EPISODE 358: Having a Clear Vision and Taking Big Action in Practice with Keith Yoho, DC

Hey, chiropractors. We're ready for another Modern Chiropractic Marketing Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, contact marketing, direct response marketing, and business development with some of the leading experts in the industry.

Dr. Kevin Christie: [00:00:00] Welcome to another episode of Modern Chiropractic Mastery. This is your host Dr. Kevin Christie, and today I'm bringing an interview with a long-time coaching client of ours, Dr. Keith Yoho. And we're gonna dive into, um, a lot of really cool vision ideas for what they've done with their practice at Total Performance Clinic.

And it's, uh, something that has been cool to see. You know, we talk a lot about. Uh, planning and vision and, you know, whether you're talking about traction or EOS, but having a clear vision and then having meetings and strategies around that to actually implement it. And I wanted to bring Keith on this show because, uh, the clinic he is part of and is partners with has really done that.

And they have quite a vision. They've had quite a substantial amount of growth. And it's not by accident and they've got some, you know, really big, big ideas that they want to accomplish over the coming years. And we dive into some of that and how you [00:01:00] can achieve your goals. But then also some, we break down some of the meetings and the structure of the meetings they have and.

You know, the fact that they're a yearly meeting now because they've grown and they've got quite a team and they've got a lot of decision makers has become like a three day event for them once a year. And so we dive into how to create a vision, how to have meetings and trainings to. Implement the steps within that vision and honestly how to think big and, and achieve it.

And so it was a great interview. It's been a pleasure to get to know and work with Keith directly for a few years now and to see the growth that they've had and that he's had as a professional. Uh, before we dive into that interview, I do have an opportunity for you to get a free lesson from CSA, the Chiropractic Success Academy, myself and.

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Without further ado, here's my interview with Dr. Keith Yoho.

 Welcome to the show, Keith. I really appreciate your time today. Uh, I'm excited to bring someone in that's, you know, really in the trenches of a clinic, uh, really doing big things, and we're gonna get kind of the history of the clinic, the, the current and what you're offering and, and then what the future looks like, and then some of the things around that to actually turn a vision into reality.

And so, uh, welcome to the show, Keith. Hey Kevin. Thanks for having me. Absolutely. So just give us a little background. Tell us, tell us about [00:03:00] yourself personally, professionally, and then we'll go in.

Keith Yoho DC: Yeah, so my background is I grew up in athletics, swimming, all of those kinds of things. Uh, went through some injury issues as a swimmer, injury issues as a professional interathlete as well, and I really enjoyed.

That side of things and went on to, uh, do some college swim coaching. Uh, had more questions than answers, especially once I went to the coaching side of things. And, uh, more frustrations on not being able to get people's bodies to move and do some of the, the things that we were trying to do despite some of the.

Working under some of the best coaches in the world. And uh, that kind of led me down the rabbit hole of understanding, wanting to understand more about human physiology and biomechanics, all that kind of stuff. And, uh, naturally the injury route, uh, and then more of the conservative musculoskeletal health route.

So yeah, I went out, went to chiropractic school at Logan, and [00:04:00] then, uh, when I came out, I started my own practice in southern Oregon. And a few years later I joined in with, uh, some of my good buddies that ended up having a practice right down the street. So we've been working together since then. Yeah. Uh, then that was 2020 that I joined in with them.

Dr. Kevin Christie: Perfect. So we're gonna dive into that for sure. Uh, give us a little bit background on some of the things you're doing. I know you do DNS, but what, what are some of the certifications and some of your thought processes on the care you're providing?

Keith Yoho DC: Yeah, so I, uh, my mentor back in Houston was a big ART SFMA guy.

So he, uh, recommended that I actually leave that area and go somewhere that I can actually have access to more continuing education. So that's why I ended up going to school in the Midwest rather than staying in Houston, just so I was able to travel to a lot of different courses and things like that on my weekends while I was in Cairo school.

And [00:05:00] I think I actually spent. Host to 30 grand on continuing education before I had my diploma. Um, but yeah, it's been a lot of. DNS coursework and I was able to go to Prague this past year and mm-hmm. Take the DNSD course. And it was actually at the DNS Manual Therapy course this past weekend down in San Diego.

Um, but yeah, so it's been very heavy on the DNS side of things. Very heavy on. Uh, MPI is really largely the background for how I look at a lot of my adjusting skills and manipulation. Um, and then, yeah, I've got the a RT background, uh, SFMA, the. Uh, I mean, you name it, the FRC FRS guys have taken coursework with them, so it's been a lot of different, different ones.

With the Neurodynamics kind of across the board, the, the whole gamut of like, Hey, we need to be able to move joints. We need to be able to move muscles. We need to be able to get muscles to. To learn how [00:06:00] to activate, but we also need the, from the DNS principles, a lot of it is learning how to activate with elongation, with eccentric activation to control, uh, control more of that joint positioning and, and all of those kinds of things.

