EPISODE 395: Services I'm Supporting

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 a solo episode. Today, I'm going to dive into some of the services that I, I support or have been using for our practice. Um, if I leave any out here, it doesn't mean I don't support it or haven't used it, but I had to, to narrow down at least for this, uh, round one of potential round two, uh, of episodes.

And so I'm just going to run through some of them. Um, but. One of the things I think I can bring to the table is really bridging that gap for, uh, you know, services into a chiropractic practice. A lot of times I use my own practice as a test lab to see if things do work, don't work, or maybe they would work for other types of practices, but not my type of practice.

Uh, you know, I, I, I tried to eat my own dog food in a sense, and, uh, there's a certain Um, services that I, that I do believe in, and I think it could help you out, or it's least worth investigating. So if you get anything out of this episode today, it's at least worth investigating into it and see [00:01:00] if it would fit into your practice.

There's no one size fits all, and I can't say it's, everything's going to work for everybody. But these are a few things. That I do think you should look into. And I think it's important because, uh, today's environment and our, and chiropractic practices are, it's different. Um, it's different than it was 20 years ago, 30 years ago.

In a lot of ways, it's better. In a lot of ways, it's not as easy, right? I mean, you know, there, there was a time where everybody had in network insurance that paid 100 and co pays were 10 bucks. pretty a lot easier. Uh, let's put it this way. I think what's happening is a high majority of chiropractors 30 years ago could do well because it was a lot easier with the reinsurance reimbursement game, right?

The very low barrier of entry for patients, very low cost commitment for the patient, very high reimbursement for the doctor that allowed for a larger swath of chiropractors to do very well. [00:02:00] Now, I think it's a narrower band of chiropractors that are able to do very well, uh, because obviously insurance is tricky in most states.

It's not reimbursing well, high copays in network deductibles, which didn't exist years ago. So the insurance game is hard. Those things, those that think, uh, having a cash practice. Is easier in a lot of ways it is easier, but in most ways your revenue is going to be substantially less, uh, than a lot of the insurance practices.

It's, it's not as easy. I think one of the mistakes, a lot of chiropractors fail to realize when they go cash and look, we're a cash practice. Um, Is you have to really position yourself as an expert in a community to get a good amount of people to pay cash. And so, uh, chiropractors can do that, and we, we help a lot of chiropractors do that.

Uh, but it's not as easy as, as, uh, it once was. So it's harder, but there's a lot of things that make it, uh, easier. [00:03:00] Better, right? There's a lot of technologies and services that are making our life easier. And I know they can add up and it can cost money, but they all should and could have an ROI. So if you're spending a 250 on something, uh, don't worry about that if you see a pretty.

Great turn on investment. Like for instance, if you're spending 300 on a, on a, on a service that is, um, allowing you to do text reactivation campaigns and you're doing text reactivation campaigns and you're getting people coming in, that's got an ROI. That's not a cost. That's a, that's an investment. So, uh, we'll start right out of the gates with that.

There's a few. Um, that are doing that type of stuff. And you know, one is our sponsor track stat. They, that does a whole lot of great things. I highly recommend you check them out. Uh, they, a lot of car buyers I know are utilizing their service and getting great results with it and enjoying that. So check out track stat.

There's obviously review wave, which is now just wanted to mention, uh, called, called Aloha. They're in the [00:04:00] middle or have finished a rebrand. So they are Aloha now. A L O H A and, uh, you know, they do reviews, but they also do two way texting and text campaigns and a lot of other things just like Traxstat does.

Uh, and then there is Trust Driven Care by Josh Satterlee does a lot of those things as well. So check them out, but have, have some kind of service that's allowing you to do a lot of good patient communication and, uh, those will really make your life a lot easier. The technology is affordable and you will get an ROI out of that.

And it's, I'm going to separate you from some of the other practices. So that's my first, uh, little recommendation on some services. Other sponsors we have is, is Darcy Sullivan at Propel. Obviously, you know, I recommend them. I utilize them in my practice for, I think it's been 12 years now. Um, our, our clients that you use us, uh, for marketing, like, again, we do marketing for chiropractors now, along with our coaching [00:05:00] and Darcy's, uh, company is a part of that.

We develop a robust blog for our clients and she helps out with that. She does a Google business profile review for our clients, but then obviously she, you can contract with her to do all kinds of things, everything from websites to SEO and the like. So we recommend Darcy. Keenest Medical is one of our sponsors now and we're, uh, I have their machine.

I'm loving their machine. We're getting a great ROI on ROI on their machine. I can't say enough good things about Keenest Medical. If you're serious about shockwave and you're looking for, um, equal parts, great technology, great clinical training, cause you do need clinical training on shockwave or someone in your practice does.

It's not, uh, it's not just like a modality that anybody can do. There is a, learning curve. And what's cool about it is when you get a clinician that knows what he's he or she's doing, and the machine has great technology, uh, the results are going to really speak for themselves and you're going to get a lot of referrals.

And we're seeing that in our practice. Uh, [00:06:00] but Ketus also has great service, uh, and, and, uh, you know, just making sure that you're, Unit is, uh, if there's everything, anything happens, they, they provide great service to that and also great marketing and business training on that. So keenest medical on the shockwave just been a game changer for our practice.

And a lot of people in our mastermind group have, uh, utilize their shockwave over the last year to six months and just been a pleasure. Uh, next is, you know, front desk front desk is tricky, right? It's gotten expensive. , employees are expensive now. And I think there's three things I'm seeing carpenters do.

With a virtual front desk. And what we're doing is, uh, during our hour. So we're using a part time virtual front desk through AvidMed. And you can just go to our website, modernchiropracticmarketing. com, uh, disclosure. I am consulting with them to make sure that the product and service is really good. And so I am helping them out with that.

And you can go on our website to check that out. [00:07:00] Modernchiropracticmarketing. com. There's a tab on virtual front desk. And what we're doing is, uh, Uh, the hours were not here during lunches and then our Tuesday Friday afternoons were not here. Uh, the virtual front desk is answering phones and scheduling patients and asking interesting questions.

They could do a whole bunch more, verify insurances, basically like having a front desk person, but virtual and it's a more affordable, not on your payroll, so you don't payroll taxes. You don't have to worry about turnover. They'll worry about it. But you actually get assigned one person. It's not like you have some, you know, 20 different random VAs doing it.

You get what you get a person. And so that's great. And depending on if you're using part time or full time, if you have a full time one for them, it's yours or not. It's not like that particular virtual front desk has 10 other clinics they're working for. They're working for your clinic. If it's part time, you're, you're splitting with another clinic.

And so I like that as well. And so we're using it for the hours we're not here. It's great. Uh, we have, um, some offices that we coach or coach [00:08:00] with us that, uh, they have a full time in, uh, in house front desk person, a human at the front doing all the things, um, with patient facing stuff. And then they have a second front desk, which is the virtual front desk through AvinMed.

And then the other thing you could do is if you're not ready to hire a full human, but you need the phones answered, you need other things done. Uh, we have chiropractic practices that would fall into that lone wolf that are now using a virtual front desk. So check that out. That is Abenmed front desk.

You can go to our website, modernchiropracticmarketing. com. I highly recommend you start to look at that. It's a way of, um, you know, having high function. And I think we have to start looking at those things.

Uh, next is Dr. Sean Thistle. Love his work. Uh, we, my clinic, I think for over three years now has subscribed to his work. If you really want to keep up with the evidence and the research, uh, he's been [00:09:00] on a guest on our podcast. We also collaborate with Sean. He, he, um, develops a really great book. Good, um, slide deck for marketing, the marketing we do for our chiropractors and he designs that for us.

And that's been really, uh, well received by our chiropractic clinics, clients that we're doing marketing for. But if you just want to keep up with the research and you get emails in your inbox, you go to their, his site, he's got a amazing information. So just Google Dr. Sean Thistle. Uh, T H I S T L E and Sean is spelled S H A W N and you can, uh, go and look at that.

But just, you know, I think a lot of evidence based chiropractors always, uh, are concerned about keeping up with the latest and, uh, Sean will help you, uh, do that. Next is MPI. Bye. Get the clinical from MPI, the hands on stuff, um, uh, as I record this, I'm actually in a couple of days leaving for the Adjust A Thon, uh, I'm sending our associate, Dr.

Gage, he'll, he'll be at [00:10:00] Adjust A Thon as well, but then I'm sending him to the, uh, GATE seminar, which we're excited about. And so check out MPI, I think as a, As a chiropractor, as a licensed DC, all too often you're looking to, uh, do, uh, CE courses on all kinds of things, but you know, you might go 10 years, you've, it's been 10 years since you graduated and you haven't been to a hands on palpation and adjusting, uh, seminar since you graduated high school, which is, which is ironic.

And so check out MPI for some of their courses. They're doing a lot more for DCs. And obviously I can't recommend MPI enough. Uh, FTCA, keep up with them. They got a really affordable membership that will keep you in the loop on, on everything chiropractic related. So, uh, still a big, big, um, enjoyment of myself being a member.

Affiliated with FTCA as much as I, I can be, you know, Bobby and I are, uh, business partners [00:11:00] in the Chiropractic Success Academy. He owns and operates FTCA. I obviously have MCM. So there's been a cool little, uh, triangle there for, uh, for a while now. Bobby and I've been business partners since 2018, July of 2018.

And so business partnerships can work out. And then, um, lastly, and definitely not least is vision spark. We're in the process. So I'll let you know when it's done, but we brought vision spark in. Uh, I know them from, uh, my, my involvement with strategic coach. They're involved with strategic coach. They specialize in hiring and we are working with them to develop a really good tips assessment.

And it's a, it's a, it's, you know, pretty substantial profile. They take, it's a 60 minute assessment. One would take, but we're developing one for a chiropractic associate to try to help make it easier for chiropractors, um, to, to hire [00:12:00] associates. And so we're in the process of that. I'll keep you up to date on how that goes.

But if you're looking to hire an office manager, reach out to them, just go to visionspark. com. We had them come to our, uh, mastermind group back in April of 2024. And we did a whole thing about this and with our decision makers in our practice other than ourselves. And it was really cool. Great assessment.

So if you're looking to hire a practice manager, office manager, a second in command, something like that, an integrator. Uh, from, from the, uh, EOS teachings, uh, contact vision spark, and I'll let, I'll obviously make sure I let you know, uh, as we go along. And lastly, I'm going to leave you with this, uh, really excited.

Uh, we're in any day now. starting the first week of the, uh, you know, 30 K per month revenue in your practice. It's an online [00:13:00] course. So many chiropractors are struggling to get to that number. I've outlined why that's so important. You can check out why on the landing page here. Uh, but it's going to be, it's going to be a course that I want you to take.

It's going to benefit you. And if you've ever had a little bit of desire to see what MCM coaching is like, you'll get a little taste of that and go to bit. ly bit. ly forward slash MCM 30 K that is number 30 in letter K. So MCM 30 K bit. ly forward slash MCM 30 K. MCM 30 K. Uh, go to our website. You'll find it there at modern chiropractic marketing.

com. It's in the show notes here. If you want to find it, you'll find it. Go to the Facebook group, modern chiropractic marketing. com. Sorry. That's not redo that Becky. Go to the Facebook group, modern chiropractic marketing. It'll be in there. You can't miss it, but we are excited. To get this rolling. We have a great cohort starting this, and it's going to be pretty [00:14:00] involved over eight weeks to make this happen.

And you will get so much value for the investment that you do in that. So check that out at bit. ly forward slash MCM 30 K. All right. That is. Uh, our episode today, those are some of the services that I am utilizing and I recommend you look into if you haven't already, there's definitely some more. If I left your biz out, don't worry, there'll be a part two of this, uh, in the not too distant future.

And, uh, just looking to make sure you as a chiropractic practice owner or future practice owner, um, are just keeping up to the, the different businesses that are trying to help you grow and have a great and thriving practice.

 EPISODE 396: Services I'm Supporting

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] Hey Docs, welcome to another episode of Modern Chiropractic Mastery. Today I'm bringing you a solo episode and we're going to discuss the realities of chiropractic revenue. I always find it interesting sometimes it's posted in in Facebook groups, sometimes ours, about certain revenues and numbers and there's a lot of misconceptions around it.

There's a lot of misunderstandings of it. Sometimes if you Here are a big number thrown out. Some people think they must be doing something unethical to, to get there. Uh, I've talked to enough chiropractors, uh, that of all stripes in, and there's a lot of chiropractors doing really well and they're doing it the right way.

Um, and really well as a very, um, it's a relative term, right? I could have a practice that's doing a hundred thousand a month in revenue and having cashflow issues. I have a practice that's doing 15, 000 a month. It has cashflow confidence. Maybe they're living a simpler life. Maybe they don't have kids or family yet.

They're younger, [00:01:00] uh, lower overhead. Maybe they're in, you know, Wyoming instead of, um, California. There's a lot of variables to it. So there's no one size fits all. And I do love the, kind of the, the quote from Westgate that is, uh, volume is vanity. Profit is sanity and cash is reality. So we're not here to have is like volume.

Discussion right where it's like, Oh, how many patients you see in a month? But yeah, there is obviously a correlation You know, if you if you see 200 people in a week, you're going to probably Have more revenue than someone that's seeing 50 in a week, but there could be overhead as well But I think there's a lot of misconceptions on what is good revenue for a business, right?

Like if you really think about it, what would it take in a given year of revenue to pay yourself a professional wage? Let's call it a hundred thousand dollars a year. But a lot of you are going to want more than that, right? If it, depending on [00:02:00] again, where you live, if your spouse works or not, things of that nature, but.

It's expensive now if you end up being 35 40 45 years old It's like you may want to make 200 000 a year. There's nothing wrong with that, right? You're a doctor and um, So, you know you think about that like if you wanted to make 200 000 a year Which is well within your right and you should want that and that's a professional wage It doesn't have to be that much but that like it's okay to want that But like what would it take for you to to make 200 000 a year in your clinic's revenue?

Because typically to make 200, 000 a year, um, you're going to need, you know, a team, you're going to need some, uh, nice office space. You're going to, you're, you're going to have to generate revenue to get there. And you know, 200, 000, even if you were really on the lucky side of it and you got to keep 50%. Of what you made, which doesn't always happen.

A lot of people throw that [00:03:00] around and there's always that game of like, Oh, well I got 60%, uh, you know, or 40 percent is my overhead and it's super low overhead. But the problem with super low overhead sometimes is it does limit your ability. to actually generate absolute dollars. And so the, uh, uh, chiropractor owner of a big practice might only bring home 30%, but 30 percent of a million dollars in a year.

Is 300, 000. That's really good. 60 percent of 200, 000 is not as good as 30 percent of a million, right? It's that saying is like, I'd rather have 10 percent of a watermelon than 50 percent of a grape. And that's some of the things that we see sometimes with practices. That sometimes we see is like, uh, the doctor has a high percentage of what they take home.

You know, they're [00:04:00] taking home 50%. But they've designed it as such as that they don't have enough revenue for their actual take home number to be a healthy number.

And so it gets tricky when you, you try to tease that out, but, um, you know, you, you ultimately want to be able to pay yourself a professional living. So let's go back to my example. If you wanted to pay yourself 200, 000. And you're on the great side of things and you're actually able to take 50 percent home.

That's 400, 000 a month that you would want to have as, as collections. And if I do the math on that, right, that's going to be about 33, 000 a month in revenue to get to that 400, 000. And that's, that's allowing you to do it. Now, a lot of you are in higher overhead, right? So if, if I had to guess. A lot of you, if you, you could even do things like [00:05:00] look at, if you look at the profit first model and I'm going to, the, the, the, the substance of this podcast today is going to be me reading a blog I wrote about why it's so important to get to at least 30, 000 a month in practice for most people.

And I'll have some caveats to that, but I even share on here, the profit first model. And if you look at the profit first model, which a lot of chiropractors do, Uh, are utilizing because it's, it's a really nice model. He's got a great little, uh, chart here, the taps, which is your target allocation percentages.

And if you get to that, uh, 30, 000 a month or 360, you're in his column B and it says here owner's pay is 35 percent plus your profit is 10%. So if you were to add those two up, you get to say 45%. You're taking home 45 percent of that. So if I said, okay, we're gonna do 360, 000. In a, in a year and we, we times [00:06:00] that by 0.

45, that's 162, 000 at your, uh, that is essentially your owner's comp, we'll call it. That's good. We're liking that, right? That's pretty good. But if you get into the column C, Which is revenue of 500 to a million, the owner's pay goes down to 20 percent and the profit goes up to 15 percent because typically as revenue increases, the percentage that the owner takes goes down because it takes more overhead to create that revenue.

It's just, it's just business. But that percentage being lower is obviously is, is nice. Okay. It's because you've got more money coming in. If I gave you a 10 million practice and you got 10 percent of that, like that's a million bucks. That's good. Cause a lot of times you can't get to 10 million unless you have considerable overhead.

That's why the percentages for the owner's pay, Timberley goes down as the revenue goes up. And what we're seeing is that just too many chiropractors. [00:07:00] Are not getting the, to certain revenue numbers to build a team and to have a practice that grows and to be able to hire an associate and they get, they get frustrated with that and they, they don't realize that it takes real revenue to get there.

Like it takes practices making 350, a million to, to be able to get there. And a lot of times. I find it's hard for a chiropractor to take home 200, 000 a year in comp. You know, you might run your car through, whatever you do with it, like, but count that as comp. It's hard to get 200, 000 a year in income, like taking home.

Pre tax, without getting revenues up to like 500, 000, uh, 525, 550, 450. It's, it's hard because if you try to keep things so low overhead, it's harder than [00:08:00] generate. enough revenue. And so sometimes people run into this, um, tug of war battle where they're happy that their overhead is really low. And a lot of times it's good, especially when you're starting out, but long term they're like really, they'll brag about the overhead being low, but that low overhead is preventing them from generating enough revenue to actually pay themselves enough.

And so they're stuck. And I see a lot of clinics where they're, their clinic revenue for the year. is 200, 000 a year for like a long period of time. And so obviously if you're, um, if your clinic is 200, 000, you may not ever get to that 100, 125, 150. Obviously you're not going to get to 200 as far as your take home pay if you're out there.

So one of the realities is that sometimes it takes overhead. It takes investing in team and equipment and certain things to get that revenue up, but [00:09:00] there's an ROI on it. So maybe for every dollar you spend, you're getting two. And that's how business works essentially. And that's why I think, you know, 30, 000 a month is so important to get to it.

You know, if you keep your overhead low and you're in, you want to keep things simple and you like that, and you're in certain areas, it's It might be 25, 000. You know, if you're in San Francisco, it probably is 35, 000. Uh, but you get the idea. So I don't want you to get married to the 30 K number, uh, but there's a blog.

You can go to our website, modern chiropractic marketing. com. You can read the blog. It's under our blog section. It was from June 1st. Of of 2023 and uh, i'm just going to read this to you and we'll go from there I'm not going to dissect the charts out here. I've got a chart. I Reference a lot of stuff in here from profit first and also greg crabtree.

So here you go having the luxury of speaking with and coaching many evidence informed chiropractors of all levels has provided me with some great insights into the struggles and opportunities [00:10:00] of the patient centered chiropractor. I've realized that the 30k month average collections is a vital goal to reach as a practice.

As a patient centered chiropractor, I know you aren't trying to make this all about finances, you're trying But let me explain why this is so important and why we are having coaching calls with our members on this, uh, pretty consistently. A practice that can have adequate revenues and profits will be able to, one, provide an excellent patient experience, two, you the doctor won't be stressing about finances and can fully engage with your patients.

Three, you can afford to hire an A team, better equipment, you'll have better space, prevent burnout because you have a team helping you and allowing you to function in your unique ability. You'll be able to potentially offer better services and then you can soon hire an associate to free you up even more and you can start doing the things that really, again, like are in your unique ability and have a little bit more of a freedom of, of time.

All right. Um, so that's it. So [00:11:00] let me continue to read. Let's do a 30, 000 foot overview of the finances. This level of practice, the 30 K isn't an exact number, but you get the point. It could be 28 K in Nebraska, and it may be 35 to 40 K in San Francisco, but I have seen the 30 K number be on point in most scenarios.

I want to take two financial frameworks discussed on our podcast and virtual summits before profit first bottle by Michael Michalowicz. And Simple Numbers 2. 0 by Greg Crabtree. I recommend both of those. Uh, there's books that you can read on that. And then I have two podcast episodes that you can gain more clarity on there.

You can look at that. And that was with Holly Tucker, who is a chiropractor that is probably first trained. And then also I did interview Greg Crabtree. So I dive in, I'm not going to. Read this here part, but I dive into the profit first target allocations that I want you to look through on this blog and, and go from there, but under column B, cause that's what the 30, 30, 000 a month [00:12:00] would fall under.

That's 300, sorry, 360, 000 a year revenue. The 35 percent owners pay in the. 30 K per month scenarios will give you about 10 K month in income, not counting your 10 percent profits. For the sake of this scenario, let's place your payroll taxes for your, your W2 pay within the 35 percent owner's comp. You'll want to seek professional guidance on all things taxes.

And I recommend, uh, that you, you do that. The 10 percent profit will be about 3000 per month. So you've got on your owner's comp. 10, 000 and in your 10 percent profit, you got another 3, 000. That now leaves about 17, 000 for taxes and operating expenses. So we've subtracted 13, 000 from the 30, 000 and you're left with 17, 000.

Let's remove the taxes. And it could be, uh, less than 15 percent from what McCallow says up here at 15%, but you will just remove [00:13:00] that about 4, 500. Uh, so that leaves you 12, 500 for operating expenses. And again, it could be, you could have a little bit more, but just for the sake of this, Now let's discuss the ideal core team.

In my opinion, adding to this core team will be the next goal. When you consistently hit the 30, 000 a month average, you've got the ideal team here is the doctor owner. That's you and in the rockstar front desk, and then the Swiss army knife chiropractic rehab assistant were just a fully involved preceptorship program.

But I do think a great core team is the doctor, the front desk and a Swiss army knife, uh, CA essentially. Okay, now we're going to transition to Greg Crabtree's 2. 0 concept, which they have researched heavily amongst thousands of small businesses. The main concept is that your overall labor costs, including payroll, payroll taxes, employee benefits, and 1099s that service your [00:14:00] business.

should be half of your total revenue. Divide 360k by your overall labor costs, which would be the 2. 0, and that's what you want to come up with. So in the 360k practice, your overall labor costs should be about 170 to 190, 000 per year, or 14 to 16k per month.

If you are taking 10k of that, That leaves you 6K for more labor costs. It also leaves about 6, 500 for other expenses such as rent, utilities, marketing, medical, and office supplies. 6K for the cost of a front desk and a CA could be a tight squeeze depending on your locations, but you could consider a few ways to make it happen.

A well developed preceptorship program could replace the CA position. You could choose to pay yourself a one to two [00:15:00] K per month less to afford both the front desk and CA for a bit. And then that CA will allow you to make a purchase. And if you want, the full 25 percent or 25 percent of the taxpayer revenue, you may, you could opt for a part time CA or one that only works your patient facing hours, and maybe your accountant or profit first specialist determines you only need 10 percent of revenue.

Tucked away for, for taxes, not 15%. That percentage could go towards your operating expenses and your CA. So knowing your numbers, making accurate growth decisions and setting realistic goals get you from being a lone wolf. To having a team based practice. It isn't easy and doesn't happen overnight, but it surely can happen.

But when you get there, you have a practice with a great team, healthy profits to grow with, and a wonderful patient experience, and you can avoid burnout. This great team and healthy profits will launch you into the next phase of growth. [00:16:00] That may include hiring an associate, adding big ticket services, such as shockwave buying or leasing a bigger office space and much more.

There are many variables that tease out for your practice and more importantly, how to get there. We are doing that consistently with our, with our clients. Some of the variables that you want to consider. Or what do you need to, you know, like what numbers do you need to see? How many office visits in a month would equal that revenue?

30, 000, right? Um, who, who do you hire first? And when what's your vision strategy to get there? Are you doing a good job of patient adherence? What's your marketing looking like? How are you developing as a leader? And do you have a remarkable patient experience? All right. And that's the end of the blog there.

You can read that again, go to our website, modern chiropractic, marketing. com to. To check that out, but that's going to give you a really good breakdown of why it's [00:17:00] important. It's not just like a number because we made up a number and we're not, it's not a vanity thing. It's just, we want to build a team and you need to be able to, to do that so that you can do this profession for 40 years and feel good about it.

And ultimately that's why, you know, we're, we're developing an online course. This is going to be a six week online course, all centered around. This 30 K a month and how you can get there. Uh, we're going to launch this on December 2nd. The first lesson will come out, um, in the month of November, up until November 15th, you'll have an early bird discount after November 15th, up until December 2nd, because it will close.

We're going to close it at December 2nd and then actually launch the cohort. Um, you'll be able to sign up in November and join this cohort. That's going to work towards getting the 30, 000 a month. That's going to be six. weekly lessons. There'll be a, it'll [00:18:00] release for that week. And then the following Monday, we'll have a group coaching call around it for asking questions, talking about particular topics.

And we'll also, uh, you could pre submit if you can't, we'll record it, get it to you if you can't make that a group call, but you'll get all that there. And this is going to be actionable stuff, right? It's going to be a lesson that's going to. not just be theoretical is going to actually lay out, um, different steps within these six weeks.

And then you're going to have homework to do. You're going to have action items to take, and you're going to get super clear on what it looks like for your clinic to get to 30, 000. And, you know, you'll give yourself a reasonable timeframe. You know, if you're at 25, 000 and you just can't, seem to get up there, then it might be pretty quick for you.

If you do this course, if you're at 15, maybe it's two years out, three years out. I don't know. Uh, we'll get clear that we're going to, we're going to have a really clear vision strategy around this for you, but you're going to have actionable steps. And [00:19:00] if you actually do the work and it's all going to, you know, you know, how we roll here, it's going to be ethical and elegant and first rate stuff as far as what we're expecting you to do.

We're not going to be having you go, it's like the uber ECO Like, Oh, sell 4, 000 care plans. It'll be easy or a six month care plans. It'll be easy. We're going to do this without you having to feel salesy and we're going to help you develop as a leader, get super clear on the numbers it takes to get there and, and start thinking about why that's important and then show you how to lay out.

Okay. What is your next team member hire? How's that hire? I'm going to help you get to another, uh, revenue level and things like that. And so if you're interested in that, you can sign up now. It's open to sign up and that's going to be at, uh, bit. ly. So B I T dot L Y four slash MCM 30 K. It will be in the show notes.

If you're in our Facebook group, like I'm, I'm going to promote this. Like I don't, you know, I'm going to really promote this. Push this hard because I think a lot of [00:20:00] chiropractors need it. And it's going to be the best money you're going to spend. And I don't speak in hyperbole, but I'm going to push this.

So you'll be able to find it. I'm going to email. I'm going to, uh, I'm going to post it in our Facebook group, modern carbon marketing. You're going to see it. You're going to see it often in the month of November to sign up, check the show notes out again. It's a HTTPS colon forward slash forward slash.

bit. ly bit. ly forward slash MCM 30 K number 30 letter K to sign up for that. And, and you're going to make that commitment to really develop a practice. That's got the revenues to be able to take you to the next step. Now, some of you are. Hopefully you didn't turn it off when you heard 30k because maybe you're at 50k a month already.

If you're above the 30k already, then you could still do this. You're just going to do a different number. Like, let's say you've been at 35, 000, uh, pretty consistently and you want to get to [00:21:00] 45, 000, right? Whatever the number is. The stuff you're going to learn in this course is going to help you get there.

You're just going to have different numbers. Okay, but a lot of I talked to a lot of chiropractors And again, there's nothing wrong with being under 30 and you might be at 18 000 a month in Pigging shit and your love in life. That's awesome But I know a lot of chiropractors that want more for their practice need more to to create To fulfill the vision they created and we're going to help you do this in a six week course That's going to have a lot of actionable items homework and resources for you, but it's not going to overwhelm you Um, and it's not going to like, you're not going to after six weeks have the 30, 000 a month revenue, but you're going to have a very clear plan and start taking all the action steps to get there.

Okay. So go to bit. ly bit. ly forward slash MCM 30 K. And, uh, I'm looking forward to working with you. If you sign up, I I'm very confident in this [00:22:00] again, if you do the work and you might need a mindset reshift as well, and just start to realize, like, I got to get out of my own way and we'll talk a little bit about that, but it's not going to be a, a theoretical mindset, motivational coaching six weeks.

Okay. We'll touch on it a little bit, but we're going to actually give you, um, real things to do in your practice.

 EPISODE 397: What it Actually Means to be an Influencer

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. 

[00:00:00] Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I'm bringing you a great interview with Dr. Steven Janopoulos, and we're going to talk about what it means to actually be an influencer. And I think you're going to be surprised. I don't, you know, uh, you don't think about the energy drinks and the bikinis and, uh, you know, the bodybuilders and things of that nature.

