Waiting, and then finally finding one that no one else is trying for, paddling hard to catch it, and often failing. And sometimes getting caught “inside,” with waves crashing down on them, pushing them into the depths or scraping on the coral reef.

But making that one ride as you smoothly glide over the ocean is a feeling that can last a lifetime.

Any adventurous activity is not for the money. It is to satisfy an internal need—the Stoke.

Improving Competence in Your Chiropractic Practice

Achieving big goals requires big motivation, and improving competence is one way to do so. Here are 6 approaches to improve your competence and that of your team to help you hit your super big goals this year:

Be a coach. Schedule in-office training, seminars, webinars, courses, advanced training, and books for yourself and your team
Feedback and support. Regular Coaching Reviews.
Recognize the wins. Acknowledge and celebrate employees’ achievements and contributions. Including your own!
Challenging goals. Set up tasks and projects that challenge you and your team. Let your team take ownership. Keep it fun.
Go for a million (or 5 million) dollar practice.
Get a coach. Suit up, commit, and be a player.

Remember, you are more than a doctor, provider, and support professional. You are also an entrepreneur and part of an entrepreneurial group.

You are an adventurer!

So set big goals and get out there. Go for the Stoke!

References:

Why We Do What We Do, Edward L Deci, Gagné, M., & Deci, E. L. (2005). Self-determination theory and work motivation. Journal of Organizational behavior, 26(4), 331-362.

Tribal Knowledge Can Improve Your Practice

Posted on April 11, 2023 by Edward Petty

teams, management, chiropractic, knowledge

Mining the Underground Innate Knowledge of Your Team

You may not have run into this term before… maybe you have. It was new to me before I began putting together the notes for The Goal Driven Business.

In any case, it is a concept worth knowing and one you can use to improve your business. I’ll give you an example and then define it.

It was spring years ago, and I was meeting with a motivated practice owner who was already doing well. We were discussing marketing plans for the next several months, and some of our programs ended in June. We needed something that would work for July. So I said, “Why don’t we ask the staff for some ideas?”

We were scheduled for a team meeting anyway, which I attended. After the usual topics were covered, the doctor asked the staff for some ideas for marketing in July. Now, the doctor was relatively new to the community, and the team was long-time residents. Various ideas were thrown around, and one seemed to percolate and draw enthusiasm from the staff. A popular promotion that they had experienced as local consumers in their town was “Christmas in July.” Since their community was familiar with this promotion, they were sure it would work well if it were tied to a patient referral program.

Both the doctor and I thought it was a dumb idea. However, the staff was already in high gear planning the promotion by the end of the staff meeting. I suggested to the doctor that he let them run with it. He did, and as it turned out, it was a big hit. They had one of their best new patient and office visit months ever… in July.

At another office, some years later, I was helping the doctor work out her mission statement for the practice. She and her associate were hitting speed bumps trying to come up with a simple definition. I recommended putting it to the staff to see what they might come up with. At the next team meeting, the doctor discussed the idea of a global statement for the WHY of the office and its higher goals and asked them if they could work it out as an office mission by next week.

And that is what they did. The following week, the manager and staff presented the mission statement to the doctors. The doctor emailed it to me.

I didn’t really like it as it was long and too mushy, at least for me. But the doctor approved it and posted it in the reception area. The staff loved it. It fit their compassionate attitudes towards the patients and captured their existing relationship with them. They memorized it, and it was recited after every staff meeting. Their stats haven’t come down since. They are a happy and Goal Driven group!

In our consulting, we routinely encouraged the wisdom of veteran staff to be integrated into the management and marketing of the office. We didn’t have a definition for this knowledge, but it was effective nonetheless.

Here is the definition of Tribal Knowledge according to Leonard Bertain in his book, The Tribal Knowledge Paradox:

Tribal knowledge is the collective wisdom of the organization. It is the sum of the knowledge. It is the knowledge used to deliver, to support or to develop value for customers. But it is also knowledge that is wrong, imprecise and useless. It is knowledge of the informal power structure and process, or how things really work and how they ought to. … But more importantly, it is the untapped knowledge that remains unused or abused.