And then obviously we need to be able to move some nerves. Mm-Hmm. So blending all of those things together to, uh, try and take a, a broader approach at what each patient might need.

Dr. Kevin Christie: Perfect. I love it. And then, um, your, your, your clinic setting now has, has allowed for, uh, you know, for you to really implement that.

And I know the other providers are, and, and you've got the performance side of things as well. So you got trainers on that aspect. Uh, tell us where you're, where the clinic's located now. Uh, tell us a little bit about the, the main clinic and then some of the growth from there. But let's just start with where you're at and what the clinic looks like.

Now give us an inside view of it.

Keith Yoho DC: So right now we have two locations. Our primary location is in Grants Pass Oregon. Uh, so [00:07:00] we're about four hours south of Portland. Um. That location is about 7,000, just over 7,000 square feet. Uh, 3000, a little over 3000 of that is a, an actual open gym space that we use for rehabilitation.

And we also have, uh, two personal trainers that do guided group, uh, training classes. And we primarily use the CFSC certified functional strength coach, uh, structure for a lot of that training. So inspiration from Mike Boyle and, and his crew. Uh, so that, that's a, that's a great program. It helps us with, you know, being able to have a small group training class where the, the workouts are really toned to the capability of each individual.

So like, I walked in there the other day and we had, my parents were training at the same time as a high school athlete, so they might be doing a similar, you know, uh. [00:08:00] Like upper extremity, horizontal push type movement, but it just looks different from what my parents are doing versus the athletes. So based off of their capabilities in that grouping of, of, you know.

Movement. So horizontal push is one kind of movement. Mm-Hmm. Uh, horizontal pull is a different one. So they're just doing different variations of the same kinds of movements that the body needs to have. So that's kind of how we structure a lot of the, uh, the gym side of things. And then in that clinic we have.

Chiropractors physical therapists, massage therapists as well. Um, we have one physical therapist and then we just started, uh, we have a physical therapy assistant that just started this month and we have another one starting up next month. I. So that, that's all getting going there. And uh, we also have a satellite clinic in Cave Junction.

So it's, uh, halfway out to the Oregon coast from our Grants Pass office. And it's a much [00:09:00] smaller location, much smaller community. Uh, so it's about, uh, between 1600 and 2000 square feet and we have chiropractic, massage and physical therapy out there as well. Nice.

Dr. Kevin Christie: And then how long, uh, have the doctors all, I know there's, there's multiple, but when did this, let's just say this clinic, what year roughly did it get

Keith Yoho DC: started?

Oh gosh. So Scott Thorson was the, uh, he's the original owner of this practice and he started this practice. About 25 years ago. Mm-Hmm. So that's very well established, uh, practice in the community. And he's had a presence in our, in the Cape Junction area as well as Grants Pass for, uh, about the past

Dr. Kevin Christie: 20 years.

Yep. And then how many are you now as far as the chiropractors that are really working towards growing this?

Keith Yoho DC: Yeah, so we have four owners. Mm-Hmm. Um, myself, Scott Thorson is the original owner. And then, uh, Nick Baker and Nate [00:10:00] Baker are, uh, my two other business partners. Mm-Hmm. So that's the, the four of us.

And then we also have. Uh, two younger docs, younger Kairos that have been out. Uh, one of them just joined us this past fall and then the other one joined us in the fall of 2020. Uh, and then we have Scott Thorson's son. Shel is our physical therapist, and he is been with us for about a year and a half.

Dr. Kevin Christie: Nice. And that's, yeah, I wanted to set the context and like, this didn't happen overnight. It was, uh, you know, definitely a lot of, of, of years and planning and building. Uh, but for our audience, no matter where you're at, you know, it's take one week by one week, one year by one year, and you start to build something that's, uh, really cool.

And one of the things that I've admired. With what you guys are doing, I've gotten to know you over the last couple years working with you, um, was the, the vision and then what you're actually doing to, to achieve that vision. 'cause a lot of people dream, a lot of chiropractors [00:11:00] want and, and desire certain practices, but they don't really set a clear vision and they definitely don't take the action steps.

So, um, can you provide us what. However timeframe you want to give us, whether it's five, 10 years, but, but what's the ultimate vision o of what you guys are trying to accomplish?

Keith Yoho DC: Yeah. And so the vision is, there are a couple of aspects of it. The one thing that, uh, it's kind of hit me on the head here, the, uh, is that probably two years ago almost was talking to some friends that work at some of the universities, and particularly at, you know, was talking to Cody and Marian d.

Uh, they're like, yeah, you know, we have two, 300 kids that are onboarding students that are onboarding in a year or in this, this next, uh, trimester. And I'm like, holy shit. Like we don't have jobs for these people and, and we can't do a ton no matter [00:12:00] how big we grow the practice. Like goodness. Like trying to just help to create some of the shops.

