I guess it happens to the best of us.

After writing over 300 weekly newsletter/blogs over the past several years, I finally missed one.  Technically, it was written. But circumstances prevented me from getting it published online in a format you could read.  Translation: virus, system crash, and a conglomeration of computer-generated evils descended upon me this past week!

Ironically, last week’s article was about preparedness, protocols and other systems for practice success!

One of the reasons I chose to write this article was the widespread lack of systems that I have observed (or not observed) in chiropractic offices over the last decade or so.  Unfortunately, this lack of preparedness, which often comes in the form of a lack of concrete systems or protocols for the practice is a major danger that lurks in all too many practices.  It leaves many chiropractors feeling overworked and causes practices to under-produce.

In fact, while some DC’s believe that their technical skills are the primary reason people seek their care versus the doc down the street, my observations and empirical data suggest the exact opposite!  In reality, there are scores of chiropractors whose hands-on skills are simply average but whose practices consistently generate in the top 5% of all chiropractic revenues.  This is not to say that the chiropractor who can’t adjust his way out of a paper bag is on the same playing field as you.  Minimum competency IS required.  However, that minimum competency is also presumed by your patient when they walk in the door.

Therefore, it is obvious that other factors are at work in your success.

Here’s a case in point:  Think of your favorite chain restaurant or secret love for a particular fast food joint.  Now, go behind the scenes at most of these restaurants and who do you see?

A stream of stuffed shirts, suits and ties representing organizational geniuses and experienced executives slaving away at the fry machine?  Hardly.  Typical employees at most fast food joints and chain restaurants include pimply-faced teenagers, ex-convicts or those who evidently fell off the career track quite some time ago.

And where are the owners of these franchises?  Well, let’s be more specific.  Where are the owners of the local store or restaurant chain?  The owners of the entire franchise are in some far off corporate suite in another state or lounging pool side at their villa.

But even the local owners of Cheesy Cheese Pizza Franchise #346 – where are they?  Likely, they are not slaving along side their slew of teenagers, dedicating their life to making the “best pizza East of the Northwest TinkiTinki River Valley.”

No, these owners have their Gerber e-Myth bible in hand and are no where to be found.

Contrast that with most chiropractic offices where the owner (you) is also the chief pizza maker (performing the technical side of adjusting the patients), may also be the assistant fry cook (x-ray tech), may also be the marketing director, financial coordinator, bookkeeper, inventory manager, human resources director, exit interview strategist, hiring coordinator, director of rehab and ancillary services, and chief financial officer.

Oh, and the typical chiropractor performs all those duties simultaneously in the typical manner of a (choose one): crackhead, chicken with his head cut off, or child just fed a steady diet of Fun Dip, donuts and pop.

Is it any wonder that chiropractors never seem to achieve anything but a subsistence level practice and that fewer and fewer seem to be genuinely thriving?

Having visited well over 300 offices in the last few years, I can tell you that 99% of DC’s fall into one of three categories:

 

  1. Fire-Frenzy.  No visible systems in place and if there are systems, they are woefully inadequate or obsolete.  These docs (and their staff) spend most of the time haphazardly putting out fires only long enough for the next one to erupt.  The one positive aspect of these offices is most know they are completely disorganized and hope to do something about it someday.
  2. Dangerously Deceived. These offices have some systems in place usually in a slightly murky form of a visit protocol (1st visit = NP Exam, 2nd Visit = ROF, Visit 3-396 = Random ) or sometimes a front desk system for processing patients or the phone.  By in large, though, these offices have still not developed systems to adequately train staff, maximize revenues, minimize patient schedule abandonment or efficiently utilize doctor and staff time.  As a result, several things emerge: the doctor is still forced to put lots of time and energy in to keep the practice running smoothly, they are always on the verge of a crisis (and may narrowly miss) and the doctor is destined for burnout (although he or she won’t admit it) because they are deceived into thinking they have systems in place.  This is the most dangerous category because they don’t really have effective systems and because the doctor has so much to lose  in the way of potential.  Unfortunately, this category is also the most common.
  3. So Close, ButThese offices have solid systems in place but can never seem to make it to the “next level” where the doctor (and staff) feel that the practice is running smoothly or on autopilot.  The doctor is savvy enough to have developed systems that have all the basics are covered and consistently taken care of, but there is no real elimination of problems.  There is still too much doctor dependence and, at times, too much on the doctor’s plate.  Although this level of practice has obviously achieved a respectable amount of success, the development of effective systems and implementation is the only way for the practice to grow without the adding more staff, more time or more work for the doctor.

So, doctor, which category do you think best fits your office?

Now that we’ve identified some problem areas, let’s discuss some potential solutions for each category so you can start working on these issues right away!

Category 1: Your lack of systems will result in continual frustration for you and your staff.  Spend the time (because it is likely more plentiful than money at this point) in fixing this issue.  My recommendation would be to go visit other chiropractors offices 1x per week to see what systems they have in place.  To avoid being perceived as the competition, choose offices that are 25+ miles away and, if you can, get recommendations to only visit offices that are doing well so you can learn.  This is time and money (barely any cost) well spent and soon you will glean some helpful ideas.

Category 2: Your systems need to be firmed up a bit. Spend some time trying to identify problem patterns in your business.  Not just the once in a blue moon occurrences, but things that seem to happen repeatedly and/or with annoying frequency. Write a list of these issues down and begin to develop a systematic plan for solving them.  Then, move on to the next item until you have developed a series of systems to really address the problem patterns in your practice.

Category 3: There may be an issue or two that you need to specifically address in the manner of those in Category 2, but most practices in this category need to really focus on efficiency and delegation.  Since this is an issue to some extent in all categories, below is a flowchart that I have used to arrive at more efficiency and better delegation:

Do_or_Delegate_Flowchart

Time to Face Reality

When looking at the issue of profitability and practice success from a big perspective, an honest appraisal of your abilities, habits and motivation will tell you where you stand.  Is your business sinking?  Either get help fast or abandon ship!  It may be noble to be long-suffering, but the question is: can you afford it?

For those of you whose business is adequate but less than stellar, sometimes an objective opinion or outside assistance is needed to get you to that next level, to conquer obstacles and achieve longstanding goals. This is not to say you are incapable, but the often quoted words of our favorite Albert come to mind: you know the quote about insanity and doing the same thing and expecting different results.  Far be it from me to call you, a perfect stranger, a little nutty but, if the shoe fits….

Fill out my FREE Practice Analysis and get on your way to getting some help.  There’s no obligation and did I mention it’s FREE!

Hope this article has been helpful, encouraging, eye-opening or just frustrating enough to spur you to do something about it – chiropractors, we need you in business and you need your business to be profitable and pleasurable!

To Your Success!

Tom Necela, DC

P.S.  Don’t worry, this post will be on-time next week – I have identified the bugs, eliminated them and placed my own precautionary systems in place so this won’t happen again, lest I be guilty of not practicing what I preach!