There is much more to this, of course. A valuable management and leadership skill is how to elicit tribal knowledge, decipher it, filter the practical from the impractical, and put it to use.

I try to keep these newsletters as short as possible. If you want to set up a time to discuss this subject more, just make an appointment (link below). No charge for subscribers to this newsletter.

Not everything can be put on job checklists. Job checklists are very useful, but there is a wealth of knowledge just under the surface with your team, even your spouse, that can be accessed and put to good use.

By creating a culture where it is safe to contribute learned experiences in team meetings, coaching sessions, and other opportunities, improvements in your practice can be made faster.

Seeking and honoring the tribal knowledge gained from the experience of your team respects them, whether the information is useful or not. This is the essence of creating a synergistic office – where team members help each other — to help more people become healthier.

Carpe Future (Seize the future)

Want to discuss how to uncover the Tribal Knowledge in your practice, schedule a short call with Ed here.

Going Public or Going Purpose

Posted on September 20, 2022 by Edward Petty

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,

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

Relationship Marketing: Build and sustain your practice through relationship marketing

Posted on April 12, 2022 by Edward Petty

You are in the relationship business.

People see you for a result – but they stay with you because of the relationship.

There are many different definitions of relationship marketing – marketing isn’t codified like CPT®! (That is maybe a good thing!)

Last week I talked about direct response marketing and indirect or brand marketing. Relationship marketing stems from direct response. It emphasizes retention and patient and customer satisfaction.

Relationship marketing works. It helps with patient retention and patient referrals. It also helps generate referrals from external sources.

But what is it, and how do you improve it?

What is a Relationship?

A relationship is a connection that you have with another person. It is based, ultimately, on communication. Therefore, the quality of that communication determines the quality of the relationship.

Good communication, one that creates a good relationship, centers around understanding. As Stephen Covey advises, Seek first to understand, and then to get understood. Understanding is fundamental for good communication.

The relationship between you and your patient depends on results, of course. But to get results requires understanding the patient. Seeking to understand the patient – showing them a genuine interest in their condition and life – is not only needed from a clinical point of view, but it is vital for good communication and developing the relationship.

How to Improve Patient Communication

Patient Care can be an overused, even over-advertised term. But care is founded first on interest in and concern about the other person.

This means not just going through your script (yuck!) or your checklist with the patient, which may help keep you on track. It means do you understand them, or how and why they came to you? Are you interested?

But how do you do this after the 10,000^th patient comes in to the office?

By being a real person who is interested. For example, a patient comes in and wears a green hat. You wonder about the green hat, so you ask them about it. “Hi. I can’t help but notice that you are wearing a green hat. It looks…stunning! Any special occasion?”

A checklist can help you communicate important information, but it can’t take the place of a real live person. It can’t make a relationship. You are not a robot, and neither is your patient.

Be appropriate and respectful, but mostly, be authentic.

This creates trust because your customer sees that you are interested in them as a unique person, not the 10,000th customer. And they see you as a real person, not just a busy professional trying to be interested but really faking it.

I am sure that you have experienced employees in other businesses trying to be interested in you but merely following a script. A bank teller asks me: “Have plans for the weekend?” I am nice back, but I know that she is just doing what her MBA executives in some office far away think she should say.

So, honest and interested communication, added with services and results, will create a strong relationship between you and your patient.

Outside of Your Practice

But relationship marketing goes beyond just your office.

Your patients know people. They can help you get to know their family, friends, and business associates.

You can create relationships with other professional practices, businesses, and organizations. I have seen many examples where a relationship was created between the doctor and an outside entity that resulted in many new patients.