Me graduating in 2016. It was a pain in the ass to open my own, my own office. But a lot of these, a lot of these young grads are forced that route 'cause we don't have enough good jobs in the profession. So for us that's part of the big, the big goal for us is so that young docs can actually be able to.

Come in and, and work and be able to grow some experience in those kinds of things and not be forced into starting their own practices. So for us, we're really looking at trying to grow our locations and to really, throughout the state of Oregon, I. Um, and when we start looking out along that 10 year horizon, yeah, we want to have several practices across the entire state, um, between, from southern Oregon all the way up to Portland, out to Bend and to the coast.

So it's not an easy task, especially when we start getting into [00:13:00] that growth. The management side is, is definitely a massive challenge and. Right now we're trying to work on here in the next year, opening up a third location to, to work on figuring out some of those, those bugs in the practice, uh, and practice growth and see what we can do as far as being able to help provide more services.

We need more conservative musculoskeletal care. Um, we need jobs for, for chiropractors and Oregon's a pretty damn good place to live, so, uh, why not do it here?

Dr. Kevin Christie: And your in insurance reimbursement is pretty good

Keith Yoho DC: there. Yeah, it's much better than a lot of other states, uh, for sure. And I mean, for us, we do live in a lower income community.

Yeah. So, uh, we are quite reliant on a lot of the Medicaid side of things, but really for. The way we're able to structure things that the reimbursement's not. Not [00:14:00] as bad as what you would expect in, in a lot of other states. Um, and chiropractic is actually part of Medicaid in this state, unlike a lot of

Dr. Kevin Christie: other states.

Mm-Hmm. Yeah. And that's something I always try to tell chiropractors when they're trying to create their vision of their practice. And they'll ask, you know, do I go cash or insurance? Like, you know, you, you gotta look at the state you're gonna be in. And some states still pay well to be a network. Some like Florida are really bad.

But then a state like Florida. Um, personal injury pays like four x of what an insurance would pay, and it pays really well. So if you could build, like, one of the things we've done with our practice is we're, we're at a network. Um, the insurance just is so terrible down here. Uh, but you know, we get anywhere from three to six new auto cases a month and that.

Pays really well. And so our overall office visit averages increase. So it's just, you gotta look at the nuances of the state and, and see where that potential growth is, uh, on it. So, um, I love it. Yeah. So you guys

Keith Yoho DC: got, the business strategy is [00:15:00] completely different in each state. Um, yes. And, and it's also been dependent on your goals.

Like for us, if, if we have the goal of being able to employ a bunch of chiropractors and physical therapists and PTAs and massage therapists and all of that. Like, we don't have the option of just being cash. The volume cannot be there. So there, there's all of those kinds of things that come into play.

Dr. Kevin Christie: And I'd, I'm glad you mentioned like the, the business strategy is dependent a lot of times on the state potentially or just how you want to do things. Like if you, like you said, if you wanna be cash, it's gonna be hard to scale it very well. Um, you know, 'cause what you end up seeing is like, say how the joint has scaled cash.

It's thirty-nine bucks. You know, it's hard to scale cash at eighty-five dollars a visit, or a hundred like whatever. Uh, so yeah, you gotta take those into consideration and, and, you know, there's no right or wrong answer on what people want to do. That's why I, I try to bring different types of people on the podcast to show [00:16:00] different avenues and, uh, you know, we haven't had someone on in, in a while that's really trying to scale.

Um, you know, in a sense of, like you said, locations, but also for job opportunities, uh, you know, teaching opportunities and things of that nature, uh, really being kind of a, a, a, you know, a professional development, uh, aspect to your business for, for chiropractors. Is that, does that, is that accurate? I know you and I have talked a little bit about it, but do you see your group having a professional development aspect to it?

Keith Yoho DC: Yeah, we already have some future plans on all of that kind of stuff as well. Um, and then the other aspect for us is that Western States is in the process of being able to allow, uh. Students to leave Portland Mm-Hmm. For a longer period of time. So we have our eyes on those kinds of things to help, uh, with the clinical development of students as well.

And, [00:17:00] um, there's some good docs up in Portland that have been doing that for a while, and we've had some talks with them as far as. Ultimately we wanna get to the point that we can start collaborating with them, whether they have them for X amount of time, and then we can kind of carry on, we know a little bit of kind of having a unified curriculum, um, so we can really keep the progression going with, with their development.

And then, uh, yeah, and, and ultimately, like school can only teach you so much of reality of. What you wanna practice, and there are so many different ways of practicing that we can help guide a little bit more in, in that realm. The, the thing that's hard is like for us with trying to plan out business growth, business development, I.