As far as an influencer, you can be an influencer. Uh, By actually having great information. And as a chiropractor, you have phenomenal information. And, and Steve does a great job of breaking that down. I had the pleasure of co speaking with him, uh, at Jay green science event. And he had a phenomenal job of talking about this exact subject.

And he tells his story of how he went from having no Instagram. influence to having a pretty substantial one. And you'll hear that in our episode today. And he talks about how you can do that. And again, do it elegantly with information that is valuable and ethical. Uh, it's not about just, um, what we think of as an influencer.[00:01:00]

And sometimes even I've had that misconception, right? Uh, but you, uh, you know, the other thing too, is Um, you know, if you are a private practice chiropractor, it's, it's more about having influence in your community. We're not trying to turn you into a national celebrity or an A list actor, right? We're, we're trying to position you well as an expert in your community.

And Steven does a great job of talking about that in today's episode. Uh, before we get to that, I just want to let you know, we are in the middle of, signing up people for the 30k a month online course. You can sign up there at bitly bit. ly forward slash MCM 30k. That's the number 30 and the letter K I'll put that in the show notes.

It's going to be all in the Facebook group. If you're on our email list, you're going to get it, but we have put together a. Really substantial online course. That's going to be actionable to show you how to get to 30k, why it's important steps. You can take to get there, setting realistic goals to get there [00:02:00] and ultimately growing that practice to a point where you have more freedom of time, freedom of money, and you're not going to burn yourself out.

You're going to do this now. You're going to get there at a certain point in the near future. And you're going to be all the better for it. And that's going to be a springboard for you to grow even more into revenue. I know many of you are above that 30 K you can take this course. You just got to change your numbers, right?

If you're at 50 K a month and you want to get the 65 K a month, you do the same type of things. You just would have different variables. But it's so much, so important if you're not at that 30 K a month and you're struggling to get there, that you take this course, invest in it and, and, and actually have a plan and strategy to do that.

And I'm going to help you do that. So again, go to bit. ly forward slash MCM 30 K. That's the number 30 in the letter K without further ado. Here's my interview with Dr. Steven Geanopulos.

Dr. Kevin Christie: All right, Steve, excited to have you on the podcast. It's been a long time coming. We've had the pleasure of having [00:03:00] dinner, breaking bread together. We've had the pleasure of speaking at Jay Greenstein's event together, and it's been fun to see what you've been doing before we dive into that. Tell us a little bit about yourself personally, professionally, and then we'll, we'll go from there.

Steven Geanopulos, DC: All right. Yeah, no, it's great to finally talk with you, Kevin, on this podcast. It was almost exactly a year ago that we met. We met at the national, uh, at, uh, Florida chiropractic association. And, um, you know, my story is, you know, I, I do like to tell an origin story. Um, you know, again, chiropractor. I graduated from Parker College of Chiropractic in 1996.

Uh, Parker University was just a great place to be. And while I was there, I was exposed to, uh, the work of Dr. Ted Carrick, a mentor of mine. And I was fortunate enough to, uh, learn neurology from one of his students, uh, at while I was at Parker. And that was for me very important because [00:04:00] I finally understood chiropractic when it was.

When, when it was presented in the context that Dr. Carrick teaches and the basic principles and even the philosophy of chiropractic just made perfect sense to me once I understood the nervous system, the way it was taught. And then, so right after I graduated, I, uh, entered into the, uh, the neurology program, got my three year postgraduate degree in neurology from the Carrick Institute.

Uh, and then from there, continued with coursework in neurology, neurochemistry, and then of course, blood chemistry, because my focus in practice was on, on the brain. My, my, my focus was, you know, what we would call brain based. And, uh, when you work with people with brain based challenges, whether it be children with developmental disorders or seniors who've had strokes.

And or, you know, early cognitive decline and anything in between, [00:05:00] you know, sports, concussion, et cetera. Whenever you're dealing with the brain, you're always dealing with metabolic health, right? We were taught in chiropractic college that the, the central nervous system is the master system. It's the system that controls all the other systems in the body.

And if. You're going to interfere with nervous system function. You're going to interfere with the function of everything the nervous system controls. And there is no place to see that more evident than in people with brain based, uh, challenges. So studying metabolic health and blood chemistry really became my focus in the two thousands, uh, going into, um, the, the 20 teens.

Uh, and then from there, uh, I kind of developed a little bit of a reputation among our profession, our colleagues, as being a go to resource for chiropractors who have more traditional chiropractic practices and would be presented with a [00:06:00] case that required some consultation with me to help them with those cases.

So I used to do a lot of consulting, patient consulting with chiropractors. And then I Kind of took that to another level during the pandemic, uh, and and created a, uh, blood chemistry reading service as well as a, uh, small nutritional supplement company. That's based on making a difference in, uh, in blood chemistry.

Dr. Kevin Christie: Love it. Love it. And then, uh, what was that transition during the pandemic to, to kind of spur that along?

Steven Geanopulos, DC: Well, you know, The one thing about the pandemic was it was one of those things that happened in our careers that that changed things. Right. So I remember when I first opened my practice in Manhattan in the 90s, you know, when 9 11 hit, we were all especially in New York City, but in our country, kind of dazed and confused about what, what, what that all [00:07:00] meant.

Right. And especially here in New York City. So, um, I found myself just kind of, you know, You know, following the crowd and seeing what everybody else was doing to, to best respond. And then fast forward, uh, to the 2008 financial crisis, uh, 2009, whenever it was. And again, found myself reacting. And feeling dazed and confused.

Uh, and I remember it, I was at an event with the UAC organization that Jay Greenstein and I belong to in, uh, in March of, of 2020. And 20 percent of the, of the attendees, uh, Couldn't come because their flights got canceled and our event was great. It was at a great hotel in Scottsdale and we had a great time.

It was almost like a spring break kind of kind of an atmosphere. But that Thursday, the world [00:08:00] shut down. In in March of 2020. So I remember, uh, being on the flight home and and thinking to myself, there's something going on here like this, this, you know, 20 percent of the flights being canceled and all of that.

There's something going on here and and I'm no longer going to find myself. reacting, like I'm going to get out in front of this. And for 10 years before that, I've really, uh, again, created that reputation to the point where I had, uh, my practice was already 50 percent virtual. And the reason was, um, you know, 50 percent of my practice were, were referrals from chiropractors.

I was co managing, uh, patients from around the country with chiropractors. And I said, you know, If there's anything that's going to, uh, leave somebody vulnerable from a health standpoint to a [00:09:00] pandemic is going to be their metabolic health. And that that's really my, my wheelhouse. And my thought process on that plane ride home was, um, How, you know, the medical profession is not going to help people improve their metabolic status.

That's just not what they do. And if a pandemic hits, well, their focus is going to be on the ill. They're not going to be on the people who are not ill. So, You know, we're 60, 000 strong in the chiropractic profession. We have a primary portal of entry licensure in every state and we're board certified and, and board, you know, we, we, our board exams include everything that would be necessary for visceral diagnosis, you know, uh, to, to be able to understand.

All of physiology and I thought, you know, I don't want to inspire chiropractors to go and do what [00:10:00] I did, right? I, I love to just do You know, sit on the beach and read a physiology textbook as opposed to a novel. Most people are not like that and nor should they be. Um, so inspiring chiropractors to become who I became is not what I wanted to do.

What I wanted to do is take the busiest chiropractors in the country who are just awesome at what they do, great with their hands, who recognize when their patients have metabolic concerns that they cannot address. They know that sending them back to their medical doctor is going to get them nowhere.

Can I scale or create a product and or service that would allow me to have a wider reach? And that, you know, I'm sorry for such a long answer to your simple question. No, this is

Dr. Kevin Christie: gonna, this is gonna help us connect the dots here.

Steven Geanopulos, DC: Yeah. So, so that, that was, you know, and then I, I just sat there and thought, how, how do I do this?

And I had no idea. And I guess the pandemic was a blessing [00:11:00] because boy, we all had a lot of time to kill. So, um, I actually, you know, So that, that was March of 2020. So I want to say March like 10th or 11th or somewhere around there. March 8th, I think was that Sunday. By the end of April, I was on a flight.

Now just think about this. I was on a flight from Newark, New Jersey to Chicago to meet with a buddy of mine to hammer this out. And we couldn't, I just knew I couldn't do it on zoom, had to be in person. I was on an airplane in Newark airport, the last weekend in April. 2020 at a, at a terminal that usually has, I don't know, 20 airplanes.

There was one airplane and three people, me and two others. And we flew to Chicago. I get there. I jump on some bus to go to a. Airport hotel and the bus was a massive bus. I'm the only guy on the bus It's [00:12:00] wrapped. The guy is wrapped in plastic and and it drops me off in front of the hotel And I walk into the hotel.

There's not a soul in the hotel. It was right out of the twilight zone There was one guy wrapped in plastic Sitting behind the front desk. I check in I go to sleep I wake up and I do what I always do when I travel I go to the gym I go downstairs. I go to the gym. There's not a soul. It's almost as if I'm the only, it's right out of the twilight zone.

It's like, I was the only person left alive and I'm going to go work out. So I do that. Uh, my buddy meets me in the lobby of the hotel and we sit there for what seems, I think was about 16 hours straight hammering out a plan. for providing metabolic health services to chiropractors. And that was, uh, again, the first weekend of May, last weekend of April 2020.

Um, we launched the business in that [00:13:00] following September as a, uh, just a beta test. Uh, we were getting great results, we liked what we saw, and we've been in business now for, for four years.

Dr. Kevin Christie: That's awesome and I wanted to hear that origin story because everybody has one everybody's got a niche and then it's going to help us bridge the gap from where you came from to where you are today, which we'll get there.

And then, uh, you know, during my talk, which was a little bit before your talk at Jay's event, I had asked a question and I was trying to put myself on the spot here. And I was also trying to get people to think a little bit and I asked the question, who wants to be an influencer? Right? No, 1 really raised their hand.

And I said, let's do it. You know, there's a whole other level of dysfunction. If, uh, if you become an influencer, I was kind of making making fun of myself with the podcast and the things you beat yourself up on when you try to get information out there. And I do want to touch on some of how you, how you manage getting yourself out there because I think some people kind of get [00:14:00] internal on that and they don't want to educate people on a grand scale because they're afraid of what people are going to think.

And I always have battled that with the 7 years of this podcast, but. One of the things I was trying to get out of them as well was understanding that, you know, sometimes words have meanings and we do see, we say the word influencer. And I think, unfortunately, too many chiropractors think of the, uh, the guy pulling up in the Ferrari and the, you know, and it has no real knowledge, but is good looking and has a Ferrari.

And is selling some kind of energy drink. So no offense to anybody that's listening. That's good looking as a Ferrari and sells energy drinks. But I think that's what they sometimes think about when they hear that term of influencer, or they, they don't even put any information out there because they think it's either zero or influencer.

It's like, I either have to be an influencer or I can't get anything done. And the reality of it [00:15:00] is, is obviously if you have a, a unique education and a unique point of view, like you do, or like our audience does, it's about becoming an educator and doing that. Can you speak to that a little bit?

Steven Geanopulos, DC: Oh, yeah, for sure.

So, by the way, uh, most people now know me because of, I guess, what you would call an influencer status, particularly on Instagram. Which, Did not exist. So that whole origin story I told you was, you know, 2020, let's say to 2022. And so, you know, we were up and run running our business was really geared towards a, uh, business to business relationship with doctors in the field.

And I was in a meeting with my accountability group, uh, people that I meet with on a regular basis to, you know, hold ourselves accountable to the stuff we say. Mm-Hmm. . We said, you know, we [00:16:00] committed to, uh, doing content, uh, on Instagram at the time, I guess Instagram was before that all of my social media, you know, I, I grew, I grew up in the nineties as far as, as a professional.

So, uh, I was by, by the time social media became a thing, I was already in practice for 15 years. And therefore I use social media just for. Family and soccer and kids and travel and some goofy opinions I have about on things, but really, there was nothing about marketing or practice or anything. And same, so when this happened, so June 18th was the first video, June 18th, 2022 was the first video I dropped.

I, I, somebody to help me with the editing, but really, the challenge was, can I come up with content? Where it would be five videos less than 90 seconds long. And when I was trying to think of what would my content be, it was, [00:17:00] the easiest, uh, thing to say was, well, what do I say every day to my patients? And what are the things that I say that get that light bulb?

To go off on top of people's heads, right? I mean, we all do that. I don't care. If you're, if you're a chiropractor, you know, there's certain ways you say things that people just are like, Oh, I get it, doc. Thank you. So that was, you know, how I started with those videos. And again, it was just a challenge. I was not comfortable with my voice, myself on camera or anything like, like that, but I made a commitment to my, to my guys.

And so I posted five videos a week. For the summer, June 18th to August 31st, I had 600 followers on Instagram only because that's what migrated over from Facebook. And from June to August 31st, I went up to 3, 600 followers. And I gave myself a big pat on the back and said, Oh, wow, this [00:18:00] exercise was fun. It was worth it.

And look at this, I quadrupled my, you know, my, my, my following or more than quadrupled my following. And next thing you know, I wake up and I have 14, 000 followers. By that night, I have 25, 000 followers. By the end of that week, I have a hundred thousand followers. And now I'm on Instagram at 800, 000, uh, almost 200, 000 on, on Facebook.

And so, uh, Let's say a million, right? Uh, so now I'm an influencer. Well, this was not even my target market. Like, I'm trying to pull back from practice, you know? Um, but now I have this whole population of people that I, My, my, my business, uh, endeavors were definitely not part of like, so this wasn't part of the plan, I guess is what I'm saying.

So when you spoke at Jay's, uh, Dr. [00:19:00] Greenstein's event, um, and you said, who, who wants to be an influencer and no, no, nobody raised their hand. I got up there and asked a different question. I said, who, if you found yourself accidentally becoming an influencer would stop. Answer is no one. So. Putting information out there is not about you.

It's just not about you. Um, it's really about, and, and, you know, for me, just getting, getting direct messages from people all over the world who are just, again, I'm not even giving advice. I'm just teaching. And, but people are taking the obvious next step and DMing me their results. And it's great. It's, it's fascinating and people just saying thank you and I never heard it explained that way and all those things.

So now My, you know, my, now I, I have [00:20:00] something there, but at the same time, I have a dream and a goal for my businesses. I'm not going to all of a sudden put that aside and start something new. Everything has to be cohesive. So that's been my challenge since this whole influencer thing started. But my intention was never to go global.

And if I'm global, great. If I'm not, who cares? Um, it is weird to kind of have people recognize you in airports. Because that has happened. Um, and that's kind of fun. Especially my, my children are like, you know, oh my god, dad's an influencer. Like, what, what, what the hell's going on? So, um, you know, to your, to your, I guess, to your question, um, it doesn't matter what your following is.

What matters is that you're providing value. In a way that is truly [00:21:00] remarkable. If there's anything we can really be joyful about when it comes to social media is the ability for us to broadcast and. You know, to, to use, to have a little discipline to not broadcast every thought that's in your head because nobody cares.

Um, but also to broadcast what is a value to people that you serve. Um, so yeah, I have a lot of political opinions. I have a lot of opinions on raising my kids or, or, you know, what, but my videos and my page is, you know, focused on one thing. Providing value in, to my audience, with content that is based on my specialty as it relates to their health.

That's it. I don't care about assassination attempts. I don't care about, you know, any kind of politics that are going on. I don't [00:22:00] care about any, uh, you know, uh, music, uh, things that are going on. That's not what I'm using my page for. I have opinions on those things, but I usually save that for people. I'm talking to in, like, in person.

Yeah, we've had those

Dr. Kevin Christie: conversations. Yeah.

Steven Geanopulos, DC: Yeah.

Dr. Kevin Christie: So, no, it's great. And it's mostly about metabolic health, right? Brain based health. And who is your. Target audience. Is there one? Is there multiple? Because I'm sure you have some crossover between obviously doctors watching and then also just the lay public.

What's the, the target there?

Steven Geanopulos, DC: Yeah. So my, my strategy is interesting to me. Uh, it might be interesting to your listeners, but the strategy is I want, so my, my superpower is I make complicated things simple enough to understand, even if you understand it just for that day, you know, some, sometimes people can explain things [00:23:00] in a way that's like, Oh my God, like that's what quantum physics is like, Oh, I get it.

But the next day you lost it. But for that brief amount of time, I knew that that explanation worked for me. Um, so I that's my superpower. So with that being said, my, my video content. is really at a doctor level. There's no question about it, but people can understand that stuff. You know, we, we, we make the mistake, you know, we, we don't realize that, or people don't realize that the language we use in, in, in medicine is basically Latin and, you know, Latin and ancient Greek, two dead languages.

That's, that's where those words come from. That's what makes it. Almost like proprietary, like you got to go to medical school just to learn that language. Well, what if we just take the concepts and explain those and use real words? People get it. They understand it. So my target [00:24:00] audience is to both the lay person and the doctor.

I want to teach the doctor how to communicate with their patients without talking over their head, you know, without saying, listen, your hemoglobin A1C is high. And that's a problem. Well, doc, why, why, why is that a problem? Well, because you're pre diabetic. All right. What is hemoglobin A1C? Like, what are you even talking about?

So, that's what the medical profession has done. They just say, this is high, this is low, do this, take, take that. And people just go about their business and they have no idea what, what's wrong with them. Whereas I say, well, here's what it means. Here's the connection to your genetics, your, your, your lifestyle, your, your diet, your, your exercise or lack of exercise.

And here's why things happen. So now you tell me. How would you fix it? You know, and, and people are like, Oh, well, since you explain it that way, the solution is to do [00:25:00] this. And the answer is yes. So that's Socratic, right? Asking questions. Um, but you, you can't ask the question unless people know what you're talking about.

So the target audience is the lay public and doctors who want to better communicate with their lay public or their, their, their patients. And if that doctor would like to learn more, well, then they, they can reach out to me and I can provide additional resources for them. But if that lay person wants to learn more, they too can reach out and I can provide additional resources for them.

Dr. Kevin Christie: That's great. Now, are you obviously you're building, you got 800, 000 plus on Instagram, 200 on Facebook. Are you trying to get some of them off the platform, like get their email address or physical address or get them to your website? What's the thought process and strategy around that?

Steven Geanopulos, DC: One thing I don't [00:26:00] do is.

Since I, I have an audience, and by the way, I mean, there's a great article written, I, Tim Ferriss used to refer to it all the time. I think it was written back in like 2008 or 2009, but it's so relevant, and it's called, uh, 1000 Raving Fans. Um, and, you know, that, what, if you want to be a tremendous success, That's really all you need, right?

You don't need 800, 000 of anything. Um, so again, building your audience. is something that is really not a lot of work. It just requires consistency, clarity of message. That's it. I think consistency and clarity of message. Um, and your audience is going to grow. There, there, there's an audience for you out there.

So we have this ability to broadcast. Um, Now, I'm sorry, just [00:27:00] restate your question. Just so are you getting

Dr. Kevin Christie: anybody from the platforms to an email list or anything? So that way you actually have that, that you don't have to worry about the algorithm changing.

Steven Geanopulos, DC: So the reason I brought that up was. I'm not going to sit there and say, Hey, I use this, like, I'm not going to all of a sudden become some kind of a product salesman, you know, like for television.

Right. So I'm not going to be like, buy this magnesium and, you know, I have my own supplement company. I don't, it's a doctor's only supplement company. I don't promote it on, on my site, on, on my, on my social media, but I can provide. a quick and easy guide to reading your own blood work. And in exchange for that, you pay me with your email address that I have a great deal of respect for.

And the answer to that is, uh, also very important because Instagram, TikTok, YouTube, all of these platforms, [00:28:00] you don't own them. They don't belong to you. That 800, 000 can become zero like this and I have no recourse whatsoever. So ethically building a list to create community outside of social media is the strategy.

Pulling down those email addresses and cultivating a relationship is, I think, a very smart thing to do. Uh, and again, you may not even have, like you might be a chiropractor just providing chiropractic care 30 hours a week or 20 hours a week in your practice. That's all you do. That's all you want to do.

You're not going to do more than that, but don't you still want To nurture your community, provide them value, and you can do that with a newsletter. You can do that with downloadable guides, and you don't ever have to sell anything. [00:29:00] Everybody knows an email list is very valuable to whatever kind of business you have.

Um, I'm sure there's formulas that, that people have on, if you have 50, 000 email addresses, it's probably worth this amount of money. And I'm sure those formulas exist, but, um, rather I don't want to be a salesman. On social media. I don't pay for ads. I don't pay for followers. I don't pay for any of that stuff.

Not that I'm averse to it. If I am going to sell on the platform, I would rather sell using ads than sell because people have an expectation. If they see that it's not an ad to not be sold to, whereas if they see that something is an ad and they still click on it, well, there's, there, there, there's permission there, right?

So I'm not averse to selling on the platform, but I will do [00:30:00] so when I choose to, uh, I will do so in an ad setting so that there's, there's permission. And it's not like a, I don't know, a bait and switch.

Dr. Kevin Christie: Yeah, you know, and I think one of the kind of segue a little bit that I really appreciate that what you've done is I think a lot of people think of Instagram growing a following they, you know, whether it's tick tock or whatever, you know, they're thinking of someone that maybe is a Gen Z millennial that's doing that.

It's never too late to change the direction of your of your life. And you were, you know, Uh, kind enough to share with me your family vision before we hit record today, uh, about travel. Uh, can you share that to our audience? I'd love to hear that and then kind of see how that's, uh, going to happen.

Steven Geanopulos, DC: Yeah. So I, I had been in practice in Manhattan for 23 or 24 years, um, before the pandemic, right?

And the pandemic hit, [00:31:00] like I said, I was already 50 percent virtual in my practice. And I saw it as an opportunity to do this new venture, uh, knowing that I'm going to have to pull back from, from practice, uh, or, or not grow the practice. And then I had to decide, do I want a brick and mortar location anymore?

And my answer to that was, no, I don't. Um, I, I think When I graduated, uh, I, I would look at dentists and chiropractors and other people, you know, uh, like, like us and say, all right, what does my career path look like? Is it 30 years of, you know, opening a practice, buying the real estate, making some good investments, going to the office, opening the doors, closing the doors, you know, just doing that and then retiring and then selling my assets and have it having a nest egg, which is a great life.

Yeah. And I [00:32:00] knew that's definitely not what I want to do. Matter of fact, I was shocked. I, I, I remember thinking back then, I only want to practice for 10 years. Now the 10 year number was important because I always prided myself on being a good clinician and I don't think you can be a great clinician without at least a decade under your belt of knowing what you're doing.

But then as I started doing this more detailed kind of work or this specialty kind of work, I remember thinking, I don't ever want to be clinically irrelevant. Okay, always want to have patience in my charge, right? I always want to have patience to be responsible for I want to stay sharp. So, so when I, when I decided to do that, I said, all right, I'm going to.

All my virtual patients are under chiropractic care, all of them. So I want to keep that going because I don't [00:33:00] want to be a kind of a chiropractor that that's, you know, the number one thing we do is put our hands on people. So if I'm going to be virtual and I can't do that, they better have somebody doing that for them.

Like whenever I get a new virtual patient, I always ask, you know, who's your chiropractor. And if not, I help them get a chiropractor. That's pretty cool. That's so important to me. I'll address the metabolic concerns, but let's not pretend. that, that what chiropractors do is not the main thing, right? I always say, make sure you keep the main thing, the main thing.

So, you know, with, with that being said, um, now I have this opportunity to take my business, And do it from my laptop. All I need is wifi. And now, you know, I, I traveled to Europe these last few years. And, um, my wife and I are both Greek and we have strong ties to the, the country that our, um, families came [00:34:00] from.

I'm an American. I want to make American dollars. I want to pay American taxes. I want to, I'm an American. I'm not interested in living, excuse me, uh, in living somewhere. That's not my home. My home is America, but now I can be an American from my laptop anywhere in the world. And our intention is to spend a total of 12 weeks.

It could be six weeks and six weeks to book end the summer. Um, and, and work, work abroad, uh, in, in, in a place that, that my wife and I are both familiar with. We speak the language. I can do all the things that I, that I want to do. So being again, an influencer opens up a lot of doors. As far as that goes and, and few chiropractors realize that, um, there are 14 states where you can get a, uh, [00:35:00] telemedicine chiropractic license, which opens up about 140 million people to, to you to market to.

Dr. Kevin Christie: Yeah.

Steven Geanopulos, DC: Um, and that's awesome. Uh, now there's outside of those. Marketplaces. Well, you can provide telehealth services that so there's a difference between telehealth and telemedicine telemedicine requires, you know, there to be a diagnostic kind of clinical decision that's being made. That's based on your license and and your malpractice insurance and making sure all of that is in order.

Um, so you can have a telemedicine license in 15 states, um, yeah. I don't know off the top of my head, I couldn't list those, but, um, that's something that if somebody wants to reach out to me, I can help them find out. And then, of course, there's now, uh, all kinds of companies that help doctors get licenses in multiple states and manage all [00:36:00] their CE credit.

I mean, you know, You got to pay for it, but could be worth it. It's certainly worth it for me.

Dr. Kevin Christie: Yeah, that's cool. And you know, and I wanted to hear that vision because you're in a short period of time, we're just talking a few years, I'm really able to get there. And I think for some chiropractors listening, it may not be living somewhere six weeks or 12 weeks.

It could be, you know what, I want to get down to two days a week of physical treating patients, and I'd love to supplement it with X, Y, and Z, because I have a unique niche, uh, that I could, you know, build a business around and become an educator around. And I just think we, I want chiropractors to start looking at that.

I think we have to, Start expanding our horizons. You know, insurance reimbursement isn't getting better. Cost of running a business isn't getting lower. Uh, you know, having a diverse, uh, revenue opportunity is, is very important. It's been something for me that I've been able to achieve with, with MCM and, and kind of, uh, you know, tackling that together with my practice.

And it does give me a level of, [00:37:00] uh, freedom that, uh, you know, I've been practicing for 19 years. So I put in my work and still treating patients and, uh, you know, but I think it's, people can. Get inspired by this. They could carve out their own niche. They can carve out their own vision, but realize if you, like you said, if you have clarity and consistency, and then you get pretty clear on a, on a good target audience, uh, it's amazing what you can do in a short period of time.

So I, I'm pretty, pretty impressed with what you've done doc.

Steven Geanopulos, DC: Thank you. Thank you. Yeah. No, it's, it's, it's, uh, you know, we, we need to just expand our horizons a little bit. We need to think about as chiropractors, what is it that interests us the most? Um, you know, where are some of the challenges going to become coming from?

Right? Uh, so there's a lot of doctors out there who are hiring associates and well, what do you do? A couple of things. One is you can hire an associate to free you up to be as busy as you've ever been. But now the, yeah. You have, you have an associate that you're earning from, [00:38:00] or the business is so successful that you just want to be able to pass it on to somebody else and free up your time.

Like you said, I only want to adjust or be in the, in the office a couple of days a week. Well then what are you going to do with that additional time? There are a lot of colleagues and friends of mine who are into hunting and they have all kinds of hobbies. Me. My hobby is, like I said, reading a physiology textbook on the beach.

I, other than riding my bike and going to the gym, I really could care less about having a hobby. Like I, I'm a, I guess somebody who likes to learn. I'm somebody who likes to innovate. I'm somebody who likes to be productive. And if I'm not going to be a hands on practitioner, well, then I'm going to use that time to create something new.

Dr. Kevin Christie: This is awesome. Well, this has been a true pleasure. Very informative. I appreciate the, uh, you know, the candor. Honestly, it's really, really nice to hear. And, uh, I think, uh, [00:39:00] people could take a lot from this. Um, how could they find out more information about what you're doing? Um, your Instagram handles anything like that you want to give us.

Steven Geanopulos, DC: Yeah, all my social media, YouTube, Twitter, uh, LinkedIn, all of it, everything, Facebook, Instagram, it's at drsteveng, so it's d r s t e v e n g. My website is drsteveng. com, um, so I'm easy to find, uh, and Well, I love to speak. I like to get up in front of groups. If anybody's in Florida, um, I will be at the, uh, at the national doing a two hour presentation on the 17th, um, in Orlando on metabolic health.

I'm really excited about that because I'm going to be talking about metabolic health. What does blood chemistry mean to a chiropractor? It's not the last thing I want to do is for chiropractors to, you know, I always, Say, uh, like an x ray. Chiropractors have been using x rays [00:40:00] since 1895. So, um, X ray is something that does not belong to anyone.

Orthopedists use it, chiropractors use it. And if you take a lumbar x ray or a cervical spine x ray and you hand it to an orthopedist, he's going to look at the data and interpret it accordingly to their needs. skill set and a chiropractor will have, will do the same and it will be very different, be very different.