Some examples:

YMCA’s and commercial gyms whose owners and managers were also patients.
Dentists who didn’t treat TMJ.
MD’s who didn’t want to deal with patients with back pain.
Ballet company that wanted to keep their dancers in shape.
High school coaches who wanted to see their athletes do their best.
Motels who needed a “house” medical doctor, dentist, and chiropractor.
Autobody shops that took care of injured cars and sent injured passengers to the chiropractor.
R. managers at companies who referred employees.

And this is vital: the relationship must be between you and another person associated with the outside entity. You are always dealing, first, with one person.

I have used this definition for years, and it still holds true:

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

There are specific barriers to implementing relationship marketing, and you will run into them. I want to keep this article short, so I will refer you to my book below, which addresses the barriers and how to avoid them or bust through them.

But regardless, just communicating more with more interest will bring in more new patients and keep the ones you have longer.

Communicate more and with interest.

And…

Seize the Future (That is where your goals are!)

Link to the Goal Driven Business Book

Link to the Video Supplement to Relationship Marketing

How to Create a Full Appointment Book with Goal Driven Marketing

Posted on February 8, 2022 by Edward Petty

busy desk, planning calendar

Happy Valentines Month!

This article is about sharing the love… the love of your services and how they can help people.

And what is the best way to do this? Create a Goal Driven Business.

A Goal Driven Business runs at FULL CAPACITY, or close to it.

That means no more room in the appointment book. It can mean that there is a waiting list to get in to be seen. But how is this achieved?

In a practice, it is a combination of excellent service and clinical results, inspired leadership, sound management, personal integrity, and … marketing.

Let’s take a took at marketing first. What is marketing?

It is a method of helping people get what they innately want through communication. Marketing communication, either through one-to-one contact or through media, communicates and educates in such a way as to point to what an individual wants. It also can inspire them to get it.

Goal Driven marketing is helping people get to their goals!

People want to be free of pain and discomfort, but they do not know about your services or how your services can achieve this. And if they do, they may not trust that you can do it for them.

Every marketing approach you have must help those people who have a particular need or want to find you, and discover how your services can help them, and why they should trust you. This can be accomplished through patient referral programs or events, setting up external alliances, direct response ads in social media, radio, through one-to-one external relationship building, speaking events – all these and more point to how you can help people and that you can be trusted.

Testimonials and reviews top the list, but so do articles, newsletters, and support from opinion leaders. These are all outward types of marketing communications.

What would someone who knows what you know about your services do if they had pains, or lacked mobility, wanted to improve their immune system, and just be healthier? They’d drop by and see you for an adjustment or for some kind of a treatment from your office.

Not everyone wants what you have to offer, and even fewer want it bad enough to do something about it. But there are more than enough people who are looking, right now, to act who could keep your office full – if they just knew about what you could do for them.

Many times, I have heard chiropractors amazed at comments from patients who say, “Headaches? I didn’t know you could help with … headaches!” And the doctor just assumed everyone knew that they fixed headaches!

Don’t assume anything. It is a noisy world, and you and what you do is drowned in the snow storm of competitive messages and personal activities.

You must be industrious in getting your message out. You have to be continuous. And this is where most doctors fail in their marketing.

Marketing fails because it is not systematized,
organized, continuous, and managed.

A Goal Driven Business focuses its marketing three echelons of activity.

Marketing Procedures. Obviously, the different types of marketing communication and marketing procedures need to occur. This is the most evident (and fun) level of marketing – marketing procedures.
Marketing Motivation. But even if you have bookshelves of marketing binders and libraries of marketing books, they will do nothing unless you and your team are motivated to use them. So, this is the second level of marketing.
Marketing Management. The third, and I believe the most essential level of marketing activities, is marketing management.

Your front desk is organized and routine. Your billing is systematized and well managed — or should be. So is your therapy area and your new patient procedures. But in most offices, marketing is not organized! It is hit and miss, now and then. When numbers are down, “Hey, let’s do some marketing.” When numbers are up, we all get “too busy,” and it is neglected.

