Big Practices Change the World

In Chiropractic we must master 3 domains of learning to truly affect large numbers of patients.  Most Chiropractors barely master the first 1 or 2, leaving them largely ineffective for the last and most important domain.  It is in this last and highest level that we are the most powerful when motivating patients to start and continue through our care.  In our offices we overcome the first 2 levels by mastering scripts.  Scripts are carefully thought out, well researched, precisely articulated slices of communication strung together to provide the exact experience you want to pass on to the patient.  Scripts sometimes get a bad name, as the Doctor fears being a robot; however, done properly just the opposite actually occurs.

Academic Domain

The first level we must master in Chiropractic is the Academic Domain or as we like to call it the Philosophy and Science.  Depending on the school, we mostly get this learning from our academic institutions and by reading the Green Books.  We also get this information by reading Chiropractic Publications, reviewing current research and attending seminars.  Most of us get this on our eight year journey to become a Chiropractor then we continually build on it each year.

Psychomotor Domain

For a lot of us in Chiropractic we call this the art.  This is where we apply what we learned so that we can facilitate healing.  As you know, there many different techniques in Chiropractic, most of which trying to reach the same goal, to remove interference, but we just go about it in a different way.  We learn a great amount of this in school and a great amount of this learning occurs through seminars and conferences for years to come.  This is where we are probably strongest as Chiropractors.  However it leaves us extremely myopic to the rest of what it takes to make a big difference.

Afferent Domain

This is the most important part of the patient experience by far.  This is where huge changes are made and big practices are built.  This level of learning refers to the listening, assessment, decision, and communication we must make in the moment when with the patient.   We also know every moment is different, very few patient interactions are the same.  We get different presentations, different questions, different objections, different reactions, crazy stories and so on.  Often times this domain is referred to as being present, however it is much more than just that.  Don’t get me wrong, not being present is a sure practice killer.  What patients want more than anything is to know that their Doctor cares about them.  We see this when the Doctor goes through a major life stressor, their practice drops, almost always.  Likewise when they are on purpose, their practices grow, often time without doing anything different at all.  However, as we layer judgment, decision and communication on top of this we are then in the zone.  The end patient experience is that they feel incredibly cared for as you swiftly assessed and communicated what was wrong, made the correction and effectively managed their journey back to health. So why do we fail so much in this domain.

Too many Chiropractors don’t own this last Domain.  They are too busy struggling to recall,  research or even make up their communication on the fly.  They are continually thinking about what they are about to say next and how to say it.  Then when they do finally get it out it has little impact as usually not even the sentence structure is correct.  The patient then loses confidence, and it is hard to retain them.

The Power of Scripts

This is where the power of scripts comes in.  Through power of scripts we are able to boil down 8+ years of  the Academic and  Psychomotor domains into precise impactful slices of communication, write it out and practice it over and over to drill this deep into our pre-cambric brains so we can recall it automatically much like riding a bike.  By doing this you leave your pre-frontal cortex uncluttered and most available to the patient visit.

You are not alone

We aren’t the only ones trying to do this.  In media, it is referred to as soundbites.   In public speaking, it is called vignettes.  In presentations, it is called talking points.  In Theater, they are called scripts. For these people it becomes essential as they can easily be distracted by cameras lights, makeup, temperature, crowds, etc.

Start with something easy

We have found that there are only 12 reasons why a patient doesn’t start care.  Gather all of the objection you get.  Boil them down to twelve.  Then when you have time free from distraction begin to think, research and write out the perfect response.  Then this must be practiced aloud over and over.  We do this through role playing patient visits.  Just remember how often you come home after not being able to connect with a patient, then the next morning in the shower you say to yourself “Darn, I wish I had said…..”

Onward and Upward…

D…

It is always exciting when an equipment lease comes to an end and you have some extra free cash available that you were used to paying.  NOT TODAY.