Now, both doctors are responsible for picking up the tumor or the fracture or the, the pathology, but their interpretation is not going to be the same. It's going to be different and neither of them are going to be wrong. Okay. Well, blood chemistry is the same thing. I'm not here to diagnose leukemia, but you know, and pick up, although I'm responsible.

To see it, if it's there, I'm saying, how can I remove metabolic interference with the optimal [00:41:00] expression of health through lifestyle, diet, nutrition, what does this mean to me as a chiropractor? So that's what I'm going to be teaching for those two hours in Orlando. In addition, there are four other assessments that are done in an office that the five together, blood chemistry and the four additional ones, are a simple, easy way to assess somebody's longevity, metabolic health, risk for injury, etc.,

in a way that's the most tried and true, inexpensive, research based. I'm not going to share what those other four things are, because if you want to know, you got to come to FCA Orlando, August 17th, or dig through my Instagram where I have plenty of videos that explain it all anyway.

Dr. Kevin Christie: Well, they can go watch your talk and then they can go watch my talk that I'm doing with, uh, with Jay Greenstein.

So, uh, look forward to seeing you in Orlando. And thanks again for your expertise today. [00:42:00]

Steven Geanopulos, DC: Appreciate it

 EPISODE 398: Protecting Your Practice If You Get Hurt

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. 

Welcome doc to another episode here. This will be a solo round and it's a topic that was brought up during one of our group coaching calls. And I was like, you know what, that that's a good podcast episode. I'd like to share that out to as many people as possible. And, uh, that's the beauty of, of some of the group coaching calls we do is we come up with great ideas and we can share some of those with you to help, help grow.

And in this case, protect you a little bit. But, um, before we dive into how to protect yourself in case you get hurt. Uh, or probably at some point get hurt. Uh, before we dive into that, I want to let you know that you can sign up for our, uh, 30 K per month online course. This is a substantial online course.

It's going to take eight weeks. We're going to give you one lesson per week. We're putting a lot of effort and thought into it. And. With action steps and resources. It's not just one of those kind of run through and get overwhelmed by a short little course. [00:01:00] It doesn't really give you any direction or guidance.

Uh, and so we're, we're really excited about this. We've put a lot of effort into it. You can check that out at bit. ly bit. ly forward slash. MCM 30 K. That's the number 30, the letter K. Uh, you can find this on our website, modern chiropractic marketing. com. You can check out the show notes, go to the Facebook group, modern chiropractic marketing.

Uh, you can find it, but we are going to have a cohort of chiropractors that want to set a goal of, uh, reaching that 30, 000 per month revenue and why that's so important and what that does. For you, but at the same time, again, we're, we want to be patient centered. We want to be ethical. We want to be. Doing anything that's just money based but the reality of it is is too many Chiropractors are struggling with the revenue and they're getting burned out because of it They're not seeing the growth that they envisioned and they're questioning why they even got into chiropractic and that's what's happening [00:02:00] Uh, we're trying to solve that for you and get you on the road.

You know, if your revenue is 12, 000 a month right now, uh, 30, 000 a month might not happen in six months, but you can get a big step forward and at least have a path to get there in a couple of years. Some of you are at 20, Uh, bump to get up there. Some of you are way past that, and this would still be good for you.

Uh, maybe you need to go from 50, 000 a month to 65, 000 a month, and a lot of the fundamentals in this course are going to help you get there. And so check that out again at bit. ly forward slash MCM 30 K number 30 letter K and join us there. You will not regret it. All right. So. Uh, what happens when you get injured first to tell a story about when I, uh, I got my hand bit by a shark in the keys.

It's not really true, but I like to tell it that way because it sounds better than what really happened to me, uh, back in [00:03:00] 2010. 17. I believe it was. I wanted to go down to Key Largo, Florida. I wanted to run a hotel for a night, go there during the day, stay the night and leave some time the next day.

Midday brought all my strategic coach stuff there. I wanted to really kind of look at the last three years where I. Made progress where I failed really do a lot of, um, reading and thinking on that kind of just an escape a little bit to, to reset. And I was going to go all out. Uh, I wasn't even going to go and do anything fun down there.

I got a nice cool little cottage on the water. I even brought my own food. I didn't want to go out to eat. I just wanted to hunker down and. and get deep. And so I went to this little Italian market where I lived and got some, some food, some provisions, one would say, and one was a can of tuna fish. Um, never forget that can of tuna fish.

And it wasn't your standard can of tuna. [00:04:00] And I got down there. I had to wait a couple hours to check in. So it's just relaxing on the bay there. And finally I was getting hungry. Finally was able to check into my room, uh, about 2 30 PM. I go in there and I get this can of tuna fish out. And it's one of those pool tabs and, uh, I'm pulling, it's not really going pulling, pulling.

And as you can imagine, finally released and like a little circular saw this tab just sliced open my hand. And unfortunately for me, It didn't cut any tendons, which I had done when I was nine. So it was definitely a little bit of a panic moment for me. I sliced a couple of tendons in my fingers, uh, when I was nine, as you can imagine, it was elaborate surgery and rehab after that lost my third grade year cause I couldn't write and had to do verbal tutoring for, for, uh, nine months, not, not a good time for an active.

you know, third grader. And so luckily I just needed stitches at [00:05:00] a, go to the hospital and do all that. But the tendons were intact. Uh, but I couldn't practice for two weeks. And, um, you know, it was one of those things where luckily I did have an associate. And so that is, um, you know, my story of, of getting injured and missing work.

And a lot of chiropractors have that story. And a lot of you, um, you know, it's something that you have to consider. And so I wanted to have this episode where we talk about a strategy of, of how to protect yourself if you were to get hurt. And we're not talking about long term disability in this particular episode.

We're talking about just, you got hurt, you're going to get better at some point, but you could miss a week. a month or even longer. And so what do you do in that sense? You know, obviously I had an associate or if you have a partner doctor, you're in a good situation. That's a big layer of protection for you.

Now, um, if you're both at capacity and one's out, yeah, you're going to lose some business in that scenario as well, but you're not going to lose all your [00:06:00] revenue. So having a, another doctor. Is, uh, obviously a good first line of defense. If you don't have that, I would start, you know, even for the vacation stuff, I would start looking for a good locum that you can rely on consistently.

So that would be my second piece of advice is, uh, find a good locum that will also help you out, uh, with, with vacations that you take. And so the locum tenons can be of use for you and definitely in a need or a pinch if you get hurt. Or, you know, let's. Let's even, um, put it this way, right? If you're a female chiropractor and you own the practice and you're the only doctor pregnancy, obviously it's not an injury, but it's a short term situation where you're not going to be able to practice.

And so you've got to be thinking about it that way as well. The, the next thing to consider, the third thing to consider would be an Aflac or, or a, Whatever else type of short term disability, this is [00:07:00] for exactly this type of situation. So all of you should to get a short term disability plan that will cover you if you were to get hurt or I, they even have it for, um, for hospitalizations and pregnancies, I believe.

So check out that. I know Aflac is one that a lot of people utilize. There might be other ones that I'm not aware of, but look at a short term disability plan. disability plan. Okay. Next is this is why you would have an emergency savings two months at least of all of your clinic expenses in an emergency savings account.

This is, this would be an emergency, right? If you, uh, got by a shark in the keys, like I did, um, uh, you would, uh, in this two weeks, it would be nice to have emergency savings to cover that if you're by yourself. So get that emergency savings going next is have a. unused line of credit, especially if you don't have a [00:08:00] healthy, um, emergency savings.

This could be a good little buffer for you. Try not to use it unless it's an emergency. So an unused line of credit would be another line of defense. And, and then lastly, just honestly, you know, You got to avoid dangerous activities. I know that's tricky, but if you don't have these layers of protection, uh, maybe don't do it.

Like I didn't ski snow ski for many years because I didn't feel confident in my snow skiing. And, uh, And it's something that, uh, I, it's got a higher risk. We know that. And I didn't want to miss work if I got injured substantially. And so I, I didn't do it for quite a long time. Now I feel like I got a lot of different layers protection and I went snow skiing and whitefish Montana in 2023.

And I'll. Be going to Park City, Utah with our West mastermind, which you can join. We have some space if you'd like, uh, go to modern chiropractic marketing. com to check that out. There's a tab for mastermind, but we'll be in Park City, [00:09:00] Utah in February and I will be skiing. Uh, but yeah, you got to, you know, consider where you're at in life and practice and can you afford to get hurt?

And if you can't afford to get hurt, there's certain activities that are on the high end of getting hurt and you want to make sure that doesn't happen. So avoid that save you a lot of heartache, right? So just to summarize. The reality of life is you could get hurt and you may not be able to work. And so it's good to have a, you know, a partner doc, an associate doc.

If you don't have that, find a good locum, definitely have a short term disability plan, start getting that emergency savings going. Look into an unused line of credit and potentially avoid dangerous activities. And if you have that in place, you've got a lot of peace of mind and you've got layers of protection for your practice.

So make sure you have that. All right. That is my, and there's might be some other ways that you could think of to, of, to, um, have some protection. Reach out to me if there's something I missed always [00:10:00] looking to learn. Uh, but this is what I look at as a guide. good safe plan in case you were to get injured.

All right. Have a great rest of the week and talk to you soon.

 EPISODE 399: Patient Reactivation Strategies

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] Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host Dr. Kevin Christy and today I'm excited to bring Dr. Noda Hashimoto onto the podcast. This is the second time he's been on and he is also from Traxtat doing amazing work there and just a wealth of knowledge around the chiropractic profession and we're going to talk about Reactivation strategies today.

I think this is one of the missing links for a lot of practices, whether you're not doing enough content marketing to your patient base, or you don't have communication technologies or other aspects of staying top of mind with your patients and making it easy for them to reactivate, you know, a practice that is thriving.

Typically does well with new patients. We know that, um, does well with patient adherence. That's important. That's going to also help your outcomes, but also has really good and strong reactivation strategies for their patients. And we dive into that today. And, uh, as always, every [00:01:00] time I speak to Noda, he's got.

really good ideas. And, and these are elegant ideas, things that are going to help your practice and at the same time, um, feel good about doing it. And, uh, this is a great episode. I'm sure it's not the, uh, last time we will have him on. And so enjoy our wide ranging conversation with Noda Hashimoto.

All right. Welcome back to the show note. I really appreciate your, your time. It's been fun to get to know you since the last time we spoke on this podcast, uh, give our audience a little bit of an update of what you've got going on since we, we last spoke and give them a little bit of a 30, 000 foot overview.

Naota Hashimoto: Um, well, like we've added in other software integrations, we're continuing to add more and more features. Uh, like our end goal is to make it where you can hire a 22 year old that doesn't know anything about anything. Teach them basic phone [00:02:00] etiquette. They log in and our software tells them what to do.

Essentially, we're pulling all the data out of your EHR. And then showing your team member what to focus on and showing the owner or manager, if their team member is doing their job, and then it's doing reminders, reviews, online scheduling, and a bunch of other things. So that's a high level thing. Love it.

Dr. Kevin Christie: Love it. Yeah. And we'll, uh, towards the end, give a little breakdown of some of the things you got going on with that. And, uh, today we're going to dive into reactivations. I think it's a. Um, something that, you know, a lot of customer talk about, maybe they talk about it. I don't think they measure it. Uh, I don't think they have a strategy around optimizing it and what to look for on that.

So let's, uh, let's dive into that, that topic now. Now, do you have a, a working definition of what a reactivated patient is or some guidelines for people to 'cause that's one question I get is like, well, what, what would you consider reactivation? Is it 60 days, 90 days? Is it a new injury? Like what, what is a reactivation essentially?

Naota Hashimoto: It's whatever you want it to be, but, like, for [00:03:00] us, like, when we were in practice, we didn't want them going over 45 days without getting in a visit. So, we did a model where when you finish your care plan, people come in once a month or every other week, and that was our model. So, like, sometimes people have vacations, so, like, we didn't really want them going more than 30 days, but, like, so anyone that was over 30 days, we just kind of pushed it.

Dr. Kevin Christie: Okay, perfect. And then it could be something also, um, with, uh, potentially depending on the type of practice and a new injury, but obviously the, the practice needs to define it, give itself a definition, start, start tracking it. And, um, it's a big thing, you know, it's like, I've got some practices where they're, they're pretty moderate on new patients, but they're good on.

You know, adherence, and they're really good on reactivations, um, and they do really good with that. They might have 15 reactivations a week, which, uh, which can be great. And they're doing certain things to, to, to do that. Uh, [00:04:00] what are some of the things you're, you're seeing as far as the trends in chiropractic practices as it pertains to reactivations?

Naota Hashimoto: I think people are doing a pretty poor job of it. Um, it's a lot easier than it used to be. Like back in the seventies and eighties, everything was written in a calendar book and they had to go through and do it the hard way. Like, you know, I think of my mentor, he literally scheduled, they had like over a thousand visits a week scheduled and written in a calendar book.

And that is hard. It's never been any easier. I think. You just it's like eating an elephant. You just got to start somewhere. Um, I think the biggest mistake people do is they just, they got to think of this big special thing is like come up with something super simple and I like the birthday recall because you can recall people on their birthday [00:05:00] month and it's not your entire patient base.

You're recalling them on their birthday month and the most important thing you really got to do is you just got to identify them as lost. Right. And a reason why, um, like, um, like you've read that Cialdini book, right? Yeah, influence or persuasion. Yeah, persuasion and influencer, but like, there was like 1 of the things in there where they talked about, like, budging in front of someone in line for a photocopier and they gave all kinds of reasons.

It's like, well, I budged in there because I just need to make 2 copies. I budget in there for it. And then it came down to where they could just give them any reason. It's like, I want to cut in front of you. Kevin just cuts. Okay. Okay. But if you give them a reason why. They will respond. So like a lot of people think that people quit coming in cause they had a bad experience or they waited long, but like the most common reason why people quit coming in is that they just forgot about you.

[00:06:00] Right. You know, like sometimes like, uh, I can't remember the study, but like it was a marketing study. It's like, number one reason why they forgot. Number two is they found a new resource or solution for their problem. I E like maybe a cream, a pill, physical therapy, medication, a surgery. Uh, number three was lousy product.

So like maybe they weren't getting better at their office. And then number four was lousy service. Number five was they moved away. And then number six was price. And a lot of people assume that price is number one, but the most common thing is they just forgot. And like, I'm pretty sure you've had a time in your life where things got crazy.

Like, let's say, you know, like your mom fell down and they broke their hip and you're helping them with the nursing home and doing all these things like getting in for your maintenance care chiropractic visit is in top of mind and you forget. You get busy and I think dentists are phenomenal at making sure people leave with their next [00:07:00] appointment.

And I'd say before the reactivation, just making sure that they leave with the next visit is what you need to do. No, it makes a lot of sense. And, um, uh, one of the things I love, you know, You, like you said, forget about it. And you know, Dan Kennedy, I know Dan Kennedy, obviously marketing guy. And, uh, I always reference, uh, in one of my presentations, I give his analogy of putting a fence around your cattle.

Dr. Kevin Christie: And, and I've tried to do that from a marketing standpoint is I feel like there's a lot of good, you know, You could kind of slice this in two ways. One could be marketing, uh, towards your patient base, your inactive patients. And the other one can be, uh, communication, you know, marketing is a form of that, but let's, let's split those up for a second.

There's kind of a process of communication you could have and there's marketing. Right. And so if you send out a weekly email with really good content, that's content marketing. You know, targeting your, your patient base and you're keeping a fence around your cattle or in the way that Dan [00:08:00] Kennedy puts it is you're putting content around your, your patients and that way they don't forget about you.

And I use the example where a couple of years ago, I hired a gutter cleaning service and they did a fine job. Um, you know, everything was good and it was like the next year I needed it again. And I completely forgot the name of them. I had no, uh, email. I have no communication from them since that one time.

And I mean, I just could not find the info. And at the time I had a dog and I was walking the dog and I saw a gutter cleaner, uh, servicing a different house. And I was like, all right, I'll call them up. And so I had them come in and clean my gutters. And it was not because of the first gutter cleaner didn't do a good job.

It was to your point. I just forgot about them and they, there was no touch points that they had. And so I moved on and found someone else. Yeah. It's just, you know, like you see those HVAC people and stuff like that. At the very least they put a sticker on something, right? Yes. Perfect. And, and that is better [00:09:00] than nothing.

Naota Hashimoto: Um, but like, yeah, like I know people that had a carpet cleaning business and they know that You know, people get their carpets clean. I'm just making it up like, let's say every nine months or something like that. So they started reaching out to them three months before they had a postcard system and then three months before postcard, postcard, postcard, and then they get them in there.

Um, you could have a membership, right? Uh, when people finish, like if you look at Netflix, like they have a membership program and it's just like, they get in there, you sign up, like I signed up with Netflix back when they just did DVDs way back when I'm guessing I'm dating myself, but, um, and I've been a customer ever since it was just, and I continue to get value from it.

So I stay in there. So like reactivations are great. Um, but like retaining people is better. So like something that I did is. We tracked future scheduling, right? So, like, we want to know how many people came in for an appointment today that left with an appointment. [00:10:00] Another thing that you could track is scheduling out your patients over the next 30 days.

How many. Uh, appointments do I have over the next 30 days? And if you did like those two things, that would make a difference for retention. And then, you know, like we'd always see all the people coming in without an appointment. And then with, um, reactivations, like you could, hopefully you have a system that will automatically engage with people, um, at certain points, like they've been out for a month, two months, three months, four months, six months, or whatever you decide to do.

And I'd say. Mistake I see people do with those automations is the texts or emails that go out. They sound spammy. It makes it sound like it came from like some marketing thing. It's kind of like, like Kevin, like you've received a text and it's got, you know, like a paragraph or two in there with the link and something like that.

And it just, I don't know. Clearly looks like marketing versus like, it's [00:11:00] like, hey, it's like, how was Orlando last week? Right? And you're like, who's this? You might like reply. Who is this and stuff like that? It makes it sound like it came from a human, but like, I'll see people when they set up these automated reactivations and they forget that we're engaging with humans.

So you want to make it sound like it's personal and then something that prompts a reply. So like if I set up any automated reactivations, everything is going to prompt a reply. It's going to be simple and it's not going to sound like it came from an automated message. Okay. Can you give me an example of a, of a prompt with a reply that might be good for you?

Dr. Kevin Christie: Just like, um, Hey Kevin, I was going through our schedule and I noticed that you left without scheduling your next appointment. Is there a day of the week this week or next week that works better for you or something like that? Perfect. I like that. [00:12:00] Good, good little way of changing things up there. Yeah.

Naota Hashimoto: And then a followup to that one is would be is like, Hey, I sent you a text about this. Uh, it's like, I noticed that you didn't book a time or something like that. And it can be like, Hey, haven't, it was like, we noticed we haven't seen you around here as like, is everything okay? Right. Like, but like, you just want to prompt like some kind of reply.

Dr. Kevin Christie: Okay. Perfect. And then earlier you mentioned birthday. Uh, what's the process of, of that, uh, the birthday recall, what does that look like? So the first thing you gotta do is you gotta identify them as lost and you gotta be able to segment them down by their birthday month, right? Mm-Hmm, . And then what we would do is we just send it out on the first of the month, be it text, an email, and then they could actually follow up with personalized calls and texts.

Naota Hashimoto: 'cause mm-Hmm. , if you segment your list appropriately, that list shouldn't be that big. It's gonna be 40, 50, [00:13:00] 60, a hundred people. Um, I was like, segmenting my audience. Right. So if someone came in for a free consultation and it's their birthday, and that happened like two years ago, I'm not going to give them an offer.

And like, you talked about like Dan Kennedy, like, one of the things that he taught me, like, is you got to give a godfather offer, right? An offer that they can't refuse. And if you're not a little bit uncomfortable with your offer. Then it's not a great offer. Like, I see so many people, they give like a really lame offer, right?

Like, uh, I'm going to give you a free consultation, right? And it's just like, and I just say, so if your previous dentist sent you a postcard for a free consultation, would you drop everything or quit your current dentist and go back to your old dentist? However, if, you know, you were an hour and a half late for your [00:14:00] appointment, because they're behind the front desk was snappy to you and they double build you and you had a bad experience that your current one, maybe you might change or maybe your job changed and you're working in a different area of town.

So, like, Those lame offers do work occasionally. Um, so some people think it is going to be a good offer, but it's just really about timing, right? Just like, if I bug you every single day for the next 3 years, you want a card, you want a card, you want a car, uh, sometime in that window, you're going to be looking for a car.

So, like, if you bug people often enough, you can, but if you give them a, a good offer, um, you're going to get a better response, right? And then you always have to have a deadline. So our deadline for that was the end of the month. So that's why we said it's your birthday month offer expires at the end of the month.

Now I'm not a compliance person. So we did a complimentary wellness adjustment, right? And I am not going to sit here and I know you have compliance people that come on, but that is [00:15:00] what we were comfortable for. And I just said, we're a cash based office. Um, even if your insurance insurance doesn't cover wellness visits, and if you don't bill it, you're probably fine.

But again, I think if you are like, depending on the state, sometimes it's like you have to offer to everybody. If they bring it up, there's like this language you use for ads, but we can, we can worry about that at a different time. What about new services? Right. So for instance, in our practice, we, uh, about four months ago, we added shockwave therapy and we've done a lot of marketing around that.

Dr. Kevin Christie: And it's actually been been good. We've made, uh, some, some mistakes. Like I think anybody would, but I think ultimately we've, we've done pretty well with launching that. And we've gotten even clearer on that, but, um, would this be a good opportunity if someone added, Um, you know, decompression, shockwave, laser, you know, but like with that one, like I might not even do a reactivation offer.

Naota Hashimoto: I just do an [00:16:00] offer. Cause you might have a current chiropractic patient that's not doing decompression or shockwave. You do that. So that one, I wouldn't just target that as a reactivation. I just target my existing patients. Um, and then, yeah, like something that I did. For that, like whenever I got a new service, I wanted to pay off that piece of equipment right away.

So I did like a beta test group thing. So whatever I'm adding. So when I added shockwave, I had that thing paid off before my credit card bill came up. So like I get a new piece of equipment and I'd say, I need a beta test group. And I'd have people come in there and it's like, I'm going to give it to you at a discounted rate, the only catch is if you're really happy with this.

I was like, I'm going to need a testimonial and I'm going to need an online review. So I gave him a godfather offer on that one. I do it for like 10 to 15 people and I'd use those as sizzle reels, uh, to market to my current pace and like the people liked it. I gave it to them at a discounted [00:17:00] package. I can't even remember what I did, but like I generated like a little over 20 grand off of my first email with that thing.

Yeah. Yeah. That's awesome. I came in, did it, and I prepaid it, and then I had a bunch of testimonials, and then I use that in future marketing. And if I had a decompression, PMF, anything, weight loss, I just, it was a beta test group. And my patients were trained that if Hash sends out this beta test group email and text, I'm going to take the offer.

Dr. Kevin Christie: Love it. Really good idea. Anything else on the new services that one should know? I like that idea of like, just don't do it for reactivations. Do it for your entire patient base. Um, yeah, like obviously you're gonna recommend it. If the, the neat thing I think about Shockwave is. It makes a sound, right? So like, sometimes like if you have an open bay treatment area, like you could have it somewhere out in the open and stuff like that.

Naota Hashimoto: So other people see it. [00:18:00] It's got good biofeedback as well. People really feel it. I think that's the big difference between laser and shockwave. I feel like. Yeah. So like, I think it's going to sell itself. And honestly, like With the instant feedback that you get with shockwave, like that thing fills up pretty dang quick.

And like we're jamming with that thing. Yeah. It's been great for sure. Um, what are your thoughts? I'm going to put you on the spot here a little bit. Well, I was going to add one more thing to that. Something that you want to also do when you get a new piece of equipment is make it easier for them to refer.

So like you have a patient that had a great experience, but they don't know how to refer. So if you just gave them like, uh, I would shoot a video. We're like referable content, so this doesn't do a reactivation, but like I shoot a video about it. I put in like an online scheduling link in there and just say attention.

If you know someone suffering with X, Y, Z, send this video to them and you describe how you help someone with X, Y, Z, and then all [00:19:00] your patient has to do is for that text or for that email to a friend. I'd also have, we also did a physical newsletter that we sent out and that we'd always have a front and back handout in there about that thing.

So it described like. Sometimes it would be about the device, like the shockwave, the PMF, or the decompression, but sometimes it would be about the condition. We had like 20 something things and we just rotate between the handouts and, um, they could just take that and then hand it to a friend in church or something like that.

Now you've got a referral, so you're going to have something. Yeah, that was actually my next question was going to put you on the spot a little bit was direct mail, uh, for reactivations. What are your thoughts around that? What are some of the best strategies around physical mail? Well, list segmentation again.

So I'm always going to go back to list segmentation because you can go broke pretty quick mailing your whole list, right? So you don't want to mail it to someone that came in for a free cup of coffee six months ago. But if you segment your list, [00:20:00] like maybe people had a visit in the last one to two years that spent over X dollars in your ideal age range, like if, you know, like I had a client that wanted to do a blast and everything like that to everyone with peripheral neuropathy.

Now, sending it to people under the age of 50 is probably a little silly. Yes, you can have someone that had chemo and they got neuropathy and stuff like that, but most of the people are going to be like in their 50s, 60s, 70s, Um, so like list segmentation matters. Some of your things are going to be better for women.

Some of them are better for men. Some of them are better for older, younger, but I think the best predictor of the future is the past. So if they've spent money in your office out of pocket or via their good healthcare insurance, that's a good thing. I'd always filter out the work comps and PIs, not saying that they aren't great patients, but I haven't had a great success taking my PIs and turning them into a good.

Cash paying patients. It's a very low success rate. It is very low success rate. There's no doubt about it. Um your list segmentation it brings [00:21:00] brings up a point to me is um, the scheduling institute does a great job of direct mail to dentists and chiropractors like I get their direct mail and um I think I'm, I was kind of higher up on their segmentation, just based, based on the referrals I've given and, um, the things I've attended on theirs.

Dr. Kevin Christie: And it was pretty impressive to watch them send me, it was a learning lesson in direct mail, watching them send me direct mail, uh, for their live event that was this past year. And, uh, at the time I had a patient who was actually, um, Semi retired, but worked in marketing and his specialty was direct mail.

And I, I had him come into my back office. It's like, look at this. And he's like, Oh, he's like, yeah, you're high up the, the, the list of, of the, um, uh, as who they're going to send to. Right. And they're willing to spend a good amount of money on direct mail to me, uh, versus maybe someone that's, you know, Hasn't done as much with them.

And so it was interesting to see that. Uh, and now does your software, I mean, I'm sure it [00:22:00] does, but what kind of segmentation can you do in your software as it pertains to direct mail? Anything you want, really? Like you can do it by diagnosis, age, sex, the next appointment provider, the last appointment provider, not having a future visit, being out for a certain amount of time, having a visit in a certain amount of time.

Naota Hashimoto: Uh, like how much money they spend, their insurance company. And like, it's about 50 different things. Do they have an attorney? Are they a PI? Um, so like I started this out, like kind of more on the marketing end, so like marketing is a big thing, but list is huge. It is huge with direct mail. Like a lot of people undervalue the list and like how it's delivered matters.

The copy kind of like matters and you learn pretty quick, like copywriting. It's never been easier with chat GPT, but I learned the old fashioned way doing it. Running stuff that worked, running stuff that didn't. Um, I used to, whenever I saw like, I'd sign up for all kinds of mailing lists too. And I'd rewrite all those things by hand.

I used to take [00:23:00] full page ads. And like, if someone's like, uh, running these remnant space ads and they keep running it, they're either absolutely moronic or they're geniuses and it's working. So I just take those things and I just rewrite it and I'd study it. And I try to figure out why is this thing working?

What is their offer? And I try to find the unique identifiers and the offers, the headlines and sub headlines. And I just go into that. But like, so for me, it was something that I was very interested in. Um, if I was in today's world, I'd probably find a copywriter, get like a couple of good templates or just do chat GPT.

It's going to pump out stuff, but the list matters. So, like, um, it's like, so, like, there's something called the response list. So, if you're going to mail to your patients, obviously, you mail to your best patients, but if you're going to go to, um, Other people, you could take your best patients and you could create like a lookalike audience, like you would on Facebook.

You could also get a response list. So like if I was doing something for chiropractic, I would [00:24:00] probably find someone that has a response list of someone that bought, like, say, mobility or arthritis type supplement, because that has proven that they have paid money to kind of do that. And you're going to pay a little bit more for that versus like a compiled list.

Compiled lists are going to go like Experian, DMV, all these things. They're going to pull that data together, and they're going to get you a list of people, but it doesn't necessarily mean that they responded. Okay. Mm hmm. Okay. I think if you're doing direct mail, like it's painful when you miss, right?

