Tag Archives: practice management

What Is Your Full Capacity in Your Chiropractic and Service Business?

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chiropractor adjusting a full capacity waiting roomWhy Running Below It Costs You More Than You Think

The idea of full capacity is so simple that it is easily overlooked.

WHAT IS FULL CAPACITY AND WHY IS IT IMPORTANT?

Full capacity is when you are serving as many people as possible, given the available space, equipment, and staff. In other words, what is the maximum number of people you can see in a day – comfortably – given full support?

This number will vary, of course, depending on how you practice.

Full capacity is a vital goal for financial survival. You are already paying full price for your space, equipment, and team. With lower production, your overhead rises and your profits decline. Overhead actually jumps. If you’re running at 50% of full capacity, you’re not paying “half the overhead” — you’re paying close to the same rent, staff wages, and equipment costs as if you were at 100%. That’s why practices at half capacity often feel like they’re working just as hard, if not harder, for a fraction of the profit.

WHAT GETS IN THE WAY OF FULL CAPACITY IN YOUR CHIROPRACTIC AND SERVICE BUSINESS

Let’s say you have a busy month. See lots of patients. Your front desk is busy scheduling and keeping the appointment book full.

One afternoon, during a momentary lull, you notice the front desk staff has a few moments, so you give them some insurance work to do. A week later, the chiropractic insurance department does the same.

The following month, everything seems the same… the front desk is busy.

But visits are down.

What happened? Can you guess?

Any system or flow pattern will accumulate unnecessary additions – extra checks, additional actions, or routings that start to slow the flow.

This gradual shift and increase in systems is called “Process Creep.”

PREVENTING PROCESS CREEP

Step back from your practice and ask the engineering question: given my space, staff, and equipment, how many visits can we see each week? What is our full capacity?

For practical purposes, use Visits as your metric.

That number is your Full Capacity Goal. Once you know that, you work backward: what’s standing between where you are now and that number?

You need to look for the capacity barriers in the way – and remove them! These are different types of bottlenecks. I discussed this in earlier articles and in my book, The Goal Driven Business*. Some barriers are in the systems, while others can be in the people.

It could be patient notes, patient scheduling, or even too many services available. Not enough new patients, interestingly, often goes back to a mindset.

Complexity occurs naturally — so you have to work to simplify the flow and eliminate unnecessary steps. This gives you more time to engage with your patient – your customer.

But it all starts with:

  • Determining your Full Capacity Goal – the real ceiling, not a guess
  • Removing the barriers standing between you and it

Contact me if you want to explore what might be holding you back from reaching your full potential!

And stay Goal Driven,

Ed

Email

*References

Communication: The Real Practice Builder in Your Chiropractic and Service Business

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chiropractor understanding patient

Seek to Understand First

Last week we reviewed the Japanese concept of Ichi-go Ichi-e – “One Time, One Meeting.”

The lesson was simple: Be present. Be interested.

But why is that so important?

Because communication creates relationships. And relationships create practices.

But you think you already know this, right? Well, yes and no.

Intellectually, perhaps you do. But in real life… a practice is busy, and life is full. So, communication often devolves into a text or is abbreviated.

Authentic human communication takes time — time that busy people don’t always make.

Communication with Your Chiropractic Patients

Doctors rightfully focus on adjusting and treating patients. Staff members believe their primary job is scheduling, collections, insurance, or even marketing.

The Clinic Director is looking at the bottom line.

But underneath it all — is communication.

Communication is the operating system that allows all the other “applications” in your practice to function.

Every patient who walks through your door is asking a question:

“Do you understand me?”

Not necessarily with words. But they are asking it, nonetheless.

Patients want competent care. They also want to be heard, understood, and valued.

When patients feel understood, trust grows. Trust is the foundation of every successful relationship.

And when trust grows, recommendations are accepted more readily, appointments are kept, referrals occur naturally, and relationships strengthen.

Communication Within the Chiropractic and Service Team

The same principle applies inside the practice.

Your practice is composed of people. Staff, chiropractic associate doctors, and providers often wonder why things are managed the way they are, why something was changed, or… whether their work is any good or appreciated.

Over the years, I have seen staff members leave practices not because of pay, benefits, hours, or workload.

They left because they didn’t feel understood. Their questions went unheard, and their accomplishments went unrecognized.

And people don’t always get up and just leave a relationship. They usually leave mentally first – months ahead of time.

