Chiropractic issues Archives - The Optimal Health Chiropractic System

Category Archives for "Chiropractic issues"

Aug 02

Resources for Chiropractors: Discussing Dr. Tedd Koren’s Exciting New Book “Cancer is Natural and So is the Cure!”

By Dr. Russ Rosen | Chiropractic Care , Chiropractic issues , Chiropractic Strategies

Aloha Gang!

A few weeks ago, Dr. Tedd Koren and I sat down as part of the Optimal Health Summit where we got into some absolutely mesmerizing concepts and resources for chiropractors. One of the things he shared with me was the debut of an exciting new book of his that would be hitting shelves in a few weeks. I asked him if we could catch up after the summit and talk about the book in detail, and he graciously accepted.

In this interview, the LEGENDARY Dr. Tedd Koren discusses his new book, “Cancer is Natural and So is the Cure!”

This book is a MUST-HAVE for your collection if you have made it your goal to help the chronically ill get healthy.

If you also want to help those who are NOT chronically ill to stay that way, then you need to check out this interview.

We dive into:

  • Why Dr. Koren wrote this book
  • Why people get cancer
  • Is there a cure? (Spoiler alert: YES!)
  • What that cure is
  • How to leverage this information and have a HUGE impact in your community

Dive right in. As always, let me know what you think. I’d love to see some discussion on our Facebook page about this one.

Jun 01

How to not just get your staff on board but how to get them on FIRE!

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies

There is not a week that goes by that I don’t get an email from a doctor complaining about their staff. It sounds something like this:

  • They don’t get what we do!
  • They don’t go the extra mile!
  • They don’t care!
  • They don’t do a good job!
  • They are ruining my life!

Does any of that sound familiar?

If you have been in practice for more than a year, you have had at least some staff challenges if not a full melt down!

We have doctors ask us all the time. “How do I get my CAs on fire? I have heard of these legendary beings, or even worse, I have seen them, but why aren’t MY CAs rock stars?!”

Is it possible to get them on fire? The answer is yes! 100% yes!

Take them through this process and they will either get on fire or they will leave. Either one is fine!

And yes… it is fine if they leave. I know that is a scary proposition but at least you now have an opportunity to find an amazing CA who can rock your practice and your world!

I had a patient who I just loved. She was a good friend and referred tons of her friends and family. She just adored me and what I did and I adored her.

Within a month or so after hiring her as a CA, my practice dropped in half.  I could not figure out what was going on. A patient of mine pulled me aside and said, “Russ, your new CA is killing your practice! She is scaring patients away!”

She loved me so much that she felt the need to protect me from patients who forgot to bring payment, missed appointments, or didn’t sign up for care plans. She gave them the “cold shoulder” and made sure they no longer felt welcome. Her emotions clouded her judgement and made for some terrible issues.

I had to let her go. My practice popped right back up again.

On the other hand, I have had amazing CAs who have really taken control and grown the heck out of my practice. Trust me on this, I hear it all the time. Your CA can double your practice or cut it in half. Put the time into making sure you have the right CAs and do what I lay out below. You will be amazed at what happens!

Step 1: Get them on board PHILOSOPHICALLY.

  • Help them REALLY understand the vital nature of chiropractic.
  • Help them understand what chiropractic IS and is NOT in YOUR office.
  • Help them understand how your patients’ LIVES can improve by having a healthy, functioning nervous system and reasonable lifestyle.

Remember: just going to your healthcare talk once is not enough. This is continuous education. But GET THEM TO GET IT if you want them to help OTHERS get it!

Help them understand that this job is really a calling, not just a job or a career. If helping people live better lives is not their calling, they really need to find something that is their calling. YES they need to know how to type, answer phones, and deal with people, but if they do not have this calling they won’t be the right fit. If their WHY is not big enough, they will never be the AMAZING ROCKING CA you are looking for!

Step 2: Go over this chart with them and find out if they are in the zone, stressed and overwhelmed or board.

If they are stressed and overwhelmed, they CANNOT grow or take on new tasks!

Instead we must REORGANIZE.

Building a practice is a theoretically simple endeavor.

  1. Reorganize (make space)
  2. Fill it.
  3. Repeat.

This is pretty simple to grasp, but not always easy to execute.

One of the great blunders we make is to tell the team we are going to grow the practice. If they are stressed and overwhelmed, then growing the practice means “more work for them”. How do you think they will feel about this?

Instead, let them know help is on the way. YES I KNOW YOU DON’T THINK THEY SHOULD BE OVERWHELMED! After all you are only seeing X patients a day! But THEY ARE overwhelmed so you must figure out why, reorganize, and fix the problems so they feel that there is space to grow!

Pro tip: If your front desk CA is overwhelmed and you do not already have your patients pre-paying and pre-booking, you can DRAMATICALLY decrease your CAs stress just by having your patients pre-pay and pre-book. Imagine how much time they would have if they did not have to meet with each person, take money, talk with them, write or print a receipt, enter it into the computer, do the banking etc.

There are TONS of ways to help them go from stressed to in the zone or even bored.

And if you REALLY want to grow your practice, you need a ton of space which takes a ton of reorganizing!

Step 3: Now that we have the right people who feel passionate about serving more people and we have reorganized so they are ready to grow, we can now set goals and objectives.

The classic mistake is to set goals too high and allow them to fail!