I was looking over my bank statements last week and noticed that an automatic lease payment that was supposed to be finished in April was still being deducted.  I immediately called the bank to verify that it was in fact my lease payment.  I then call Priority Leasing, who by the way is now Priority Capital to ask them to stop taking out my money and to return my over payment.  They explained to me that they had sold the lease to someone else, Marlin Leasing.  I called Marlin leasing and politely asked for them to stop taking my money.  She explained to me that it automatically renewed for another term and that I now had another full year of payments before I am allowed out.  In fact I only have a very small window to “end” my lease each year.  She told me I had to submit my request in writing 90 days before, but not more than 180 day before, the lease term end date.  Otherwise it will keep “renewing” forever. Huh?  When I was sold the lease I opted for the 1$ buyout at the end of 3 years.  Now because I didn’t write some silly letter I get to pay an extra 8400 over an above paying off the equipment in full.

The Evergreen Clause

After having her fax over the contract I signed, I realized that in the very small print it did in fact state that it would renew if I did not notify them in writing 90 before but not more than 180 days before.  Fired up, I decided to do some research.  This is known as the Evergreen Clause.  It is a nasty clause put into agreements hoping you won’t notice or remember until it is too late.  Worse then that, it is legal in most states!

The “Evergreen Clause”, the Industry term for contract language that automatically renews a lease or finance obligation beyond the original lease term.  The contract language varies by lender (see some actual examples below) but the common thread is that the monthly payment obligations automatically renews for additional periods of time (often 12 months) unless specific notification is provided to the Lender.

This obligation is rarely emphasized to you when you sign the contract and likely you are unaware of this provision.  Because of this, many customers do not realize their contract has extended beyond its original term.  Most Business Owners are busy running their companies, not complying with the “fine print” in their contract.

Read Carefully

Below are some examples;

… you must notify us by certified mail between 90 and 180 days prior to the end of the Lease Term if you intend on returning the equipment.  If you do not notify us, the Lease will automatically extend for 12 months…

…No more than 180 days and no less than 90 days prior to the end of the Term, Lessee shall give Lessor written notice of Lessee’s intention… If Lessee fails to so notify Lessor or, having notified Lessor, Lessee fails to return the Equipment at the end of the Term… at Lessor’s option automatically renew for another 6-month period under the same terms and conditions…

Action Steps

1. Go check any current leases to make sure that clause is not in there and if it is make sure you write the letter NOW and put it in a place you will remember to send it during the proper time frame. Then send it certified mail with signature.

2. NEVER sign a lease with that language it.  There are plenty of leases out there without this language.

Well, I hope my $8,400 lesson saves you some money and keeps your blood pressure in check.  Of course if anyone has any ideas how to get out of this let me know.  I sent it over to my attorney today, will keep you posted!

Onward….

I have been underground for a while but finally emerged with some great news.  We were able to get a hold of some great technology that will transform the way patients interact with the Chiropractic office.  I am very excited to share this with you.  It won’t be fully released until October but there is a opportunity to help us finish it up.

Kaizen Wellness Goes Beta!

Kaizen Wellness in an Internet-based wellness platform designed to enhance and maximize your patients’ access to vital wellness strategies, tools and information, especially in between office visits.  The Kaizen Wellness experience begins with a comprehensive assessment of the six dimensions of well-being.  This provides the patient with an overview of their strengths and weaknesses, which allows them to set and track relevant goals as well as receive additional information and resources as determined by their doctor.

Connect Your Patients To Wellness

Dramatically improve the overall health of your practice by connecting every one of your patients to the wellness resources that you have defined.  By so doing your practice will experience an immediate increase in sales of the varied products and services that support your wellness programs.  Kaizen Wellness features built-in behavioral tools to promote change along with unlimited access to a Certified Health Coach.  Patients will stay engaged through regular challenges issued to motivate and stimulate participation in various in-office programs.

Be A Part of History

Kaizen Wellness is currently in Beta Release.  This means that the entire platform is fully functional and we are making minor adjustments over the next few months in an effort to maximize the patient experience.  We are allowing 30 clinics to participate in the Beta Release before we move into regular licenses.  As a Beta Release participant you will receive full access to the platform and can begin to optimize your practice experience immediately.