I bet right now, you can think of how this applies to you and your situation.

This applies to any team. It applies to family and family members as well.

And it certainly applies to your patients.

__ __ __

Communication is more than talking. It is more than giving instructions. It is more than conducting meetings.

Communication requires being there — with attention and genuine interest. Then it needs understanding the other person’s point of view well enough that they know you understand.

It also requires time, but it is time well invested.

When the quality and quantity of communication in your practice improves, the practice numbers will go up!!!

As Stephen Covey says, in his 7 Habits of Highly Effective People, Habit #5 is:

Seek First to Understand, Then to Be Understood

Stay present. Stay interested. Listen to understand.

The results may surprise you.

People stay, and are happy and productive, where they feel understood.

Patients.

Staff.

Providers.

Family.

Keep driving – what you are doing is important!

Ed

P.S We work this concept strongly on our Practice MBA course this fall – with tough but fun exercises!

And remember,

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

Ask Lisa – Compliance 201: Your Shield Against Bad Risk

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compliance in the health care field for chiropractorsAs a follow-up to our previous compliance articles, I thought what I’d do this month is put together a FAQ list for my dear readers and call it Compliance 201. Keep reading to learn about upcoming new requirements in the compliance/cybersecurity world to keep you at least safe-guarded when you are hit with a cybersecurity incident. Special thanks and credit goes out to ChiroArmour and Dr. Scott Muensterman for his research and presenting at the Chiropractic Society of Wisconsin Fall Experience last month on some of the content in my FAQ.

Q: What is HIPAA and HITECH?
A: HIPAA is the acronym for Health Insurance Portability and Accountability Act of 1996, in which uniform standards and requirements for the electronic transmission of certain health information were put into place and made into law. HITECH is the acronym for Health Information Technology for Economic and Clinical Health Act of 2009, a countrywide adoption and standardization of information technology to securely support the sharing of clinical data.

Q: What is Cybersecurity?
A: Cybersecurity is the practice of protecting digital systems, networks, and data from malicious attacks, damage, and unauthorized access.

Q: Is there a checklist available to ensure we are in compliance?
A: Yes. Current and Active PM&A clients have access to our HIPAA/HITECH compliance checklist, on the PMA Members Site, and compliance services are included upon request from the client.  If you are currently inactive or not a client, we can provide you with the checklist for a nominal fee. Please keep in mind your staff are already very busy, so ask yourself who is going to take on ensuring compliance at your office and going through the checklist? We can help.

Q: Isn’t it a matter of IF a cyberattack at my office occurs, not WHEN as you stated above?
A: On average there are 11 to 12 cyberattacks happening per minute in the US. So in today’s world yes, it is a matter of when, not if. And after research, it has been found that small businesses are more of a target for an attack than large organizations mainly because large organizations can put more dollars into security measures.

Q: What does Windows 10 and Windows 11 have to do with compliance?
A: Windows 10 no longer supports the security patches it used to support, effective 10/25/2025, so all of your computers must be operating on Windows 11 at minimum by this time. You CAN extend your Windows 10 protection for 1, 2, or 3 years at a significant price, but your software vendor may not honor the upgrade.

Q: I heard that there is something called an OIG Exclusions report – what is this and does it affect me and my practice?
A: The OIG Exclusions database is a reporting site listing every individual who is prohibited from seeing Medicare/Medicaid patients due to prosecution of a criminal activity, which can include being found guilty of fraud against Medicare/Medicaid, non-compliance of court-ordered child support payments, and illegal drug convictions. It is and will be a requirement to run a report MONTHLY on every person in your office including owners, subcontractors, and upon a new hire.

Here’s the link to check names: https://exclusions.oig.hhs.gov/
If you don’t see your name, that’s a good thing. Some of you are already running and checking this report due to insurance contract requirements. Save or print and file the results page.

Q: How can I confirm if my practice management program is fully compliant?
A: The website for verifying compliant healthcare software programs is down as of this writing, so for peace of mind if you are not 100% certain, call your software company or IT person.

Q: When do changes/new requirements occur?
A: As of now, no date has been set by HHS, but if you are doing the above steps and have written policies in place, you should not worry, but watch for future communications. You can subscribe to HHS email notifications here: https://cloud.connect.hhs.gov/subscriptioncenter

Q: What does Medicare documentation have to do with cybersecurity?
A: To avoid a documentation audit and subsequent potential visit from the OIG to further audits on compliance with HIPAA and your cybersecurity policies, keep your documentation and billing practices solid per Medicare chiropractic documentation standards, and make sure to securely send your notes to Medicare upon audit (and any other payer group who requests) to ensure you are staying HIPAA compliant.