The admin side of things builds up a lot more. The practice management side of things and demand of that builds up a lot more and trying to cover overhead gets more challenging for a while, and then now we can start getting revenue in [00:18:00] from other providers. Then that allows us to actually be able to take a little bit of a step back, like today is my.

First day of only having a four day actual end clinic work week or my first week of that. So now, mm-hmm. I'll be spending the rest of my day doing more of the administrative management side of things that we need to have to, to help support some of our growth and development. But then like a hundred percent, I wanna be at that point where.

I can sit here and take some of the material that I learned at my DNS manual therapy course. Mm-Hmm. And get some group training stuff and things like that really planned out. And, uh, and really work on that development for all of us. And that was, I totally missed that 'cause I, I did a ton of that while I was in school, uh, with working with our RTP club.

So I did a ton of that teaching type of stuff and that was really enjoyable for me. And I definitely want, that's something I definitely see us getting back to here in the, in the near future. Yeah. No, that's, that's great. I think, um, and [00:19:00] also man, like we, we also have like all the massage therapists and some of these, and some of PTAs at PT assistance and, you know.

We function off of utilizing our chiropractic assistance for helping us with some of our rehab and all those kinds of things. So not just on the chiropractic side, but like getting our entire practice. More in a, into a unified approach as well, and unified mindset. And everyone has some different backgrounds and experiences.

So, and, and just, just education levels. So really getting everyone on the same page would, would be as, as where we're, where we're trying to progress to that as well. And it'll help, it'll help, you know, not just with our morale around the office and our ability to communicate and work together, but it will definitely help with our, um, our outcomes and our, our.

Patient care and all those kinds of things too.

Dr. Kevin Christie: Yeah. And you guys have built a team and, and one of the things that a lot of chiropractors have to build is their skillset around leadership. And, you know, you get out and if you open up your own practice at some [00:20:00] point it's typically a very small team, sometimes front desk and, and you, and then you add, and then as it gets more complex, you know, you need to build a team culture.

You need to build, uh, a leadership and management aspect. Uh, do you guys have an office man, like an actual office manager at this point?

Keith Yoho DC: Yeah, so we have, we had a office manager and then it was way too much. Yep. So we separated her off to really the billing finance manager. Mm-Hmm. And then we have an operations manager who does her operations in hr.

And then next month we actually have an assistant coming in to help take over some of both of their responsibilities, uh, as well. That's perfect. You know, it's all the insurance that we're doing and, and she does all of our billing and things like that in house and it gets very complicated. So it does a lot of volume, a lot of that she has to be able to do.

And [00:21:00] then keeping up with all of the changes with some of the different insurance companies. And I mean, it's, it's hectic for her to. Her to be able to manage all that. So there's no way that at, at our point, like, I mean I think at our Christmas party we had like twenty-eight employees. Like we're not, she can't manage all of that by herself.

And then the onboarding of of new staff members. Yeah.

Dr. Kevin Christie: Lemme ask you a question. I'm not sure if you guys are doing this, but I was recently at an A RT seminar and I, it was hosted at this, um. Ortho PT Group, just massive in Long Island and the tons of locations. I mean, the place was massive, tons of physical therapists.

And one of the, uh, a RT instructors was one of the PTs there, and he's in a management role there. He's a physical therapist. He still treats some patients, but he is, um, the manager, a sense of the clinical team. And so he makes sure everybody. Is obviously functioning well and as, as a team, have you guys done that [00:22:00] yet?

Whereas one of the providers becomes kind of the, uh, for a lack of a better term, the manager of, of the

Keith Yoho DC: clinical side. Yeah, for sure. So we went through, I know I've talked to you about it, so we went through, uh, Traction. Yeah. Uh, so that's that book and a little bit of the information from Traction is kind of how we've structured things.

So we definitely have our organization start charter, we call it. Mm-Hmm. The accountability chart. So we have, Scott is our CEO and then, um, Nick Baker is our operations, our director of Operations. Mm-Hmm. Which is really where a lot of the clinical stuff falls. Uh, and then, so with him, he's got, his, the operations manager really falls under him, and then our physical therapist falls under him.

And then, so he's also the head of our chiropractic branch. So ultimately, uh, from a reporting standpoint. All of our providers really report to him on some of those things. Mm-Hmm. [00:23:00] And a lot of, and a lot of that's really more of like, okay, the function of the business, the logistics and those kinds of things.

If a provider has questions about something, man, like it's just Mm-hmm. We'll go talk to someone and be like, that actually sounds like a Nick question. Or Nick might be like, that sounds like a Keith question. And so we just kind of have a little bit of our own. Specialties as we've developed in practice and, uh, our thought processes are all a little bit different.

Mm-Hmm. And that's, it's nice to have that diversity. So as far as from a, an actual clinical education standpoint and, and for the, the younger providers or even some of the older providers who are like, what the hell is this? Mm-Hmm. Like, what do you think about this? But that is a little bit more of a group effort.

