Posts - The Optimal Health Chiropractic System
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!

 

-RR

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,

Russ

Apr 23

Back in the Saddle Update from Dr. Rosen PLUS Should I talk about symptoms?

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies

Should we talk symptoms?

I often get asked this question by doctors who are considering coaching with me.

More often than not they sheepishly ask this question as CLEARLY they are not comfortable NOT talking symptoms but feel that if they are a true, “Vitalistic” or “Straight” or “Subluxation based” chiropractor they should not talk symptoms.

Or they are religious zealots telling me how it is not “Real chiropractic” if you talk about symptoms!

Regardless, if we sheepishly ask that question or act like a religious zealot and to cram it down peoples' throats, we are all “Buck-toothed, inbred chiropractors”. Whether we consider ourselves one of the above types of chiropractors,  a technique freak, or a philosophy freak, we all seem to think that everyone else either sees things the way we do or are TOTALLY wrong!

Here is my opinion when it comes to speaking with patients about their symptoms.

I guess I should start off by saying: for several years, I did talk about symptoms in relationship to the subluxation and nervous system. Then, for 3 years, I would not talk about symptoms. I told my patients “If you are here for any other reason than connecting with spirit at a higher level, you are in the wrong office!”

Here's another way to look at that: if you were rushing into the ER on the brink of death, how would you feel if the doctor started out by asking you “Would you like to connect with spirit at a higher level?” After thinking through that, I then started talking about symptoms with patients again. 

I had a really funny experience when I was speaking in New Zealand. The speaker right before me was the legend Reggie Gold. Reggie was going on about how we should NEVER talk with our patients about any of their symptoms. That is just not what we do!

I was there at one time in my practice. The idea makes perfect sense. “I would not talk with you about what drugs to take, how to cut your hair, do your nails, or tune your guitar. All I do is address subluxations and not your symptoms.” Great rap, makes sense from a very limited point of view and has some great indignant and righteous teeth to it!

I was sitting in the audience listening to (at that time) a living legend, I was dripping sweat. You see, I was just about to go on stage and do my hour lecture on just how to talk with your patients about their symptoms, how to connect their symptoms to the nervous system from a vitalistic perspective, and why it is so critical to know how to speak with our patients about their symptoms when my dear friend Angus Pyke elbowed me in the ribs and whispers in my ear, “Mate, I would hate to be you right now!”

I think the real question is not “Should we talk about symptoms?" It is, “How should we talk about symptoms?" How do we put symptoms in context from our world view and through the lens of vitalism?

I think it is very harmful for our profession to NOT to talk about symptoms and I believe the pendulum swing from never talking about symptoms to only talking about symptoms and relieving their symptoms with no context of the subluxation and vitalism is a huge mistake and very harmful.

Let me ask you this question: If your patient is getting healthier, does it make sense that- in time - they should feel better, too? Yes, I get it can feel worse before it feels better and I get retracing or reactivation. I am just asking us to get out of our dogma for just a moment and answer this question. In most cases, if someone is actually getting healthier shouldn’t they eventually feel better? I believe most of us would say yes.

The problem is that so many doctors that do talk symptoms use it as THE indicator of their patient’s health.

If you are feeling better, then you must be better. You must be healthy. Nothing could be further from the truth! Just ask uncle Joe: never sick a day in his life, goes to the doctor, does all the tests and exams, leaves with a clean bill of health and on the way home, dies of a heart attack.

Did the heart go from 100% healthy to dead in an hour? I don’t think so! People can go from feeling a lot of pain to little to no pain because of adrenalin or endorphins. Fall in love, go shopping and buy something, break up with your lover, these can all dramatically effect symptoms.

So using symptoms as THE indicator as to whether our patient is getting healthier or not is not a good idea.

But I believe it should be AN indicator. I want to have tons of reliable OBJECTIVE tests as well as a very detailed outcome assessment questionnaire that not only looks at how they may feel different over time but also how their quality of life is changing over time. But yes I also want to hear from them how they are feeling. I think it is a critical indicator that too many of us either will not talk about or if we do that is nearly all we talk about.