Q: Can my staff be our Security officer?
A: By law, yes, but you as the doctor owner are always ultimately responsible for any attack or breaches, and payments to the government, so it is strongly recommended that the doctor owner be the compliance security officer for the business.

That concludes our FAQ for now. I know you’ll have additional questions. Feel free to reach out with those we’ll respond within three calendar days!

Stay Secure,

Lisa

References: ChiroArmour

 


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2026 Marketing Habits for Your Chiropractic and Healthcare New Year

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social media marketing for consistent marketing in the Chiropractic Practice for 2026

2026: The Year to Make Your Healthcare Practice Thrive

2026 will be a make-or-break year for healthcare business owners—potentially your best ever. More details in future newsletters, but for now: build unbreakable marketing habits starting today.

Trust: The Core of Healthcare Marketing

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.” – Aristotle (via Will Durant)

You’re selling the invisible—outcomes patients can’t see upfront. That’s why trust is everything. Build it through:

  • Consistency
  • Empathy
  • Proven Results

Your brand = how you consistently show genuine care and deliver excellence.

The #1 Killer of Momentum?  Stopping What Works

I’ve seen it repeatedly:
Q: “What were you doing when patient numbers were high?”
A:

  • “We sent newsletters.” → Not anymore.
  • “We called new patients post-visit.” → Nope.
  • “We did thorough financial consultations.” → Are you kidding? No!”

Stopping proven tactics = death by roller coaster.
You lose trust, momentum, and the systems that made it effortless.

Your Fix: The Recurring Marketing Checklist

Discipline is hard—but checklists make it stick. Systems atrophy without them.

Monthly Discipline Hack:

  1. List your top 10 internal + external marketing actions (70–80% of your total efforts).
  2. Assign ownership to your manager.
  3. Review at every staff meeting.
  4. Grade % completed—full accountability.

Layer In: Special Promotions

With recurring actions locked in, plan 2–3 months ahead for:

  • Facebook ads with a partner
  • Food drive with a local pantry (especially needed now)
  • Health talk at a yoga studio

Deliverable:Monthly Marketing Planner
→ % of recurring actions completed
→ # of special promotions scheduled

Let’s Make 2026 Your **Best Ever**

Download Free Tools:[LINK]
— Ed

The 4-Hour Fix for the Chiropractic Healthcare Practice Roller-Coaster

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the ups and downs of the Practice Roller Coaster stay Goal Driven to stay up

One Simple Role to Streamline Chiropractic Marketing and Growth**

Chiropractic practices often face inconsistent growth due to a Practice Roller Coaster, where marketing drives patient numbers up, but attention shifts to patient care, staff management, and other tasks, causing marketing to stall. This leads to fluctuating growth. To address this, assigning a trusted staff member as a part-time Marketing Coordinator (4 hours/week) can ensure consistent marketing efforts. Their role is not to handle all marketing but to keep systems like recalls, referrals, and metrics tracking active.

The Marketing Manager System, developed by Edward Petty in the early 2000s, emphasizes four key issues: marketing fails when it’s not done, no one is in charge, insufficient time is allocated, and the coordinator needs support and accountability. To succeed, the clinic director should schedule weekly marketing time, hold monthly planning meetings, track metrics with charts, and ensure accountability through written plans and reports. This approach eliminates marketing bottlenecks, sustains momentum, and reduces stress, helping practices grow steadily.

Note: A Monthly Marketing Manager Program to support coordinators with training and systems is planned for launch soon.

Building a Practice Through Relationships

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a happy bus driver like a chiropractor with happy people on their bus

Advertising has always been important. When we grew our Wisconsin network to 25 offices, we invested heavily in newspapers, shared mailers, radio, and even TV. Today, the focus has shifted to social media, SEO, and now Artificial Intelligence — positioning your practice for AI discovery will soon be essential (more on that later!).

But advertising is expensive. What truly sustained our growth was relationship marketing — connecting authentically with patients, referral sources, and our own team.

What Is Relationship Marketing?

Relationship marketing involves creating trust-based relationships with patients and referral sources, generating loyalty and organic referrals through genuine care and ongoing connection.