Yeah. But yeah, a hundred percent. On the administrative side, we, we definitely have that parsed out.

Dr. Kevin Christie: Perfect. Yeah. And so couple, couple of the big nuggets I wanted to get from, from talking to you. You know, one was the growth mindset, and you, and you guys definitely have that, which I, which I love. And it it just allows you to realize, okay, yeah.

[00:24:00] Like we want to get there. We don't necessarily know exactly how it's gonna play out when we do it, but this, we feel comfortable that we will grow into that. Um, the, the second thing I wanted to really dive into is the traction. Meeting aspect. You know, we, we talk a lot about team meetings and our coaching programs, and I've kind of relied on you a little bit to help out on some of our coaching calls with that be because, you know, a lot of Carpenter's have small teams, like you mentioned, 28 people at the Christmas party.

That's not, that's not common. A lot of times it's 2, 3, 4, 5 team members and, and, and they're not doing any team meetings and so we try to get them to do a quarterly team meeting, a yearly team meeting. We try to make it maybe three hours or a half day. But obviously with the vision being as big as yours, is the team being as big as yours is the management, uh, and leadership team being four or five people.

Uh, tell us what your big yearly meeting looks like to, to really plan [00:25:00] this out and then people can kind of, you know, deconstruct from there a little bit.

Keith Yoho DC: Yeah, so we have, uh, quarterly meetings. The, within the quarterly meetings are, we have one that's designated as our annual meeting, and that's where we really go back to restructuring our, uh, our ten-year goal, our three-year picture, our one-year, uh, our one-year focus, and then getting into our from there, but then can goes into like, what do we need to do this quarter?

Mm-Hmm. Uh. Every other quarter. We don't necessarily go back to restructuring the ten-year and the three-year goals and changing some of those things if we need to. And it's more of like, Hey, where are we at from the last quarter? Where are we at as far as reaching that one-year goal? And it becomes a little bit, uh, more targeted, a little bit more focused.

Mm-Hmm. [00:26:00] So the annual meeting last this year was four days. Uh, we left on a Thursday, got back on a Sunday. And then our quarterlies are Friday through Sunday, and we leave town every single time. Uh, uh, just we need to have that separation so we can maintain a little bit more of that focus. And we come back from those meetings, absolutely fried.

But, um, they're, they're great meetings and that's, it's, we would not have the structure or the growth that we do without it.

Dr. Kevin Christie: Yeah, because so many people don't have a plan and what the traction meetings allow for, and especially when you do it like you do, where you really dive into things is, you know, like you mentioned kind of the quarterly rocks in a sense.

Something that traction talks about, which you're gonna be your bigger ticket items. You know, if you're gonna change your EHR in a quarter, that would be a quarterly rock. If you're gonna completely revamp your website, that would be that. If you're gonna try to hire and onboard a new. [00:27:00] Chiropractor that would be a rock, you know?

And then you're gonna have your issues list where it's like, okay, uh, we we're, we're seeing that we're not having, um, continuity of care between visits of patients. Right. That might be an issues list or the review. Reminder thing is not functioning well. Like these little things that happen that's gonna be a little more issues list that you may be able to tackle.

Um, what are, what are some of your thoughts on the difference between quarterly rocks and some of the issues list stuff?

Keith Yoho DC: So, and this is where it's, it's nice for us having several people. We have, so we have five of us on our leadership team that go to those meetings, the, the four owners and then, uh, shell, our physical therapists, and.

We have projects and things that we need to accomplish in a shorter timeframe to ultimately build up to that, that one year goal. Mm-Hmm. Of what we are trying to accomplish in that [00:28:00] timeframe. So this, this allows us to be like, Hey, I. Uh, we are going through a server change. So Nick is helping, helping really lead that big rock project of the server change.

And, um, we've got some business plan work that myself and the, uh, finance director are really working on with all those kinds of things. So it's like, no, we have these administrative roles that need to happen that are bigger picture. Mm-Hmm. The issues list, man, that's like. What needs to happen this week?

What needs to happen in the next two or three weeks, like the get it done now. Okay. All the things that just naturally pop up in practice and in life that Mm-Hmm. That holds you back from more of daily function, daily operations. Mm-Hmm. Um, the thing that is, we're working on the two. Help us actually. Like, so we have our, our quarterly meetings, but we have our weekly meetings as [00:29:00] well.

Mm-Hmm. With our leadership team every week, five of us get together and, and have our meeting that goes over largely the issues. Mm-Hmm. And then we briefly touch on the rocks, and we're trying to get to where a lot of the issues are really handled more at the departmental level. Mm-Hmm. And like this takes a while for us to be like, Hey.