Most practice marketing is reactive and symptomatic. This causes the PRACTICE ROLLER COASTER.

There are simple methods to effectively manage your marketing systems to help create a full appointment book which we can cover in another newsletter.
But keep in mind two important points in marketing:

Help People Get to Their Goals and Obtain What They Want. You are helping people who already have a perceived need and want to purchase what they are looking for. You simply must help them find it in what you offer and convince them that you are worthy of their trust.
Manage Your Marketing Procedures and Keep them Running. Stay motivated, find the procedures that work best for you, but organize your marketing procedures so that they continue. This will help you avoid the Practice Roller Coaster.

To find out more about how to create a Goal Driven Business and create a full appointment book, buy and read the book the Goal Driven Business. Read about it here.

Happy Valentines Month! Spread the Love!

Are Your “Engines” Driving Your Practice?

Posted on February 1, 2022 by Edward Petty

A service business needs 5 different engines to become a Goal Driven Business

Five engines drive your business to its goals.

If these are installed and firing at 100%, practicing will be enjoyable and profitable. When these engines are not fully performing, the daily demands of running a business shift to, and fall upon, the owner.

These engines are functions and characteristics of a dynamic team that drive the practice toward its goals.

Many offices that seem to be doing well are driven by heroic owners fighting each day to grow their practices, and not by their engines. But this isn’t easy to sustain. At some point, it becomes too much, and they settle into a comfort zone below their abilities. As a result, their long-term goals remain unfulfilled.

This is the plight and path of the entrepreneur – brave, independent, but too often without a map on how to build a strong business that drives itself.

The five engines that drive a business to its goals are:

Marketing
Leadership
Management
Service
Personal Integrity

I want to begin passing on tips on the marketing engine– what is working now and my best estimation of what will be working in the future. Marketing is vital, for without paying customers, the other engines won’t work and aren’t needed.

But before I do, I want to invite you to look at your business and gauge the health of each of your engines.

You can do this by reviewing how successful you are at achieving each engine’s outcomes (goals) and giving them a grade from one to five (1-5). 5 would be the point where the engine is achieving its goals.

Marketing. Abundant new patients and goodwill with local allied businesses, organizations, and your community. A waiting list practice. (1—5: ___)
Leadership. A business with clearly defined goals that are agreed upon and pursued happily. (1—5: ___)
Management. Expert team members, acting as an expert team, implementing simple but effective procedures. (1—5: ___)
Customer Service. Customers (patients, clients, customers) who are extraordinarily satisfied with the services they receive and their outcomes. (1—5: ___)
Personal Integrity. Each team member is happy because of the positive and and responsible manner in which they manage their personal lives. (1—5: ___)

By grading each engine’s “output,” you can immediately see what needs the most work.

But these engines do not work independently. One affects the other so that there is a synergy created. As one improves, so do the others. The opposite is also true – the more one engine dies down, the more the other ones do as well.

It could be said that everything begins with leadership, and that may be true. But unless you are marketing your services, there will be no one to lead!

So next week, let’s look at a few effective marketing strategies and tactics that will help drive your business to its goals.

And by the way, how to achieve a 5 for all your business engines is described in The Goal Driven Business. If you haven’t read it yet, I encourage you to do so.

A great new February to you all,

Tempus Fugit (time flies)

Posted on July 8, 2021 by Edward Petty

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

We are halfway through the year – 2021!

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

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

What are the goals for the rest of the year?

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

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

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

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

But remember… TIME WAITS FOR NO ONE.

Carpe Diem,

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

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

Posted on December 15, 2017 by Edward Petty

Progress in practice is made by steady persistence and passion.

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

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

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

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

The Vital Few

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

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

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

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

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

Diamonds in Your Office

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

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

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

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

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

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

Looking for Your Diamonds

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

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

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

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

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

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

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

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

Merry-Go-Round

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

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

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

Go faster… and push less.