Examples:

  • Host a community event like a holiday food drive — invite patients and their families to participate and offer consultations in exchange for donations.
  • Encourage patients to refer loved ones with a personal touch (“Let’s check your spouse before their next soccer game!”).
  • Build partnerships with local professionals — massage therapists, trainers, or nutritionists — and support each other through referrals or shared promotions.

Your Most Important Relationships

Don’t overlook your team. When doctors and staff work together with shared purpose and positive energy, patients notice. It’s almost magnetic — phones start ringing and old patients return.

As Stephen Covey reminds us in The 7 Habits of Highly Effective People, success comes from empathy, communication, and a win-win mindset that creates synergy — or, as some might say, Universal Intelligence at work.

GETTING AND KEEPING PEOPLE ON YOUR BUS

As a doctor and clinic director, you are like a bus driver. You aim to make sure you are on time and complete your shift according to schedule.

One day, you turn around to look at the back of your bus and wonder why there are so many empty seats. “Where is everyone?”

Well, maybe you missed some stops and the people never got on! Or, you didn’t take time to say “hi” when they boarded, so they all left at the next stop. Or, you were so busy driving, you didn’t ask about your assistant’s new workout routine.

Take time to connect with people.

More than anything, you are in the people business.

Enjoy the ride!

Ed

Hobby, Practice, Business. Which is it for You as a Chiropractic Doctor?

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The 3 Phases of Practice Evolution

Is your work as a doctor a hobby, a practice, a business—or simply a job? Let’s explore.

1. HOBBY

Every practice begins as a hobby—or at least, it should. Early in your career, you’re driven by fascination with the science, philosophy, art, and technique of chiropractic. Your passion keeps you going, while business operations take a back seat.

2. PROFESSIONAL PRACTICE

The next phase is building a true professional practice. This stage is entrepreneurial and personality-driven, fueled by your presence and commitment. You create strong patient relationships and build loyalty through consistent care and connection.

3. PROFESSIONAL SERVICE BUSINESS

Finally comes the service business stage. Here, your practice is structured, systematized, and able to operate independently of your constant management. You may step into a CEO role or scale back to part-time patient care, but either way, the business runs on clear goals and proven systems. This is what people call “scaling.”

DIFFERENT PATHS, DIFFERENT GOALS

Not every doctor wants to build a business. I once knew a chiropractor who loved nothing more than adjusting patients. He wasn’t concerned with scaling or management systems. His secretary kept the office running, his patients were happy, and so was he. That was enough.

Most doctors, though, do want to grow—to serve more people, expand their caseloads, and run a strong practice while still enjoying their profession.

Then there are the entrepreneurial doctors who aim to scale beyond themselves. By setting goals and creating reliable systems, they can expand without adding more hours or overwhelming overhead.

But many who try to scale fall into what I call the Practice Roller Coaster. The excitement of practice gets buried under stress, inconsistency, and management struggles. What once felt like a calling begins to feel like just another job.

BREAKING THE ROLLER COASTER CYCLE

There are exceptions—many doctors do successfully build thriving service businesses. I’ve helped dozens achieve exactly that.

Five years ago, I wrote The Goal Driven Business after observing this cycle of burnout. In the book, I explain the hidden barriers to growth and outline the step-by-step process for building a scalable, independent practice.

If you find yourself on the Roller Coaster, here’s how to reset:

  1. Hobby – Fall back in love with chiropractic. Make practicing fun again.
  2. Professional Practice – Build and enjoy your patient community while earning a solid living.
  3. Professional Service Business – If you’re ready to scale:
    • Read The Goal Driven Business for a complete roadmap.
    • Or, reach out to me directly through our Goal Driven Consulting program for hands-on help building a profitable, self-sustaining business.

Take back your future. Build a business that runs without depending on your daily management.

Stay Goal Driven,

Ed

 

Preventing Procedural Atrophy in Your Practice

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eroded asphalt highway

In any business, routines and procedures can slowly be shortened, skipped, or abandoned. When this happens, quality slips, and the practice begins to decline. I call this Procedural Atrophy, a key concept from The Goal Driven Business.

When results falter, doctors often try new approaches. These may work temporarily, but without consistent systems, the same decline sets in again. This creates the Practice Roller Coaster—a cycle driven more by personality than by clear goals and structure.

Think back to what you did when your practice was thriving. Did you call new patients after their first visit? Hold morning team huddles? Run patient education classes, progress exams, or referral drives? Chances are, when numbers dip, it’s because those proven actions have slipped away. The solution is often simple: return to what worked before.