I like to start with quarterly objectives. But for some this is just way too big. I don’t care if we start with weekly goals. But just make sure it is doable. Make sure they can be successful, and they see that this process of setting goals and accomplishing them really can work.

Step 4: Let them know that if they do a better job and we serve more people they deserve more money. Set up a bonus system. Bonus systems NEVER work if we have not done steps 1-3. If your team’s goals are too far out of reach or ill-defined, the idea of a bonus never becomes real. They will prefer a simple raise and won’t be “in it to win it”. This will kill your growth and momentum.

Pro tip: Some people do not want money as a bonus. Find something that will work for them and inspire them. But know that bonuses alone will never work in the long run. So PLEASE MAKE SURE you nail steps 1-3.

These are just simple things that you can do right now. I promise you will see amazing results when you trust the process and get out of your own way!

As always email me and let me know how it goes. We are always here to help!



May 19

Moooving On Up with Chiropractic Marketing: How to Separate Yourself from the Herd

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies

Years ago, it was a safe assumption to bet that virtually all chiropractors “did” the same things. Nearly all new patients came from internal referrals, too.

My, how time changes things.

Today, you could probably visit ten different chiropractors and get ten WILDLY different experiences.

  • You may encounter a high volume doctor who sees one or two adjustments in a minute.
  • You might get the “Flying 7” (mobilize the neck left and right, three times down the thoracics, then roll the patient in left and right side postures)
  • You might even discover one of the many wonderful non-force or light-force techniques.
  • You could get a knee injection or end up on a traction table.
  • You could also find applied kinesiology or clinical neurology or neuro-emotional work.

The list goes on!

Back in the “good old days”, no one really knew what chiropractors did. That was the downside… but it was also a huge advantage.

Without any preconceived notions, chiropractors had the opportunity to welcome patients to their world: how they practiced, what chiropractic care was, and everything else. There were no hurdles to overcome. There were no competing ideas, either.

Somewhat recently, Australian and New Zealand doctors had this opportunity… though the industry there failed to do anything different than their predecessors in the US, quickly bringing the masses to the idea that chiropractors only fix neck pain, back pain, and headaches.

Today, parts of Europe still have this tremendous opportunity, as chiropractic care is relatively unheard of in many places in Europe.

So what does this brief history lesson mean to you, the practitioner in the trenches? You must have a process of separating yourself from the herd! (Note: regulations in some places may stymie this idea, so act according to local law)

If you are doing a specific technique or using a specific type of technology, you want to make a big deal about it.

When we work with our chiropractors, we help them get clear about what makes them special. Why someone would want to see them vs. the average “Joe” down the street. We then teach them a series of steps to subtly let the patient know the difference between a “Saw horse” and a “Seahorse”. Yes they sound a lot alike, but the truth of the matter is they are very different! Our chiropractor business coach reviews show that our process works, so be sure to read through this fully.

So I would ask you to get very clear about what makes YOU so different. Why would someone want to see you instead of heading down the street and get “Cracked at the Joint”? Do you have specific niche markets that you are really great at working with, such as ADHD kids, pregnant women, elite athletes, or people with gut issues?

  • What makes you so good?
  • Your technique?
  • Your technology?
  • Something else altogether?
  • Who are you great at helping?

Then, I want you to start to figure ways to help your patients understand how lucky they are to see you and why you are indeed a “Sea horse” not a “Saw horse”! Be sure to capitalize on the limited scope of your competition, too.

Here is one simple thing you can try today. When a new patient comes in, I want you to build rapport right off the bat with two questions. Then, I want you to let them know WHY they are so lucky to be here (but do it under the radar) and why they are in the right place to get the care that they need.

Step 1: “Mary, it is great to meet you. I see Sally referred you in. How do you know Sally?” Whatever they say I want you to find a “Secret handshake”. Something very simple and quick i.e. if Mary says that she works with Sally, and you know where Sally works, you can just say, “Oh, so you work at Napa Elementary school. Both of my kids went there. Great place.” Or if she said that they train together and you know that Sally is an elite athlete you can say, “Oh my goodness. Sally is off to the Iron Woman triathlon. Are you at the same level as her? Wow that is quite an elite level!”

Just find something so they know that you know them or the person that referred them or understand something about them.

Step 2: I want you to ask: “What did Sally say to make you want to come in?” Whatever Mary says, I want you to ECHO back to her. When we ECHO and use the EXACT same words, it magically builds rapport. They subconsciously think, “Oh, we are from the same tribe”.

So if Mary says that Sally shared that you really fixed her lower back and hopes you can fix hers, too, I want you to say, “Yes, we certainly did fix Sally’s lower back and I sure hope we can fix yours too.” You will be amazed at how this works so well and so quickly. (But it is CRITICAL that we use the EXACT same words. If you say, “Yes we certainly did HELP her low back” instead of “…FIX Sally’s…” it will not work!)

Step 3: Make a comment like this: “I will tell you, Mary, one of the reasons we were able to help Sally and so many other people like her is because…”

The rest of that sentence might be: “…because we do this particular technique where we can find the true underlying cause of the problem, instead of just chasing symptoms around like from your history, which I see you have done quite a lot of!”

Another option would be “…because we have this particular technology, so we can find the true underlying cause of the problem instead of just chasing symptoms around like from your history, which I see you have done quite a lot of!”