Because you're paying a lot more money with it. For sure. No, it makes sense.

Dr. Kevin Christie: Um, all right, uh, moving on now, tell us what tracks that does to make reactivations easier. Give us kind of a, a visual of like, how, how do we make this easy? Cause I, I know a lot of chiropractors feel overwhelmed when trying to, when we talk about segmenting lists and this and that and the other thing, how does this make it easy for them?

Naota Hashimoto: Well, we have a pre set up [00:25:00] birthday campaign ready to go with filters and everything and then we'll help them set up their first thing and it takes like two minutes emails, texts and scripts and then yeah, I could give you a website where you could pop in the thing. It's, um, they could go to, uh, one of them is track stat dot org.

Or it's slash patient dash reactivations. And that's where they could get like a free trial of it. And then I have another one that's, um, uh, trackstat. org forward slash reactivation, which is a script. Uh, where you just get like a script and like a little bit of a playbook, but with that 1, we'll just tee it up for them.

Here's your birthday campaign. Here's it. We'll just get on a zoom segmented for them. Make sure he's like, okay, you want to filter out these insurances. These people, great. Here's a text. Here's an email. Here's a call script. And then when people come in for reactivation, another mistake I see people [00:26:00] make is they just jam them in there with all their regular appointments.

Dr. Kevin Christie: You need to identify them as something different. So like, just give them a different appointment type. And you just want to find out, is there any new flare ups, anything else going on, any new insurance, if you're an insurance based practice and just find out why they quit coming in and then you need to have like some kind of a godfather offer for them.

Naota Hashimoto: Right? It's like, hey, we're going to do this one on the house. And it's like, by the way, um, you know, like, if they quit coming in because of price, it's like, we have this membership program. Even if you didn't have it back then, you could say, hey, Kevin, did I ever tell you about our membership program when you left?

Oh, I didn't know. Yeah. It's like, oh man, it's like, it's like, you know, I was like, I wish you would have called in. It's like, we had this thing. Yeah, that's a good point too. And we talked about reactivation on services, but you could definitely reactivation on something like that. Yeah. It just, I like to teach people that doesn't require them buying like a 20 piece of equipment.

Dr. Kevin Christie: Yeah, for sure. Get that for sure. Um, [00:27:00] Perfect. I love that. I love that. And then, uh, obviously text messaging campaigns. It does, you got the birthday list. You could segment it out and get it to a direct mail person, uh, email. Yeah. So in about three minutes, you'll be able to identify your list, create a direct mail list and, uh, set up a text and an email and a call campaign.

Naota Hashimoto: So that's pretty dang quick. And then on your call list, it's not like a. Print out where you're calling from. So as soon as someone schedules on your call list, they get pulled off the list. And then from the call list, you could text, email, and call them from that list. Add notes. And as soon as they schedule it checks every five minutes.

So as soon as they schedule, they get pulled off that list. You have it set up correctly.

Dr. Kevin Christie: And, you know, there's a big percentage of my audience out of the evidence based chiropractors. They, they, uh, they tend to shy away from maintenance care for various reasons, um, but we won't go down that rabbit hole.

Um, [00:28:00] so if you're, if you're not going to have, uh, maintenance care as a common part of your practice, then the reactivations are going to be all that much more important. Cause I think what I see amongst the evidence based chiropractors that, um, Set up a very low percentage of their, um, discharge patients on any type of maintenance care.

Uh, they, they can struggle because they also have no reactivation plan either. So they're really, they're, they're a hoping on a lot of new patients, uh, and be, they're hoping that people don't forget about them. And that's just not the reality is as good as they think they are. People do forget, even if they had a good experience.

And so the reactivation for that segment of chiropractor is going to be all the more important. And then the second point I want to make is that, uh, we, we talk about reactivations and getting them to come back in. Uh, but what's cool about when you communicate with them often and effectively, whether it's through.

Communication like we've talked about with you, we're marketing and you [00:29:00] put that fence around your cattle. It actually will increase your new patients also, because now those folks that had good experiences in your practice are getting your information. And it's like you're. You're educating your work, your sales force, and they're out there in a community thinking about you when their colleague or their family member complains of something, there's a higher likelihood that they're going to say, Oh, you got to go see my chiropractor, Kevin.

He can help you out. Whereas if they forgot about you, not only have they forgotten about you for themselves to come back in, but also to refer to you. And that's something that I think a lot of chiropractors, um, fail. Any, any thoughts on that gutter cleaner, right? If you would have. Just if you would have sent out a postcard like at month 9, 10, 11, 12, just like that carpet cleaner guy, um, you would have gone back to them and you would have remembered and if you would have put like a little sticker thing in there, like, it's.

Naota Hashimoto: It's not that hard. You just gotta think of all the ways that you can stay in touch with them. [00:30:00] Okay, well, you have their appointment reminders, you have their birthday, you could have their anniversary, their first visit date, um, and then like, yes, you could do a weekly email. You have to come up with content with that.

Uh, you could do a monthly newsletter and it just, we got to realize that we're in the infotainment business. Right. We're not like in about giving them information. It's just, you want to keep it entertaining and you want to keep it light. And then when you're staying in touch with these people, just not constantly selling to them, you don't need to teach them a home exercise program, but it could be like, some of the stuff is like, Hey, we went to, uh, Cooperstown for a baseball tournament.

Here's like little updates. Here's like a couple of dingers that my son hit and key games and stuff like that. And it just, just create the relationship with you. Yeah. And to your point about not selling all the time, uh, Kim Walsh Phillips, who co wrote the one book with Dan Kennedy. She was on my podcast and she talked about the, you know, your, your content should be 85 percent PBS free information [00:31:00] and 15 percent QVC selling.

Dr. Kevin Christie: You want to make sure you have a nice balance of that. So you're not just overselling all the time. Yeah, and I just tell people think of the list that you stay on. Right. So it's like, and if you think about the things that you stay on is because it's important to you, you either find it funny.

Naota Hashimoto: Entertaining informative, like, I get emails from our kids school, just like you probably do because it's important because we have, you know, like, our investment or kids are going to school and, you know, like, I stay on there because of that. Uh, I'm like, uh. You know, like a nut for, like, baseball stuff. So, like, I get these, like, flash deals that pop up for, like, baseball gloves and baths and sometimes I buy it.

So I buy it because it's a timely. Offer that comes out just for like that weekend. And, you know, the other stuff I'm on there for information, entertainment. But if you think about the list that you stay on that and just always be learning, right. Yeah, I, I agree. And hopefully they're listening to this [00:32:00] podcast and learn a few things today.

Dr. Kevin Christie: I, I, uh, I definitely appreciate your, your time and your commitment to the profession. Uh, you, you've mentioned a couple of URLs, but where can they find you the easiest to schedule a demo, reach out to search for track stat and you should find that, but T R A C K S T A T dot org. Um, and they could watch a demo, do a free trial of it.

Naota Hashimoto: They want the reactivation script and they couldn't find the URL. Um, I'll just give it to them and that's it. And even if you don't have a, if you have an EHR, that's not one of ours, you know, I'm happy to talk to you, share anything that I know. Perfect. All right, doc. Have a good one. Thank you for having me.

 EPISODE 400: Fluid vs Crystallized Intelligence

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: Welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I am bringing you a solo episode, and we're going to talk about the difference between fluid intelligence and crystallized intelligence and what that means for your chiropractic career. And, uh, this actually comes from the book that I highly recommend.

I read this maybe a year or so ago, and that is, uh, Uh, from strength to strength by Arthur Brooks. And it's a phenomenal book. Um, you know, I think at any stage of life when you can read it, but me, I read it, I'm 44. Now I was 43 when I read it and it talks about bridging that chasm from, uh, that first half of your life where you have, Uh, fluid intelligence into that second half of life when you have crystallized [00:01:00] intelligence.

And I'm going to kind of break that down for you a little bit and what that means, uh, ultimately for your, uh, chiropractic, uh, career. Okay. And so let's, um, let's dive right into that. And I've got a little bit of an article here I want to start out with is just going to read this a little bit. And this is from, um, University of Utah, uh, their health department and it, uh, first talks about, uh, and it kind of does a little breakdown of Arthur's book and it talks about overcoming the striver's curse.

And so I'm going to start there and, uh, read this real quick here in his conversations with members of the medical community, Brooks, here's a lot of concern about wellbeing, not just physical health. By definition, physicians and healthcare professionals are strivers. Brooks explained he defines a striver as someone who was identified as a high achiever early in their education or career.

The world we live in convinces drivers that as long as they work hard, play by the rules, [00:02:00] graduate from a top tier college, go to medical school or get a PhD, it's going to be okay. and have a successful career, then they will be happy. On the contrary, Brooks explained, strivers tend to be the most disappointed with their lives after the age of 80.

Researchers call this the striver's curse. Strivers expect themselves to live up to high standards of success year after year, but the inevitable disappointment hits and happiness levels plummet. In his research, Brooks studied a group of strivers who were happier when they were older. Why were they happier?

He discovered a pattern rooted in the theory of two intelligences in the lives of happier, older strivers. Know the curve you're on. Brooks discussed the different kind of intelligences that happen naturally at different periods of life. He explained fluid intelligence is what gives us working memory, unrelenting focus, and innovative capacity.

However, the fluid intelligence curve peaks around [00:03:00] age 30. Brooks went on to explain that crystallized intelligence, on the other hand, increases in our 30s and 40s and stays high into our 80s and 90s. This curve is based on what we know and have, and how we synthesize information to explain highly complex ideas, often referred to as wisdom.

Brooks says crystallized intelligence revolves around intelligence. Teaching capacity, mentoring, and managing others. Brooks discovered that happy older strivers willingly step from one curve to the next, from innovator to synthesizer. When we know which curve we're on, he explained, we can have the best years of our career, the most fun, greatest satisfaction, and highest levels of success.

If people are reading your resume at your funeral, You did it wrong, Brooke said. And so it kind of gives you an idea. And he gives some examples in his book where, you know, how come most of the rock and roll [00:04:00] musicians or even musicians in general come up with their most creative ideas in their twenties.

But then, you know, I think like the Rolling Stones and some of these other bands, they haven't come up with a new, good song in 50 years, if not longer, but they came up with so many early on. And why is that? And he talks about, he actually was like a classic. Uh, he was an orchestra. I forget what instrument he played, but he was at the highest level in Barcelona and all that.

But he started, um, knowingly that perfect particular profession starts to decline in their mid to late thirties. And they peak at their late twenties and early thirties. You think of like the tech entrepreneur and the founder, they're able to do stuff. But then as you move along, You don't necessarily see that, uh, later on in life, but what you do find is, uh, the tech entrepreneur becomes a board member and has a lot of wisdom and things of that nature.

You see a lot of, uh, people that are certain professions become leaders and managers and [00:05:00] executives, and it's a completely different type of intelligence. And if you ask anybody my age, it's like, if you asked me to do the things I did in my mid to late twenties, early thirties, even mid thirties to build my practice, I.

I'd vomit. I couldn't do that anymore. Um, but I feel like I can synthesize information a lot better than I did before. I wasn't just trying to create from scratch. And that's something that has helped me, um, kind of get an understanding of, of how my career arc has been. And as I, at age 44, try to bridge that chasm into that second part and utilize more of my crystallized intelligence.

Uh, to help chiropractors out, to help build our practice, to help mentor and things of that nature. And you got to think about that a little bit for you, for, uh, your career as well. Right. And it's, um, one of the things they talk about in this different article I was reading about this. Yeah. Was essentially like the blank [00:06:00] canvas versus the block of jade in that early part of your career as a chiropractor, you are a blank canvas and you're trying to build from there, whereas later on, you're more of a block of jade.

You're trying to carve that out. And they even, um, will reference that. Um, a little bit of a sidebar conversation, but Eastern versus Western philosophies in Western culture, it's kind of the blank canvas of keep on building, building, building, you know, adding, adding to that blank canvas consistently, um, you know, more houses, more cars, more things, more, uh, Uh, stuff, more fame, more notoriety.

It's just building and it's just, just massive accumulation of stuff. And that's how we deem, or at least, uh, you know, think of success. Whereas in Eastern culture, it's more of the block of Jade. And what can you remove from that to carve out the essence of yourself? Right. And that's what they consider success [00:07:00] is how, uh, Um, how exquisite can you make your life and how simple but effective in utilizing the wisdom that, you know, to get rid of all the fluff.

And that's fascinating. And I think we sometimes see that in our careers. And I even saw that in my own, right? When I look back, it's. You know, I remember in my thirties, I, I actually opened up my own practice at age 30 exactly before that I was obviously building my expertise and knowledge and then I opened my practice and then a year and a half later I opened up another practice in Miami.

Then we had corporate locations. We had six at one point. Uh, I was doing other things and, uh, you know, traveling for the NFL combine doing a bunch of stuff. It was like this accumulation of, uh, of, uh, business. And then, um, then added MCM and all that. And then I finally hit a point, I think it was probably late thirties, like 38, 30, I think it was 38 where I realized, you know what, it's like, I'm starting to synthesize what [00:08:00] my career is going to look like.

And it took, uh, that block of Jade that I had built up. Uh, by 38 and started carved that away and, you know, selling to Miami office and moving on from the corporate stuff because it was eating up more bandwidth than it was worth as far as profit margin. And it was profitable, but sometimes there's, um, there's profit and it's just not enough to where it makes sense.

And you've got that opportunity cost. You always have to measure in life. And so I kind of, you know, Chipped away and carved out, um, you know, just have the practice in Boca, but on the real estate and, um, and then obviously MCM is growing and I'm really putting a lot of focus on that. And so I feel like for myself, I am seeing what the vision is for me, crossing that chasm into the crystallized intelligence or that from one strength to the other strength, which is the name of that book from strength to strength.

And so that's kind of been my. Uh, guiding light here

and then, you know, you got to think to yourself, what does that look like, uh, for you as a [00:09:00] chiropractor? And I've, you know, I've got concerns for that. And you know, if you're, if you're not building your practice the right way, I talked to a lot of chiropractors of all different age groups. And I, I would say the one that always is the, the toughest or the ones that feel the struggle the most is when you get into that middle age.

Let's call it forties, but it could be late thirties, early fifties, you know, you get in that middle age and you don't feel like you're jumping from the one curve to the next. And that, um, that visualization I got from this book really made a lot of sense for me where a lot of chiropractors, um, don't feel like they're able to, to do that.

And that, cause that could look like, right. If you're a, see a really clear path of like, yeah, I'm going to be 53 and we're going to have a practice that's going to allow me to. You know, work three days a week, three and a half days a week. I've got an associate, I got a team around me. I'm a, I'm able to show up to work and provide leadership [00:10:00] and, and wisdom and be able to practice the way I want to.

And I've, I'm, I'm enthused to go to work. Profit margins are good. My life is looking good. Like that, like you've done all the things and now you're, you've put in the 20, 25, 30 years, and now. You're on that other curve. You're in that crystallized intelligence and utilizing those strengths. Um, and you're able to invest money instead of time into certain things.

You're able to delegate effectively because you've got a team that is a really a good place to be in. And I, I talked to a lot of chiropractors that aren't seeing that vision. They're not, and this is what I think is happening to you is you're, you didn't, without knowing it, you're. You're having a hard time seeing how you're going to jump from that first curve to the second curve in your career.

And you need some guidance in that. And that's where I get a little, you know, my concern for the seasoned veterans is they haven't done that. And an even worse than that, honestly, if you don't handle it now, because it's never too late, but if you don't address that [00:11:00] now, uh, I also talked to chiropractors that are 65 years old and don't have a practice that's sellable and they didn't do enough to get themselves for retirement.

And then they frankly, um, have to keep on working physically pretty hard, even though in their heart of hearts, they wouldn't really necessarily want to now some do. So there's definitely, there's definitely that, uh, there, I know a lot of awesome chiropractors that are in their sixties and even seventies that have jumped to that other curve that are still loving, treating patients.

They've got this wisdom they can project to their team and to their patients. Um, and so that's awesome. There were still got the energy and that's how, if you're, if you're If you ever see a 65, 70 year old still practicing with energy and loving going to work, it's because they did jump to that next curve and they did build a team and they did build a practice that they enjoy going to.

The ones that you don't is like, they never unfortunately made that, that jump.

 My concern for the younger DC, and I've kind of made that pretty clear over this last year, if [00:12:00] you've been listening is, um, you know, if you do not build the fundamentals correctly, you then end up down a path, uh, to where you do hit age 40 and you didn't get to where you wanted to, uh, for various reasons.

And, uh, my, my, there's a lot of concerns I have for the young DC. I know it's harder. I, I do believe there was a time where, uh, 20, 30 years ago, a higher percentage of chiropractors could do well just because it was a lot easier. Insurance paid well, low co pays, uh, you know, in that sense, the insurance situation was so good at a certain point, a high percentage of chiropractors, even average chiropractors could do very well financially and really good chiropractors were really good, were You know, personality chiropractors could make a killing.

And I know, so I know that's changed and I, and, uh, so now you're probably have a lower percentage of chiropractors that are, uh, doing great. Uh, if you're in network insurances, if you're not careful, [00:13:00] you're not building good systems around that. I know chiropractors that are in network with insurances that pay bad, but have built great systems and care around and doing, doing really well.

Um, and then there's a lot of chiropractors going cash. Uh, but to be a cash chiropractor, it's even a lower percentage of chiropractors are gonna make a good amount of money to where you're gonna pay yourself a professional living and build a team and, you know, ultimately build a practice that brings in 350, 400, 500, 700, 800, a million dollars a year.

Those practices, um, are few and far between in the evidence based cash practice world. And that's concerning, right? I, I talked to a lot of cash based chiropractic practices. And a lot of them are at 200, 000 a year revenue. And these are practices that have been going on for a while, five, six, seven years, four years, 250, 275.

And you just think about that number. If, if you're bringing in 250, 000 a year in revenue and you have overhead, like how much are [00:14:00] you able to actually pay yourself after overhead and taxes and, and all that, uh, it's, it's hard to let it alone. employ people, right? And so I'm concerned about that. I'm concerned about the amount of time young chiropractors think they need to spend with patients and they, and they get into this, um, vicious cycle and they never get out of it, but we got to get evidence based chiropractors.

We got to get practice owners getting to that 350, 000 minimum. Revenue in a, in a year and in working your way up to there to 400, 450, 500, uh, depending on scenarios and overhead scenarios. But, um, and then, you know, you'll hear on some hands like, Oh, well, I'm going to keep it really, really low overhead.

And I'm going to rent from a gym. And again, I rented from a gym. I love the idea, but you got to get a, you have to have a path out of the gym because I did the gym and there's, and I did the really low overhead. And when you're really low overhead, there's typically also a very low ceiling of revenue.[00:15:00]

That is associated with that. So it's got to be this climb and it's this, this topic here of like, you got to have a steady climb out and, and, and really innovate and be creative and get revenue coming so that by time you have to cross this chasm into the fluid and tell into the crystallized intelligence, you have the revenue and revenue coming.

Profit and resources to do that, to hire the team, because you may be 28 years old or 30 years old now and be able to spend 30 or 60 minutes doing rehab with a patient or, you know, also being the front desk person and also doing insurance and all these things. But I can guarantee you, you're not going to want to do that when you're 40 years old.

You're not going to want to do that for 25 years. You're going to want to be a sniper by the time you're 40 years old, where you're coming in and you do what you do. And you're, you know, And you've got a team doing the other stuff. And so that's my concern with, with the younger DCs is they're, they're following certain models that I do not think have longevity and are setting up a struggle to be able to, uh, [00:16:00] cross this chasm when you get into your late thirties, early forties, and you'll, and you'll be very frustrated and you'll blame the career, you know, you'll blame the profession.

And, and, uh, I know a lot of chiropractors are doing phenomenal in this profession, and so you got to make sure you. Are setting things up right and are people that can help you with that. And then I'll kind of leave you with this. Um, Arthur Brooks, the author, he, um, he explained that general happiness levels in the U S have been on the decline since 1990 to versus trend.

He says, individuals, societies, and employers. should focus on the big four. So he's got the big four here and I'm just going to read them and and chat about it for a minute. Uh, one is faith and philosophy. Seek transcendent experiences, whether it's religion, spending time outside or listening to music. Uh, take time to zone out.

To zoom out on your life. It could be philosophy, right? You know, there's certain authors out there, stoicism and certain things of that nature. It doesn't have to be faith per se. It is for me and it is for a lot of people, but [00:17:00] something that is a transcendent experiences, uh, you've got to have that to his family, whether traditional or nontraditional.

Brooke says family life is the biggest predictor of happiness. Three is friendships inside communities. Loneliness is a serious crisis in our society. Brooks explained regularly connecting with other people impacts happiness levels. And then fourth, this is where I'll kind of chime in a little bit more attitude about work as a society.

Our orientation toward work has shifted to be much less vocational. Brooke says striking a balance between work and life contributes to our happiness and your attitude about work or about the profession is going to really be a big determinant of your satisfaction in life. And too many chiropractors are jaded about the profession.

And, uh, but then on the other hand, I know so many chiropractors that absolutely love what they do. They, it's just the biggest, um, driver of happiness in their life, uh, aside from family and the other ones, [00:18:00] but it's just, you know, you could take someone. Um, that hates their vocation or their career and it's really hard to have a well rounded happy life.

And if, you know, if you're one of the fortunate that is, um, independently wealthy, you don't have to worry about the work thing, but that's not, uh, most of us. And so having a great attitude about work and less cynical and more optimistic about it is better. And I think, um, a big. Reason for cynicism within our profession of chiropractors because it's not easy, but every like every profession is hard like somehow like somehow we think You know chiropractic is the only thing that's hard and struggling.

I mean, I got friends of all kinds of professions It's they're all struggling if they're or they're not like I can give you every profession and I can give you people that are Loving it because they're doing well and they're doing the things that have allowed them to do well And then I can give you people that are bitching about the profession because they're not doing the things that So for every person that's struggling in chiropractic, I can give you another person that is doing really well [00:19:00] with it because they put in the effort and they're strategic about it and they're keeping a level of optimism and they're doing the things they're investing in themselves and they're growing.

And so your attitude about work is going to be a big predictor of your happiness as you move along in your career. And so, um, I just want you to start thinking about that. Like how, where are you at in your career now? It's never too late. And how are you going to bridge that chasm from one strength to the other strength?

If you're already past that typical age for it, you're not there yet. Then, you know, there's people that can help you out. And this is something I think we do a great job of all levels of chiropractors, whether it's the young DC or the seasoned veteran is to help them recreate their vision and, and actually take steps to get there.

And so if you are interested in having. Somebody help you out with that. You can let us know. You can obviously go to our website, modern chiropractic marketing. com. Uh, but we try to make sure that we keep your vision in mind and help you get there with action steps. This is all I got for you today. Have a [00:20:00] great week in practice and, uh, you know, check out that book from strength to strength by Arthur Brooks.

 EPISODE 401: Chiropractic Student Loans Strategy Update with Kristin Lawrenz

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] Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I'm bringing on Dr. Kristen Lorenz from Student Loan Planner. I've had this group on some years ago, it might've been four or five years ago. And so things have changed and we needed to have a kind of update show on your student loans.

I know it's a point of concern, point of contention. And And, uh, you know, it's, it's not easy. There's no doubt about it. It's obviously hopefully worth the investment in putting you in a position to do well for many years, but you need to have a strategy. And we're going to talk about certain new updates and new programs and strategies to really set it and forget it.

Honestly, you know, it, it was a cost of doing business. Just like if you were to, um, You know, buy a business or start a business. Most entrepreneurs take out pretty big loans to do that. And a lot of times millions of dollars of loans to start businesses, uh, or take on debt to do it. And so you ultimately had to take on [00:01:00] debt to, uh, become a chiropractor and hopefully it's paying dividends or will, or if you do the right things, it definitely will.

Um, and so we talk about the, the new updates on that. And Kristen brings a lot of great information, uh, and updates for you today. So without further ado, here's my interview. with Dr. Kristin Lorenz.

Dr. Kevin Christie: All right. Welcome to the show, Kristen. I really appreciate your time. Uh, it's been a while, uh, since we've had you, your, uh, company on our podcast. The podcast is seven and a half years old now. I think, uh, it might've been five or six years ago that, uh, Travis was on and talking about student loans. It's always a front of center topic, especially for our chiropractic audience.

Uh, but before we dive into that, tell us a little bit about yourself personally, professionally, uh, the company, things like that.

Kristin Lawrenz: So the company that I work for is called Student Loan Planner and we do student loan consults for any type of student loan borrower. So we have a lot [00:02:00] of, uh, physicians, we have a lot of dentists, chiropractors, um, you know, all types of complementary health care professionals, lawyers.

Uh, so we generally have those types of professionals that we give consults to. So I started working for Student Loan Planner, um, About a year ago, giving consults. I'm actually a practicing chiropractor. So I've been working as a chiropractor for almost 20 years. I graduated from New York chiropractic college, which is now Northeast.

And, uh, yeah, so I've been practicing in Rochester, New York, and I currently work part time doing that, and I also work as a student loan consultant. I had to take out a lot of student loans when I started. So I, you know, this is kind of a. Something that I love to talk about with, you know, up and coming chiropractors, because it is such a huge impact on our lives.

So, so yeah, I'm happy to be here today. [00:03:00] Thanks for that.

Dr. Kevin Christie: Yeah, absolutely. You and I graduated chiropractic school about the same time. And it was a little bit friendlier for us. At least I get to speak for myself, you know, and I know it's not like that anymore, but, uh, you know, for me, uh, I think I was 160, 000 to get through chiropractic school.

Luckily, I didn't have any undergrad loans. And then I was able to, in 2004, lock in at a 2. 8, I think it is, 2. 8 interest rate. And so my full monthly payment from that point on, or actually I did, I was able to, Lock it in prior to graduating. So once I graduated, uh, my full monthly payment has been about 725 a month.

And again, that's the full payment for mine. And so that's obviously pretty digestible. Um, it wasn't necessarily digestible when I first graduated, but it's been digestible for some years now. And obviously having a low interest [00:04:00] rate, uh, has been beneficial. What's the state of. Student loans now for chiropractors that have been kind of that last 10 years, five year, whatever it's been.

What are the amounts you're seeing? Is it 200 to 5, 300 for student for chiropractic is, uh, what's the interest rate ranges you're seeing? What are some of the details of that? .

Kristin Lawrenz: Yeah, we were lucky, lucky, lucky when we got those two, I think mine was 2.87%.

Dr. Kevin Christie: Yeah,

Kristin Lawrenz: those are no longer. So, you know, most chiropractors that we see have between 200 to 300, but we've seen more.

Mm-Hmm. . Um, it's great when we see less than that, but I would say yeah, 200 to 300 is pretty much the average for, for debt these days. And the interest rates are running, you know, around 8% currently. They, um. You know, we're down a little bit to maybe 6 percent when some of these Kairos who are graduating now started, but yeah, they're, they're high.

Dr. Kevin Christie: Yeah. And that's, [00:05:00] and that's equating to, obviously it's all ballpark. Um, but if someone were to actually pay their full monthly minimum, it 500 to 3, 500, give or take a month. Is that correct?

Kristin Lawrenz: Yeah, absolutely. If you wanted to pay, you know, if you wanted to do a standard 10 year plan, it would absolutely be that much.

If you wanted to do more of an extended or graduated type plan that kind of graduates up a little bit, you know, we can get up to 30 years or so if our borrowers consolidate. Yeah, though that would be a little bit less, so that would be maybe around 1, 500. But It's still that's hard for, you know, beginning chiropractors to make that much, especially if you have an associate job and you're making 50 or 60 in some parts of the country.

So, you know, there's two different ways to pay back your loans. You can either pay that fixed, you know, amount every single month, or you can do more of an income driven repayment [00:06:00] plan, which we'll talk a little bit about. I think those are, um, generally, Much better for this group of folks who are starting out with an income around 50, 000, 60, 000, something like that.

Um, we, you know, when we have professionals that are starting out more at 100, 000, that's a little bit more palatable and they can kind of handle that bigger monthly payment. But the income driven plans are great for people who have that higher debt to income ratio, like chiropractors do usually.

Dr. Kevin Christie: Yeah, for sure.

And so let's, let's dive into that income driven, uh, I believe it's called the SAVE plan, right? And that's kind of where people have thrown around the, you know, the tax bomb word at the end and different things like that. Um, is that that income driven plan is the SAVE, which is an acronym, I guess, right?

Kristin Lawrenz: Yep, it's a it's Biden's new plan. That's stands for save for a valuable education. And that's the acronym [00:07:00] save that we refer to it as. So there's a couple different income driven plans. There has been since 2009. Actually, I got in on an income driven plan when we first got out of school because I was one of those people who was like, Oh, my gosh, I cannot make this payment.