 Solution 1: Set the Standard – Quality

Stand out in a noisy world by being consistent and excellent. Define exactly what a successful patient outcome looks like—for example, a patient who pays, stays, refers, feels healthier, understands their care, and is happy with their results.

Then, create brief checklists that outline the essential procedures needed to achieve this. Examples include:

  • Day 1, Day 2, and ongoing patient steps
  • Collections
  • Internal and external marketing
  • Team communication and coordination
  • Leadership and management

These checklists keep your practice systematic, repeatable, and reliable.

 Solution 2: Accountability Reviews

Consistency requires feedback. Use monthly statistics, chart trends, and review them with your team or a coach. This ensures everyone stays focused and motivated. Just like in life, accountability keeps us on track.

—

Bottom line: What you provide for your patients, team, and community is valuable. Don’t let your practice erode through neglect of the basics. Stay consistent, keep improving, and remain Goal Driven.

Ed

He walked away when I asked, “Who is going to do it?”

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distressed overwhelmed male business man When you are the bottleneck

Many years ago, I attended a large chiropractic conference. I was new to the profession and curious about how things worked.

One of the seminars at the conference was on how to generate new patients. There must have been several hundred in the room. The speaker was charismatic and had some sensible recommendations. The audience seemed enthused.

I was sitting in the back of the room. When the seminar was over, I was one of the first to leave and walk into the hallway where attendees began to cluster to discuss the presentation.

I remember one doctor in particular. He was tall and had his name tag with ribbons hanging down. I didn’t understand what the ribbons meant, but I figured he must have been important.

I asked him how he liked the seminar. He was deliberate, almost authoritative when he said that he liked it and was going to implement some marketing projects. I told him that I thought that was good.

But then, thinking about it, I asked him, “Who in your office is going to do it?”

I remember him looking down at me. He seemed perturbed, as if I had insulted him. He looked up and walked away. Didn’t say a word.

I’ll never forget it.

This was a long time ago, but it made an impression on me.

REMEMBER THE OLD MAXIM
“Do what you do best, and delegate all the rest.”

You can’t do it all.

In the beginning, when starting and growing your practice, yes, you pretty much had to do most everything.

But at some point, you must create other team members who are trained and motivated to share the load. I know practice owners know this, but it’s easier said than done.

This is why a manager is so vital to your practice. Your manager is the fulcrum point that helps you make a team. They are a servant to the team — as you are to your patients.

They help put in the systems that allow all your internal and external marketing procedures to be effective. And not just marketing. Standard procedures for patient retention, patient services, patient reimbursement, and so on.

They take the load off of you, so you are not the bottleneck!

We’ve found that most staff and managers are very willing and want to help their offices grow. But in most cases, they are not sure how, or how best to work with their team, or their doctor.

It is because of this we have developed our Practice MBA program.

Take time each week to train your team.

And for some of you, our manager training program is just what you need to answer the question,

“Who is going to do it?”

Stay Goal Driven,

Ed

P.S. Get on our Waitlist today to ensure you get a spot. First come first serve. Only 15 spots available this fall.  [LINK]

Raising the Vibe Level in Your Chiropractic Office

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lady walking on the beach listening to music

We ordinarily send our Goal Driver newsletter out to chiropractors and other healthcare business owners and support staff on Tuesday at 11 Central Time.

Today is different. This newsletter is going out early.

Today is the first working day of this week (in the U.S.) after a refreshing extra-long Labor Day weekend. It is the first day of September, and summer vacation is behind us. And it is just 4 powerful months (120 days) to 2025!

I wanted to send this to you before your day begins to help you get your motor running.

So here is some music.

You can listen to some tunes while you take your morning jog and cold plunge (!), get your kids ready and drop them at school, and drive into the office.

You can play it at the office with your team. And patients.

Pick your vibe below, or any music, turn up your speakers, and get your motor running!

Have a great day,

And seize the rest of 2024!