OBVIOUSLY, you need to come up with something short and sweet that lets them know, “I AM NOT AT SOME REGULAR CHIROPRACTOR’S OFFICE. I AM AT SOMEONE SPECIAL’S OFFICE! I AM IN THE RIGHT PLACE!”

Now of course we help our chiropractic business coaching clients customize and fine tune this rap but I want you to give it some thought and give it a try. It is just the first touch point of helping our patients begin to get an idea of why we are a “Sea horse” and not a “Saw horse”!

Let me know how it goes.

Much love and aloha,


Nov 10

System to Sustain Practice Growth

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies

The conventional wisdom out in the chiropractic business management world is that you can sustain a 20% increase in practice growth each year. If the practice grows faster than that you can expect the classic “roller coaster” in which you grow then crash and repeat… not a fun ride!

Although this is true you can take specific action steps to sustain your growth and not crash your practice. I have seen many of the offices I coach literally double their practices during a year’s time and continue tremendous growth without the roller coaster effect.

The intent of this article is to show you exactly how to sustain growth in your practice without burning out in the process.

The first thing to recognize that this is not by chance or luck but it is absolutely by design.

Follow these simple steps and get off the roller coaster forever!

Make Space

The first thing we need to do is make sure we have space to put the patients.

We need space for New Patients, ROF’s, Re-exams and Re-reports and of course plenty of space to adjust our patients. I continually see docs who do not have special allotted time slots for all of these appointments. I was working with one doc who would bang his head against the glass ceiling of 55 per day. He would hit 60 or so then crash to the 40’s and had been in this cycle for years. I asked him why this occurred and he said there simply was not enough time in the day to handle the load. When we examined his schedule and made space for all of the appointments we found that there were 102 spaces to adjust people and we added a new patient and ROF to his daily schedule! One of my specialties is helping docs see more people in less time and get BETTER results. Personally when I started in practice my visit 1time and visit 2 time was an hour and a half a piece and eventually came down to 6-7 minutes. My close rate, referral rate, and p.v.a. all went through the roof. Clearly it is not the amount of time you spend; it is the focus and quality of that time. I also needed 30 minutes to adjust one patient! Eventually that came down to 2.5 minutes per patient. Let me help you see more people in less time and get BETTER results!

Next we have to make sure there are no capacity blocks clogging up our flow. The first thing to recognize is WE ARE AS STRONG AS OUR WEAKEST LINK! It is not just a trite cliché, it is reality. A classic scenario I run into is the staff feel like they simply cannot see more patients. The doctor pushes for new patients but runs behind. The patients get pissed off and give the CA “stink eye.” The CA’s stop scheduling so tight in the operating system and the practice drops. This is a classic story and has several weak links that need to be addressed. First if the doctor runs late people get pissed. If they get pissed the doctor rarely knows because they take their vengeance out on the staff and the staff stop scheduling so tight. The patients also stop referring new patients. In this scenario we also have staff who feel they cannot handle the load. We need to realize that you can only put one gallon of water in a one gallon container. But the fact of the matter is many offices have a half a gallon in a gallon container and don’t see how to put any more in. Classically I will speak with staff and ask why they are so busy? They are seeing half as many people as other offices I coach but they simply have no more room available. We then examine each and every task and system until we find the weak link. You may not believe this but the most common first problem we deal with is the CA just can’t schedule everyone and write receipts and deal with the rest of the flow. I ask them if they were to have patients prepay and only have to write one receipt every month or two instead of a receipt for each patient each visit and if the patients were to pre-schedule would that make a significant difference? Of course it would they say, BUT THAT WOULD BE IMPOSSIBLE! Of course it is not impossible as it is done in every other office; we just have not taken the time to train our CA’s in this new model. As soon as we clear up their headspace around this issue and then show them the appropriate procedure to accomplish this goal we create a tremendous amount of space. Of course we could go on forever discussing how to create more space but instead I will ask you to read the article entitled “Practice Growth and the Weakest Link” and “Creating the Perfect Life.”

Fill the Space

In other words now that you have the space and capacity to handle practice growth we need to fill that space with warm blooded beings. We need to do “Marketing.” Of course we could spend hours on this subject and won’t but there are a few key points I would like to review. (Please read “New Patients and the Marketing Calendar.”) Many doctors do not like the idea of marketing. They somehow feel they are “above” that. They feel that people should just come to see them because “I am a doctor not a car salesman for crying out loud!” I like to help docs shift their headspace to realize that everything you think, say and do is marketing. What your office looks like, what posters you have what your staff talks about as well as what promotion you run. Literally everything you think, say and do! Also I like to point out that although the end result of marketing is new patients the real reason we market is to tell our story. Because our Mission, Vision and Purpose are so big that we have no choice but to get out and tell our “truth.” I have seen this slight shift in headspace free doctors up to bring in boatloads of needing souls!! My basic formula for marketing is:

External Marketing

Get out in the public and let them know what you do. Make sure all of your marketing is congruent with your mission, vision and purpose! If you are a “Wellness doctor” don’t do “Spinal or back” screenings. I have an entire process but the classics are:

  1. Outside talks
  2. Screenings
  3. Print ads
  4. Social media
  5. Website

Get families in

Now that we have fresh new blood give them an opportunity to get their entire family in to get checked for nerve interference. If you have shifted their consciousness to realize they have a health problem not a back problem AND they really want to get healthy now, prevent problems in the future and have a better quality of life then how could they possibly leave their families at home?? We have an entire process to get families in.