The Beta Release will be offered at a substantial discount as compared to our regular offering.  In return, all we ask of you is to provide us with your feedback.  We will have regular electronic surveys that will help is incorporate your feedback into the final version of the product.

The Beta Experience

Kaizen Wellness is completely built out and very functional.  What is left is all the little nuances that will make the user experience simple and elegant.  The beta member will receive huge discounts in exchange for valuable feedback.  When kaizen is fully released there will be a configuration and customization fees starting at $1000-2500 and monthly fees of $499.  As a beta member we will wave the configuration and customization fees and lock in a rate of $299 for 1 year after full release.

Click here to get started…

2009 Blair Chiropractic Conference

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Atlanta, Ga

Sept 18-20, 2009

September is just around the corner and we are preparing for the most powerful weekend we have had at any Blair Conference.  Year over year the energy and excitement just gets better and this year is already no exception.

Again this year The Society is focused on making the Conference the best value of the year.  You pay the regular price of one of our technique seminars and we throw in the technique seminar, powerful speakers, awesome networking opportunities and a  huge banquet all while extending deep discounts to the Blair Society’s partnerships like Coaction Software, American X-Ray and the Upper Cervical Store.

Register at

www.regonline.com/blair2009

FREE LODGING FOR STUDENTS!

As always the Blair society has a strong commitment to the students.  The Society will again offer the first 40 student who register, free lodging for 3 nights!  This year we are staying at a BRAND new “W” Hotel!  The W Hotel is a very hip, swanky hotel located in downtown Atlanta.  You won’t be disappointed. Register right now there are only a few spot left!  www.regonline.com/blair2009

]]> http://www.ownyourdreampractice.com/Blog/2009/07/2009-blair-chiropractic-conference-in-atlanta-ga/feed/ 1 http://www.ownyourdreampractice.com/Blog/2009/05/getting-things-done-while-you-sleep/ http://www.ownyourdreampractice.com/Blog/2009/05/getting-things-done-while-you-sleep/#comments Sun, 10 May 2009 19:09:00 +0000 Darren White http://www.ownyourdreampractice.com/Blog/?p=297 I have been so excited to see Brandon Harshe take the lead at his Atlas of Life Blog regarding the need for Upper Cervical Chiropractors to jump into the Social Media World.  He recently has published a series of Blogs explaining in great detail how to get started on a Blog.

When I first jumped into this arena I easily found myself intensely engaged in the learning curve till the wee hours of the morning.   Even with easy step by step directions there is still a lot of tweaking required to get it “live.”  We must keep in perspective what we do best and make sure we are operating from that place.  We need to make sure this opportunity enhances our practices and lives not keeps us up all night.

The Dream Team

You might look at someone like Brandon Harshe, Shawn Dill, Michael Dorausch and other great Bloggers in Chiropractic and wonder how do they do that AND practice?  PlanetC1 does SO much for Chiropractic, and though I don’t know him well, through twitter and the like I “see” he still has a huge practice.  How do they do it?

I wondered the same question as I have been on this journey and below I have compiled my “leverage list.”  I have learned to leverage currency and timezones to get things done while I sleep and for a fraction of the cost.

All of the sites below have a few things in common.

• Low Bids – Most of these sites will generate 30-50+ bids for your project posting allowing you to examine their portfolios and see who is a great match.  Also because there are so many bids they are forced to keep their prices very competitive.

• Currency – Most of the bids do come from India, Pakistan, Russia, Eastern Europe etc., therefore our dollar goes a lot further.  It is not uncommon for someone to do great work for you for less than $5-7 per hour.

• Timezone – Lastly because they are usually  12 + timezones away, they are working in their day while you are sleeping in your night!  Just before bed you write out a project….you awake to find it DONE!

Elance.com

This site allows you to post a job or project.  Pretty much any job or project.  These for me have ranged from helping me customize an excel spreadsheet, cleaning up my Quickbooks, creating websites, creating blogs, fixing glitches and the list goes on.