I was making a very low amount as an associate. And, um, so there have been, uh, plans called the income based repayment plan. That's also an income driven plan. And there's been other plans called, uh, the pay plan, the income contingent plan. But the big one for the past few years has been the save plan and, uh, the Biden administration made it really favorable for student loan borrowers.

So they had, um, a lower amount. Of discretionary income, like a percentage that you paid that was lower than some of the other income driven plans. They also had a great interest subsidy where if you made a payment that isn't going to cover your interest for the month, which can happen pretty easily for someone who has 200 or 300, [00:08:00] 000.

The rest of that monthly payment would be waived that you didn't make instead of capitalize, which it would be on some of these other income driven plans. So some folks saw these, you know, these older income driven plans, their loans just balloon up because they weren't able to make that monthly payment.

Um, it was basically, they're just paying a little bit of interest on it and then that interest would capitalize each month and their loan would just grow and grow and grow. So the save plan kind of put a stop to that. Um, if you weren't able to make that monthly payment, that minimum monthly payment based on your income, then basically the rest of that amount just got forgiven and not capitalized.

So people's or people's, uh, loan amounts were staying the same, which was a huge. You know, win for student loan borrowers. Um, so yeah, people have been on the save plan, uh, for a few years and have been very happy on it. Um, and then, you know, there's been some changes with [00:09:00] the income driven plans lately, so there's definitely some, uh, changes to the save plan so we can.

Talk about that when you're ready to

Dr. Kevin Christie: okay. And so on the, on the save plan, is it, uh, you know, you make your minimum payment that's based off income. So it's going to be a lot less than what your full minimum payment would be. And then you do that for, is it 25 years? Um,

Kristin Lawrenz: yeah.

Dr. Kevin Christie: And that could

Kristin Lawrenz: borrowers. Yeah.

Dr. Kevin Christie: Yeah. So that income minimum could increase if your income goes up. Is there a certain amount, like if we got a chiropractor that's, you know, doing well for themselves and they're making 200, 000 a year, um, are they just not going to qualify for that anymore? Essentially

Kristin Lawrenz: they will qualify, but the one problem with the safe plan is that there's no cap on it.

So they would still qualify, but their payment would go up in proportion to their income or some of the other income. Specifically, the income based repayment plan has a cap. So sometimes when you get, we get folks into it that [00:10:00] are, um, have a lower income to start and then ramp way up, there is a cap on that.

So let's say their cap is around 2, 000. It's based on your standard repayment plan of 10 years. That's your cap. So they may be paying for, um, You know 10 years at a lower amount than that and then they hit that cap and they get to stay at that cap Instead of going above that so that was kind of the one drawback about save is that there wasn't a cap so for people who You know got into these really high income Levels that was tough because then their payment's going to be way more than well,

Dr. Kevin Christie: I guess Yeah, I guess tough on one end but good on the other that they're actually doing very well.

And I true, you know, I I um I'm not sure I've had a lot of, you know, a lot of my, it's fun now to be 20 years out and see a lot of my, uh, classmates I graduated with. And, uh, you know, a handful of us have been fortunate to do pretty well. And I've had some where, you know, they've done real well and they just, paid the thing off, you know, and it was part of what they wanted to do.

Um, [00:11:00] and so if a chiropractor is making, you know, two to 50 a year take home income, um, and maybe their spousal income as well, uh, you know, are you seeing Some of these chiropractors actually decide to just let's, let's pay off what we got to pay off. Let's, let's put 10, 000 a month on it. Or like if maybe they came into a big payday of 40, 000 of something, whatever, uh, maybe they sold something, invested in something and decided to pay off big chunks at a time.

Are you still seeing younger DCs do that?

Kristin Lawrenz: Yeah, absolutely. And that's kind of where a company comes in because we kind of weigh the benefits of. Should we put that extra money towards retirement or some other kind of financial goal that we have, or should we pay off the student loans. So there's always kind of that, you know, waiting those two, um, those two options.

But yeah, some people just feel really emotionally strong about, you I just want to pay it off. I want to pay off all my debt, you know, [00:12:00] whichever kind of debt it is. Um, and some people kind of take the long road with it, where they pay the minimum amount they can and put the rest towards their other life goals.

Yeah.

Dr. Kevin Christie: Yeah. I mean, I, I've, I've been. Transparent about it. Uh, I haven't paid mine off completely. There's been a handful of times where I probably could have just done that, but there's a different decision making process when you're at a 2. 8%. It was like, I'd rather just invest money, um, and, and just pay off.

And there's been times where I put extra on it. And so it's, it's down to a pretty nice number that I'm, I'm comfortable with psychologically. So I do think there is the psychological component. And speaking of that psychological component of it, I think the one thing I want to make sure chiropractors.

Don't fall into the trap of is if they are in one of these safe plans is, is don't hinder your, uh, financial growth in pay because you're worried of what you'd have to pay. You know, like, Oh, I don't want to pay. I don't want to make 200, 000 a year. Cause I don't have to pay my student loans more. Don't, don't [00:13:00] fall into that, that trap there.

As you said, you could work with them to figure out. Good balances. And depending on what they think of psychologically of paying down debt or investing and things like that. There's a lot of options. It sounds like.

Kristin Lawrenz: Yeah, absolutely. We always, we always want you to make more money. We'll figure it out on the other end.

Yeah. That's like paying taxes,

Dr. Kevin Christie: right? It's like it sucks when you have a big tax bill, but it means you paid, you made some good money. So that's, that's positive. Right? Definitely. Okay, uh, I guess one of the questions I, I, I also had was I heard that the SAVE plan is on hold. What's, what's the reasoning for that?

What's the, what's the plan on that?

Kristin Lawrenz: So there have been a few lawsuits over the years against the SAVE plan. Um, mostly coming from different states that are part of the servicers being a big part of the state. Um, Ohio is one of them. They are located in Missouri. Their state is not [00:14:00] happy that there's some kind of plan that's really helping borrowers and, you know, limiting the amount that people pay.

So, This current lawsuit against SAVE is, um, through the, the federal courts and, um, it's put everything on hold. So this is, this is the one that kind of took really well and, um, the servicers are all kind of scrambling, like, we don't know what to do. We kind of have to put everything on hold in terms of letting people apply for these income driven plans, consolidating their loans, that kind of thing.

So everything as far as through the servicers. Um, processing is all on hold for all that. Um, so yeah, we're waiting until we've heard some, um, talk about October 24th. There's supposed to be a hearing, um, in the eighth circuit. That's supposed to give us a little bit more information about where the safe plan's going.

And hopefully, you know, we'll get a little bit [00:15:00] of clarity to help folks figure this whole thing out. Um, it may end up getting kicked to the Supreme Court. Um, in that case, the, this may get pushed back until June. So for right now, borrowers who are on save are not paying anything. They're on, they're in forbearance, but this.

time is not also counting towards their forgiveness timeline. So let's say you have to pay for, you know, 25 years. This is, everything is on hold. You're not getting credit for the, these, this time at all. And this is really affecting people who are more on public service loan forgiveness, which is a 10 year forgiveness plan.

So these folks are having everything on hold and they're not getting, um, credit for these 10 years. I currently have A client that's a teacher who has parent plus loans. So she's taking them out for her kids

Dr. Kevin Christie: and

Kristin Lawrenz: she wants to retire. Like, today, but unfortunately, she can't none of the none of these months [00:16:00] are counting toward her public service.

So she's waiting. I think she needs 3 more months. So she's unfortunately having to wait until this is all decided to kind of go on with her life. So, yeah, it's holding up quite a bit. Right now.

Dr. Kevin Christie: Yeah, I think like I try to, I try to see both sides, but I think I'm, you know, I'm in that gen X, 44 years old and, and I've tried to look at it a lot of different angles.

I do know that, um, not that 160, 000 is anything to laugh at that. I had to pay for chiropractic school, but I do know I have a low interest rate. I do know I have a digestible amount. So I, I, I do appreciate that. I'm in a, a different scenario, um, but I, I do get where some people are like, well, I don't know.

It on the same plan. If you're not even making them the minimum of the income based and you're not getting interest accrued, who, who obviously is footing that bill, right? Like who, who's paying that, uh, are the, uh, I can, I'm not an economics expert either, but [00:17:00] these loan companies in Missouri or whatever, uh, are, are they getting impacted financially because now they have, you know, no money, not enough money coming in because people are just deciding not to pay Uh, even the minimum of what they are supposed to be paying.

I, I see where those dominoes typically in banking can, can fall, uh, or obviously you got a lot of people that are in trades and didn't go to college and then, you know, their tax dollars are doing it. So I, I see that, but I know that there's a huge problem when chiropractic school is 300, 000, 250, 000, interest rates are 8%.

Like that's just. Unimaginable in a, in a very tough, um, situation, obviously. And so hopefully they, they can get that figured out and maybe we'll have to do an update once we do, uh, get some, some details on that. But I'm sure I'm assuming you're able to talk these chiropractors through some of the different options, whether, you know, if there is not the safe plan currently, uh, there are the, uh, there is the other [00:18:00] income based one, but that's where the interest does accumulate.

Is that correct?

Kristin Lawrenz: Correct. Yeah, right now we're down to people can apply for the income based repayment plan or the save plan technically. Um, but the servicers have all shut down their online applications. So you'd have to send in a paper application, um, and then basically we've heard it's, they're just sitting on the servicer's desks there, that nothing's getting processed at all.

So people are really in a limbo. There's not much that's happening right now. So they can't really switch their plans right now. But yeah, after this, after this October 24th date, hopefully we'll know a little bit more about which plans are available to folks and, um, you know, what, what they can do with that.

Dr. Kevin Christie: That'll be good. Obviously. Um, and then the fresh start program, you mentioned pre recording. What are the details of that?

Kristin Lawrenz: So the [00:19:00] Biden administration had also, they're trying to kind of rectify some of these wrongs that have been made over the past 20 years or longer with some of these income driven plans.

And, um, One of these things was the Fresh Start program. And basically, this was a program to allow borrowers who were in default. And you go into default when you haven't made a loan payment in nine months. So after nine months, they put you into default. And it's, um, obviously ruined your, your credit score, your credit history.

And you have a lot of fees that accumulate with default and trying to get out of default. It's not easy to do. So, um, part of this, whole thing to try to get, you know, everyone on equal footing here is this fresh start program. It expires September 30th. And basically what it is is just a way to get out of default, um, easily.

So you can go online. I can give you the, it's at studentaid. gov is where you do all [00:20:00] of your student loan. Processing. Um, but you go on to StudentAid. gov, you go to the Fresh Start page, and you basically easily can get out of your default and onto a repayment plan. And without all of these hindrances and fees and Um, consequences that there were before.

So it's just allowing folks to kind of, you know, step it up, you know, take responsibility for their loans and start, start fresh again. So that is one thing that does end September 30th. So if you're in that situation, Um, it would be very prudent to, to try to get out of I'll have

Dr. Kevin Christie: to, uh, I'll have to post in the Facebook group when we hang up, because this won't come out before the end of that.

Oh,

Kristin Lawrenz: gotcha. Okay.

Dr. Kevin Christie: Yeah. Yeah. Um, yeah, but we'll do that. And then I'll get that post out there. Uh, and then, you know, I just want to like, let's say someone, um, Let's say everything goes back to normal with the save plan and that's opened and everything's going there or the income based one. And, you know, obviously the, at the end of the period, [00:21:00] you're forgiven the amount, let's say it's just 25 years from now.

Um, but you have the tax liability on that. Is that correct?

Kristin Lawrenz: Yeah. So that's what we call the tax bomb. So when people hear about the tax bomb, that's what that is. So you get your loan canceled, but then you may have to pay taxes on that. Um, so for now, um, there is a, a law that's gone into effect that expires at the end of 2025 that says there is no tax bomb.

So right now, the federal government is not taxing people on their loan forgiveness. So again, that's going to expire at the end of next year. So that may be something that is pushed back. So maybe, you know, for the five years after that, we won't have to pay taxes on our forgiven loans. Um, there's no way to know right now.

But yeah, that's where that tax bomb comes in. Some states are still Taxing people on their forgiven loan amount. Um, so some people will have [00:22:00] state taxes and you know, if the federal one comes back, that could be, that's obviously based on your income. So it's an income tax, um, that canceled loan is, let's say it's a hundred thousand, basically that a hundred thousand is added to your income.

So that tax could be. Depending on what tax bracket you're in, anywhere from, you know, 15 percent to 35 percent of your, your income. So it could be significant for people, especially folks who are getting 200, 000 per given, you know, something like that. That's a, it's a

Dr. Kevin Christie: big number. I guess paying that amount on the tax bomb is a lot better than paying your student loans.

Kristin Lawrenz: Yeah. So we always encourage people to, to save for that. We have, you know, a whole conversation about let's put this money into a certain account to save for that tax bomb in case it happens. And if it doesn't, then you have a bonus 40, 000 that,

Dr. Kevin Christie: yeah. Graduated five years ago and have been on this maybe in 20 [00:23:00] years, they, they would have to hope that there's a forgiveness without the tax bomb.

And so even though if there's a tax, no tax bomb now, or in two years from now, that could change in 20 years for them.

Kristin Lawrenz: Yeah, everything will change in 20 years. It's unbelievable how much has changed in the one year that I've worked for this company.

Dr. Kevin Christie: Or, I mean, think about what's changed in the 20 years since you and I graduated, right?

So.

Kristin Lawrenz: Absolutely. Yeah. We have no idea where student loans are going, so we'll see. But the truth is that both Republicans and Democrats want an income driven plan. They both agree that this is needed. You know, our debt is just, you know, The student debt in this country is out of control. So they both agree on that.

It's just coming to a plan that they agree on that seems fair for all parties involved.

Dr. Kevin Christie: Yeah, I think that's the hard part, but at least they agree on something. That's, that's a good start. Um, let's say a chiropractor has got 250, 000 in student loan debt. They're on this safe program or one of these income based, does this impact their ability to get a home [00:24:00] loan or, A business loan.

Uh, I mean, I guess if you have debt on the books, your debt to income ratio is always going to impact your ability to afford a home and then get a certain level of, uh, of a loan. I'm, I'm, I'm aware of that. Is there any other things that's a problem?

Kristin Lawrenz: So in this case, actually doing an income driven repayment plan is better than doing, um, a fixed plan because what they look at at the mortgage lenders, they look at your monthly payment.

Dr. Kevin Christie: Yep.

Kristin Lawrenz: So if your monthly payment is lower, you have more of an ability to get a higher mortgage, um, or you have a better ability to get a, you know, a business loan. So yeah, in this case, you know, we tell folks who are in that situation who are either buying a practice or wanting to start their own, um, generally the income driven plans are better for them because the monthly payment is going to be less.

Dr. Kevin Christie: That's good. That makes sense. And, and then, um, [00:25:00] let's, let's say someone's been saving money appropriately for, for, uh, eight years. Uh, because do you guys have taught them how to put money in and uh, I don't know, money market count, whatever it is, but it's got some kind of yield to it. And you're, uh. Saving up money for that quote unquote tax bomb, um, you could actually use that money.

Like, let's say there's 40, 000 in there when you go to buy a house and show that you obviously wouldn't use that for your down payment, but you say, look, I got 40, 000 of liquidity. That's the other thing a bank looks at is do you have money to back you up? Because they want to make sure that if something happens, you have money to pay your mortgage.

So I guess that you could use that tax bomb savings money as a liquidity to back yourself up when you try to go get a loan for a home or again, a business to buy a practice or start a business. Is that correct?

Kristin Lawrenz: Yep. You're, you're exactly right. Yep. Absolutely. It always looks good to have a chunk of money sitting there to show the mortgage lenders.

Yep. They love that.

Dr. Kevin Christie: It's like [00:26:00] they want, it's always funny, right? They always say it's like they only want to loan money to people that already have money. Yeah.

Kristin Lawrenz: Correct. Yeah.

Dr. Kevin Christie: All right. Well, that's good news on that front because that's something I know a lot of people are concerned about is that if you get on an income based, you've got your, you know, you've got a certain income level, you and your spouse potentially, and your monthly payment is 500 a month, give or take whatever it is, you got money saved up for this tax bomb.

You might actually be in a pretty good position to get a loan, uh, obviously given that your credit score and all the other variables are, are, uh, Yeah. Yeah.

Kristin Lawrenz: And it helps your credit to actually when you have a monthly payment that you can afford, um, and you're making that monthly payment that also helps your credit and your credit score.

So, you know, being on an income driven plan is good that way too. And the other thing is, you know, You know, people are nervous sometimes to get on these income driven plans, and, uh, you can always switch back. You can always switch back to some [00:27:00] kind of standard repayment plan. You can always pay off your loan early if you want to.

So it helps you in times when you're making less money as new grads, but you can always switch out of it.

Dr. Kevin Christie: Yeah. And I think one of the things I, I get a lot of chiropractors to ask me about it. And, uh, you know, first thing I usually say is I'm not an expert in it, but what I do talk to them about is the fact that, you know, getting the student loans to be a chiropractor was the cost of doing businesses.

Most entrepreneurs, most people that own a business had to take out some level of debt to do so, uh, sometimes substantial. Right. Like if, you know, most businesses are taking out hundreds of thousands of dollars, if not millions of dollars to start a business and they have that debt to pay down, um, to be a professional, like a chiropractor and other types of doctors and attorneys and stuff.

Uh, part of that, uh, cost of doing business was getting your education and there, there is a cost to that. And so I try to tell them, it's like, look, you know, uh, it's [00:28:00] just forget about it, like do what you gotta do, get organized with someone like yourself. Get a plan and then just get it out of your mind.

You know, like don't worry about it's there, but it's just like I, I might, you know, run into 10 different successful business people in my practice and they all have, I shouldn't say all. A lot of them have debt. They have business debt. It's, it's leveraged to, to, to grow. There's good debt and there's bad debt.

Student loans is a good debt. As long as you do your, your work and you become a, you know, a intrinsically motivated chiropractor, that's good and builds a practice. Um, it's just considerate, uh, part of the business loan. It's not, it's personal debt. It's definitely different, but psychologically just say, you know, I had to do this.

I wouldn't be where I'm at, not a big deal. I'm going to make my monthly payment and I'm going to deal with it in 25 years. Not no sweat.

Kristin Lawrenz: Yeah, that's exactly what we try to do at our company too, is minimize this because it's a small part of your financial future, you know, and don't make it everything.

Don't put every cent you have [00:29:00] towards paying down this debt, you know, unless you can, but most people can. You know, the more we can kind of minimize it and it is, you're right, a justifiable debt, um, that will hopefully pay off for you if you share with, with a doctorate degree, you know.

Dr. Kevin Christie: No, exactly. You know, like I, if someone said like, knowing what I know now, 20 years in, would I pay 250, 000 back then for what I did?

It's like, yeah, I would, you know, I've, I've had a great career now I've worked hard and I know not every chiropractor feels the same and I get that. Um, but you know, sometimes, Uh, you have to look at why that is and maybe seek some help to get your practice a little bit more, uh, profitable and be able to, um, feel good about where you're at and, and it's never too late.

It's never too late. That's for sure. So any other, any other words of wisdom for our student loan borrowers?

Kristin Lawrenz: You know what? I think the only thing that will help you [00:30:00] keep on top of this is just keeping on top of this and try, you know, figuring out what's happening with your student loans, because of course, we want you to set it and forget it and pay the loan and. Don't, you know, think twice about that part of it, but there's so many changes.

So you can sign up, um, at our company student loan planner. We do a free newsletter every week that tells you kind of all the new happenings, or you can go to studentaid. gov, which is the government site too. Um, that can keep you updated on, on the new changes and, um, yeah, just be educated about it because it is a big amount of debt and you just want to make sure you're on top of it.

Dr. Kevin Christie: No, absolutely. So, um, well, this has been a pleasure. This has been informative. Good to get some new updates on things and things will obviously be changing as, as the weeks and months go by. But how can someone reach out to you all and find out more and set up a call?

Kristin Lawrenz: So to reach our company, it's [00:31:00] studentloanplanner.

com. And, um, you can book a consult with us and we have hour long consults and basically we go through your whole student loan situation. We have you download all your information from the studentaid. gov website and we go through each piece of it and tailor it specifically to you. Um, yeah, so there's a lot of free resources on our website to you.

There's a lot of different calculators that you can. Plug in your numbers and see if it's a better idea for you to do an income driven plan or a fixed plan. Um, we have some mortgage lenders that we work with on there that are specific to, um, physicians and chiropractors and that kind of thing. So you can kind of get some, uh, quotes through that too, if you want to.

And we also have some. refinance calculators. If you're in a position of private loans where you need to, or you want to refinance to a lower interest rate, we have some preferred lenders that we work with too. So yeah, lots of good information there.

Dr. Kevin Christie: Perfect. Well, this has been very [00:32:00] informative. I appreciate your time, Kristen, and then, uh, it won't be the last time we'll chat.

Kristin Lawrenz: Good. Thanks, Kevin.

 EPISODE 402: IG Reels Update Show with Gage Winkels, 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. 

[00:00:00] Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I'm excited to bring on Dr. Gage Winkels, who is, uh, an associate chiropractor at our, at our practice. And we're going to dive into Instagram reels and some of the things that he's been doing since he's, uh, you Taking that over for our practice and some of the things we're doing also for MCM clients as well And we're going to dive into You know things from branding to the mechanics of instagram reels some strategy around it certain tactics.

We've learned, you know Instagram has changed Uh, quite a bit, and it really is putting a lot of emphasis on Reels because they're trying to keep up with TikTok. And so Reels is a, a really good way of marketing, and we're going to dive into the formats of that. You know, it's, it's video based and the difference between even Reels and posts and stories.

Uh, but we're going to give you a nice fresh update on what's going on. With Instagram reels. And he's done a great job [00:01:00] since he's been in our practice to grow our following on Instagram and to get a lot of, um, frankly, awareness and conversion into our practice. And so we're going to dive into that today and we'll keep you updated as we go along.

I think Instagram, just like marketing, just like anything, social media is always changing. And we are consistently trying to stay on top of that for you and give you the updates when we do. And so we have a great little IgE real update show for you here today. So without further ado, here is my interview with Dr.

Gage Winkels.

Dr. Kevin Christie: All right. Welcome to the show, Gage. It's a pleasure to have you on. I get to see you enough every day, but now we get to actually interview each other. So that's always fun, right?

Dr. Gage Winkels: Yeah, I appreciate it. Thanks for having me on, Kevin.

Dr. Kevin Christie: Yeah, absolutely. So before we dive into Instagram Reels, which you've done a great job of kind of revamping our practice for it, uh, tell us a little about yourself personally, professionally, and then we'll dive into it.

Dr. Gage Winkels: Yeah. So, uh, I'm Dr. Gage Winkels. I'm a chiropractic physician here at [00:02:00] HealthFit Chiropractic in Boca Raton, Florida. Um, also known as a Kevin's associate here for the listeners. So, um, I stem from a small town in Northern Minnesota, Grand Rapids, Minnesota, um, went to undergrad in, in Southern Minnesota there, and then did my chiropractic schooling at Northwestern Health Sciences University, uh, just South of Minneapolis there in Bloomington, Minnesota.

Um, before coming down and joining the practice here in Boca.

Dr. Kevin Christie: Yeah, it's been great. And then obviously on the clinical side and doing all that type of stuff that we've, uh, on boarded, you started with us in may, we're recording this in October, we'll probably come out a month or so after that, but, uh, The clinical, uh, onboarding has been good, but then the thing that you've really, uh, taken head on is, is marketing in general.

And I think that's something that I want to spotlight first for the young DCs that are coming out, whether you're, uh, going to be an associate, you're going to start your own practice is, is having an intrinsic motivation [00:03:00] and kind of an ownership mentality, uh, to, to get out there and, and realize that you're More than likely not going to be in a scenario again, whether you're working for someone or in a partnership or opening up your own practice where you can just hang a shingle, uh, you, you gotta, you gotta get out there.

You gotta get out there physically. You gotta get out there digitally. And you've been doing a great job of that. We're going to focus today on, on Instagram, but just for our audience. You've. Um, definitely done more. You've done a lot of the community outreach. You've done a lot of video in general and things like that.

Uh, when, at what point of whether it was in school or it was in the interview process where you had a really good preceptorship program that you were in, uh, or when you started working, did you realize like, yeah, I'm going to have to get out there? Uh, when, when did that occur to you?

Dr. Gage Winkels: Yeah, I would say, um, you know, when you're when you're in school, you always kind of know, like, oh, I want to want to run a clinic someday or, um, you know, be just be a small [00:04:00] business owner there.

Um, and then really, I felt like when I started my preceptorship in that last year of school. Um, I was lucky enough to join a practice, um, just southwest of Minneapolis there in Eden Prairie, Minnesota, and, um, it was two docs who were kind of starting from the ground up there. They were fairly new into taking over a practice.

They had both been associates themselves. Um, and so we were able to discuss a lot on that and just how. Um, how it's important to to get out in the community there. Um, and I think that was kind of the first time I realized like, you know, patients don't necessarily just just show up at your office and sign up for for care.

Um, and so it's, there's a few different ways to go at it. Um, and as we've discussed, it's, it's a good to have a blend, right? You want to be able to do a lot. Um, online with today's day and age and, and how relevant social media has become, but also, you know, there's still a lot of, a lot of value in becoming the guy or the person in your community.

They're getting [00:05:00] out, meeting people, showing face, things like that. So, um, it's been a little bit of a two headed approach there. And I think we've done a great job of it here, but, um, really for like the young DC out there, you know, it'll start to click. I think as you, whether it's in your preceptorship or.

Or when you get out into the real world there, that, you know, your schedule, just, it doesn't fill that first day in practice there, right? You got to put in some, some time, whether that be, uh, online or in person.

Dr. Kevin Christie: Yeah. And I think the key, and I've mentioned this before, is if you're going to. Uh, work for someone.

Uh, and then you have a goal of someday opening up your own practice. You don't want that someday to be the first time you're trying to build a practice or a patient base and getting out there. Uh, you'd like to get your sea legs underneath you maybe under someone else's time, uh, late, let them make that investment in it.

And so, uh, look at it as, because I think the The mistake I've seen a lot of young docs and I would even admit that maybe early on, I had a little bit of that thought process was that it's like, Oh, it's [00:06:00] like, like, I don't know, put all this effort into build a his or her practice type of thing. And it's not the way you want to look at it.

It's you're building up your chops, you're building up your patient list. And then even if you were to move. An hour away to open up your own practice. That was a very good experience, just like your clinical would be a very good experience. And so I commend you for taking that head on and, um, kind of segue a little bit.

Uh, one of the tricky parts about naming your company, modern chiropractic marketing is that everybody expects you to stay modern, uh, with all of the social media. And when you're as old as I am, uh, not that I'm that old, but my, Uh, we had a funny story about that, where I took you to an out, a community outreach event, and we had a young lady come up and chat with us.

She was a marketing person. Probably what was she? 25, 26, your age.

Dr. Gage Winkels: Yeah, somewhere in there.

Dr. Kevin Christie: And then she asked if I was your dad. So that was a hit to the ego. But when you get to my age, it's hard to keep up with all the modern marketing [00:07:00] things myself. Like I'm not on Tik TOK and in, frankly, our Instagram, uh, for the practice was not up to snuff because things change rather quickly.

And, uh, one of those big changes for Instagram has been trying to be like Tik TOK. And so they're really. emphasizing the reels and they're emphasizing short form video. Um, and, and that's where we had a blind spot and you've come in and, um, really took that on and learned a lot with that. Uh, what was some of the early, uh, learning, Processes for Instagram reels that you had to kind of undertake and what were you doing to, to learn that?

Dr. Gage Winkels: Yeah. I mean, I think some of the things early on is, is just, you know, first of all, I mean, you got to understand what an Instagram reel is, right? So it's, it's essentially for those who aren't currently making any Instagram reels, it's a, it's a short video. Um, can be up to, like, 90 seconds in length. Um, and and with the immersion of tick tock over the [00:08:00] last few years, um, you know, it's something that that attention spans, whether it be from tick tock or just content in general, the shorter, the better there.

Um, and so for us, it was something that. Um, I noticed that we were, we were doing a great job posting frequently, but however, we weren't necessarily posting a lot of these short term videos. We had the, um, you know, educational content through MCM and things like that are slide decks. Um, but I felt like we were lacking in that.

Um, kind of shortened content version. Uh, and so that's where we, we decided we were going to come up with a plan for that. Um, and we've had some, some great interns over the last 6 months or so here that have helped with that. And it's been kind of a fun little project there. Um, but there's definitely a learning curve with it.

Right. And we'll dive into, um, kind of how, how you can develop a social media plan through Instagram reels here. And some of the metrics you'll want to, um, track throughout the process there. But it is something [00:09:00] that that there's just a learning curve. It's like learning anything, right? There's there's trials and tribulations and.