Internal promotion

Now that we have new families under care let’s give them an opportunity to get their friends in. Remember people want to refer! Do you ever tell friends about the new great block buster movie you just saw? Of course you do. Were you paid to do that? Were you coerced? Of course not, it is in our nature to share good things with our friends. In Robert Cialdini’s book “Influence: The Psychology of Persuasion” he helps us realize that there are “windows of time” where people not only will refer to us but they actually WANT to refer to us. In fact, if they do have the opportunity to refer to us THEY WILL HAVE A BETTER EXPERIENCE AND LIKE US EVEN MORE!!! All new patients come from one thing. And that is ENERGY! If you and your team get psyched up and it is part of your mission to “help save lives” vs. “get some people out of pain” you will see amazing results with your internal promotions. Remember to let me help you and your team with some killer internal promotions.

Piggyback internal promotion

Usually right after a great internal promotion we can do another one. Because it was such a great success and we have a bunch of new patients in from that event we can now give them an opportunity to do the same. There is a science to this Make sure we discuss it in detail.


Now that we have given our active patients an opportunity to refer in their family and friends it is time to go and do our external community outreach program.


Now that we have filled our practice it is time to reorganize. The classic blunder that most offices make is they continue to fill the practice till it bursts!! Remember, a one gallon container can only hold one gallon of water. So it is time to rest, recover and REORGANIZE!! As soon as our practice has growth we have to ask our entire team these questions:

  1. What worked?– Get very clear about what worked and then do more of it. By design, not by chance. So clarify what has worked in each position and make it part of your system. Make sure it becomes part of your training manual and continue to do more of it! (Michael Gerber’s “The E-Myth Revisited” is a must read!)
  2. Challenges– Were there any challenges? Remember you are only as strong as your weakest link. I ask my offices to look for the challenge. The question is not “Is there any challenges?” The question is “Can we find them before they become a problem?” So as part of the Performance Appraisal System every person on our team must review every “behavior” and “task” (See Performance Appraisal System in the “Dream Team” workbook.) We all need to see if any of our “A” performances have dropped to a “B”. Remember classically we will have capacity issues but we will not see the effects of those problems for 60 to 90 days. We then have the classic downturn of the practice and we have no way of figuring out why it happened. We always look for the problem in the last 30 days… but of course it is not there. So each person must clarify where their capacity blocks or challenges are. We recommend asking each person on your team. “Are you bored, stressed or in the zone?” If they are bored then carry on. If they are in the zone then ask them would they still be in the zone if you got to your next goal. If so then REORGANIZE. If they are stressed then of course you must make space and reorganize. You cannot sustain growth and be in defense at the same time.
  3. Fix challenges– Now that we know where the challenges are we need to fix them. This is what the performance appraisal system is all about. The offices who use this each and every week thrive. Please be one of them! Remember this phase may take several weeks. WE DO NOT WANT TO DRIVE A BOAT LOAD OF NEW PATIENTS TO OUR OFFICE DURING THIS REORGANIZATION PHASE!! It is time to rest, regenerate and reorganize!
  4. Set new goals– Now that we have successfully cleared up any challenges and recovered from the filling phase we want to set new goals. Please read the article called “Goal Setting.” Be clear, be specific, make sure the goals are agreed upon by the entire team and make sure they are exciting.
  5. Action plan– As part of the goal setting process we need to have in writing what each person on the team is going to do by when to help reach the goals. Without this step goal setting is simply WISHING!



Now that we made space, filled it and reorganized we are ready to repeat the entire process again. Figure out ways to make more space. Again please review “Practice Growth and the Weakest Link.” Also realize the only way to make more space are to add more staff/associate, space, equipment or speed.

I realize this was quite a bit of information and in reality we can spend hours on each step. My wish is that you not only gained a few pearls of wisdom from this discussion but more importantly that you implement those pearls, plant those seeds and experience the joy of Sustained Practice Growth.

Oct 17

What to do when a patient says, “I can’t afford your care.”

By Dr. Russ Rosen | Chiropractic Care , Chiropractic issues

If you’ve been discovering how to run a profitable chiropractic business for more than 5 minutes, then a patient has told you that they need to stop or reduce care because they could no longer afford it!

This exact situation tends to impact us as chiropractors on so many levels. For many of us, it’s like an arrow to the heart and brings up all sorts of issues around value and self worth.

I want to share with you the two big mistakes chiropractors make when confronting this situation and share my top strategies for getting to the real reason your patient wants to stop care.

How You Respond Initially is Important

In my experience working with thousands of doctors around the globe, I have realized that most chiropractors respond to this statement in one of two (equally bad) ways.

Bad Response #1: The Confrontation

Classically “High Ds” or “Drivers” or “Assertives” respond by getting snippy or angry with their patients – trying to scare or manipulate them into care. By letting these troubled patients know about all of the terrible things that are going to happen to them without their care, “Assertives” tie up their frustration and anger in a beautiful pink ribbon labelled “in their patient’s best interests”.

At chiropractic seminars, they get to tell their friends about the time they really laid into their patients. They get to feel good knowing that they said what they wanted to say.