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

Enjoy the ride!

With admiration,

–Ed

The 3Goals Practice Development Process for Chiropractic Success

Posted on January 18, 2016 by Edward Petty

Four steps to continuously develop and improve your practice

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

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

It is based upon the idea of constant improvement.

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

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

The Practice Development Process has four steps:

Access
Plan
Supervise
Document

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The Importance of Why in Chiropractic Practice Development

Posted on May 18, 2015 by Edward Petty

Remember when your child, or a kid you knew, constantly asked you “why?”

“Time to go to bed honey.” “But why, Mommy?” “Dad, why is the grass green? ”

This happens for a few years until the child finally learns that it is just so much trouble to keep asking the “why” question.

This happens to us all. After a while, we all just become inured to the day to day demands and take for granted our eventual roles of working in a world of work that has little other reason than to pay our bills. And we begin to live just for the weekends.

But living for the weekend is not much of a motivation to do good work, to perform our duties with excellence that inspire trust in others, and to be happy with it.

Our jobs should have a reason beyond money or relief from work. What we do for money should have a higher purpose than money. It should satisfy us and motivate us in and of itself.

After many years of research, Stephen Covey determined that those people and companies that were the most effective followed the habit of: “Begin with the End in Mind.” In other words, start with a goal in mind. He emphasized the value of developing and living by a personal mission statement as well as one for your business, and even your family.

Some of the better offices that I have had the privilege of working with would often end their team meetings by reciting their group’s mission statement.

While this helps, it can also become rote so that the real meaning of the mission becomes dull. One way to remedy this is to now and then ask “Why?” Simply ask each team member to describe, in their own words, why this is, or should be, the mission statement.

We are all looking for greater meaning in our lives – or at least have at one time or another. “What does all that I do account for?” “What do I account for?” “What will be my legacy after I am gone?”

This applies in leadership as the CEO of your chiropractic business.

The primary responsibility of a leader in a purpose-based organization is to build, nurture, and sustain the core purpose of the organization. (“It’s Not What You Sell, It’s What You Stand For.” Roy M. Sence, Jr.)

But leadership is also marketing. You are putting your noble ideas out into the world to give others a clear vision of what is possible and why it is important. You stand out as different – because you are stating WHY you are making a difference.

A few years ago, I posted a T.E.D. talk on our website (www.pmaworks.com) that focused on how “WHY” was so important in leadership. (TED stands for Technology, Entertainment and Design.) The key differential between the very successful companies and leaders was not what their company provided, or how they provided it. The key difference was that they communicated why they did what they did. (The link to this talk by Simon Sinek is below.)

Much of corporate medicine has devolved into a goalless and soulless technology and bureaucracy. The relationship between the patient and the MD has become interrupted by critical paths and reimbursement protocols, techs, testing, and terms (codes and abbreviations), and lots of notes. Yet, the stats for America’s health care relative to other industrialized countries worldwide are poor.

Be nice and genuinely interested in patients and talk about WHY you want to help them AND their family, and do so, and you can’t help but win.

Let prospective patients know WHY you are a chiropractor, why you chose their community, and why you do what you do. Let them know why you adjust children, seniors, teen athletes, and “Los Pobres.” Communicate this to your existing patients as well. In fact, any promotion you do will work better if you tie in to WHY you are promoting.

For example, take the donation campaign called “Coats for Kids. “ It has all but lost its meaning over the years with every TV and radio station jumping onto some kind of faux goodwill activity. Promoting what it is about and how it will benefit kids as well as patients will help make it successful. But to make your promotion much more successful, explain that the reason you are participating in this campaign is that you have worked in homeless shelters and seen shivering and poorly clothed kids. This is “why.”