For us, it was, it was to definitely keep those videos a little shorter. Some of the first ones we did, we're pushing that 90 second mark. Um, and then you see the average watch time on them is averaging 10 to 15 seconds. Right. And so it's okay. How do we, how do we still educate the public? How do we reach out to the community?

Um, you know, show that we're experts in conditions X, Y, and Z. Um, versus, you know, a longterm video and how can we do that kind of more concisely and effectively there.

Dr. Kevin Christie: And one thing I've liked that you've done, because it's, you've been able to blend in, cause obviously the essence of what I try to, uh, coach, or we talk about at MCM is content marketing and educational content and being useful.

And you've done a good job of. Short format videos, but still providing a value and useful because I do, I do keep up with a lot of other chiropractors stuff. And, and I, [00:10:00] and I do think it's really good to sprinkle in some fun stuff and things that aren't educational, but I've seen too many where it's just all, it's all gimmicky stuff.

It's not providing a health education to the, to the practice. And you've done a pretty good job of doing that. What has been your thought process of trying to say, okay, I got 20 seconds to make this useful. Uh, how are you doing that?

Dr. Gage Winkels: Yeah, so like you said, it's it's a lot of clinics, you know, are, um, they either just follow trends, which there's nothing wrong with that.

And, and, um, I think there's benefit in that as well. Or it's the, um, one thing I see the most of and it's the Instagram page out there that has a happy 4th of July post. And then, uh, nothing for, you know, until labor day and then it's a office closed on labor day post and things like that. And, um, you know, it's, you gotta get content out there and you gotta, you gotta work that content to attract those, those patients or those people in the community there.

And so for us being, you know, a sports chiropractic [00:11:00] clinic primarily. And, um, that's something that we focus on is we want to take those videos and say, okay, we have, you know, 20 seconds, 30 seconds. What type of condition do we want to approach this with? Okay, tennis elbow. Okay. How are we, you know, treating that best clinically in practice here?

We're doing some ART, or obviously we're checking some joint motion throughout the kinetic chain there. And then we're doing some rehab and shockwave therapy. Perfect. Let's get a little clip of each one of those. Build our little collage video and post it out there. And and then we can also reuse those clips in the future, which has been something that helps improve efficiency with it.

So that's one way we've kind of approached it here and and brainstormed, you know, yourself, myself and our interns here have done a great job at kind of coming together at some of those conditions and how we can make a little collage video to attack that.

Dr. Kevin Christie: Yeah. And I just go over a little bit of the mechanics of it just for audience.

Um, that might be my age. Um, [00:12:00] there's, uh, when you Instagram, there could be a post, it's going to be your traditional posts that you might see. It might be an image that you're going to see. There's also stories and then there's reels. And then like when you go to actually post you on the, usually in the bottom, right, you'll see post story reel.

You're going to click on that reel. It's going to be video based, uh, essentially. And again, it's short format. And then within that, So once, let's just, I'm going to take you into it. We've clicked on that reel, we've selected the video that we're going to put on there from your phone. You got to do this or, or probably a pad, but typically from your phone, uh, what are some of the strategies within now that they've done that?

What are they looking at as far as let them know that they can edit the front and back of it and, you know, kind of the mechanics of it as they're hosting that.

Dr. Gage Winkels: Yeah, so, so, like you said, they're on Instagram. You have your standard posts. You can do kind of slide decks. Um, you can do your stories. Um, and then, you know, we want to focus on the Instagram reels there.

And so within an Instagram reel, [00:13:00] you can select multiple clips if you want, and then it will automatically play those in the order of selection there. It will then take you to kind of the editing platform on Instagram there. Um, and some real like basic things that I think you can do there is, um, you can obviously trim your videos.

So if you want, you know, if it's a 15 second video, but you just want to do two repetitions of an exercise, you trim that down to five seconds. Um, and then you, you can kind of play the collage of videos like that. Another one is transitions between videos. So, um, there's a transition button where between each clip, you know, the screen can.

Um, kind of fizzle away or it can swipe away in a direction. Um, that's some stuff that just makes it look more presentable. Right. And it also helps keep attention in there versus just these short choppy clips that get played over and over again. Um, and so the third thing I would say after, um, that would be, uh, captions.

[00:14:00] So I love using, you know, captions and text. Um, it kind of helps bring attention again to the screen. Cause. Get that hook in, right? You gotta, you gotta hook, um, that person who sees it on their explore page on why they should continue watching. Um, and then the fourth component I'd say is, is music. So, um, on Instagram, there's a plethora of sounds and, and things like that on their songs.

Um, and so what you can do is, is on those, um, they'll actually be a. upward arrow on sounds or songs that are currently trending. And so I always typically try and pick one of those sounds or songs there because that means that, um, that song or sound is getting a lot of plays on the app. So that's kind of a little insider tip there when you're, when you're looking at that.

Dr. Kevin Christie: Yeah. It's funny. Um, one of your early patients was a, an influencer model and she, uh, she gave you that secret and some other ones, right?

Dr. Gage Winkels: Yeah, she's, [00:15:00] she's, uh, she's helped us, uh, quite a bit there. She keeps us up on the latest trends and stuff. So being in South Florida here, you get, get some of that patient population and it's, uh, Hey, I mean, I'll take all the tips I can, right.

It's, uh, it's free advice and, and people like that who do it for a career. They, uh, they know a lot about it. So it would be, I'll take it any day of the week. That's for sure.

Dr. Kevin Christie: And it's safe to say you're not yet making the same amount of money off of, uh, holding like a Celsius drink or something like that.

Is that true?

Dr. Gage Winkels: Yeah. Yeah. We, you know, with our, our health page, we haven't got any brand ambassadors from, uh, athletic greens or Celsius or some of these companies that are maybe our patients have, um, but, but maybe someday it's not out of the cards yet. So we'll, uh, We'll just keep plugging away there.

Dr. Kevin Christie: Maybe it'd be a good hair product you can get. Just keep adding.

Dr. Gage Winkels: You know, I'll, uh, I'll take everything here, right? It's, it's, um, all the cards are in the deck there.

Dr. Kevin Christie: So, [00:16:00] um, it sounds like within the platform, You can just do so much. I think that's something I want to make sure that people understand is it's not that you have to use some other, uh, software.

I mean, I'm sure there are others that you could do more elaborate things, but within the actual platform of Instagram, you can do all the editing, even like certain things. Like if you're, you know, you might be the only doc in there and you shoot a video and it's like, you ought to clip out the fact that you were setting up to go hit the button.

And then you went to go shut the butt, the phone off. Um, you want to get that out of there. You can clip that, but you In the platform of Instagram, you can really produce this video essentially, right?

Dr. Gage Winkels: Yeah, absolutely. And so like we do, I mean, 99 percent of our, our editing, we just started to dabble with some other platforms there, but really all of our editing is within Instagram there.

And a lot of it is that, that rather basic editing, right? Like it's not complex, you know, it's going to take a long time to learn and steps to do like the app itself is fairly easy to use. Yeah. [00:17:00] And it can just be simple things like adding, um, you know, adding a trending song and clipping the video. So it doesn't start with.

You starting the camera and then walking in front to get get set up for the video, right? So it it really is efficient and it doesn't take a long time And I think one of the things that is beneficial too is as you create these clips You just keep them in in sort of a bank, right? You keep a cache of that and and so then down the road you can pull that old You know, that, uh, old clip you had for your favorite exercise for patellar tendonitis.

And you can combine that with a new clip of doing some, uh, grasping on the patellar tendon. And there's a new video right there without having to reshoot all these videos as well.

Dr. Kevin Christie: Yeah, it's cool. It's like, uh, you go back to your tennis elbow scenario. You could shoot a quick little video of you.

Assessing it, maybe a little bit of video of you doing something like air to your graphs, then a little video of a rehab exercise, a little video of shockwave. And then you've got different clips of that. And then you in the, [00:18:00] again, in the Instagram platform, you can combine it into one reel,

Dr. Gage Winkels: right? Oh, a hundred percent.

And I think that's a big challenge for a lot of DCs out there with Instagram is, is it's like that time commitment, right? Is your You're maybe you're a lone wolf dog or you're just you're busy. You're treating patients all day. You're doing, you know, backstage things like that in the practice. Um, and sometimes it might seem daunting to have to go create social media content, but you can keep those clips and reuse them and, and, you know, recollaborate them with new video and thing like that.

So.

Dr. Kevin Christie: Yeah, that's pretty cool. And then, um, you know, we've kind of talked about strategies, like, you know, what we just talked about with the tennis elbow would be kind of a strategy, uh, content in a short form, but educational content as a strategy. Then we mentioned some tactics like trending music as a tactic and, uh, certain things like that.

I know you put some overlay graphics sometimes on there. That would be kind of a tactic or production. That's cool as well. Now, um, on the metric side, what are some of the things [00:19:00] that you've been. Looking at and trying to improve on the, on the metric side, if you can just kind of run through some of those.

Dr. Gage Winkels: Yeah. So what we did is, is, um, after about a month or so that we started to really implement, um, consistent Instagram reels on our page, I thought we need a way to audit this, right? Just like clinically, uh, you need a way to audit. Audit, something that's going on with the patient. Um, and so why not audit, you know, metrics surrounding Instagram.

Now, uh, with Instagram, it's extremely beneficial. There's a, um, a section on Instagram if you are a business account. Um, there's, there's two sections. One is the professional dashboard, um, and that's a fairly newish feature. And what that does is that can show you. best practices it's called. And so that's some of your best videos and how to remake those as well as it can.

It has an inspiration tab, so it can show you other reels that might give you ideas and things like that. Um, but the biggest thing with the Instagram [00:20:00] account is the insights page. So on Instagram, in your account, you can go to insights. Again, this is as a business account. Um, and you can go to the insights and within insights, You can see, I mean, dozens of metrics on there.

Everything from just how many views, um, you, you get on a post to, um, they have the, uh, average ages broken up onto the people who are viewing your content. They have the, the sex of the people viewing your content, the location, right? And that can be by country, city. I mean, there's so much insight there. I think a few of the, the biggest ones, um, that we like to see is, is obviously views.

Um, and that's that's great because that's just general exposure. Um, and then one that I think is really cool to track that we have is, um, you can look at your views or your interactions with your Instagram account as a follower versus non follower breakdown now. So as you post an Instagram [00:21:00] real. You'd love to see that non follower breakdown increase, meaning that you're getting into the algorithm.

You're getting on people's explore pages. You're reaching people who aren't already following you. And so you're getting that community outreach there. And so that's a huge one that we like to like to track there. I think one, one other one that we like to track here, and it's kind of fun to play around with is, um, it'll show you your busiest times for your followers on Instagram.

And that's by day of the week and time of the day. So we can see that, Hey, um, on, on Monday at noon to 3 PM, that's the best time for us to post on a Monday. And throughout the week, it's, you know, Monday, Wednesday and Saturday at times a, B and C. And so then we can target those times when, when our followers are most active on the platform.

Dr. Kevin Christie: That's really good. And then, um, one of the [00:22:00] things I also recommend is what we try to do is get patients to follow your Instagram, because you do want to obviously have some of your followers, um, watch it. And then if it's your patient even better, which is great, because one of the things we saw a benefit of is when we did get.

Shockwave therapy. And for you listening, you might get something else, but if you have a new service or a new doctor, uh, we did a lot of reels on shockwave and a good amount of our patients that were falling in RIG, it kind of helped, uh, prime them for that. And we had people that came in that were already kind of coming in on a regular basis, then ask about shockwave and they converted to that, or we had patients come in because of that.

And so you can, uh, you can really. Educate your patient population if they're following your Instagram, which has been nice.

Dr. Gage Winkels: Yeah, I mean, that was that was an awesome kind of turning point for us there. And even myself personally, like, joining the practice and starting up those Instagram reels fairly early on, um, [00:23:00] it was kind of cool to see, you know, patients coming through the front door here and meeting them.

And they said, oh, hey, I recognize you from that post or from that Instagram video. Um, and it helps bring familiar faces into the office. Right? And even with our interns, it's been nice to do that and helps helps us establish that care team here. Right.

Dr. Kevin Christie: It does. And I wanted to bring that up and I'm glad you did.

Um, what I noticed it did was a few things by you doing a lot of the reels for our practice. It, it helped them, uh, get that no like and trust quicker for you. Uh, it helped position you as an expert a little bit better. Like, Oh, like he really knows his shit. You know, that's good. And, uh, it also just gave them awareness that we had a new doctor here and that, um, You know, they may be seeing you.

So that was really good. And so I, I had a lot of patients that I was still treating say, Oh, I saw you got a new doctor. That's great. Uh, you know, and I think it did a great job of, uh, onboarding you into the flow of things, uh, with our patients. And then now that [00:24:00] I've kind of cut down to part time care, a lot of them have been fine seeing you and staying on your schedule, which has been pretty cool.

Dr. Gage Winkels: Yeah, and like, you know, the non, non follower versus follower breakdown is, is always great. But, uh, at the end of the day, we're all, you know, not all of us are going to go viral. Right? And, and that's not necessarily the goal, nor should it be the goal there. Um, we're not trying to, to hit the lottery here.

Um, but we want to establish that, that, uh, connection in the community. Um, a lot of that's with preexisting followers. And like you said, I think it's a great way, you know, we utilized it a lot with myself, but also with shockwave therapy. And so new, new modalities or new aspects people are bringing into their clinics.

I think it's a great way to get exposure to that. And, um, it was really cool to see, you know, the benefits of that start to pick up where. Um, I still remember like, uh, you know, we had a patient who, um, came in, shoulder complaint and, and she suggested she wanted to try the shockwave before we even had mentioned it, you know, and implementing it into her care plan because she, uh, saw a [00:25:00] video that we had posted.

So, um, that's something that, that can be really beneficial for the practice as well.

Dr. Kevin Christie: Yeah, absolutely. Um, another one that something we used to do, uh, because we had to do it this way. We, we called it the IG takeover. And it was like, if you went to another, uh, facility and then you would actually give them your login credentials and they would shoot video or whatever, uh, you using your plan, your Instagram.

And it was cool, but you know, a little riskier. We'd have to change the password afterwards. Uh, then I was at a, I worked one of the, we worked this, obviously this tennis Academy, they have a tournament every weekend and I worked the one Saturday and there's an influencer there and, um, they're going to like the, the brother, or not the Not the brother, the guy that wants to be like, Oh, take a, take a picture, blah, blah, blah, and do the whole thing.

And then she's like showing me all this stuff that I had no idea about. And it was a collaboration. So it was like our health fit account collaborating with her account, which had a lot more followers. Uh, [00:26:00] so now you don't have to necessarily do the IG takeover strategy. You can do this collaboration thing and you can also do it with reels.

Can you explain that a little bit for our audience and the benefits of that?

Dr. Gage Winkels: Yeah, so, so the collaboration piece of Instagram is, is awesome. So it's, it's when you're out there boots on the ground in person, right? You're, you're working a community event. You're, um, you know, interviewing someone in the community.

You're, you're doing marketing events, things, community outreach like that. Um, it's a great way to expand that following. And so what it is is, um, by you doing a post on Instagram or a real, you can then, um, add another account on Instagram as a collaborator. And so then that post will appear on all the. Um, pages that follow, you know, the, the other site or the other page there, as well as your clinic page.

So, um, a lot of the docs out there who are doing, you know, things like with gyms in the community, or, um, like, we do tennis academy, right? Run [00:27:00] clubs, things like that. Um, that's a great way to get more exposure to that area. And I think with that too, you build, you know, like you said, you build some credibility of, you know, hey, this gym or these trainers or, you know, this provider in the community also works with HealthFit over there.

Uh, you know, if they trust those guys, I'm going to trust those guys. And so it's a great way to do that. And it's, it's really easy. You can just add collaboration. Type in the account and go from there.

Dr. Kevin Christie: Yeah, I really liked that. And it's cool. It's like a, it's like an old school meets new school. You know, you're out doing the old school in person, uh, networking or community outreach, but then you utilize a new school technology and you exponentially.

Get that out there. And so like you said, if that, if that gym has 5, 000 followers and you do a collaboration reel with them, not only is that getting in front of your following, but also theirs. So you increase your audience size of like minded people. And then, yeah, it's a, it's [00:28:00] a, um, social proof type of thing like, oh, okay, this must be a place to go to if they recommend them.

So I love that strategy. I think it's something that chiropractors need to, to double down on for sure.

Dr. Gage Winkels: Yeah, and it's something, you know, you, you sit down in the office and you say, you know, Hey, what community outreach events do we have coming up in the next month or two? Um, and, and then would they, you know, could we ask them, you know, Hey, if we put this on Instagram here, can we add you as a collaborator?

And, uh, and then it'll just appear on your feed and, you know, you can also share it to your story or whatever. Because you got to think to them, then they're getting the collaboration on their end from your clinics following as well. So it really is a win win situation there. Um, and we haven't had any issues with with anyone denying that or anything.

And, um, it's something we hope to continue to going forward with other community events around us here.

Dr. Kevin Christie: Yeah, no, it's, it's awesome. And then, uh, the last one little topic I have, and then I'll see if I didn't ask anything that our audience needs to know, [00:29:00] but, um, we've been messing around trying to, uh, we're doing it for our practice a little bit, but also trying to be able to offer this to our, uh, coaching clients that we do their marketing for them.

And that is, uh, and I've mentioned it on the podcast before, but Opus clip, uh, where you could, if you, you know, if you're Uh, practice and you've got a bunch of YouTube videos and they're longer format, three minutes, 10 minutes, five minutes, whatever, uh, you can run it through this Opus clip and it'll spit out, uh, reels for videos.

So, uh, explain to our audience what that is and some of the details of it and how you're leveraging that.

Dr. Gage Winkels: Yeah. I mean, Opus clip has been something we've kind of. Come on to, um, over the last few months here. And it's something that I think, um, has some great opportunities for clinics in general, and especially for clients of MCM in the future here, where, um, essentially you can put in a video, um, of really any length.

Um, and so we've uploaded a few of your speeches that you've given that are in our [00:30:00] duration. Um, and you can upload it into, uh, it's a website platform there. It's AI generated. Um, and it will essentially process that video. You can select, um, you know, you want clips spit out from that at zero to 30 seconds, zero to 60, all the way up to three minute long clips.

Um, and it will go through, analyze that video. It will put in those clips. Those captions that are coming up, it will add B roll clips, which are like little side clips that'll come in and interrupt the video in the middle of it. Um, it will do all of that for you. And then it also, it provides a written description of what's being said during those clips or of the clip itself.

And then what's kind of cool is, um, it's in a beta mode right now for the website, but, um, it, it'll essentially grade things like. Um, how capable this is of joining a trend, how well the hook is on this video, um, how well, you know, the, the phrasing is of this video, things like [00:31:00] that. You get graded on six or seven metrics there and it ranks those, so it will spit out these clips and your top clip will be, you know, it has an a hook and, and it has a minus for ability to catch a trend and things like that.

And, um, all of that is, is processed by AI. You just plug in the video. Um, it's a subscription based based website there. But yeah, it's, it's awesome. I've enjoyed really, really working with it and we're diving into it, you know, head first here and really, really seeing what the capabilities of that could be in the future here for.

Um, for clinics in general and especially MCM clients here.

Dr. Kevin Christie: Yeah. What do you think is the, um, ideal, like taking into consideration that these are chiropractors, these aren't marketing specialists and plenty of time on their hands outside of patient care. What would, what would be a good frequency of posting reels, uh, on, on Instagram?

Dr. Gage Winkels: Yeah, I mean, I think, I think if you could post, um, [00:32:00] you know, as a, as a standard clinic there, and you're not, you know, Mr. Social or Mrs. Social Media Influencer there, um, honestly, I think one reel a week would be a good, a good thing there. So it'd be for a month. Right. I think that would be a good frequency there because on top of that, you can always post your standard posts.

You can post stories. You can, you know, post other video. Right. This is just one more component. And it's just tailored to, uh, the type of content that society's enjoying the most right now is that short form video content. So I really think a frequency of, of once a week, a week or four posts a month would be great.

Um, kind of a great starting point for a lot of clinics and be really beneficial. Um, and that's, I mean, we didn't, we didn't start here posting, you know, seven reels a day every day from week one. So you gotta start somewhere. And I think that would be a really good frequency about about four a month there.

So one a week.

Dr. Kevin Christie: Love it. And then, uh, is there anything I didn't ask or we didn't [00:33:00] discuss that could really help the chiropractor get started with Instagram or even just improve? Maybe they already are doing it, but, but some strategies improve or anything.

Dr. Gage Winkels: Um, I mean, I think I'll just briefly go over here.

You know, one thing that we kind of did, um, early on there is, is we broke up, you know, how we're going to attack social media into three components. Um, those three components would be brand audience and plan. Now, under brand, it's, you know, who are you as the provider? What, what's the clinic like? What's the vibe, values, mission statements, things like that, um, under the audience, like on Instagram and those insights, you can see, you know, where, where people are from, where they're viewing your content.

Obviously, a lot of that's going to be local there so you can kind of know like, hey, the content, you know, social media stuff I would post in the hometown I grew up in is going to be different than what I'm going to post down here in South Florida, right? I'm not going to talk about golfer's elbow in [00:34:00] January in northern Minnesota as much as I would in South Florida here in January.

Um, and then that third component of it would be developing a plan, and that's just, you know, what type of post do we want and and a frequency and then let's find a way to kind of track some of these metrics. So I think, you know, brand audience and plan and just going over that with with either yourself or as a clinic would be a great way to kind of come up with with something to get started with Instagram.

It can be daunting and social media in general can be. Um, a bit overwhelming. And so, you know, why not develop a good solid plan and just follow that and track some metrics and see what you can get, um, over, you know, we're doing 90 day time periods with ours. So, uh, give it three months and kind of see where you're at there.

Dr. Kevin Christie: Yeah. And the other cool feature on there is you can schedule it out. So you can, um, you know, if you've got an hour a week to sit down and do it, you can, you can schedule that out for the month or however much you want.

Dr. Gage Winkels: Right, [00:35:00] right. And as that clip cache, you know, builds and things like that, I mean, now it takes us, you know, not even 10 minutes to pick a few clips, throw a video together, schedule it out for two weeks from now on Tuesday afternoon, because that day works best for us.

And that's the time our followers are most active and you set it and forget it.

Dr. Kevin Christie: Awesome, man. Well, this has been great. And I know there's a lot to it and we could probably do a part two and three and a four. Um, but, uh, yeah, we're, we're continuing to learn from it as well. And in monitoring our metrics, uh, what's your, what's your, uh, your next goal with, with Instagram of like one of the metrics or something that you want to achieve.

I know you and, uh, uh, one of our interns, Matthew was, uh, kind of competing with each other a little bit there. What do you want to hit? What do you want to do?

Dr. Gage Winkels: Yeah, I mean, I think one thing for us is, um, we're coming up on our, our second 90 day metric here. Um, the first one we, um, our, our interactions or our impressions there, we had hit, uh, 27, 000, which is kind of crazy to [00:36:00] think by just doing a few extra Instagram reels a month, you, you impact 27, 000 people.

Um, our goal was, was 35, 000 and we're looking like we're going to beat that there. Um, I'd love to hit that 50, 000 mark. So that's, you know, 50, 000 views over 90 days, um, would be sweet. And, and overall followers too, right? Just building that community, um, establishing that connection in the community, and we're coming up on, on 1600 here and, um, In the next, you know, 90, 90 days or so, if we could stack on another 50 or 100 there, um, that'd be awesome.

So all those metrics you can track and, and it'll show you, um, the percent growth on those and things like that. So that's something that I think will be a good goal for us going forward into the end of the year here.

Dr. Kevin Christie: Yeah, I just, I'll leave, uh, the audience with a couple of things. One is, uh, Ashley Jordan, one of our associate coaches, they've implemented in their practice where they, every Friday they, um, they just follow new patients and a lot of time to get follow back, [00:37:00] which is different than friend requesting someone on Facebook.

That's a little bit probably, you know, maybe not going to do that when patients come in, but following patients, uh, on Instagram. could get more people following you back. Or if you, you know, all the things that all the entities that you reach out to in a community, like say you go and connect with that gym or that coffee shop or that, um, tennis academy, you, you name it, you follow their business.

A lot of times they follow you back. And so that works out. One thing that I've also done is, uh, we sponsor a group that's called Boca Raton triathletes. And I went onto there Instagram. And I started looking at some of the people that I knew from that group and I followed some of them and I got followbacks with air.

So there's some strategies to increase your followers where it's more manual. Like you got to go in and, and, and try to, uh, siphon that a little bit more. Uh, but I, I just wanted to, to, to leave it at that as far as, um, growing the audience.

Dr. Gage Winkels: Yeah, absolutely. And I think, you know, one last [00:38:00] thing is, is don't get discouraged.

Like I said, we're not all all going to go viral. Um, that shouldn't be the goal. But if you host a lunch and learn and 15 people show up, you might consider that a win. And you can post an Instagram real on a condition you enjoy treating or feel like you have a good grasp on and maybe 200 people will see that.

And so you can look at it that way as well. So, yeah, absolutely. Just, uh, don't get discouraged. Social media can be a bit daunting, but, uh, we're all in it together here. So

Dr. Kevin Christie: do you have any haters yet? Like I have haters.

Dr. Gage Winkels: I don't yet. I'm still in the young DC category there. So I feel like I'm, I'm avoiding it as of now.

Um, but we'll see as we grow this thing and stuff, it's, you're not going to appeal to everyone. I mean, I'm sure some of our, our videos and, um, Things, you know, around the evidence based world wouldn't appear to everybody, but, uh, we'll just, we'll just keep plugging away here. So there you go.

Dr. Kevin Christie: Can I have a thick skin?

No, I'm just kidding. Obviously, you know, if you're, if [00:39:00] you put it, if you're a chiropractor, they're listening, you're putting out good content. You're not going to get the haters. Uh, it's when you do dumb shit. So just don't do dumb shit. Yeah. Well, Gage, this was awesome, man. Thanks for, for everything you've been doing.

And it's exciting to see the growth of, of everything that you are Doing and thanks for sharing that.

Dr. Gage Winkels: Yeah, absolutely. Thanks for having me on and I'm excited to see you know Where where people can go with this and where we can go with this as our clinic as well

 EPISODE 403: 2024 Positive Focus and 2025 Vision

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. Every year around this time, I do a positive focus. I learned this from strategic coach and, uh, it's a really helpful tool for me to get clear on the positives from the year and then go into the next year. Feeling good about it. No matter who you are or what you're doing, there's going to be challenges throughout the year, but there's always going to be positives and you got to take those, uh, when you can.

And a strategic coach was instrumental in teaching me that. And then each year I do this episode, uh, to give you kind of a, an update on what's positive in my world. And, and honestly, to hopefully compel you to do the same for yourself. And so we're going to dive into that. And I'm just going to read real quick from strategic coach, one of their tools on the positive focus and why to use it.

So here we go. Uh, the positive focus is a simple and powerful tool to reinforce and protect your personal confidence. Confidence is the foundation of everything. every day [00:01:00] progress and achievement. When you're not feeling confident, no matter how capable or resourceful you are, it's hard to take action.

When you are feeling confident, there is very little you can't do. The positive focus has you measure progress from where you started rather than against an ideal result. When you focus only on what still needs to get done, you risk feeling as though you're never achieving enough.

This depletes your mental energy. By focusing on actual progress and achievements, you create momentum that leads to even more progress. Being in charge of your confidence means being in charge of your future. The bottom line, focus daily on your progress to protect and reinforce your confidence. So, um, I'm going to go over.

Uh, my positive focus for this year. And then I'm going to also go over some of my vision for 2025. So let's dive into that here.

So when you're doing your positive focus, you're going to [00:02:00] one, write out your achievement to the reason why that was an achievement. And three further progress, if any, and if there is further progress, number four, your first action in that. So some things you, you may not have for further progress and that's totally fine.

And some you met. And so I'm going to dive into it. Now we've got a handful of things here. One is we had great trips and vacations this year. We, uh, celebrated Laura's, uh, my wife, Laura's grandmother's 90th birthday out in Tucson, Arizona, took the family out there. That was Great. We had a lot of, a lot of cool birthdays and anniversaries this year.

Um, we had our fifth wedding anniversary. So we went back out to Sonoma at the MacArthur place, uh, where we got married five years ago. If you have not been to MacArthur place in Sonoma, I highly recommend it. It's just, uh, it's amazing. Um, Napa hotel resort type place. Uh, my dad turned 70 in August and we went to St.

Augustine, Florida, where he was actually born. And it's somewhere we've gone every year when I was a child. And I've been there many times. It was [00:03:00] very, uh, sentimental. So I, I kind of paid for everybody to go out there and have a great weekend. There, and then, uh, you'd had a ton of great mastermind trips.