Bad Response #2: Rolling Over

Classically “Non-assertives” join what we call the “O.K corral” and just say, “okay”, letting the patient simply leave without a discussion. They feel very frustrated because they didn’t say what they really wanted to say and the relationship is essentially over.

Regardless of where you land on the assertiveness scale, the end result is almost surely the same: you are frustrated and the patient fails to get the results they came in for. It’s an absolute lose-lose scenario.

Responding with the Patient’s Perspective in Mind

I want you to imagine your patient has mustered up enough courage to finally say to you that they feel that they need to stop care because they don’t have enough money. I want you to recognize the stress that they are most likely under by the time they finally say this to you.

This is a big deal.

Now I want you to imagine you say to them:

“Mary, if you stop care now you will never get the results that you’re looking for and you will have serious problems in the future.”

Although you may manipulate her into continuing care in the moment, the odds are she will very soon quit care for good and never return.

What we find rarely ever works is TELLING people what they “HAVE TO” do. Regardless if they are patients, spouses, children or bank tellers, telling people what they have to do rarely works!

Instead, we need to ask Socratic questions to help us clarify what the problem truly is so we can come up with a reasonable and logical solution.

LAASR Focused

In our L.A.A.S.R process (Listen, Acknowledge, Ask, Solution, Resolution) we always make sure that we actively listen to our patients. Then we must acknowledge them. In this case I might say,

“Mary I am so sorry you’re going to have to stop care. I absolutely love working with you and you’ve been gaining such ground and doing so great.”

Do you see how this de-escalates the situation? Remember: she is stressed about having to quit -or even disappoint you – and has possibly come in ready for a fight! By Acknowledging their concerns and the situation this way we can take the wind out of the sail and de-escalate the situation. Now we can begin to have a conversation. But I am NOT going to TELL her what she HAS TO DO!

Instead we want to ask appropriate questions. I.e. “Mary let me ask you a question, if finances were not an issue – and I know that they are – but if they really were not an issue would you want to continue care? Or are you just (feeling good/unhappy with care/feeling stuck in care etc.) And would rather not continue at this time?”

If Mary says that she would do anything to continue care but she simply cannot afford it. She just lost her job, her mother got sick, her dog got hit by a car and she was living out a country song then I personally would buy it. And I would try to figure a way for her to be able to get some of the care that she needs. The odds are some care will be better than no care. (Of course you have to do what you feel is clinically best for your patients.)

But it if she were to say, “Yes the truth of the matter is I am really feeling pretty good and I think I will just stop at this time” then you have clarified the real problem that you can now address.

My experience is, if you will really focus and clarify the problem the solution will become self-evident. Then if you will use the L.A.A.S.R. process you can help people find solutions and resolution versus pissing them off or joining the okay corral.

I’d love to know your thoughts and hear what’s worked for you.

Much love and aloha,

Oct 17

How to FINALLY feel GOOD about DECREASING adjustment times

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies

Have you ever wanted to see more people in less time but you were afraid your patients would leave?

Perhaps you’ve thought, “If I did spend less time per patient, they will think all I care about is the money!”

Or maybe you’ve asked yourself how it is that other doctors are able to see more people per hour and not only get great results but also have patients who happily stay, pay, and refer?

Seeing more patients in less time can be such a conundrum! We want to serve more people but we also want to make sure that were getting the best results we can.

How many patients should you see in an hour?

I personally spent 45 minutes per adjustment when I got out of school and thought anyone spending less than that was ripping people off. I then got to two per hour and eventually settled at about 23 per hour (doing NSA when the average NSA doc was seeing 20 per day) and of course by then I recognized that it was not the amount of time I was spending but it was the results I was getting.

Now this might sound strange but my worst day in practice was actually my busiest: the day I saw 179 people in one day!

You see, I believed that if you were not seeing 200 patients per day you were not a real chiropractor (crazy hey!) At the end of the day I literally thought I was going to die! I ran an hour over and I was completely wiped out.

I cried that night knowing that I would never be a “real” chiropractor.

So when doctors tell me that they want to see more people, I like to rephrase that for them and say in reality: we want to serve more people in less time getting as good or better results.

Finding a Balance Between Time and Experience

This can be such a challenging problem for so many reasons. First we have to figure out how much time we actually need to spend with each patient to get the desired results and second we need to figure a way to help our patients be happy with that much time and that experience.

I ask doctors: if I were to duct tape your mouth AND duct tape your patients mouth, and all you did was give them a great adjustment, how much time would it take? (Duct taping your patient’s mouths is not a recommended strategy for practice growth!) I also ask them how much time they spend adjusting their family members.

I then ask them: how much time do you actually spend with your patients? The answer is usually 2 to 3 times more time spent then what the doctor really feels they need.

In other words, the doctor may say I truly need two minutes to give a great adjustment but I’m spending 5 to 6 minutes per person right now.

When I ask them why they are spending so much time the two most common answers are first that they need to talk with the patient in the extra time to “educate” them and second that they don’t feel the patient will be happy unless they spend that much time with them or they will think it is all about the money.

Does any of this ring a bell for you?

So what is the answer?

Establishing Goals for Your Adjustments

First I recommend getting extremely clear about what you want to accomplish with your adjustment.

Now I realize what I’m about to say is highly controversial and will offend many but from my experience we can either go deep or we can go wide. We hear the super high-volume doctors make fun of doctors spending more time and they say something like, “You only saw 50 people per today? I saw 50 people in the first half hour, what are you doing with the rest of your time?”