Along those lines one of my favorite lines relating to symptoms goes like this. Patient walks in and says, “My RD (real doctor) said nothing is wrong with me.” And I say, “So it is all in your head? I am so sorry that your doctor misinformed you like that. What they meant to say was I am sorry I am so arrogant as to believe that there is nothing wrong with you and everything is in your head. The truth is my limited tests do not show me where the real problem is. And since I cannot be wrong. It must be you!”

Thanks for getting this far, doc! I hope that this content was helpful and interesting to you. Shoot me a message and let's talk about it some more. I'm always happy to hear from another member of the profession who is ready to better connect with their community and grow their practice!

Jan 02

Chiropractor Business Coaching – What Good Does It Bring?

By Dr. Russ Rosen | Chiropractic Strategies , Communications

One of the things that I really enjoy about our profession is the reality that there are so many interesting and innovative ways to help our communities.

There is no “right way” to adjust someone.

There is no “right way” to run a practice.

There is no “right way” to change the lives of our patients.

Instead, we have amassed this community of passionate professionals who do whatever it takes to become the change that their neighbors need.

There is, however, one thing in common that virtually ALL highly successful doctors use in their toolbox: a personal coach.

Hear me out on this.

While our industry is very well established, there are constant innovations in technique, tools, and products that result in a wide variety of options for how and why to operate a chiropractic practice. When you try to go at it alone, you run into all kinds of issues with these choices. As an “army of one”, you are left to your own devices to evaluate, understand, select, and implement the tools and techniques that will help you grow your practice. This can be excruciatingly challenging when you operate in a silo.

Modern chiropractors benefit significantly from having personal coaches. Instead of making a compelling, sales-y argument for why you should hire a personal coach, I want to share the stories of some of my coaching clients.

Dr. Jake Smith talks about building his own practice. He’ wasn’t new to the business, though, and had this to share:

“I worked as an associate chiropractor for many years before I opened my own practice.

To me, the best part about coaching is that I have been able to find and create my own chiropractic Identity. I feel more genuine when I interact with my patients.  This was TOTALLY unexpected; my main goal was only to grow my bottom line.”

I love hearing stories like this one from Dr. Smith because it conveys something that I wouldn’t think to share. Coaching isn’t simply about telling you what to do, when to do it, or how to do it. Dr. Smith found his chiropractic identity in our work together and that has made him more successful as a result.

Wherever you are in your career, you can benefit immensely from the right kind of coaching. Dr. Thomas Williams has hired other coaches in the past, and was initially hesitant to get started with me. After a short while, he shared the following:

“Hiring Dr. Rosen has been one of the best decisions I have made.  My practice has grown, but the biggest growth has occurred in me personally. My certainty has never been greater. Dr. Rosen is a master communicator who has taught me how to effectively communicate with patients and have them understand what I do and want what I have to offer. “

I place a TREMENDOUS importance on certainty and I know that this comes through with my coaching clients. Dr. Michelle Ten-Klooster said:

“I think the most helpful take-away so far for me has been the change and work that I have done on my mindset and the realization that nothing can or will ever change until I change my thought patterns and look at where they are actually coming from.”

Dr. Brandon Hill, another coaching client of mine, shares his thoughts on where we place our emphasis during our time together:

“When you are scheduled with Russ, it is 100% of the time focused on YOUR goal.  He focuses on teaching you ways to really understand the patient and to figure out what they want. Other coaches I have been with focus on the general script, where the script is the main focus while the patient is secondary. Russ, gives you a guide on how to ask the right questions and to have the person understand what chiropractic isRetaining the people in the office has been much easier learning from Russ. I have a better understanding of chiropractic and I have improved dramatically on communicating that to the patients.”

When you really “get” what it is that you should do to help your patients, you’ll find new energy to pursue it. This is another incredibly important point that many doctors miss when they think about coaching. This isn’t about memorizing scripts at all; this is about changing the way you look at the concept of chiropractic and ensuring that your patients see it the new way as well. I hear a lot of scary stories about bad experiences with other coaches.