We are still trying to figure out our, like, how we function in these different management roles and we want to make sure that everyone's on the same page with this stuff. So we spend more time on some of those daily issues right now while we're really finalizing and, and getting more comfortable in those, those positions and roles.

And then we can really, and hopefully in the next 4, 5, 6 months. Uh, a lot of the issues are just not handled at the leadership team level. Yeah. Uh, that's our, one of our big goals. And, um, we can trust people to handle shit, man. Like Mm-Hmm. Get it [00:30:00] done. We trust your experience, your knowledge, you have more information.

Like some of the guys will ask me stuff and I'm like, dude, I don't know. I don't care. You have way more information on how to handle this. Handle it. Let me know what the decision is and how we need to move forward. Right on. Let's, and then we can work to help each other more so on some of the rocks.

'cause it definitely gets to the point where like the issues build up a ton to where the rocks kind of fall behind and then sometimes it goes the other direction and it waxes and wanes and all those kinds of things are like, oh hey we have, uh, someone has a vacation and then you are getting back into the swing of things for a week or two.

Um, as, and catching up from some of the admin stuff that happens while you're gone. So certain things fall off and then come back on and all of that. So trying to, trying to level out some of those things so we can be a little bit more consistent.

Dr. Kevin Christie: For sure. And I want to, I want to touch on that a little bit.

Um, what you said is, and I've, I've been having this conversations with some of my patients recently that are doing big things. I've got some [00:31:00] patients that are just, uh, at high. Positions of, of corporations. And then, uh, someone I, I've read his books. I listen to his podcast as Cal Newport. He, he, um, mm-Hmm.

He wrote the book Deep Work. And to your point, what can happen as you get, I. You get so much inbound that it's hard to find the bandwidth and time to do the deep work to work on a project. So like if we were to take the rocks, that's typically something that's gonna take some heads down. Deep work from team members.

If we take. The issues list, that's gonna also take some, uh, bandwidth and head work. But then what ends up happening is we just get this continuous inbound of, of issues. And if we're not careful that inbound of consistent issues and things and stuff that just comes into our inbox or patient issues or whatever, it, it eats away at our ability to really focus on the things that are gonna move [00:32:00] the needle.

In our business, which are gonna be those rocks. Mm-Hmm. And so what Cal Newport would, would really talk about and, and have a plan with it, is that you need to get ahead of your schedule and block off time for deep work. And, you know, maybe 2, 3, 4 hour blocks of time where you really, to get all the distractions.

Like you're not in your inbox, your cell phone is in the other room, you're maybe you're listening to some music and you're pounding some things out. But as a clinic, and, and I'm not just speaking to you. Um, it's, it's anybody is that you gotta really focus, have some focus time to work on those rocks, and that way you can, you know, get the, the ball rolling with it and not be overwhelmed with the inbounder.

Are you guys seeing some of that where you could really try to carve out more time to focus on the growth rocks?

Keith Yoho DC: Absolutely. So, um, I, I've, that book's been on my radar for a long time and I just ordered it while you were talking because it's a, it's, I'm in the middle of that [00:33:00] exact transition right now, so, yeah.

Um, since I joined the office in 2020, I've been doing. Two days at our satellite clinic in Cave Junction, two and a half days working at our primary clinic in Grants. In Grants Pass, and with some of the growth and development that we're working on and, and with also with some of the new providers that we have, like with that office being a smaller office and we've got four docs going, four chiropractors going out there for two to three days each, like no, like there's not enough volume to really support those number, that number of providers out there.

We don't need that many of us out there. So I've pulled back to where I'm only in our, uh mm-Hmm. Our Grants pass location and spending some time actually getting some deep work done. So today is day one of, of actually having some of that deep work time. Mm-Hmm. Uh, it is, previously I had my Wednesday mornings off and then like, okay, I've got our meeting on Wednesday mornings that I, that I go to, and then I [00:34:00] have my department level meeting with the referral coordinator and our operations manager.

Mm-Hmm. Then I have my leadership team meeting. So it's like I've got all three of those meetings. There's no time for, for me to really get some of that deep work done to, to get some of the work on the rocks and all those kinds of things. So yeah, thanks for reminding me about that book. And that's, that's, that's something that we are intentionally working on trying to create and like it's, it's really hard to step back from practice once you've been.

Working in the business that much to step back and be able to work on the business. Mm-Hmm. So it's, uh, we're a hundred percent in the middle of that transition and, and being able to get a little bit more of that deep work. So that is exactly what we are. Mm-Hmm. What we're working on right now in this little bit of transition

Dr. Kevin Christie: time.

And you know, when I talk to a lot of my corporate employees, they run into the problem of meeting death by meeting, essentially it's like constant meetings, it's constant emails, it's constant inbound and no time to [00:35:00] make productive work. As, as chiropractors, it's, it's typically we're just busy with patients and then when we do have downtime, we got patient notes and it Mm-hmm.