Don’t kid yourself – there are all kinds of tremendous styles of chiropractic out there that get different types of results. Some doctors need to spend more time doing specific things with their patients and they will get deeper and better results. I personally saw Scott Walker (NET Fame) eight hours a day, for four days in a row and I was his only patient for the week. He literally saved my life.

So first: get clear about the type of results you want to get AND the technique that will get you there. Do NOT hope to see 30 people per hour using a technique that takes 10 minutes per person. It will not work.

But the truth is most doctors do not spend more time because their technique requires it; they spend more time because they are insecure and they feel if they spent less time their patients would not be happy.

Three Important Steps

  1. Clarify exactly what you want to accomplish each and every visit.
  2. Figure out how much time that truly takes assuming you are not talking.
  3. Make sure that you are only talking when your hands are on your patients. So if you need five minutes to give an adjustment you want to be able to talk while you are giving your adjustment and literally spend five minutes with your patient.

You must cultivate patients so that they understand how you do things in your office. You are not here to talk about all of their symptoms every time, you are not here to talk about the weather or sports, you are here to make sure that their nervous system is getting the best adjustment it possibly can and along with a great spine adjustment you are giving them a great mind adjustment.

Record an hour of your adjusting time and listen to it. You will find you are repeating certain concepts over and over again. I.e. I found I talked about retracing, subluxation vs. compensation etc. with a lot of patients throughout the day. So as soon as I recognized this I made up a handout for my patients.

Remember the only way to get amazing results in the shortest amount of time is to be able to stay in the zone or in present time consciousness! This is where magic happens. THIS IS A HUGE PIECE OF THE PUZZLE! And we spend quite a bit of time helping our docs find the zone and then stay in the zone! Automate your process as much as possible. Do killer health care talks, have handouts do whatever you need to do so you can be 100% present with the person in front of you, give them the best spine and mind adjustment possible and move on! I promise you it is NOT about the amount of time you spend. Instead it is about their perception and their experience of what just happened and it is about their results! People are happy to pay for a great experience and great results. The odds are you CAN spend less time and get way better results!

Hope this helps, I’d love to know your thoughts.

Much love and aloha


Oct 17

How to set MEANINGFUL Quarterly Objectives AND Follow Through

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies

I just had a great a great conversation with a client of mine who said,

“Russ, I see the value of quarterly objectives, really I do! I don’t want a rudderless ship! I have tried setting objectives in the past but felt pretty clueless and the truth is after we set them up we never looked at them again. I am really confused as to how to go about setting up reasonable objectives and then following through with them, can you help me?”

Below is the long and short of our discussion that I hope you will find valuable.

Get the Team to Grow the Practice

When setting quarterly objectives first you must make sure your team is on board. If you are in our program please take your entire team through “Get the Team to Grow the Practice”.

The first part of that module is all about getting the team on the same page philosophically and making sure they are all EXCITED to grow the practice.

Remember: seeing more people means more work so we MUST make sure they really get the big picture about what our Mission, Vision and Purpose is and they WANT to grow.

Since seeing more people means MORE WORK, you really want to have a great bonus system in place.

Now… how to set up meaningful, realistic and doable objectives:

Step 1: Get clear about what you want the BUSINESS to accomplish over the next 90 days.

There are two categories:

  • I.e. get new software, change the carpet, record the visit two presentation etc.
  • Make a list of all of the projects you want to get done over the next 90 days.
  • Prioritize that list by what is most important to get done first.
  • Put down how much time the project will take, who will be responsible to get it done and when it will be done by.


  • Number of new patients
  • Number of patient visits
  • PVA or retention
  • Missed appointments %
  • Etc.

In general, we recommend coming up with up to five quarterly objectives for the business. If this is your first time setting quarterly objectives, error on the side of too little versus too much. I want your team to feel successful with this system. The last thing we want to happen is that they feel dejected that they couldn’t get everything done. You have plenty of time to add more if you like and course correct in your next set of objectives.

It is said that most people OVERESTIMATE what they can do in a day or a week but UNDERESTIMATE what they can do in a month or a year. Imagine how much you could get done if each person on your team got done one thing every week for 52 weeks. It is astounding! In fact I dare you to have each person make a list of 52 different things they could do!

Step 2: We now need to ask ourselves the question, “What will EACH person do on our team to make this business objective happen?”

This is how we come up with personal quarterly objectives.

Here is an example:

One quarterly objective for the business is to bring in an extra two new patients per week. So the question is: what will each person commit to in order to make this happen?


  • Ask for referrals.
    • Review “No stress secrets to easy and instant referrals”.
    • Commit to asking for 2 referrals per shift.
    • Set a safety net (I realize I may not remember so my tech CA has a window pop up to remind her to remind me before and after each shift).
  • Commit to the Fast Track to Health Talk each week.
  • Do an internal event with special offer for family and friends.
  • Monthly theme.
  • Go out and do one screening per month or two outside talks etc.
  • Etc.

