Using Checklists to Improve Your Chiropractic Practice

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

Don’t overlook the humble checklist as an important tool in developing your business. Simple and low tech, the checklist is yet so powerful and vital that everyone from pilots to surgeons use them.

Here at Petty, Michel and Associates, we have been promoting the use of checklists as a simple tool in chiropractic practice development since the early 1990’s.  All successful businesses use them, and certainly all professionals, from airplane pilots to cowboys.

Are they just more paperwork? Or can they really make things faster, simpler, and actually improve the quantity and quality of your services?

It really is just a simple matter of helping to ensure that your office continues to do the things that work.

Let’s be honest: sooner or later, we all get bored.  When we start something new, we are fully engaged. But after a few weeks, months, let alone years, continuing to do the same thing can be painfully tedious. So much so that we are tempted to follow other diversions.

Excellence does require creativity and innovation. But it also requires doing the same thing that worked yesterday – today and tomorrow. Improve upon it; add a new service or product or communication channel.  But don’t let your feelings of monotony dictate your management planning or procedures.

At PM&A, we advocate management by the numbers and by your own proven procedures.  Execute your procedures routinely with care and interest. Don’t manage by emotions or chase other people’s bright ideas or change everything to follow the current management flavor of the day.

The fundamentals ALWAYS apply.

This is the meaning of what Aristotle spoke of as recorded in his talk on ethics:

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

Practically, a checklist is a reminder of a what should be a habit: “Don’t forget to:____. ”  We are all busy and sometimes can take things for granted or take necessary shortcuts.  There is a tendency for any activity to atrophy to its minimal functions. For example, at the beginning of the year you got up early, had a cup of freshly ground coffee, and went to the gym for 40 minutes. By July, you were settling for instant coffee and a walk to and from your car.

A simple list of duties, such as how to open and “start” the office in the morning, “closing” the office in the evening, or “10 things to do on a patient financial consultation” can act to help train and as well as review excellence in performance. A list of duties for each position in the office is also very useful for training and just reminding.

Atul Gawande, an endocrine surgeon, saw the need for checklists in surgery.  He surveyed  fellow surgeons who said that they did not want to do checklists before surgery. But when asked if they wanted their surgeons to use a checklist if and when they went under the knife, almost all said they wanted their surgeons to use a checklist.

“What is needed… is discipline.

Discipline is hard — harder than trustworthiness and skill and perhaps even than selflessness.  

We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals.  We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.

Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything–a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps–the ones that even the highly skilled professional using them could miss.

Good checklists are, above all, practical.

                                     -Atul Gawande, M.D., Endocrine Surgeon, Associate Professor at Harvard. (author of The Checklist Manifesto)

Managing the work you do as a chiropractor or chiropractic team member in your office may not be as complicated as surgery, but your patients are just as important.   Maybe even more important.  Why? Because your chiropractic care may help keep your patients from ever needing surgery.

The Checklist: a simple and humble tool to improve the quality and quantity of your chiropractic services.

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Links to Atul Gawande: Quotes, TED

2 thoughts on “Using Checklists to Improve Your Chiropractic Practice

  1. Excellent topic Ed! I always had several checklists. And I made sure each employee had one. I could tell at a glance what was getting done and what was not in my chiropractic practice. This helped keep my mind clear to focus on the patients and their needs!

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