Odesk.com

This site is great for managing a team of people you hire for ongoing projects.  This is by far my favorite site.  It allows you to post your job, interview candidates, manage their work by seeing their screen shots and activities and most importantly it allows them to communicate between other team members you hire.  This gets addictive because it is so easy to manage a whole team and odesk.com works out sending them a 1099 so you don’t worry about payroll problems.

Crowdspring.com

LOVE this site.  Used it many times for logos.  I have written about it before and they always continue to impress me.  Here you post design projects like logos, landing pages or even entire website then you will receive 40+ designs to choose from.  The CEO @rosskimbarovsky is also a great person to follow on twitter as he tweets the conferences he attends.  You will learn a ton from him.

Asksunday.com

This is a great site for a personal assistant.  They have English speaking project managers that help you leverage economy while still being able to communicate clearly.  I use them mainly for research projects.

I still do most of the work myself as I love it.  This blog post was written from my front yard on a sunny Seattle Sunday morning with a great cup of Earl Gray Tea!  However, to really move fast you must outsource your weaknesses and the things you dislike.

PLEASE comment below if you have any other great resources you would like to share!  Or just comment a thumbs up if you liked this post!

darren…

The real estate market has lost an average of 22% in 2008.  The stock markets were down 46% from their high.  It leaves you wondering, where should we put our money?

3 years ago I consulted with a coach from the Small Business Development Center, who helped me discover my I.R.R.  I.R.R. stands for Internal Rate of Return.  This set me on a very powerful journey that has surely proven true in this economic downturn.  Let me explain.

I.R.R is the return on your money that you put BACK into your business.  So instead of buying shares of xyz stock you go ahead and invest in your own business.  We will work on an EXPONENTIAL gain of your investment.  I know that will beat anything else you see in 2009.

There is only ONE way to grow ANY business.  It all comes down to this equation, which I have talked about previously.  Your business is always a product of the number of new clients, multiplied the number of times they do business with you, multiplied by the money they spend each time.  To put it Chiropractic Terms:

Your Money = New Patients(NP) X Patient Visit Average(PVA) X Office Visit Average(OVA)

We typically use these monthly terms;

NP = The number of New Patients you see in one month
PVA = The average number of times a patient will see you.
OVA = The average dollar amount collected for each encounter

These are the only three areas you can invest money in.

New Patients – Investing in this category might include screening at local festivals or expositions, putting an ad in the paper, telemarketing, website or online marketing, social media, Dinner with Doc etc.

Patient Visit Average – Investments here might be a Brican Patient Education System, upgrading the aesthetics of the office, Neuropathalator, or even just spending the extra dollars on upgrading your paperwork with Patient Media.

Office Visit Average – Investment here might include hiring a billing consultant for 3 hours to make sure you are charging for what you do, adding supplements or pillows for sale in the office, or maybe outsourcing your billing to achieve a higher collection percentage.

NOTE: Hiring a practice management coach may be able to help you in all three categories.  I have been in Five Star for 7 years and I am also a big fan of Dr. Dill’s That Something Coaching Program.

The Magic

It is easy to understand that if you invest in New Patients then you will get more new patients and receive a linear growth. NOW, watch this for EXPONENTIAL growth.  Let’s say we spend $1,000 per month attending festivals and screening events that gets us a mere 5 more new patients per month.  Then we invest $300 in Daniel Clark’s New Patient Book for each New Patient along with $1000/yr spent sending out a newsletter to tackle our retention (PVA) category.  Finally, we invest $1,000 in a billing and coding consultant to help us make sure we are billing correctly and collecting timely patient payments to increase our collections.

NP        X        PVA           X            OVA       =          $$

Last year        20        X         15            X             35         =       $ 10,500

2009             25         X         20            X             40         =      $ 20,000

We invested $14,300 distributed over each of the 3 categories to get a small gain of 14-25% in each category.  However the whole practice received an additional $114,000 in revenue for a near 100% return on our investment.  What other market are you going to see that in?