Front Desk CA

  • Ask for referrals
    • Review “No stress secrets to easy and instant referrals”
    • Commit to asking for 2 referrals per shift.
    • Set a safety net (I realize I may not remember so my tech CA has a window pop up to remind her to remind me before and after each shift).
  • Get great at setting up talks and commit to X number of active patients, X number of friends and family of patients to each talk.
    • Read and implement, “How to get people to your health talks” article.
  • Review how to give out the internal event flyer and inspire people to refer.
  • Review how to talk up the monthly up theme and commit to X people per day.
  • Learn how to open up conversations with people outside of the office and bring in referrals.
    • Review “No stress secrets to easy and instant referral”.
  • Etc.

You would then do this for each team member.
AND you would do it for each of the objectives.

How do we recommend each person figure out what they need to do to determine what their objectives should be? Get clear about the BUSINESS objective (i.e. increase new patients) and then:

  1. Ask each person what they think they:
    1. Need help with?
    2. Need to improve upon?
    3. Could possibly add to what they do? (I.e. learn to open conversations outside of the office.)
  2. Look at their Bonus Appraisal form which is really just a task list. Look at every BEHAVIOR and TASK that you have listed for them, have them grade themselves, you grade them and in essence use it as a springboard to help figure out BANG for the BUCK where they should focus and the things that need to become quarterly objectives.
  3. Ask each team member what THEY think the other team members should work on, improve or add. (Wait to do this in group until you know everyone trusts each other etc. We don’t want fights!)

Yes, in our module on this we have the entire goals program, how to set up SMART goals, how to DIVE deeper into goals etc. But this article is only meant as an overview.

Step 3: It is critical that we have regular weekly meetings to review our objectives.

THIS IS WHERE MOST DOCTORS BLOW IT! They set the objectives and don’t look at them again for 90 days if they ever look at them again at all!

In our meetings, the second step is to do a “Brag Session” where each person brags about the one thing they promised they would do last week and how well they got it done and then they get clear about what they promise they will get done next week.

Obviously if they were not able to get it done as a team you would need to figure out why and make sure it got done the following week. Two weeks in a row of not getting something done would require using the “Action plan for improvement form” as we will not go week after week not getting things done.

Again, imagine what would happen if every single week each person on your team not only knew the highest priority items to get done but they actually did them.

Classically, people never get ahead of the game and because they don’t they are always putting out yesterday’s fires.

The 10,000 foot view of growing any type of practice is simply this. Reorganize and make space then fill it. Reorganize and make space then fill it. Repeat!

So here are some ideas in setting your quarterly objectives.

  1. Make a list of all of the things you need to do to get caught up. Prioritize that list by what is most important to get done first. Put down how much time the project will take, who will be responsible to get it done and when it will be done by. Make sure that you also have a “Parking Lot”. This is a To Do List that you MAY get to at some time. Get it all on paper (or word document) out of your mind so you can focus on THIS prioritized to do list from your quarterly objectives.
  2. Implement your Quarterly Objective System.
    • Get clear if you are in a “Reorganizational Phase”.
    • Ask each team member if they are bored, in the zone or stressed. You cannot SUSTAIN growth if ANYONE on your team is chronically stressed!
    • If no one is stressed look at the 90 day objectives. Ask each team member when you get to the next level will anyone be stressed? If so you MUST reorganize and make space, become more efficient etc. so they will not be stressed when you get there. If they are stressed you are sure to crash and stay on the roller coaster of growing, crashing, growing and crashing!
  3. Stay ahead of the game by having REGULAR meetings!

Too many doctors never gain ground because they are always chasing their tails! Don’t be one of them. Implement the above procedures and you will create the practice and life of your dreams!

If you got some good energy from reading through this, you really should go grab a free program that I put together for some of my coaching clients. It’s literally called “Creating Time” and it helps a lot with setting goals!

Oct 17

Stroke Ammunition

By Dr. Russ Rosen | Chiropractic issues , Communications

I was going back and forth with Dr. Christopher Kent about info I could send to my docs about this whole stroke issue.

If you have not heard, it has blown up in California; I am sure there will be a ripple effect.

As far as I am concerned there is no one on the planet who knows more about this and who I trust more than Dr. Kent. Below is an email that he put together and we wanted to forward it to you.

Here is an interview I did with Dr. Kent several years ago and although it is dated there is still tremendous information.

Much love and aloha,

Russ and Angie


Here are a few other articles that some docs sent me:

Email from Dr. Kent:

Dear Colleague—

Many of you have been trying to contact me regarding recent media coverage alleging that chiropractic care causes strokes. This e-mail is to address such requests. One of the latest and best papers on chiropractic and stroke was authored by a group of neurosurgeons. Their conclusion: “There is no convincing evidence to support a causal link, and unfounded belief in causation may have dire consequences.”

The paper is available free online. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Here is the link.

The best available evidence reports that people may present to an MD or DC office with a stroke in progress. See this link.

Failure to recognize the signs of a possible stroke, chart them, and manage them appropriately can have devastating consequences. An excellent resource is a summary by the professional liability company, ChiroFutures. The link to the article is here,

At a minimum, you should study these materials carefully.

For those who would like to purchase an online course addressing types of stroke, mechanical forces affecting the vertebral arteries, what occurs during a dissection, the issue of causality, imaging, and most important, how to recognize a stroke in progress and what not to do, visit: this page.

Best Wishes,

Christopher Kent, DC, JD

With all this said gang… (Back to a few thoughts from Russ…)

The question comes up as to how to deal with this in your office if patients bring it up.

As always I would use the LAASR process.

Listen, Acknowledge, ASK, Solution and Resolution.

Don’t dive right into a sermon.