Attached is an article on “Why We Promote.” It is a sample letter you can mail to your patients after their first progress exam, or simply have it as a handout. You can also use its theme to end a new patient class. Feel free to embellish it or change it. (Active clients can get a customizable Word doc here. http://pmamembers.com/?p=874)

Personally, take time to remind yourself about the WHY for what you do. Study resources that support this “why.” What is the mission of your office and why is that the mission? Remind your team about this “why.” Training new staff on this is particularly important. Go over the “why” for the office, as well as the “why” for their particular role.

So the next time your child, or any child asks you “why?” take your time to answer. And as they get older, you can start asking them “why?” (Get even!) But the world unfolds and reduces to its raw and basic truths when you do – and this in turn allows passion and purpose a clearer channel to help you achieve your goals.

Golden Circle a TED talk by Simon Sinek. http://pmaworks.com/observations/2011/02/10/leadership-in-chiropractic-the-golden-circle/

Sample Letter to pts-Why we promote.

[This article is from the upcoming book: “The Third Goal: A New Practice and Business Building Methodology That Is Simpler, Faster, and More Fun than What You Are Doing Now.) by Edward Petty, due to be published in late 2015. © 2015]

10 Practice Development Strategies for Chiropractors in 2015

Posted on December 31, 2014 by Edward Petty

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

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

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

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

Here is a shorter version:

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

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

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

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

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

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

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

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

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

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

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

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

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

Ed Petty

Your Biggest Chiropractic Bill Each Month

Posted on January 23, 2014 by Edward Petty

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

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

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

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

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

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

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

It is YOU.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Ed Petty

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References

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

Posted on January 23, 2014 by Edward Petty

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

We routinely help our chiropractic teams with the hiring process.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

GOOD TO GREAT: The 1st Step in Taking Your Chiropractic Office to Greatness

Posted on January 3, 2014 by Edward Petty

Jim Collins, author of Good to Great, after researching many successful companies, noted that great companies “confronted the brutal facts.”

“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality.”

If you want to take your chiropractic business to the next level —the 1st thing you need is an exact and honest picture of where you are now.

You see, you can’t get to “THERE” if you aren’t exactly clear on where “HERE” is.

You may be looking at where you want to go — visualizing your goals — and you should. But before you head out on your path you should really look at where you are now and review your strengths and weaknesses.

It is goal setting season now. If you don’t clearly assess your current practice condition, a year from now you may be right back where you started.

In a hurry to get THERE, we often don’t spend enough time really LOOKING at and assessing what is honestly going on HERE. In fact, it has been our experience that most doctors do not face the blunt facts right in front of them but instead try to “solve” their practice challenges with a new solution. It is similar to a patient embarking on a new treatment program without first receiving a thorough examination.

We have often seen a doctor set goals designed to fix a challenging practice situation in one area when the problem was really emanating from another. For example, your external new patient difficulty may really be coming from messes in your office management.

How is your front desk team member doing (really) after her husband lost his job? What is going on with that therapy procedure you wanted to implement three months ago? Is my billing coordinator writing off too much? How many new procedures has the front desk been given over the last 6 months? How much money am I spending/not spending on marketing? What’s going on with our newsletter program? Where’s my blue coffee mug?

Sometimes we just can’t see the forest for the trees. We become so accustomed to what we do each day that we can overlook what can be choking off our growth – or potentially fueling it to the next level. Plus, we are busy.

Half the battle of growing your business is in squarely observing what is in the way, as well as recognizing what are your greatest resources. Only then can you effectively set your goals.

To help with this, we have developed a practice assessment specifically for chiropractic businesses. It digs into your office and measures 11 different dimensions of your operation. Our first version of this was created nearly 14 years ago and has been used successfully since. This new version is even better.

Much like a functional assessment for your patients, this survey inspects vital areas of your practice and gives each a score. From this, we make a chart that gives you a portrait of what areas are strong and what may need immediate attention. We also provide a written interpretation of the assessment.

Originally, this assessment was used with our active clients as part of their service. Using this assessment tool as well as practice statistics, we could uncover what areas of their business needed the most correction. We also discovered untapped or underutilized strengths that could help energize the office. At regular intervals, we could reassess and note the improvements and what to work on again.