Onward and Upward,
Darren

I spent this last weekend joining the most recent graduates of Life Chiropractic College West as they celebrated their completion of the Doctor of Chiropractic degree.  Clo Lau, in her Valedictorian speech, referred to the journey as “bittersweet” which really set the tone for the weekend.  I was amazed at how intimately connected, philosophically sound and success driven these two classes were.  I am incredibly excited to see where this group of Chiropractic warriors takes our profession.

Everybody had a plan… and diverse these plans were.  I met graduates going to Spain, Brazil, Canada, England and even the beautiful St. Thomas!  I truly wish you all the best and just wanted to extend 5 of my most favorite reads I have had since Graduation.

1. E-Myth Revisited, Michael Gerber – Hands down the the first and foremost business book anyone should read.  Almost ANY coach, mentor or consultant will offer up this gem as a first read.
2. The Success Principles, Jack Canfield – This collection of success principles is a great overview of just about all the success habits one needs to lead our selves, patients, community and profession.
3. Richest Man in Babylon, George C Classon – If you don’t pay yourself first right from the start you will surely be challenged in the future when you are compelled to give back.  This short but profound read is a classic and an absolute must.
4. Book Yourself Solid, Michael Port – One of the best books on the shelf that outlines a specific plan to fill your office with well qualified patients that are compelled to refer.
5. The Art of the Start, Guy Kawasaki – Guy is a huge hero of mine.  I love to cross appropriate success principles in other industries and apply them to ours.  Guy is from the technology industry, but his message is SO Chiropractic and very consistent with the TIC philosophy.

BONUS

I am currently trying to get through what will probably end up as my most favorite read this year.  Tribes, by Seth Godin, is such a tiny book; however, every time I pick it up I can only get through a couple pages before I have to put it down because I just got so fired up to implement a new strategy.  There is NO fluff in this book.  In fact there isn’t even any chapters, just pure innate thought.

Call to Action

1. If you haven’t already, please download the Dream Practice Blueprint.  Not exhaustive but a great first insight into starting your Dream Practice
2. Check out Success Has a Reading List for more book recommendations.
3. Lastly, and most importantly.  This Blog is to serve as a conduit that directly connects successful Doctors in the field to students that are about to graduate, so YOUR success stories, tips and insights would be invaluable for the graduates behind you.  Please email me your success and comment here frequently, and each group will graduate stronger and stronger.

Final Words

In school you are charged with tasks to complete and hoops to jump through all of which have already been created and given to you.  You are given the syllabus, time line and most of the tools necessary to complete your degree.  Not that it is easy – it surely isn’t – but what you need to do is always in front of you.

In practice you are given nothing.  You are charged with the responsibility to create the tasks, figure out the time line and find the tools necessary to create the practice you dream of.

This is a huge blessing and opportunity.  In school you don’t have much say in the final product.  You trade input for a given and known path.  In practice, it is the opposite, you trade the known path for full control of design and final product.  You can now create exactly what you want, where you want it and even with whom you want it with.  I would take that trade any day.  It is certainly a tougher path and certainly not meant for all, however the rewards are that much greater.  Not many career choices allow for full expression of oneself with such a huge lasting impact on the lives millions in our world.

Some will associate, some will open their own practice, some will partner, some will teach and some will research, but ALL together you will form the next chapter in Chiropractic’s history.

Onward and upward,
Darren

OUCH!  AGAIN!

I am currently in the process of opening another Upper Cervical Chiropractic Practice and I am humbled and reminded once again how daunting the process can be even if you have done it a few times before.  Every situation is different.  The permit process is vastly different, from city to city, the loan/leasing situation is always changing, marketing that used to work is now obsolete.  The insurance/cash situations pose unique challenges from location to location.  Then there are the things you don’t know, you don’t know!  Those are my favorite.

Since every process is so different and poses a unique set of circumstances it can often feel lonely in the process.  There are a few places to reach out to but what if you could reach out to a group that was entrenched in the same process as you are now?  What if you could quickly and effortlessly check in on your computer or phone for some sage advice or even just to vent a frustration? How great would it be to share a win in your area that helps another warrior get unstuck across the country.