We kind of go back and forth between those two things and we have all these other inbound things that we have to take care of and. And we're never carving out the time to, to move the ball forward and, and having quarterly. Yearly meetings that are impactful, like you guys are doing, is very, very important.

But you then have to have a in-between strategy, right? Like those three months in between meetings, we gotta have a plan. You know, is it a weekly team meeting that's just centered around solving the issues? Do we have periodic meetings that address our updates on how we're progressing on the. On the quarterly rock, do we have time to sit down and work on our business, which would be hopefully those quarterly rocks.

And if, if we don't do that, that's where we feel like we're, uh, unfortunately spinning our wheels and we're not [00:36:00] making progress forward. And I was listening to an interesting podcast interview. It was like Tony Robbins was on Ed Mylett, which is quite a dynamic duo. Um, and I think it was them and, and they were just talking about like where people feel like.

Success is happening or they're feeling really good about themselves and they're feeling good about where they're at is when they're seeing, when they're making progress, when they're working towards something, they're seeing progress. And when you don't is when you get frustrated, burned out, um, agitated short with patients, short with team members, short with family members.

And so if you get ahead of it and really have a great team meetings like you guys are doing, and then have a structure to move the ball forward with those things, I think. It would not only improve your business, but it would also improve your psyche.

Keith Yoho DC: Yeah. Well, and so the, the big thing about the meetings is also the accountability factor.

I. Um, and that's, that's fine. And like I have to do some meetings by myself and keep [00:37:00] myself accountable to some of my, my tasks. Uh, but like, it's really, that's one of the most important things for us with the meetings, is to be able to discuss issues and, and keep each other accountable as well. Sometimes, like, especially when we get into that grind mode.

Mm-hmm. We all fall into. Yeah, the like the accountability side of it gets tough. You're like, yep, nope. We need that little bit of reality check. You're right. I did not get this thing done. Or sometimes things that end up on your to-do lists aren't that important. Yeah. So those, some things are like, no, this is not a priority.

Yeah. Why are we even worrying about this right now? I actually have a, like, so I'm on our, one of our most recent. Level 10 leadership team meetings. I have a lower priorities to-do list that's on a separate document and linked to this because it's like, no, those actually weren't priorities. Like we gotta have to get this, get some of the fluff out of the [00:38:00] way and actually get down to what we need to focus on.

Um, with that here, I'll go over kind of how at the, the level 10 or like our standard meeting is structured, our weekly meeting. Perfect. Uh. It starts off with just kind of a segue, Hey, how you doing type thing. Like we just kind of etch up sometimes, uh, the segue goes straight into discussing some of the issues that are going on and we have to temper people back and put it on our actual issues list.

Yeah. But segue is just, Hey, how you doing? Like that's the only time that all five of us are in the same place at the same time. Mm-Hmm. At any point in the week. So it's good for us to all be able to do that. Then we review our scorecard. The scorecard, one of its big roles is for us to be able to identify issues that might not quite be palpable.

Just going through the practice on a day-to-day basis. So looking at, I. Our total, uh, new patients, looking at our total visits from the [00:39:00] previous week looking if, uh, we've got what our charges are, so our, our actual expected collections from the charges from the previous week, what, how much payment came in, and then I parsed it out across each provider and our visits and billables and all of that kind of stuff as well.

So trying to see if there are issues or trends. And that's a big thing with some of the stuff in tracking A scorecard like this is like you have to have X amount of time to really be able to see the trends and what you expect. So that is really helpful for, for us at the higher level. And then we also have like our management team scorecard.

So like for example, my, the referral coordinator, that ref that works with me. She's not, we're not just tracking the total number of new patients, but like for us, we're very heavy on, on MD referrals. I mean, I think last month it was like 120 referrals in the month of December, which is not a [00:40:00] particularly busy month for us.

So we're getting all of that kind of stuff built up. So we need to see like the incoming referrals, not just the new patients. So all of those leading indicators. Whereas our, our new patients would be a trailing indicator relative to the referrals. Mm-Hmm. And obviously the total office visits is a trailing indicator also from the new patients.

Dr. Kevin Christie: Yeah. And let me give a definition for the audience real quick. Go. Is that the, you know, like the leading indicator or the trailing indicator would be how many new patients from MDs, the leading indicator to the things that you actually do to get those referrals. Like, okay, we're meeting with MDs, we're doing this.

Too many people will set a goal of five. MD referrals in a month, but they do nothing to get those. And so that's the leading indicator. Just, just wanted to make sure our audience knew that.

Keith Yoho DC: Yeah. Right on. So for us, the, the initial couple of things in the meeting is just trying to help develop our. Our IDS, it's identify, discuss, solve.