Dr. Marla-Robertson-Tarpo from Laguna Hills, California, shared that one of her colleagues just fired their coach out of frustration. She described the situation:

“So here’s why my friend is not going back to his coach: he’s tired of feeling beat up. When we are in a learning phase we need a learning environment. One doesn’t learn well under stress. “

She goes on to talk about the difference between what we have done together and what her colleague has experienced.

“With you, I find out where I’m at and have an uncanny sense about what I need to hear that will propel me forward. 

For instance, I wasn’t ready to do the TTAT even though I’ve been organically incorporating it more and more. So you shifted our time to where my energy lit up, in giving me more testing that i can do, which is fuel for MY power right now. 

Here I was thinking I needed to take a month off because I’m implementing this new software… but BOOM!!! You come in with the perfect value for me at this time!! 

As I go through where I am drawn to study, for my growth, I am able to send you emails and you help me on the spot!! I get my questions answered and I keep moving forward. You’re like the Chiropractor I wish I had… someone who sees in me what I need and addresses that. You’ve seen the big picture… I haven’t.

How to Find a Chiropractic Business Coach

If you don’t have a chiropractic coach guiding and directing you to prosperity, I want to invite you to reach out and chat with me one-to-one as soon as possible. If your chiropractic coach sounds NOTHING like what these other doctors have experienced and you realize that you want something different, then this is the right time to reach out. Together, we can get you, your practice, and your vision aligned and moving forward. There is no better way to ensure success in 2018 than with the RIGHT chiropractic business coach in your corner.

Dec 06

How to Deal with Patients Who Tell You They Don’t Have the Money BEFORE the ROF

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

In the past week, I have had a similar conversation with 3 of my chiropractic coaching clients so I thought I would write about it.

Part of our responsibility as practitioners is to be able to communicate clearly with our patients.

Today’s digital world can be dangerous for personal health because there is so much misinformation everywhere.

As a result of this misinformation, many patients come to us with expectations for the treatment’s length and cost. We talk a lot about chiropractor communication strategies and how to utilize them so that patients truly “get” what we do and want what we offer.

Chiropractor Communication Program

But what happens when a new patient brings up money even before your consult or ROF?

My ROF process specifically addresses cost by building value, understanding the true motivators behind the visit, and helping my patients understand that I am NOT viably substituted with a bottle of Advil. If you can’t get to that part of the process, what do you do?

This can be a bit tricky. I have just seen so many chiropractors ruin their relationship with the patient by using statements like, “Listen you want to get better or you don’t.” or, “You can’t afford NOT to get this care!” My favorite very well may be “Okay, tell me what you want and we will do that”. From our perspective as the certified experts, NONE of these lead to long term relationships and NONE of them honor the patient and their health!

When the cost of chiropractic care comes up at the front desk or during a pre-consultation with your CA, I would recommend that you address it right off the bat during your consultation.

Build rapport by relieving concerns and addressing fears. This would sound like:

Mary I understand that finances are a concern for you, please tell me what’s up.

Listen to what they have to say, commiserate, and say something like this:

Can I make a suggestion?
Why don’t we do a detailed consultation and thorough examination so we know exactly what is going on with you.
In my report of findings, I will tell you EXACTLY what’s going on and if we can help.
Then, you and I will get very clear about the level of health that you want to obtain.
I will show you what it will take to get there.
At that point, we will get clear about what it would cost to get to that level of health.
If we agree, then we will work together to make sure that you can get the care you need and respect your budget.
How does that sound?

A Critical Moment in the Report of Findings

During the report of findings – right at the beginning – you are going to let them know that you understand the finances are a real concern and that you simply want to help them understand the truth about what’s going on as well as the consequences of the choices that they have. This gives you the time to help them “get” what you are trying to do for them. Once this clicks, you can show them what it would take to get to the level of health that they choose. By taking it in stages, you can always customize a plan that will fit their budget.

This allows you to go through your entire report of findings without them worrying about money or that you’re going to try to hold them captive to make them do some type of care that they don’t believe they can afford. You will be amazed at how many people will find the money to get the care that they truly need once you take them through the entire process. (There’s a lot of time dedicated to this pivotal point in our Optimal Health Communications Program.)