Dream Practice Mastermind

I am putting together a small group of committed Chiropractors who are on a mission to open an Upper Cervical Chiropractic practice in the next year.  We will form a mastermind group where we can share ideas, work on grand opening campaigns, find money, celebrate wins, overcome obstacles and ultimately facilitate the growth of Upper Cervical Chiropractors across the world.

Are you starting an Upper Cervical Practice in the next year?

Step 1 – Please send an email to me at drdarrenwhite@mac.com letting me know when and where you are opening a practice.  Please also include your Technique preference.

Step 2 – Please log on to DreamPractice.ning.com and update your profile as this will be where the group is hosted.  If you are NOT a member please email me for access as this is a closed group.

Step 3 – Polish or at least have a rough business plan ready.  If you need help please check out the Dream Practice Business Plan inside the Dream Practice Blueprint here.

If you know someone who is opening a practice in the next year please forward this post to them.

Onward and Upward,
Dr. Darren White

The Dream Schedule Book

I am a huge fan of the enormous over sized appointment book on the front desk.  The dimensions of the book are 2′X2′ and my book is pictured below.  This was actually last Wednesday’s schedule. If you were working at the Front Desk, answered the phone, and were trying to fit a family of 4 into the schedule below you would probably not be alarmed and quickly schedule them in.  If a new patient called in you wouldn’t think twice about scheduling that person into the schedule.  If someone asked you how the day was going you would probably answer, “Well we’re steady.”  In other words you would not block the growth of that schedule in fact you will even try to pack it in more.  Nature abhors a vacuum.

How many patients do you think are on the schedule? First guess at the number then count. There are actually a lot more patients on their than it looks right? The power of perception.

Onward and Upward
Dr. Darren White

This post was inspired by the book, it’s not the BIG that eat the SMALL.. it’s the FAST that eat the SLOW, by Jason Jennings & Laurence Haughton

We are experiencing a Global Unwinding and though the President passed a massive economic bailout a week ago the market continues to spiral down. We are in the biggest economic crisis we have ever seen in our lifetime and the most powerful person in the world made a huge decision and it will take weeks to even notice and years to recover fully.

As small business owners we have the ability to make a decision in the morning and see the effects in the afternoon. There is no campaigning, politicking, voting or winning anyone over, you just make the decision and it is done!

The trouble is we can suffer from analysis paralysis if we stew over the decision too long. I have stewed over many decisions for months even years then when I finally made the decision the results were immediate and explosive leaving me feeling like, Duh!

It’s not the BIG that eat the SMALL… it’s the FAST that eat the SLOW

In order for us to be able to make these decisions FAST we should all adopt a set of Guiding Principle’s. Then when making a decision only one question needs to be answered, “does it fit our Guiding Principles?” We can then quickly run the decision that needs to be made through these principles and swiftly arrive at the appropriate answer.

Schwab’s Guiding Principles

• Is it fair and responsive to our customers?
• Does it respect our fellow employees and the spirit of teamwork?
• Are we striving relentlessly to improve what we do and how we do it?
• Will it earn, and will we worthy of, our customer’s trust?
• Will it reinvent the business?
• We are willing to risk short term revenue to do the right thing for the customer and ensure long-term success.
• Will we own the technology?
• Does it leverage the brand to build trust?
• Will it create and nurture a spirit of innovation?

When Schwab’s CEO was presented with the idea online trading and saw a demonstration of a online transaction he didn’t have to think too much about it. Quickly running this revolutionary idea through their guiding principles they KNEW they could act FAST. Now, almost all financial institutions offer online trading.

What Are Your Guiding Principles?

One of the most important things you can do as you start out is fashion these principles. Your success is directly a result of what and how fast you make decisions. Below is a list of some of mine:

• Is it in alignment with the concept of Innate Intelligence?
• Does it provide for an exceptional Chiropractic experience?
• Does it distinguish us in the marketplace?
• Can it be explained in one or two sentences?
• Is it consistent with how we would take care of our own family?
• Does it have at least 30% Return on investment?

These are just a few of our company’s Guiding Principles, please add yours below in the comment’s section.

Onward and Upward,
Dr. Darren White