Instead I would recommend Acknowledging what a tragedy this persons death is.

Then start Asking questions i.e. what do they think happened? Do they think a chiropractic adjustment could cause that? Are they concerned that your adjustment might cause that for them?

Clarify THEIR concerns first.

Then address those.

Having the above studies will help in punching a hole in their faulty premise or belief system of, “Chiropractic adjustments can cause strokes.” But my experience is if you get defensive or offensive they cannot HEAR what you have to say.

Hope that all helps!

Much love and aloha and thank you for being on the front lines and for all you do!

Russ and Angie

Oct 17

Making Health Screenings & Outside Talks Work for Your Chiropractic Business

By Dr. Russ Rosen | Chiropractic issues , Communications

We have all heard the quote, “Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime”.

Can we really do well with outside talks and screenings? In this day and age do they still work?

YES! Emphatically yes! But you need to know HOW to get in and HOW to do them.

I speak with docs all the time that first don’t know how to set them up and second don’t know what to do if they do set them up. How about you?

I personally did not realize that “The Amazing Dave Mager” not only came out and did screenings and talks and taught offices how to do them, but he ALSO sets up talks and screenings with Corporations and nearby companies and teaches you how to do it!

In this interview Dave Mager and I talk about:

  • How to set up talks and screenings
  • What information to give to businesses
  • What handouts we recommend giving at talks and screenings
  • And what your mindset needs to be

Not only that, but Dave has offered to give you FREE OF CHARGE examples of:

  • Cover letters, introduction letters and letters to the businesses
  • Flyers
  • Spinal Health Survey
  • Basic instructions for screening flow using the substation
  • Information on Corporate Wellness programs
  • Checklist for doing screenings
  • Before contacting businesses you MUST do the following list

Did I mention that he gives you all of that for FREE?!


Listen to my interview with Dave Mager where we talk down the subject!


We also did an interview together where we discuss HOW to do screenings.


You can contact Dave at [email protected] to receive his special package of FREE content that he put together for our doctors.

And as a SPECIAL OFFER to our doctors, you can save $150 when you ask Dave to come out to your office to:

  • Set up talks and Screenings
  • Perform Talks and Screenings
  • Teach your team to set up Talks and Screenings
  • FIRE UP your team and rock your world!

Nothing to it but to do it! Take action!

Oct 17

When Life Gives You Lemons

By Dr. Russ Rosen | Chiropractic issues , Chiropractic Strategies , Communications

When life gives you lemons: Every moment contains the ingredients for a positive lesson and an epic new adventure.

Recently my daughter posted this in her blog.

I thought we could all find value in it. Has life given you any lemons recently?

Hope you enjoy…

When life gives you lemons… squeeze out all the juice you can possibly get!

Life throws (sometimes hurtles, sometimes aggressively catapults) experiences our way in hopes that we will grow from them. But at the first sign of discomfort, we often wriggle out of the lessons’ hold, squirm out of the teacher’s reach, and head to safer ground.

Phew! We made it. “Think again!” life chuckles as she gently taps on another domino nearby–watching with upturned lips as the chaos gracefully makes it way into our unknowing lives.

And there it is again–cloaked in different colors and shapes, but the underlying lesson is the same. And it will come and find its way into your life no matter how many times you escape its terrifying grasp. That is, and this part I hope is true, that is unless you give in, let those arms pull you in to the dark depths of the unknown, learn that damn lesson, make it your bitch (so to speak), and become the master. Once you have mastered the lesson, it will no longer be hungry for you. It will no longer seek you out.

And then… as life goes on… the lessons will continue. New lessons will keep rolling in, all brilliantly disguised that you may forget they are simply lessons, and you will just see them as the brightly colored masks they put on. They may appear to you wearing the tearful mask of a tragedy or the grief-stricken mask of an epic heartbreak. They may turn up one day as a loss of a job, and the next day a gut-wrenchingly difficult decision.

I believe the key is to first recognize it is only a mask, and second, to look inward and decide for yourself what priceless and life-altering positive lessons we can learn from them. The tragedy slips away to reveal inner-strength. The heartbreak flutters lightly on leaving the wing-prints of maturity and self-love. The decision that kept you up at night pushes you to take command, be purposeful with your life, and choose a direction.

Take off the masks that greet you. Don’t run in fear. Smile and embrace them as moments given to you to help push you up, reach greater heights with even greater perspectives, and become more powerful and whole versions of yourself.

When life gives you lemons–thank life for her sweet gift. Even when it stings and even when it burns, do everything you can to get every life-altering drop out of them. Each drop will stimulate you and inspire you to evolve. So if you truly squeeze every lemon’s lesson out, you will never have to look back on an experience with sorrow or anger. You will be able to look back, smile, and say, “I am so grateful this happened. Look what it taught me. Look who I have become.”

Wow! I am so impressed with my little baby! Clearly she got the writing gene from her mom!

So here are my questions to you…

  • What lessons have you learned recently? What lessons are you in the middle of learning right now?
  • What lessons have you shied away from that keep rearing their same heads cloaked as different experiences but truly they are the same?
  • What will you embrace this year to make it your best year ever?

Know that we are always here to help. If you want the rest of 2017 to be as good as it can get, please contact us for a free consultation. You will be amazed at how we can help you make SWEET LEMONADE with more ease, less stings, and fewer burns!