An Example of Implementing This Chiropractic Coaching Concept

I teach my chiropractor coaching clients to record their patient interactions whenever possible. In one such recording, the patient let the doctor know right at the beginning of the ROF that finances were a real concern. She was a single parent with three children and she just truly could not afford the care.

He started talking with her about how important the care is for her now as well as for her future self.

You could hear her getting more and more frustrated… almost to the point of crying.

They were going nowhere! What came next was something that we have all experienced. The patient became extremely aggravated at her situation (NOT the doctor, by the way). She said that there are people in the world who “have” and there are people who ” have not” and she is one of the latter. She would have to get another job to afford the care she needed, but that would only make matters worse.

I want you to recognize that the doctor had not yet started the report of findings.

He had not yet gone into any details about how much care she would need or how much it would cost.

So why did she become so upset?

In this situation, her fears and misconceptions are telling her what to expect to hear from the doctor sitting in front of her. She has convinced herself that there is no ACTUAL scenario where she can get healthy and stay healthy. When this happens, we MUST de-escalate the situation before we start any type of conversation.

How do you de-escalate a patient who isn’t ready to listen?

We de-escalate the situation with the L.A.A.S.R. framework: Listen, Acknowledge, Ask, Solution, Resolution. By first listening, we are able to do something truly amazing. (LISTEN)

“Mary, I know how frustrating this must be for you.
I know that you are in a lot of pain and I know you really do want to get better.
I know you’re single mother with three children who eat like horses and the thought of having to get another job to pay for the care that you need is simply overwhelming.  (ACKNOWLEDGE)
I’m so sorry you’re going through this; I need you to know that you are not the only one.
Can I make suggestion? (ASK)
Why don’t I just go over my findings with you and show you what it would take to get this problem taken care of.(SOLUTION)
If that ends up being more than you can afford right now, we can customize a care plan that will fit within your budget.
I promise you if the amount you can afford is not going to be valuable to you – if it simply going to be a waste of your money – I will let you know. (RESOLUTION)
Mary, how does that sound?”

As always, we will use the L.A.A.S.R. process. You’ll notice the first thing I did was L for listen. I then A- acknowledged or commiserated what she was going through. I then A- asked her a question to see if that would find a S- solution and then I just checked in to see if we R-resolved this problem.

Without the L.A.A.S.R. framework, you are left with pretty terrible options:

•Roll over, agree with the patient, then just give them what they can afford right now and send them on their way

•Blast the patient with scare tactics and shame them into submission (I will NEVER agree with this option, by the way)

Neither one of those have any value for you OR your patient. Use L.A.A.S.R. and you will find you get much better results.

We go into great detail about the L.A.A.S.R. process as a key part of our Optimal Health Chiropractor Communications Program. Take a look – if this article has been helpful, it may be what YOU really need to move forward and help your patients “get” what you do.

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 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.

Repeat

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.

Reorganize

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!

Repeat

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.

I reference this article in my complimentary resource called “Creating Time for Chiropractors” – click the image below to grab it if you don’t already have it.

Oct 27

Chiropractic Practice Building (good chat)

By Dr. Russ Rosen | Chiropractic Care , Chiropractic Strategies

One of my all time heroes, amazing communicators and Legends in our industry, Bill Esteb, and I had a very fun and interesting conversation that ended up being a really great blog. Do you ever have a really good chat with someone and think afterwards “Boy, I wish I had written that down!”? Well, I had that thought, but was fortunate that we DID write it all down!

We talked a lot about communication and just how important it really is in all aspects of practice building. In fact, it’s probably one of the most misunderstood and overlooked parts of a successful practice that few figure out on their own. I built The Optimal Health Chiropractic System with it as the “hub” of success, so that I could help docs nail their communication and grow their practices quickly and effectively.

Without further ado, I present my conversation with Bill Esteb as part of his “Chiropractic Practice Building” series. Take a look and let me know what you think!

Chiropractic Practice Building with Dr. Russ Rosen

Oct 25

An Interview With Dr. Phil Ricchiazzi

By Dr. Russ Rosen | Chiropractic Strategies , Communications

One of my strong suits as a chiropractor and coach is the ability to connect my linear left brain with my intuition or right brain and have miracles. Whether it is what I adjust, when I adjust, what not to adjust, what to say, or what not to say, I’ve been gifted with the ability to just “know” when it’s right.