That's like our actual problem-solving portion of the [00:41:00] meeting. So with that, we review our scorecard, we review our ROCs, and that's like very simple. Hey man, are, are you on track or are you off track? Or do you need help with something? Yes, no. If there, if you're off track or if it's something that you feel like you need help on.

Then that goes on to our list of issues to, uh, to possibly be discussed. Uh, so our proposed issues, Mm-Hmm. And then we go through our to-do's, like, okay, I'm gonna be working on, uh, a bunch of marketing plan strategy stuff today, which falls under a little bit like for, for some of our growth and development.

And that portion of our business plan, like that is a part of my rock. Like at our Cave Junction office, my assistant and I were just looking at some of our to-do's. Uh, at a a to-do is like my assistant and I need to move the a band attachment so we can Mm-Hmm. Get the right mirror size, like Mm-Hmm.

That's not a rock, that's just shit that has to get done. Yeah. Just [00:42:00] basic things that need to get done. Um, those kinds of things where like, oh, hey, we have this, we made a decision at the leadership team level. I need to go. Put that on my agenda to discuss with my department. Mm-Hmm. Those kinds of things are to-dos.

It's not necessarily the higher level stuff. So checking through all of those. And then throughout the week we also add in proposed things that we need to discuss in our issues. Now once we go to issues, like we don't go super detailed on the notes here 'cause we're actually trying to focus on the discussion.

Yeah. So like identify the problem. Discuss the problem. What's the resolution statement? Mm-Hmm mm-Hmm. Every issue on our, on our IDS here, our issues that we discuss has a resolution statement, and it has the person who's accountable for it. We had that issue for a long time, and we were initially starting to implement traction where it'd be like, oh, shoot, no one's [00:43:00] name got put on this resolution statement, so it didn't get done.

Like, it's just very basic things that completely derail the function of like, the practice whenever you're trying to do big growth and development. Yeah. So, and I, that's, that's our, that's our primary meeting right there, man.

Dr. Kevin Christie: That's good. And I think a lot of people have too many open loops. You know, they talk about these issues, this and that and the other thing, and it's not a sign and it just becomes a bunch of open loops.

And then. As the leader or o owner, you get frustrated, then you snap like, you know, this is a way of of of, of avoiding those open loops and having closed loops and, and then when you have that next level 10 meeting, someone say, yep, we got that mirror removed. And that's all set and you cross it off and boom, don't have to worry about it

Keith Yoho DC: anymore.

Yeah, absolutely. And uh, it's funny 'cause you always have like that, that to-do list always seems like it's growing and expanding. Yeah. And it's, that's one of the beautiful things that about like the quarterly meetings is like, you're like, oh dude, I'm so far behind on all of these other things and this, that, and the other.

And then when we sit down and we actually [00:44:00] go through like, what's happened over the last three months, we're like, shit, we actually got more accomplished than we thought we did. Yeah, for sure. Because you just get stuck in, in that, that mode of getting things done that it, it just doesn't always feel like you're.

Getting things done because there's always, always more to do. Mm-Hmm. So it's, it's nice to have that, that step back reflection moment. Mm-Hmm. And realistically, man, on a, we need it on a three-month basis for sure. Because if we went six months, like we would get fried. Like it's nice to step back and like have our reality checks and have our decompression point.

Then obviously there are points within those big discussions that, uh, get a little bit more tense and compressive when we're figuring things out and we're all very passionate about what we do. So, um, if you have a good team like that, expect, expect it to get a little bit passionate at times as well.

Tell people that.

Dr. Kevin Christie: I love it. Well, Keith, this was great, man. I really, really appreciate your, your time today on this. I, I wanted to [00:45:00] give people a vision, you know, and they can always kind of deduct from there where they're at, if what their growth wants to be. But this is how you actually can achieve the growth that you want as, as a particular chiropractor and, and as a practice.

So I, I appreciate your time today.

Keith Yoho DC: Yeah, man. Absolutely. And I just definitely encourage people, especially business owners out there to. Consider if, if like you have big goals and you want to grow and develop your practice, like you gotta bring some people on to help you with it. You don't have to go it alone.

Um Mm-Hmm. That's definitely like the biggest thing. I will, I will a hundred percent come in Scott on as being the original owner and, and him bringing on, you know, some of these other guys as owners. 'cause we would not, we would not be where we're at as a single owner practice. Yeah. Um, and. And we've really needed a lot of the diversity and mindsets and experiences and those kinds of things that, [00:46:00] that each person on our leadership team

Dr. Kevin Christie: provides.

Yeah, that's a whole other great topic would be kind of how the benefits of a group practice and the trends toward that. So maybe we'll do that

Keith Yoho DC: again. Uh, maybe that's a debate between us and a and a solo guy. We'll see. Yep.

Dr. Kevin Christie: All right, Keith, have a great rest of your day. Yeah, you too,

Keith Yoho DC: man.