Ed

Steppenwolf – Born To Be Wild   https://www.youtube.com/watch?v=egMWlD3fLJ8

“Unstoppable” (The Score ft. Fleurie) https://www.youtube.com/watch?v=_PBlykN4KIY

“Eye of the Tiger” (Survivor)  https://www.youtube.com/watch?v=ob8TNqQw2hY

Chariots Of Fire Theme Song https://www.youtube.com/watch?v=8a-HfNE3EIo

“Lose Yourself” (Eminem) https://www.youtube.com/watch?v=xFYQQPAOz7Y

“Gonna Fly Now” (Bill Conti) (Theme from Rocky) https://www.youtube.com/watch?v=ioE_O7Lm0I4

“Brave” (Sara Bareilles) https://www.youtube.com/watch?v=4Ny_LX3byp8

 Beastie Boys No Sleep Till Brooklyn  https://www.youtube.com/watch?v=IDVq9s6HCB4

“Enter Sandman” (Metallica)  https://www.youtube.com/watch?v=9Q8SxnbL1ms

Dream On (Aerosmith)  https://www.youtube.com/watch?v=iJDtukGW79Y

 “It’s a Great Day to Be Alive” (Travis Tritt)  https://www.youtube.com/watch?v=d4tSE2w53ts

 “This One’s For the Girls” (Martina McBride) https://www.youtube.com/watch?v=4fvKzTC3-BA

 “I Hope You Dance” (Lee Ann Womack)  https://www.youtube.com/watch?v=F44nrK0MxEQ

Somewhere over the Rainbow – Israel “IZ” Kamakawiwoʻole  https://www.youtube.com/watch?v=V1bFr2SWP1I

Stand By Me | Playing For Change | Song Around The World  https://www.youtube.com/watch?v=Us-TVg40ExM

 Bobby McFerrin – Don’t Worry Be Happy  https://www.youtube.com/watch?v=d-diB65scQU

I Dreamed A Dream. Susan Boyle (part of Britain’s Got Talent) https://www.youtube.com/watch?v=mS5Om47vsaA

 

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

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

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

 
goal driven business www.goaldriven.com

The Goal Driven Business

goal driven business buy now button

How to Win as a Chiropractic and Healthcare Practice Athlete

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balance beam athlete

Like the Olympic athletes, as a chiropractor or practice owner, you have begun a venture few dare. Where you go, there is no hiding or coasting. You are immediately rewarded or penalized based on your and the entire team’s performance. There is no guaranteed tenure in your job or assurance that you’ll have business next month. It is all up to you and each member of the team.

Read Ed’s weekly newsletter to find out how to:

  1. DEVELOP A CHAMPION’S MINDSET.
  2. BUILD YOUR SUPPORT TEAM.
  3. CONTINUOUSLY IMPROVE.
  4. CELEBRATE THE WINS!

Read More[LINK]

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

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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/

More links to references:

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

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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:

  1. Be a coach. Schedule in-office training, seminars, webinars, courses, advanced training, and books for yourself and your team
  2. Feedback and support. Regular Coaching Reviews.
  3. Recognize the wins. Acknowledge and celebrate employees’ achievements and contributions. Including your own!
  4. Challenging goals. Set up tasks and projects that challenge you and your team. Let your team take ownership. Keep it fun.
  5. Go for a million (or 5 million) dollar practice.
  6. 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!

Ed

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

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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)

Ed

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

Going Public or Going Purpose

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Be like a juvenile delinquent!

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

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

But I had another inspiration.

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

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

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

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

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

Chouinard, with his family, own Patagonia.

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

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

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

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

And one other note!

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

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

So, have fun, and seize the future,

Ed

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

Ed Petty in front of Chouinard Equipment Company, Ventura California

 

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

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

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

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

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

Relationship Marketing: Build and sustain your practice through relationship marketing

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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 10,000th 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!)

 Ed

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

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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.

  1. 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.
  2. 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.
  3. 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:

  1. 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.
  2. 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!

Ed

 

Are Your “Engines” Driving Your Practice?

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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:

  1. Marketing
  2. Leadership
  3. Management
  4. Service
  5. 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.

  1. Marketing. Abundant new patients and goodwill with local allied businesses, organizations, and your community. A waiting list practice. (1—5: ___)
  2. Leadership. A business with clearly defined goals that are agreed upon and pursued happily. (1—5: ___)
  3. Management. Expert team members, acting as an expert team, implementing simple but effective procedures. (1—5: ___)
  4. Customer Service. Customers (patients, clients, customers) who are extraordinarily satisfied with the services they receive and their outcomes. (1—5: ___)
  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,

Ed

Tempus Fugit (time flies)

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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?

  1. Yourself as a professional?
  2. The office as a whole?
  3. The quality of service/outcomes of your patients?
  4. 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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,

 Ed

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.