Uh, part of what's amazing about the mastermind and the members can tell you that is not only do you learn a ton for your practice, uh, but we go to cool places and you hang out with cool people and you have accountability groups and friendships out of this. And it gives you an escape from your practice four times a year to not only again, learn, but to have a little camaraderie and a little bit of enjoyment.

You know, we work hard. And, um, It's really good to get out of there and have fun, you know? And so in the East group, got, we did, we were in Jupiter, Florida early in the year. That was fun. Then we were in Nashville, Tennessee, summer Chicago, which is awesome. And then we're, uh, we were in San Antonio. So really cool areas there for the West group.

We started in Phoenix, Arizona. And Phoenix, Scottsdale, Arizona, that area. Then we were in Denver, Colorado, then Jackson hole, Wyoming in the summer, [00:04:00] which just was a remarkable experience. And then we wrapped it up in San Diego, California. So we had some really cool trips and, um, you know, that's just part of what.

My family and I have, , are cultivating is a, is a, , you know, a lot of travel, a lot of experiences for our kids, my, my wife and kids come to some of these masterminds. We, we travel as a family for vacation things as well. , but ultimately vacations and trips are going to be a vital part of our life.

And even around the mastermind, they're going to come to, , three or four of those every year, which are, which is pretty cool. And then, um, you know, further progress is just 2025 coming up. We got, um, mastermind, we've got great locations, we've got some vacations planned. So just, , first action is to plan out our two week vacation, come next summer.

It'll be the first time in a couple of years that I've actually taking, taken a two week vacation. Um, complete free days vacation. So that'll be our next step to plan that out. Next [00:05:00] is, um, couldn't be happier with, um, bringing on Dr. Gage Winkles to the practice here. Uh, he was in may, he started may 1st and it's just been a really good onboarding.

Um, as I record this, uh, it's just been, it's been great and, uh, I can't, uh, commend him enough for the effort he's putting into the practice is, and it's allowing me to, to focus more energy onto MCM and, um, one of the great, uh, things from that is I'm now down to part time care. And so it's allowing me to put more focus on MCM and the creative and, and frankly the growth that we're having at MCM with helping practices out in many different avenues.

And so, uh, that's been a, just a phenomenal positive to the practice. As many of you know, I was out of practice or sorry, out of treating patients on the practice, uh, and then had to jump back in full time for a year. And I took my time finding the right associate and I feel strongly that I did. And, uh, And, uh, that's been really cool.

So that's been a phenomenal aspect of [00:06:00] 2024 and looking forward to continuous progress into 2025 with that. Um, we really don't have a first action on that. I think we're at this point pretty well onboarded and ready to, to really grow the practice, which kind of leads. uh, to a 2025 vision, which I'll get to in a little bit there.

So I'll, uh, I'll cut the, this one short and finish it up here on that 2025 vision. Uh, the other thing we did, uh, in 2024 was back in about mid April, we added shockwave therapy, uh, from Kinas medical to our practice. And, uh, it's been quite amazing. The results we're getting from, uh, from it. Conditions that we were getting good results from before, getting faster results, conditions maybe we were struggling with, or we had some blind spots on, it's really helping out with.

And then frankly, the ROI has been a lot more than I could have imagined. It's been a really good support system from Kinas, from the clinical side of things, from the support. Just from the [00:07:00] technological support, but then also launching it appropriately to our patient base And to just to the community So I think we've done a really good job with that and it's going to it's it's honestly It's changed the complexion of our practice in a very positive way So that's been really good.

I would say further progress with that as we are Uh, we have been through our, we're in our thick of our busy season right now and just making sure that we continue to excel at this and, uh, if we run into any bottlenecks in the practice and, you know, maybe we have to hire someone or even add a second shock wave if it keeps growing, which is good, a good problem to have, but, um, for the progress is to keep on, um, getting awareness out in the community and honestly separating ourselves because a I think a lot of people are getting shockwave therapy and I know there's a lot of people in our area, but there is a clinical component to it and there's a communication of component around it.

And I think if we do better than, than everybody else at that, [00:08:00] which I think we can, um, we will separate ourselves in the area and position ourselves, uh, frankly, like say how Dover did. Dr. David Rudnick, who's only about 30 minutes away from me has done for his clinic is, uh, there might be a lot of people around him that have shockwave, but he is the shockwave guy there.

And he's positioned himself well because of his clinical skillset with it. And so shockwave has been a great positive, uh, to our 2024. Uh, next is we had a successful launch of the 30k course, and we're in the thick of that. Now, uh, we had a good amount of docs sign up for that. They're looking to get their practice to 30, 000 a month.

I think this is just such an instrumental thing for practices. I've, I've talked about a lot. You probably heard me talk about it enough, so I won't dive too much into it. But it is a positive. And I think further progress is we are actually in the middle of the drip of that is to keep on making sure we provide value during this two month stretch of the 30 K online course that also has group zoom calls and other touch points with it.[00:09:00]

And I think first, you know, maybe first action after this is if this has panned out pretty well, and everybody likes it. What are some other pain points that we can develop some online courses with for you through MCM and or. Uh, CSA. And speaking of CSA, uh, the digital dashboard, we keep on improving that.

Um, that thing is becoming a great dashboard for planning out all of your practice growth needs. It's not a, um, it's not like a track stat or a blue IQ or anything like that, where you're going to get a ton of the analytics, which is great. And you need those things. So, um, you know, A lot of our members have track stat and do that.

I highly recommend it. The CSA digital dashboards a little bit more on the community outreach planning, the marketing planners, uh, uh, indicator score cards. It's a really good practice growth, a planning tool for you. And we keep on improving that. So check that out. That's at CSA circle. com. [00:10:00] And our next action is, honestly, just keep on improving it.

We get a lot of good feedback from our clients and our chiropractors, and we, we try to implement some of those with our developer, Joshua, who's amazing. And, uh, so we'll keep on improving that.

All right. Next one is the clearly heart exam. I am 44 years old in my paternal 47 years old from a heart attack. Now, uh, You know, always worry about the congenital. My, my, as I mentioned earlier, my dad turned 70 and he's very healthy, which is great. Uh, my, his father, uh, who had passed away at 47, uh, just lived a different life.

So I know there's some, uh, environmental factors versus say congenital. I mean, he was a flamethrower in the Pacific war for four years for World War II, uh, you know, came back drinker, smoker, you know, all that type of stuff after [00:11:00] living a life of war like that. And, um, the stress of it. And. being shot and the malaria that he got out there.

There's a lot to it. And it was a different day and age. Um, but I always want to keep that content congenital possibility in there. And so there is the clearly heart exam. And I got this, uh, from Dr. Jonathan say he had mentioned it in our mastermind group in our East mastermind group. And essentially what you're doing is a year ago I had already done the Um, CT scan of the heart to measure the calcium and I had a zero score on that, which was good.

But then with the clearly heart exam, and I won't dive too much into it other than the fact that I had a clear bill of health on it. You do get a CT angiogram. You take, they take that in a upload into an AI software called clearly and that is C L E E R L Y. You could check that out. They don't offer it everywhere.

Sometimes you might. Depending on where you live, you might have to fly to somewhere to do it. Luckily in South Florida, we have a couple. It is not covered by insurance. It's not cheap, a couple thousand dollars, but it really does a great job of measuring all the soft plaque. And [00:12:00] if you have inflamed soft plaque versus not in different, all the vessels, it really gives an amazing view of the plumbing of your heart.

Again, this isn't going to be the electrical component, but the plumbing and mine came back as good as it could. So I'm very thankful for that. And um, For the progress is just to keep on, uh, staying healthy and keep on working out, keep on trying to eat healthy and do all the things to help with my health span.

And, uh, lastly, the last positive is just overall, I mentioned a little bit, but the mastermind, uh, just two great groups we're growing. It's so good. It's, it's an investment on their end for sure, but they're getting the ROI because I mean, the percentage on each group that is coming back for 2025 is just insane.

Um, and so that's pretty cool. And we, the percentage of our East group, which has been three years now going into the fourth, how many are from the original? It's just showing that some of the groups are doing something, right. They're getting stuff out of it. So it's just been a very positive [00:13:00] 2024 on the mastermind and we're looking forward to a great 2025.

So, um, yeah, Let's dive into the 2025 vision. That was my positive focus for 2024. Um, just like any year there's hard things, there's challenges, that's life, that's chiropractic, that's business ownership, but it was a great year. And, um, I want you to get clear on a positive focus for your practice. Now, 2025 vision.

Uh, one of the things I remember learning some years ago, some years in business, you're going to have stabilizing years and sometimes you're going to have accelerating years in a practice or in a business. And I would say 2025, I'm looking at for it to be an accelerator year in, especially in our practice, but also in MCM, 2023 was a big stabilizer year for both businesses.

2024 was a stable, stabilizing year in the practice with kind of a tail end of [00:14:00] it. You can start seeing the acceleration, which is cool. Uh, MCM, this was an accelerator year. We stabilize everything. Becky as our integrator took over that role. Just amazing what a, what a person can do to, to grow something and help grow something.

And that's where we've been. And we've got a great team around us now with obviously with Kurt and Ashley as our associate coaches, we added Ashley this year. So that was amazing for MCM. She's just been a. been great. Kurt's been great for a few years now. Uh, we've got Emily and Anthony as our account coordinators and Lizzie as our blogger.

And also we got Brian as a blog. We just got a great team of people around us now that have been awesome. Those are the ones that are really working with us. And we have some other, um, great people we have on that are, you know, Kind of contractors that we do. Obviously Darcy helps us out. Dr. Sean Thistle helps us out now, and we've just got a lot of people around us around MCM and the [00:15:00] collaborations, whether it's FTCA or MPI.

I mean, it's just, the list goes on and the collaborations that we have with MCM. And I'm proud of that because I think a lot of people in our space in chiropractic, um, don't have those collaborations and there's a reason why. And I think the re the, the ability for us as a company to. have and maintain long collaborations with groups.

I feel good about that. I feel like we're doing the right thing and we're going about it the right way. And I know a lot of coaching and marketing companies or practice management have not over the years. And there's always a bad reputation around that. And so I feel good about the people that support us and the collaborations that we do have, because they are upstanding chiropractors and people.

And for us to be able to maintain those relationships is really cool. And so, uh, this year has really been a, uh, an accelerator year. For MCM, but I think next year, 2025 is going to be an accelerator for bowl. And, you know, just a learning lesson from that is if you find yourself in a stabilizing year, just recognize it [00:16:00] as what it is.

It's not a big deal. It's going to happen. I don't care if you're in practice for 40 years, probably 20, we're going to be stabilizing years. And that's okay. Cause once you stabilize it, now you've got a solid platform and it didn't accelerate from it. And that's going to, um, really help for better growth.

Next is, uh, I'm excited in 2025 about CSA. You know, Bobby and I are really working hard on that. We've been partners in that since the summer of 2018. So we are, we are six years rolling into seven years as partners in CSA and we keep on getting it better. And we got a few things we're doing, um, to, to optimize that, including, like I mentioned earlier, the digital dashboard.

And so look for some good things from the chiropractic success academy in 2025. 2025. I'm also looking, like I mentioned earlier, getting back to a two week unplugged vacation in the summer. So that's going to be good. We're going to continue, um, to really grow this mastermind. Also, I'm hoping that we're, we're, we're full in the East group.

[00:17:00] Essentially, we'll see how, like, in the summer of 2025, I'll launch for. 2026, we might have to fill a few spots there, but that group seems to be, uh, getting at that 25 or staying there, which I cap it at 25. Cause I want to keep it a true mastermind. You know, you'll hear other folks have masterminds, but it's more like a conference, uh, or a workshop or seminar where there's a lot of people and it's, it's around, it's about one person.

is actually limited people. It's high level people, uh, that are, uh, been, you know, doing this for a bit, trying to help each other out. Um, and so we're looking for those types of folks that are looking to help each other out. And, uh, I think we'll get that West mastermind filled in 2026. So that is our One of our visions and goals and, uh, just overall looking to, um, keep an open mind.

I don't have anything massively big in 2025 that I'm trying to [00:18:00] completely overhaul. I feel like we, over the last year and a half, whether it was my team at HealthFit or my team at MCM, we've done a good job of really, um, implementing the things and the changes that we wanted to. And now it's time to get more.

Um, chiropractors, uh, growing, you know, and then obviously getting more patients getting better. And I think we put everything in place to have an accelerator year and I'm excited about 2025. So your homework is to do a 2024 positive focus. You're going to write out the achievement, the reason why that was important, the further progress if there is in a first action.

If there is further progress. And then I want to know what's your 2025 vision. What are you going to, what are you going to get done in 2025 to feel good about that self? So that when we do a 2025 positive focus in December of 2025, you look back and see what you accomplished and you made it a good year.

Even though of [00:19:00] course there were obstacles, you're going to still look back and see all of the things you achieved. Here's to a great 2024 and an even better 2025.

 EPISODE 404: In-Network, Out of Network, and Cash Practice Essentials

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] Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I am bringing Brandy Brimhall on to discuss certain things like insurance, credentialing, billing, coding, how to optimize being an in network provider and the systems and organization around that, how to have checks and balances with your billing.

Things to consider if you are in network or if you're out of network, but you're billing insurances, or if you're just cash. So no matter what type of practice you run, you're going to learn a lot of information from Brandy during this episode. The first half of this, we do dive into a lot of in network insurances and some best practices with that.

And ultimately, you know, how to logistically make this work for your practice. And then we segue into out of network insurance is where you accept insurance, but you are out of network and you do bill for the patient. Some of the [00:01:00] things you need to look out for with that. And then lastly, we do dive into some of the details of cash practice and some of the pros and cons of all three of those types of scenarios that we discuss.

And as you're going to see from this episode, Brandy really knows her stuff and is a wealth of knowledge and a great resource for many chiropractors on the whole revenue cycle. And she defines what she means by the revenue cycle. And there's many points within the beginning and end of that. And her and her company, uh, can help you out with that no matter where you're at.

So without further ado, here is my interview with Brandy Brimhall.

All right. Welcome to the show, Brandy. I really appreciate your time today. I'm excited to dive into all things credentialing and the like, uh, before we dive into that, tell us a little bit about yourself personally and professionally. Sure. So, uh, just like we just started talking about a few moments ago, I am from Colorado and I am still located here, uh, doing the credentialing and, and really everything [00:02:00] to do with the revenue cycle system.

Brandy Brimhall: It's been a passion of mine for a little over 25 years now. So, uh, because of that, I have gotten certified, as you might know, in credentialing and coding and collections and auditing and billing, and I've spent the last 25 years helping clinics in lots of different ways with that area of their practice.

So this is really the summary of the professional side. On a personal side, I have 13 year old twins, and any time I'm not spending time working, which is the majority of the time I'm doing twin stuff. like the rest of us do that have kids at that age. Yeah, it's two jobs for sure. That's for sure. Um, perfect.

Dr. Kevin Christie: And so if you could actually define for me the, the revenue cycle, what would that look like from beginning to end? Yeah. So we often think of it as, well, we enter our patient claims, submit them and then post them when the insurance comes back. But I think that's where we have an oversight initially [00:03:00] because the revenue cycle really starts.

Brandy Brimhall: When the patient contacts us to initiate care or to inquire about care in our office. And so that's when we're collecting information on. They're a payer if they have one, making the determination if it's a payer we're submitting to and then, you know, to, to expedite the processes or the steps or then doing the data entry and setting up the patient and the payer for billing or reviewing the claims once the charges are entered to make sure that they're correct for coding with modifiers, the patient information, the payer information, all of those things, submitting the claims paper and electronic.

Following them through the clearinghouse to make sure our rejections are clean all the way through the receipt and review of the EOB to make sure the claim is process properly. And then of course we post it accordingly if it is and if it's not, what are the next steps that we're taking in order to, to, uh, get access to that money that we, you know, if it's an appeal or resubmission or correction or whatever.

So that's really the sum of it. [00:04:00] And beyond that would be our patient receivables as well, making sure we're collecting over the counter from our patients and having good processes with patient statements where that applies. So that's the sum of the revenue cycle system end to end. And all the way at the very top of that, as far as insurance is concerned, is making sure our business and our providers are properly credentialed and enrolled so that we are eligible to submit to the third party payers without issue.

Dr. Kevin Christie: Yeah. And I get, there's a bunch of questions I want to tackle from that. But the first one here is, are you seeing like a lot of providers have. Essentially like this black hole in their billing where, uh, they, they can't keep track of, uh, denied claims, uh, trying to reprocess and they're, they're just losing money that they may not even know of.

Brandy Brimhall: Yeah, and I would even say that it's not even necessarily in just one place. Pretty much all the time, right? So you know how the docs we, we educate our patients on interferences in our nervous system, right? So we're going to evaluate the patient and [00:05:00] identify and then determine the path forward, make the recommendation of a treatment plan to minimize or remove those interferences in the nervous system.

Otherwise, the patients have their symptoms and conditions that will continue to progressively worsen over time. The same thing applies to the revenue cycle system. If you would look at it that way. And just look at all of the moving parts of the revenue cycle system. And so one of the things that I do all the time is help clinics to identify the interferences in the revenue cycle system so we can determine the fastest pathway to minimize or remove those interferences through the multiple moving parts of the revenue cycle system, like I mentioned before.

So to your question, Absolutely. There's certainly a black hole, always weak areas and clinics where we just either don't know, excuse me, or don't have the time to get to the things that are really our pain points in the clinic. And because of that, we find ourselves just constantly having a deeper hole [00:06:00] to dig out of.

Dr. Kevin Christie: And, um, one of the things we had, uh, uh, we do coaching calls on different topics and our clients. And we did a whole call on the difference between service and hospitality and service is something that you expect, right? You go to the restaurant and you expect to be, uh, seated. You expect to have a waiter, waitress, things like that.

There's, there's essential. service. You expect your steak to be cooked, uh, the way you wanted to. And then there's hospitality, which is going above and beyond. But one of the things that, um, was discussed is how, unfortunately, um, if, if you don't have proper service, it can impact your hospitality, right? You could, you could, uh, theoretically, uh, have a practice that has amazing patient experience and Very hospitable, friendly.

It's, you know, uh, you serve coffee in the waiting room, right? All the nice niceties of hospitality, which we'd love to have. But then if you have issues within your [00:07:00] service, it's going to impact that. And no matter what the, the hospitality was on point, but the service was a problem, right? It's the same thing.

If I go back to the restaurant analogy, uh, that even Jay, this is a do this with Jay Greenstein, but. Uh, if you go to that restaurant, the hospitality is great and they're super friendly, but your steak is just terrible and isn't cooked right ever, you're just not going to go back there. Um, and I think I want our audience to think about this is that if you don't get this right, what you're talking about, you're going to have a lot of opportunities to aggravate a patient based on the service of dealing with the insurances.

Are you seeing that a lot in some of these practices? Yeah. Yep, absolutely. In fact, 1 of the things that I cover in any time I'm lecturing on the revenue cycle system is that our patient relationships are impacted 1 way or another, regardless of what we're doing or not doing in our clinic. And then I also would add that there are [00:08:00] typically 2 primary reasons and granted, there's others that always would apply, but there are 2 primary reasons a patient would discontinue care.

Brandy Brimhall: 1 of them has to do with someone of that hospitality that you mentioned, which is the overall patient experience. In the clinic, the other one has to do with their finances and what's being communicated or not communicated or managed, or how it's managed for them in your clinic. And you can lose patient credibility really quickly, and it's very hard to get back.

And, of course. Especially with our new patients, as we know, you only get 1 time to make a 1st impression. And this is an area that really should constantly be reevaluated all the time with clinics, just to make sure that it's truly a streamlined as it can, because, you know, the revenue cycle system is imperfect.

It's always going to be imperfect. There are things that are going to happen. And we know that. However. If we really do our best to keep our fingers on the pulse of our internal processes and systems and communications, we really can minimize a lot of those things that [00:09:00] happen that impact that service experience that patients are having as it relates to the revenue cycle system in our office.

Dr. Kevin Christie: Yeah, and what are a few of the things that you see that frustrate people? Uh, not having insurance verifications collected in time or not having them collected correctly. So the clinic is out of network and we've accidentally collected in network benefits. Now we've miscommunicated with the patient, miscollected from the patient and have to go to them to send another statement.

Brandy Brimhall: Um, determining that some services that we thought were covered now are actually covered under a different umbrella under the policy. So the patient has an additional copay deductible coinsurance and things like that. So, those are the types of things all the way at the top of the stream moving downstream.

It would be inefficiency in patient statements, not getting them for long periods of time when patients call in or come in with questions on their statements. The uncertainty and lack of confidence and being able to explain how the balance arrives to what it is Those types of things are [00:10:00] definitely super impactful And you know, we we build relationships with our patients and that certainly anything related with money Is it going to impact any type of relationship?

Certainly a patient relationship, too Yeah, absolutely. Now, do you recommend uh, you know, let's say obviously A lot of uh in network insurances now have deductibles Uh, do you recommend uh You know, these practices collect the deductible, the, the, each, each visit, right? Like, so the patient comes in and you do their codes and it adds up to 63 and 40 cents.

Dr. Kevin Christie: Do you collect that at a time or do you, because I go to sometimes like my dermatologist and they don't even collect anything because I have a deductible and network and, but then I get a bill and a statement. How do you recommend chiropractors do that? The best thing to do, from my perspective, is to collect the verification of benefits, the details on the deductible, to have the details of the allowed amounts of those payers, which we often think is harder to get than it really is, uh, but to have that information so that we are able to collect [00:11:00] the deductible amount at the time of service.

Brandy Brimhall: Certainly, if we're not able to do that, if our systems don't allow it, The next best thing to do is collect something from the patient so they're in good habits of knowing that they are paying something at the time of service when they're in the office. And then, of course, get your claims out clean and timely to be able to collect the remainder from them shortly thereafter when those claims come back through.

Dr. Kevin Christie: Yeah, I used to be a network provider. And what we did, we put together a pretty nice Excel spreadsheet. This was 10 years ago. I'm sure there's other softwares now that can do it. And maybe some of the EHRs do it, but we could actually have a different tab for each insurance. And we just had a system where the doctor had to get his or her code codes in.

Before the visit ended, because at a certain point in the visit, you know what you're going to do with that patient. And we would get the codes in, even if the note wasn't done yet. And then the front desk could check what codes it was tabulated on there, put in what the [00:12:00] co insurance was, and it would spit out exactly what that patient was going to owe.

And, and then we would collect that amount and it really reduced those patients statements that you, uh, that you mentioned. Are there, is there any software out there or EHR is doing that now? Like what's the if you wanted to really get an ideal. Uh, of the deductible, sure. So I would say the majority of the EHRs out there now have, they have lots of bells and whistles that they didn't use to have.

Brandy Brimhall: And the majority of them will allow you to input the allowed amounts to help you very quickly calculate whatever the patient co insurance and deductible is. So certainly if you have a software that does that and again, it's, it's the majority of them use that feature. A lot of clinics don't at the same time.

I'm like you, I still use spreadsheets in a lot of ways because it's easier for me to update the allowed amounts to see everything at a glance. So sometimes the old fashioned way works just as well. Yeah, spreadsheets are, are, are amazing. I'm uh, I'm not good at them, but I've started to learn what the capabilities of, and I have a couple of buddies in different [00:13:00] professions that, um, literally run, they work for hedge funds and they, they run multi billion dollar.

Dr. Kevin Christie: Portfolios off of Excel spreadsheets, because I mean, it's, it's insane what a spreadsheet can do. Uh, and so fine, you know, if you're listening to this and you want to do that, maybe find someone that can do it for you, it's not necessarily that complicated, but I'm always, I'd rather you, uh, figure out someone else, delegate it to, to do it, but it's amazing what a spreadsheet, uh, can do for you.

Cause you know, cause one of the things that we had to contend with on that too, was at a certain point that the index, the in network deductible was met and then it was a co insurance. So it's like, okay, the. The codes added up to 63 and 45 cents, but they've met their network deductible. So, and they've got a 20%.

And so we had, we had a whole thing tabulated really nice and it would spit out that they owed, you know, 12 and whatever. And, uh, it was, it was efficient and it really helped us reduce the patient statements. There's still going to be patient statements, but it was nice. Um, on that, on that topic of. On [00:14:00] patient statements, and this isn't going to be for some of our audience that may not be in network with insurances.

We're going to have a little segue here in a minute, uh, to to some of the cash, uh, conversation there. But for those of us for those that are in network with insurances, and they have patient statements often. What's some of the best practices around that of, uh, you know, getting those out in a timely manner, getting people to pay it.

Uh, when do you consider collections? What are your thoughts on sending people to collections? I'd love to hear some of that. Yeah. So the best thing to do follow everything all the way at the top of the stream, because I'm in a, I'm a big believer that aging accounts receivable for insurances and for patients has a lot to do with upstream interferences.

Brandy Brimhall: And so follow everything upstream to be as. It's streamlining as seamless as they're there as you can, without being said, collecting over the counter at the time of service as best as you can, as correctly as you can always the best way to minimize your patient statements next, like you [00:15:00] mentioned, making sure you're sending patient statements in a timely manner.

Those patient accounts that don't make sense to you, that need audited schedule time to go and audit them and not push it off from one month to the next and then have a process because Those patient statements, you know, that 40 or 50 balance after you've sent that statement out. four, five, six times, suddenly you're losing money on that.

And you really do need to have a stopping point. And so what I always recommend clinics do when they arrive at that is we'll first determine what that stopping point is to them. And some clinics it's a year, some at six months, make your decision and be consistent with that. But when you identify those statements, follow it upstream to see how it happened to start with.

So you can do your best to minimize that or reduce that same issue from happening again. Next, what are you going to do next in order to remove that balance or deal with it from the account? Is it sending collection letters? Is it making collection phone calls? Is it going to small claims court? I've done that.

Not the most fun [00:16:00] thing ever, and it's time consuming, but it's an option. And otherwise, selling those accounts is essentially what you're doing to a collection agency, so they can be removed from your books and the responsibility of someone else to collect. That's my preference at this point, making sure that, you know, that your books are clean, because you always, in the clinic, want to work with movable, collectible money.

If it's no longer movable and or easily collectible to you, moving on to somewhere that can work on that. And in my view, that's a collection agency. Perfect. I love it. And then, um, you know, communicating with patients, uh, let's give a couple of scenarios that I think are, that are common. Uh, you know, scenario a is that you've collected that in network, uh, amount, uh, of 60.

Dr. Kevin Christie: And then one of the codes gets denied. So then you, do you technically owe that? Let's say the code was worth 15 bucks. And do you technically owe that 15 bucks back to the patient? Uh, [00:17:00] is there a period of time where you're going to fight the insurance to try to get them to not deny it? What are the, what's the details of that scenario?

Brandy Brimhall: Yeah, so you would have to read the EOB and collect from the patient according to how the claim has processed. So if that 60 copay or whatever the patient responsibility is still shown as the 60, which typically it would be due from the patient, you are still entitled to that man and should have collected it.

With that being said, you're denied procedure code. You'll need to read those EOBs, the remark codes, to determine why that charge was denied. Was it denied because of a missing modifier, because of insufficient diagnosis, because of a payer error, because documentation was requested and you need to send it in, because prior authorization was required, or whatever.

And in that, in any event, Determine why it was denied and that will help you to determine what your next step needs to be as far as collecting on that charge. If you're able to at that point, sometimes you're not because it's, you know, the [00:18:00] coverage has maxed for those types of services. In that case, you know, you adjust the charges and post the EOB according to how the EOB reads.

Other times, you're appealing it, you're submitting records, you're correcting your coding, whatever you need to do in order to get that charge back through and processed. Perfect. And then scenario B would be, uh, let's say it's a straight, there's no deductible straight copay of, uh, you know, 40 bucks, your codes add up to 60 and you know, you're, you're expecting 20 from the insurance.

Dr. Kevin Christie: You got the 40 from the patient. Uh, the insurance denies a code, so that patient actually owes you 20 now, um, which if you fought it and everything and they're just gonna deny it, they owe you the 20. Uh, how do you, like, what are your recommendations on communicating with these patients to, again, not let the insurance company, which they always do, but let them impact the patient doctor relationship there?

Brandy Brimhall: Well, I think it's [00:19:00] important to keep in mind that every EOB or ERA that we get in our office, the patients get a copy of also, so they have the ability to see what was processed, how it was processed, and why the patient balance is what it is understanding. They're not always going to read it, but they do have a tangible resource directly from their insurance company with their name on it, because it was addressed to them.

That explains them the processing detail when I was in the clinics all the time. That was one of the things that we did was we would look at the EOB specifically. Importantly, it's it's very essential for clinics to make sure that they're preparing clean claims, meaning they're processable by the insurance company to the best of their ability, submitting them correctly to the best of their ability and taking whatever next step needs to be taken on denied charges.

if there are denied charges. So we have to read our EOBs, but with all of those things in place correctly, then we're in a good position to have that dialogue with the patient. If they ask, oftentimes we, you know, we send out the patient statement, they may call in and we can show them, [00:20:00] here's a copy of your EOB.