We are now offering this assessment again as a special service which includes:

The assessment
Graded and plotted assessment
Statistical analysis with charts
Phone consultation
Written report with practical action steps.

Each question will provoke a greater understanding of your practice. With the results of the assessment charted and the consultation, you will obtain a new perspective of how your office operates. You will also see more clearly what needs to be done to bring it to the level of success that you desire.

Practice Statistics. Of course, you can’t evaluate a business without also analyzing its performance monitors. Most offices keep practice numbers – somewhere. Unfortunately, they are rarely reviewed properly. We know how to analyze them and show you your ratios and the trends that they reveal. If we do not have your current practice statistics already, we will request them on a separate form. After interpreting your statistics, we plot them on charts and correlate them with the results of your Practice Development Assessment. Together, this will allow us to give you an excellent overall analysis of your business and what needs to be done to take it to the next level.

Send in when Completed. When you have completed this assessment, you can fax or email it back to us at Services @ pmaworks.com or Fax: 877-868-0909. We will score and chart each section of your assessment and set up a time to discuss the outcomes with you. We will also send you the results with our written observations and recommendations.

The standard fee for this for non active clients is $250.

NOTE: As of January, 2014, for a limited time promotion, we will be charging only $25. This is almost free, but I don’t want to take up our team’s time with people who aren’t seriously interested in this service. If you take us up on this assessment, I will assume you are hard core about improving your business. As hard core as we are! 🙂 Use the promo code CPDAPROMO to get the discount when you click the link below.

Ed Petty

To purchase: LINK

Chiropractic Practice Management, Marketing, and Leadership Recorded Training Webinars

Posted on January 31, 2013 by Edward Petty

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 Webinar – Job 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 Staff – Video Ms. Phyllis Frase shares 5 secrets to keeping yourself and your staff motivated.

Chiropractic Manager Webinar – Team 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 Webinar– How 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 II – Tips 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 Retention – Summary 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 Education – Summary 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 Tips – Summary 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 I – Summary and Video The Why, What and How of Marketing. Getting your Marketing off the Ground. (55 minutes)

Chiropractic Marketing Management – Session II – Summary 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)

The Chiropractor Versus the Chiropractic CEO

Posted on October 15, 2012 by Edward Petty

There is a constant struggle in your office.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Best regards,
Ed

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

5 Levels of Administrative Support in a Chiropractic Office

Posted on October 10, 2012 by Edward Petty

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

Front Desk
Patient Accounts
Hallway/Therapy.

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

The smart doctor knows this rule:

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

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

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

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

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

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

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

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

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

5 Levels of Administrative Support

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

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

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

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

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

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

Why You Shouldn’t Have Promotions

Posted on September 25, 2012 by Edward Petty

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

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

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

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

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

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

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

In terms of traffic lights, promotions are GREEN.

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

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

Ultimately, there are three basic reasons for not promoting:

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

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

Hope to see you there.

Best regards,

3 Goals Management Introduction

Posted on August 6, 2008 by Edward Petty

3 Goals Management System

How to Achieve Financial Abundance and Practice Freedom
A unique practice development strategy and process created by Petty, Michel & Associates

An Introduction

Goal Driven
We all have goals. When we were younger, they might have been brighter than they are now, they might have been clearer, or seemed closer. Maybe yours still are. Or, maybe, they have become dulled with wear and tear, with disappointments and frustrations.

But we are goal driven creatures and our goals stay with us. The better we can define these goals in concrete terms, the more likely we are to achieve them.

What All Doctors Want — The 3 Goals
Ultimately, all doctors would like to create a practice that allows them to provide the highest quality care to the most people for the most profit.

Most doctors want to do this with professional and personal integrity. Maybe most importantly, they want to be able to do this in such a way that they are not chained to their practice, slaving at their work at the expense of their personal and family lives.