Since 2000, I have helped many doctors strengthen their intuition and integrate both right and left brains so they move from “just a regular chiropractor” to “Kahuna status.”

I recently interviewed Chiropractor Dr. Phil Ricchiazzi – a coaching client of mine – who is definitely in the Kahuna status.

We discussed the exact steps he went through to get to the point where he can lay his hand on a patients spine and get “guided” by innate wisdom as to what to do and what to say.

His stories (and I know they are true) will astound you. You can do this too!

Oct 17

Experience what it is like to speak from your heart and BE YOURSELF!

By Dr. Russ Rosen | Chiropractic Strategies , Communications

Aloha Gang,

You will notice I start all of my emails and posts with “Aloha”
Here in Hawaii that actually means something very dear to us!

If you would like to experience the true “Aloha Spirit”…
If you would like to see how a person can truly speak from his heart and touch others…
If you want to see how a person can just be himself with pretenses…
If you would like to learn what it is like to BE YOURSELF vs. a Carbon Copy of what others think success looks like PLEASE WATCH THIS VIDEO!

Check out this 9 minute Commencement speech by Mayor Billy Kenoi, of Hawai’i Island as he inspires graduates at Hawai’i Pacific University’s commencement, May 15, 2014. “Love, aloha — it doesn’t cost any money and it doesn’t take any effort. And the most amazing part? The more you give, the more you get and the more you give, the more you have … and you can never ever run out.”

I am also posting this on our Facebook page.

I am interested in your thoughts.

I sent this out to my docs and here is one of their responses…

“Hey Russ,
Watched this last night and I L-O-V-E this man!
What an inspiring, fun message!
A great reminder and wow, hey guess what?
I can be myself and not have to be some cheap carbon copy of someone else?

But, but, but, that’s what a lot of the big talking heads from the pulpit tell me I HAVE to do to be successful in practice and have a fulfilling life….
LOL!

Thanks for the sharing and thanks to the doc who posted this on FB.”

-Dr. Janice

Hope you enjoy this and take it to heart!

By the way – have you spent time thinking about your own headspace lately?

Much love and aloha,
Russ

Oct 17

Do you Struggle getting patients to your WORKSHOPS?

By Dr. Russ Rosen | Chiropractic Care , Communications

Has this ever happened to you?

At the start of the day, you have 10 people scheduled into your workshop. You’re pumped about the opportunity to share the chiropractic message and are looking forward to providing boat loads of value. But…as the day goes on you can hear your CA on the phone taking call after call as your patients continue to come up with excuses about why they can’t make it to your workshop tonight. By the time the workshop comes around your delivering your talk to 2 people….arghhhh!

If this sounds familiar then know that you’re not alone. This scenario plays out in this form or very similar ones in chiropractic offices around the globe!

So how do we get patients to our talks?

I have doctors and their entire teams tell me all the time that people just won’t come to talks in their area. And my response to them is this… nonsense! The truth is they just don’t know how to get people to their talks.

If this has happened to you enough then you’ve probably starting telling yourself that running workshops aren’t a good use of your time and you’re better off leaving the office early and spending some time with your family.

Well…the good news is, there is another way.

Don’t kid yourself though, if you really want your patients to GET IT…
• If you want them to see the value of a healthy functioning nervous system and reasonable lifestyle…
• If you want to be able to see a reasonable volume of patients and not have to spend tons of time with each patient every visit “educating” them…

Then you MUST do a killer series of talks!

If you want to get your patients to your talks you MUST have the right headspace as well as the right procedures to get them to your talks.

I’ve written an article that will show you EXACTLY how to get boat loads of your patients and their family and friends to your talks. (And if you have seen this article before I just added a new section of how to get your active patients to the talks, not just the new patients.)

Just click this link and it will take you right there. (Don’t worry, there’s no opt in and there isn’t even anything for sale, I just wanted to “hook” you up).

 

Love to hear your thoughts and comments.
Much love and aloha,

Russ and Angie

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