This is a fundamental goal for all doctors, so fundamental that we call it Goal 2.

Even more fundamental, however, is basic survival and solvency. We call this Goal 1.

But nobody works just for money. Whether it’s saving the planet, helping your grand kids, assisting the poor, or funding your church, we all have higher goals.

Goal 3 are your higher purposes.

All three goals can and should be achieved, and with over 20 years of experience, we have put together a practice development system that allows doctors, and their teams, to achieve all three goals.

The 3 Goals Practice Development System is a step by step approach to help your practice grow naturally to its full potential and stay there.

Goal 1
Goal 1 is survival. In business, this means solvency. Are you making enough profit to pay your bills? To achieve Goal 1, solvency and survival, you have to move fast. It requires passion, energy, and an aggressively friendly approach to getting your services known and delivered. For the patient, you can think of Acute Care. For a staff position, you can think of 20 – 30% proficient.

Goal 2 and the Practice Development Process
Goal 2 is a fully functional, franchise-able, sale-able, and sustainable business that is very profitable. For a patient, it is a maximum spinal correction. For a staff position, it is 100% proficient and competent, rain or shine.

After you have achieved Goal 1, you can now start identifying those procedures that worked best. You can write these down on checklists. These checklists will become your Practice Playbook.

With more staff training, you can delegate more procedures to staff. As you continue to grow, you refine your procedures and continue to train your staff so that they become more competent.

Every 2 months, or as needed, you assess your list of successful procedures and add to them, or revise them. Every week you work on improving them, and train your team on them. Much like any athletic team, you practice and review your plays and procedures.

We call this process the Practice Development Process. It helps you to continually improve the practice and gradually take the office to Goal 2.

Getting Organized: The Baseball Diamond
To get to Goal 1, organization is not vital. Production, speed, and promotional activity is. However, getting to Goal 2 requires good organization.

Imagine a baseball team that stands around the pitcher’s mound with the pitcher. A batter hits a fly ball to the right field. The whole team goes to chase it. Once they reach it, they realize that no one is on the first or second base to throw the ball to in order to stop the runner. They are all out in right field.

Many offices operate this way. For example, in some offices the front desk does insurance, the insurance department does therapy, the therapist schedules appointments, and the doctor takes time off to buy office supplies.

Moving the office upward to its peak capacity includes all areas of the office improving: first base, third base, centerfield, etc. If you only have a few of the departments doing well, the other departments will hold down the entire growth.

Goal Three
Our greater goals give us meaning. These are the accomplishments we want to have said we achieved at the end of our lives. They are based in love, hope, and faith. They are for our heritage, our parents and those upon whom we owe so much; they are for our legacy, our children and their children; they are for our community and the fellowship we share with rich and poor.

Goal three is your “Give Back” goals, to your family, to your community, and to yourself.

All Three
This is your road map up and out of the roller coaster. These three goals form a sequence, but you have to keep all of them in mind as you travel up your road to success.

This is directed to a business owner, but also applies to team members and how they can improve their competency. It applies to patients, and how they travel from acute care, structural care, to wellness. It actually applies to many activities.

You have to be willing to shift between goals, and if you find yourself suddenly in the poor house, you have to lose your self-important attitude and run like a rookie again until you build your business back up to Goal 1.

Where many doctors fail is that they are not willing to shift, either up, or down, as needed. Having achieved Goal 1, they are two insecure to delegate their duties to staff and procedures, or work on improving themselves. Many doctors, having achieved Goal 1 who should be working on Goal Two, feel the need to keep doing what they did to get to Goal One and so, quickly find them selves back down struggling just to survive.

It is easy to get lost, but now, with the 3 Goals Management System, you have a road map.

We have seen too few doctors achieve financial abundance and practice freedom. Hopefully, with the tools provided in the 3 Goals Management System, more doctors will be able to reach their dreams and help others do the same.

For information on our coaching and management consulting programs. LINK