By the way, if you haven't already received a copy, you will be receiving one also to review in detail. And we can always let them know that they are able to contact their insurance company directly if they would like, and if they have specific questions. Perfect. Love it. And I think if you do that with a smile, it'll be, uh, even easier, right?

Dr. Kevin Christie: Um, now what are your recommendations, um, or, and I'm not sure if your company does this or whatever, but you know, you, let's say, let's say a practice, cause I've seen this happen many times, whether it's you have in house billing. Or you outsource to a billing company. What are your recommendations for the owner of the practice to have some kind of oversight to make sure that they're not losing money because, uh, either a billing company or a billing person in house is not doing their job, not fighting it, not understanding it.

Maybe sometimes it's blatant neglect. Uh, and sometimes it's just, you know, it's ignorance. They don't know what, what's happening there. What are your thoughts on oversight and what, what do you [00:21:00] recommend? Yeah, as far as recommending, I'm an advocate of both in house and outsource billing. I love both of them, and I think whatever is best for the practice is ultimately best for the practice, and that's a decision for them to make.

Brandy Brimhall: As far as oversight, with an outsource billing service, I think the best advice I ever would give to someone is to know that you can and should be monitoring those processes. And having communication with that person or that entity, just as you would someone in your office. We monitor by statistics. So you can pull your AR reports, your collection reports, all of the details.

And it doesn't take a long time. It does. It's not, you know, anything overly scientific, but you can compare 1 month to the next, as far as, you Your rejections, your claims that have gone out, your reimbursement, your AR, is it climbing? Is it reducing? All of those types of things, the same processes you would have internally, have with, with an outsource billing service.

And when you meet with them, because they're all different in, in [00:22:00] many ways, make sure that you fully understand where their role starts. And where it stops. And so that the clinic isn't overlooking in the passing of a baton, because that's sometimes actually a lot of times, one of the things that happens is, oh, well, we thought our billing service handled this, but really they don't, some of the common things are, oh, we thought that they would do the verifications for us.

Oh, we thought that they would get our preauthorizations. Oh, we thought they would call the attorneys on all of our PI claims, but they haven't, they're not doing that. So make sure you're clear on what, you know, where you start, where they start and whose responsibility is what. No, it makes, makes sense.

Dr. Kevin Christie: And I, I'm going to, we're going to segue a little bit, but before I do, I just kind of, you know, I, I think there's, there's a trend of a lot of chiropractors that are, uh, you know, going cash, they're, they're not doing the in network thing. Uh, I used, I built my practice in network and then went out of network and, uh, you know, and, and there's a lot of.

There's a lot of pros and cons, but you know, I will [00:23:00] say like, just because my practices is not in network with insurances, doesn't mean I'm against it. And I think there's a lot of variables and I can say with, um, the insights I get from working with a lot of chiropractors, whether we're coaching their practice or they're in our mastermind, some of the biggest practices that I know in the evidence based world are in network with insurances.

So, I mean, it's. Uh, there's definitely some cash practices that are big, not saying that, but the ones that I see that are generating 750 a year, a million, 1. 5 to, uh, they are in network with insurances and, uh, they have built really good systems to, to maintain that. And they are paying themselves handsomely, um, in their personal life.

They're, they're making a professional wage and they've built a team around that to, to, to do it. Now. At the same time, I know a lot of in network doctors that are also struggling. Uh, but [00:24:00] you know, I, I remember listening to a podcast and I, I want to say. I want to say it was Tim Cook, the CEO of Apple, uh, who, who took over, I want to say it was him.

It was definitely a huge company. And uh, you know, I think it was Tim Cook when, when, when, uh, Steve Jobs had passed away. And the thing that Tim Cook was uniquely skilled at, um, was actually logistics. And uh, as you can imagine, a massive company has. Logistical nightmares, uh, that are beyond the scope of what we can imagine.

And this, this particular CEO was just, uh, he was a savant at logistics and he paid a lot of attention to it. And I bring that up because, uh, as, as a chiropractic business owner, if you're going to be. Uh, in network with insurances, uh, you're going to really have to pay attention to the logistics of it.

And you're going to have to know that you can do it. I know practices that have amazing logistics around insurance, and it's [00:25:00] not the nightmare that, uh, one would think it's not easy, but it's, can be worthwhile. And so, um, What are your thoughts on that long little soapbox? I was on with that. Are you, do you see some of the same things that I kind of mentioned there?

Brandy Brimhall: Yeah. And it's payer specific and it's region specific, right? And so a lot of clinics find themselves in network that really aren't advantageous to them, or perhaps they don't have very many patients that have that insurance. And so working with that network may or may not be something that's really beneficial to them.

Yeah. What they need to do first and foremost is get to know their payers because they all have their different rules. They all have their different guidelines. And in order to really communicate with anyone, we need to get to know them a little bit. And the same thing applies for our payers because that helps protect us from vulnerability to and.

audit, recoupment, rejection, all of those types of things when we understand our responsibility in their expectations and how to work within the [00:26:00] parameters of that payer. But but yeah, it's it really is everywhere. One of the clinics that with the credentialing service, one of the calls that I get probably close to every day is I don't know which networks to be in.

So should I just get in everything? And I would say, no, don't, don't do that. What you need to do is do some investigating in your region. What payers are most common and prominent in that region? What employers are, you know, have at the blue cross or, you know, Cigna, Aetna, whatever those networks are and determine from that information what might be a good first choice for you.

Medicare is really common and, you know, most everywhere, the Department of VA, a really good one. So you can get a good grasp on a few of what's likely to be your best payers. And then after that, your patients really start deciding for you because you're going to have patients calling in or coming in saying, Hey, do you take Humana?

Hey, do you take this? Whatever. And as you start to see those types of payers, that helps you to decide, okay, now I need to [00:27:00] investigate this network to determine if it's something that I should and can do, and then move forward with the credentialing enrollment, if that's ultimately your decision. Yeah, no, that makes sense.

Dr. Kevin Christie: And that was like part of what, as you probably know, in Florida, we got the, uh, ash holes took over. And so Blue Cross and Cigna, you know, we, the ash thing and, uh, you know, going back and like, I actually know, I know chiropractors in Florida, really good ones that are still in network with, and they're doing really good with it.

They, uh, they have good communication with patients. And after five visits, when they're not going to let you have any more, they, uh, They tell the patient, they convert a lot of them to cash. And, you know, it's, it's, it's pretty, pretty fascinating how they've been able to do it. And so, um, you know, if I would have, if I were to rewind and go back to 2015, when I started making the decision to go out of network, I don't know if I would have changed my decision, but I know a lot more now about it.

And there's a lot more variables that I think. Uh, clinics need to take into consideration, but let's, um, let's segue a little bit to, to people that are not credentialed with insurances. They're not in [00:28:00] network providers with, with any insurances. Uh, let's exclude the Medicare thing for right now. Do you work with clinics, uh, that are not credentialed with insurances?

Brandy Brimhall: Uh, yeah, a lot of them's coding still matters. We still have, that's a part of the complete and the correct record is coding. making sure that we know our state laws for how we can establish. Some of them do packages and payment plans and things like that. So we have to investigate what they are able to do in their region.

So I help a lot of clinics with with all of that side of their practice. Totally unrelated to the credentialing enrollment and the insurance billing. So like billing compliance, right? Exactly. Yeah, it seems like one of the misconceptions is, and you can correct me if I'm wrong, is those that are, um, those that are cash practices, we'll say, they almost feel like they don't have to abide by billing and coding things.

Dr. Kevin Christie: You see that? All the time. In fact, the most common phrase is, well, I'm under the radar. And so there's, there's no such thing as under the radar. [00:29:00] You have a license, you're seeing patients, you're practicing, you're on the radar. It could be with your state board. You could be requested records and information from an attorney, another provider, even an insurance company.

Brandy Brimhall: In some cases, you know, suppose the patient was in an auto accident and they're trying to determine what was related to the auto accident and what wasn't, you could be requested those records. You're coding is a part of that record. So lots of different ways to show that we're on the radar, whether we're dealing directly with insurance or not.

Dr. Kevin Christie: Yeah. And obviously there's, you know, let's say, uh, you got two clinics that are not credentialed with insurance. They're not in network with insurances. Um, you still could be. Credentialed with insurances, but as an out of network provider. And so you could have a clinic that accepts out of network benefits and does the billing, um, you know, for that patient.

And, and then you could have some that are, are not right. Like there's, uh, we actually are just moving away from that. from it for many years, we have, uh, build out a network benefits for [00:30:00] patients. We, as of, uh, October one of 2024, we've stopped doing that, uh, for the added network insurances, just like so many had high deductibles, this whole thing.

And so, um, we've stopped, uh, doing that. What, what are your. Thoughts on that. What are you seeing with that? What are the things to look out for if you're, you are still out of network with insurances and billing insurances versus just your, you're just not even messing with insurances. Yeah. So a couple of things with out of network, just exactly like you said, if you're not in a network, you are eligible for most of our payers, not, you know, not all of them to bill out of network.

Brandy Brimhall: And as an out of network provider, the first thing that we need to know is we still are responsible for collecting that patient responsibility as it's shown on the remittance, because though we don't have a contract and obligation directly with the insurance company, the patient does, and we can't cause the patient to be in violation of that.

We're putting ourselves at risk too. So that's the first thing. The next is you're right. The deductibles are higher. The patient amount due if it's co [00:31:00] pays co insurances, that tends to be higher with out of network. Some patients like to have a build. Some practices like to bill out of network and it works well for them.

And I think that's fantastic. If that's the case, uh, what you'll definitely want to do upstream in your clinic is make sure your biller, your front desk. Knows the plans and payers that you're out of network with. So they're not miscommunicating with the patients or or collecting inaccurate verifications when those are being done.

Dr. Kevin Christie: I know. Otherwise. Go ahead. Well, yeah. One of the, uh, let's, I don't know if you want to call it tricks or whatever, but you gotta, you've, there's been a lot of chiropractic practices over the years where they are out of network. Um, they'll bill three or four codes to that out of network insurance and collect, you know, uh, 200 for that visit.

Uh, and then, you know, they got the cash patient doesn't have an, and now we're going to collect the 75, like you're going to run into issues there with the dual fee, dual fee [00:32:00] schedule. Uh, there's been a lot of people that will get their 200 and not in the way of the co insurance, right. Uh, you know, what are, what are some of the things you've seen with that part of it?

And it's probably, it's, I'm sure it's still prevalent. You can answer that if it is or not. I know that the deductibles are so high now for out of network It's maybe not as often, but the same thing, even if you build a 200 and whatever dollars out of network and it goes to their out of network deductible, but you do not collect that 200 from that patient.

That's a problem, right? That's a compliance problem for sure. And believe it or not, the payers do find out and they do investigate just about a year and a half ago. I had a clinic that. Contacted me to look for help, you know, to be contacted, connected with an attorney to help them because they have been waiving out of network copays and deductibles and the payers had a particular payer had concluded that was what was taking place and actually had gone directly to the patients to gather information [00:33:00] on what the patients were and were not paying and what ended up happening next.

Brandy Brimhall: Because now we have. You know, we have the enrollment portal and we have the payers have a way to communicate with one another. That really wasn't possible 20 years ago. Right? And so, you know, knows this is what the providers doing now. They've notified Cygnus of the clinic ended up in another audit. With Cigna, not because they were billing improperly, but because they were waiving patient responsibility.

And to the best of my knowledge, that is still going on and has been a very costly situation for that clinic in a lot of different ways. And so just definitely important to keep in mind, it's never worth it. And again, the patients get a copy of that to telling them you're responsible for whatever amount now, they're not necessarily going to come to you and say, oh, geez, I should have paid this much instead of just, you know, instead of nothing in your office.

But it does. Compliance matters and it's. It's never worth the risk for sure. Yeah. It's, it's tricky. Like if you're a chiropractic practice and all you're doing is the manipulation and that's all you build the out of [00:34:00] network. And then let's say there's a deductible and you make that patient pay that amount, it's usually digestible, right?

Dr. Kevin Christie: Like an adjustment for out of network, let's say it's 60. I don't know, like whatever our network would pay. The patient could digest that where you see a lot of the problems is where the. The practice is doing, uh, you know, adjustment, they're, they're doing rehab, they're doing STEM, they're doing, they're doing all these codes and then they're building all that to the insurance.

That's going to like for most of these out of network insurance, like that's going to be about a 200, uh, visit. Uh, and, and you need to, if that goes, if it's deductible, like you need to collect the 200 from the patient, if you're doing it right, when you, when you bill it out to the Cut to the insurance and then you only charge them your cash rate.

Like that's, that's going to be the problem. And that's obviously where if you wanted to get a lot more cleaner as it, as a cash practice is you would just not accept out of network benefits either. You just wouldn't bill. Right. And that [00:35:00] makes sense. Yep, that makes perfect sense. And what you could do instead of billing on behalf of your patients is allow them to self submit.

Brandy Brimhall: They can request a super bill or an invoice from you at any time and self submit. The only thing that you need to keep in mind as the provider is that payer is still going to process that claim information based upon information you provided. So you're still responsible for having correct information.

Claim information, correct coding, and whatnot, because they are processing it based upon information you gave to them, but it makes it cleaner, saves time upstream in the clinic, saves time with follow up, you know, all of the things that take place with billing, and that's one way to go about it if it's a clinic that just can't find themselves any way to comply with the out of network billing rules and collecting properly from the patients.

Dr. Kevin Christie: Yeah, for sure. And then obviously another level of that is where you could, um, you know, contract with a company like Chuso where we've had them on the podcast where, uh, now that we're not going to dive into that, but essentially one thing that I'm pretty sure of, and you can correct [00:36:00] me is that if you do that and, uh, and then that patient, um, signs that Chuso agreement with you and on, on that part, now you're not able to bill to that out of network insurance.

Is that correct? Yep, that's correct. And CHUSA is for things exactly like that. Patients with high deductibles and really almost unreachable benefits, no coverage or limited coverage. And so CHUSA is a fabulous resource to us in clinics and to patients for those exact types of things. And absolutely. Yeah.

And then obviously, um, You know, where it could benefit too is, uh, you know, you're like, you know, state that personal injury pays really well and you bill four codes out to personal injury and you get 200. Um, it's, it's tricky to, to do that. And then the same patient comes in, does four things. And you charge them 65.

That's where it gets, gets tricky. Um, although it's funny and I'd love your thoughts on it or, uh, I won't [00:37:00] mention, but someone posted in a closed Facebook group about a hospital experience and, and he just literally told them the whole time, I just want to pay cash. What's my cat? He had insurance, but he's like, I want to pay cash.

What's my cash rate? And it was crazy because he had a, he had a high network deductible. And if, if he did service a and ran it through his network deductible, it was going to cost like 1, 000. But then they had a cash rate of 400, right? And so even these imaging centers and these hospitals and these big groups, they essentially have dual free schedules.

Is it, am I not wrong in that? No, you're right. And you, they, I do think in some ways they have some latitude that are, is different than what we have in our types of facilities. But at the same time, their rules are, you know, very like the, the no surprises act and the good faith estimate. There are things that clearly.

Brandy Brimhall: Are questionable and how you know what their processes are as far as collections, but to your point, I've done the same thing [00:38:00] numerous times knowing that I'm likely to pay less. Not having insurance or not using my insurance versus using it and then having to pay the deductible because then I'm bound by my contract and they have to collect it.

They don't have the same type of wiggle room as they do if I'm not using any insurance and it's different for them. So, uh, so, yeah, I. I'm right there alongside whoever posted that because I've done it too. It's funny. It's just, uh, yeah, but I'm not here saying just don't worry about it. Have a dual fee schedule, but I just, I find it ironic for sure.

Dr. Kevin Christie: So, uh, this is great. So what are some of the things that you, um, Do you do training for practices on all this type of stuff? Do you, what are some of the services you offer? I know you'd offer credentialing. Actually, let me ask a question on that before we move on. Um, are you finding a lot of insurance panels are not accepting new young doctors in different areas?

Brandy Brimhall: In different regions, there are quite a few closed panels. 1 of the things that we do to help get across the finish line is is simply just to follow up with those [00:39:00] panels because eventually they do open. Many of them are reevaluating their, their rules for enrollment right now. At the same time, for clinics that are chiropractic, and now they're newly integrating, sometimes bringing on a medical doctor or a DO or a nurse practitioner opens up a door for you for enrollment that maybe you didn't realize before with the panel, so there's different things to look at, but we follow up with those panels, but again, to your question, yes, definitely close panels, best thing to do, be persistent and follow up with them, because eventually they'll open, you just, you can't take your fingers off the pulse of it, or you'll find yourself having missed the window.

Dr. Kevin Christie: Yeah. And do you, do you help, uh, practices that are looking to medically integrate with credentialing as well? Or is that different animal? I, we do lots and lots of credentialing for the multi specialty clinics that are already integrated or that are newly integrating, and they're having to shift everything over onto, under a different business group with the, you know, expanded or, or broadened, you know, other specialties.

Brandy Brimhall: So we [00:40:00] do a lot of credentialing for that. Not, not quite half, I would say, but it's, it's a lot, a lot, mostly chiropractic. Yeah. Love it. Great. And then, um, yeah, what are some of the things you're doing for practices? Aside from that, obviously we got credentialing, you're doing some with even medical integration.

Dr. Kevin Christie: I obviously probably do training on billing and coding, but do you help with kind of the logistics of it? Like lay out a map of like, look, this is how you need to implement in your practice to have a proper billing system. Yes, so in addition to the credentialing and enrollment, so we do end to end credentialing and enrollment, lots of help and almost like helpdesk type support.

Brandy Brimhall: So I get a lot of questions of, you know, hey, this denied, what do I need to do next? What's my state law for that? So helpdesk type questions from clinics. All over the place on coding, billing and compliance things, but otherwise clinics that say, hey, you know what, we're, we're struggling in these different areas of our billing, or we're trying to figure out how to build a system.

That's manageable and workable that we can get ahead of and stay ahead of we [00:41:00] schedule. We have actually a lot of recordings on that to help them too, but we schedule private sessions on zoom similar to what you and I are doing right now, other than we're screen sharing and going through their specific steps and processes and helping them to establish that.

while at the same time being support as they begin to execute, you know, here's phase one of what we're implementing for your billing processes. And then we'll come circle back to make sure that's moving along and then, you know, into step two and so forth. So it's very custom for every single clinic.

Dr. Kevin Christie: Awesome. I love it. Well, this has been amazing and a wealth of knowledge, just like when we first met at Jay Greenstein's event there this year in June in DC. Uh, I thank you for your time. Where can our audience reach out to you if they want to find out more information or want to work with you? Yeah, they can reach me at Brandy.

Brandy Brimhall: So it's with a Y so Brandy at rapid credentialing. com and they can also go to the rapid credentialing website and that is rapid credentialing. com and they can contact me. There's a contact us right there that comes straight to me [00:42:00] also. Perfect. This was great. Thank you so much. Absolutely.

 EPISODE 405: 8 Economical Marketing Ideas

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] All right. There's a lot of different things you can do to market your practice, but what are some of the economical marketing ideas that you can do to grow your practice? And luckily, there's a lot of them, and we're going to cover those today. And let's start right out of the gates with email marketing.

I think it's one of the best things you can do. And many chiropractors aren't doing it. I recommend weekly. Content emails like educational based emails to your to your patients. You're, you're educating them on what, you know, and you become a resource in their inbox on health related information. And that helps you stay top of mind with your patients.

And you'll get a lot more reactivations and even referrals. If you're emailing your patients weekly, if you. Think weekly is too much. It's not. But if you want to go every other week, that's fine. But the practices that do like a quarterly email or an email when they have to close their practice because of the snowstorm or something like that is not going to suffice.

And so things like [00:01:00] MailChimp is a great service you can utilize very, very affordable. And it's actually free up to a certain amount of audience members on your email list. But it's a really good way of doing it. You know, design a nice banner image, have the scheduling information at the bottom of the email.

Um, you know, just design a nice template email where you just plug in new information and it does not have to be too hard. You can do an occasional promotion and practice updates. There's nothing wrong with that. But when that's all of your emails, only promotions and practice updates, it's not going to be effective.

And then you'll think email marketing doesn't work. And if they don't want to be emailed, they just unsubscribe. It's not. Not hard. No one gets offended because of that. Um, it's a really great reactivation strategy. I mentioned, and you can also onboard new patients with email. And then lastly, keep them in the email.

If you put a blog in the email, just have them read it. The whole blog within the body of the email, don't send them out, uh, to the website to read it. Just keep them into the email. And we've got [00:02:00] lessons in the academy about more depth of email marketing. Uh, but this is a phenomenal and very economical way.

To grow your practice, uh, video marketing, um, they have, you know, video marketing is really good and whether you use those videos, put them on YouTube, put them on your website, educate patients and send it to them based on certain things they need, put it on your Instagram, Facebook, uh, you can get a lot of economical value out of video marketing.

It's going to create that parasocial effect. And that just means it's like they feel like they know you and you may not know them. It's like if Brad Pitt walked in, you'd feel like you knew him because of the video, the relationship you've had with him watching on video for the last 30 years, that's called the parasocial effect where you feel like you know them, they don't know you.

But the video does a great job of your community and your patient base, uh, feeling like they know you as the doctor and what, you know, think about certain video projects, right? Like, um, condition pages, uh, you can do, [00:03:00] you know, if you treat 25 different conditions, you can have different pages on your website for each condition.

And you can do a video on those conditions, how you evaluate and treat that. And so certain things that you do for that particular condition is going to help with your SEO. So think about projects can be services. It could be topics like, uh, you know, pickleball. It could be, you know, it's, um, golf season.

You could do video projects on around golf injuries. Video equipment is super easy. Now, if you have a smartphone, you're good. Um, you can get a lapel mic and that works out, uh, but the video equipment is super easy now. And then just think about the video strategy that you want to do is your video strategy.

You want to be short Instagram reels that are like 90 seconds or less. Are you going to do, try to focus on YouTube length? Are you just going to do video to educate your patient base? Um, think about the different strategies, strategies. And again, in the Academy, we have video marketing lessons. So check those out are kind of our, um, point of our call today is just to teach you a [00:04:00] build, like build an economical marketing plan, and then you can access some of the resources that are already in the Academy.

If you need to do a deep dive into email marketing or, or video marketing or Instagram reels, right? So this is a really good way of gaining traction. We put. Um, to Instagram real trainings in the academy for you to look at and, uh, Instagram is, um, they are really, really trying to, um, focus on Instagram reels are kind of competing with Tick Tock.

And so the reels again is going to be 90 seconds or less. on the video and then you post it as a reel, not a post on Instagram, not a story. So you got post stories, reels, this is reels, watch the, uh, tutorials in there. We're seeing a lot of chiropractors growing their practice through Instagram reels.

Okay. And they're also getting their patients to follow their Instagram. So when they do post on there, they are staying top of with [00:05:00] their patients through IG reels. Okay. So a big one.

Text message campaigns. There's a lot of softwares out there now. This isn't you texting from your phone to them. This is a bulk text messaging campaigns.

And again, we have a whole, um, breakdown of that in the academy with even scripting in there and what you can do. And there's certain platforms now, obviously review a, which is now a low hop. I don't have any vested interest in that. Um, There's also tracks that does it. There's trust driven care that does it.

You might have some other services that do it, but it, but essentially it's doing monthly and quarterly text message campaigns to your patients or promotional text through certain services. You've added and it's a great way to get into your patients. And again, now it's 2024 going into 2025. People are used to getting texts from the businesses that they service now.

And if they don't, again, those services allow them to easily unsubscribe. They're not going to get [00:06:00] mad at you. And you're going to get a lot more ROI from this than you are patients being mad at you. It's just, uh, we do it and we've been doing it for two years now and don't have complaints. We just have some people that, uh, unsubscribe from it, just like they would an email, very economical way of, uh, reaching your patients.

Next is your allied health network. And this is a phenomenal way of of marketing and getting out of the community for health providers and performance related folks like because a health provider would be your orthopedic surgeon or your acupuncturist and it runs the gamut from there all your specialties and then the performance would be something like the personal trainer the golf teaching professional the tennis coach the pitching coach the running coach you know there's a lot of people in the performance world that you'd want to connect with and um I'm just going to give you an overview of it because again Like I mentioned, all these have lessons specifically [00:07:00] for this in the academy, but you want to a have a world class referral system for your patients, right?

That's part of being a doctor is the patient comes in. I need a good massage therapist. You have a good referral for them. I need a, um. primary care doctor. You got a good referral from them. I need a functional medicine doctor. You got a referral for them. Uh, do you have a tennis coach? Yes, I do. Right. So part of your job, in my opinion, is to have a world class referral network.

And then the second you can actually leverage this idea is to connect with other people. Let's say you, you look at you, you go on your dashboard that we provide for you. And it's got all the different things you could have as far as specialties or performance people. And you say, you know what? I don't have a foot and ankle specialist.

I need one, but I do have a knee shoulder orthopedist that I'm friendly with. I'm going to contact that doctor. That's the knee shoulder ortho say who's the best foot and ankle doctor in the area. He or she's going to give you that information. You're going to call that office aid, you know, orthopedist, Dr.

John Smith, um, is recommending [00:08:00] that, um, I connect with your, uh, foot ankle specialist here, Dr. Sally and said, you're the best. I'm trying to build a world class referral network for my practice. I don't have a good foot and ankle specialist. Is there a time I could stop by and introduce myself and get some information from your practice?

And that's just one example of how you can then leverage contacts to build out your allied health network and. Not only refer to them, but build relationships with them to hopefully they refer to you. Next is just patient appreciation days. These are always really good, um, to throw those in a couple times a year.

And, um, you can dive into the nuts and bolts of that, but I, I definitely recommend patient appreciation days. And there's many ways you can slice those.

Community outreach, right? You got to get in the community. And there's a lot of ways you can do it that are very economical. Um, events, workshops, public speaking, MD marketing, meetings, you name it.

You want to be [00:09:00] doing some credibility enhancing community outreach. And we have a whole community outreach planner in the dashboard. We have a community outreach lesson in the academy. So check out those. Okay.

And then lastly is website and search connection. You want to make sure your website has condition pages on there.

Like we discussed services pages on there that's going to help your SEO blogs on your website are going to help your search engine SEO or search engine optimization or Google search essentially videos on your website is going to help with that. Make sure your website has really good messaging so they find your website.

They're compelled to come into your practice. It's your website shouldn't just be an online business card. It should compel them. You want to have good Google reviews and many of them. That's going to be economical marketing. Great pictures on your Google business profile. So when people search that and they find it and you see your Google business profile, they see all the great images of you, your team, your office, your, you [00:10:00] know, all the things you got.

Um, I want you to think of your Google business profile as a second website, um, and then you should be posting on your Google business profile as well. That's going to really help you with your overall search engine. So if you do a great job of organic search, which is this right here, um, you're going to get, um, good marketing without having to spend ad dollars on, uh, Google ads.

And so let me stop sharing that. I'm not against spending money on marketing. I think. Practices need to do more of that, you know, whether it's Google ads, Facebook ads, direct mail, um, MD lunches and things of that nature. But depending on the scenario you're in, maybe you're limited in that. These are the economical ways you can do it.

Or, frankly, if you're spending money on all the other things, too, you should be doing the economical ones also. And that comprehensive approach is going to allow you to get great marketing results without spending too much money.

 EPISODE 406: Legal Considerations for The Medically Integrated Clinic with Michael Silverman

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. 

Welcome to another episode of Modern Chiropractic Mastery. Today, I've got Michael Silverman. He is a local attorney. And as you listen to us really dive into some of the details of considering an integrated, integrated practice, you know, realize there's different levels of having an integrated practice and, uh, you know, it can be small, medium and large in, in the way, in the scope you want to do things and the different types of providers.

And we're going to dive into some of that and some of the best practices. And obviously. Um, you know, you always want to have your own legal team when you're going to do something like this, but we wanted to dive into some of the things that you really got to start thinking about if you want to do this currently or into the future.

Uh, you will notice that Michael, like myself, is in Florida. And so we, we talk about Florida a fair amount, but a lot of it is applicable to your state or it'll give you the understanding of what you need to look at and see, [00:01:00] okay, yeah, my state. Differs here, right? And so you're going to be able to, uh, you know, transfer what we talk about sometimes here in the state of Florida to other states or give you the idea on what to think about.

And, um, you know, Michael and his team, uh, work directly with our state association a lot at conferences. That's how I first met his partner speaking, and they really have a wealth of knowledge in this field. And, uh, you're going to get a lot of great insights into this, uh, very. You know, it's, it's, it's a, a trend we're seeing in the profession.

And I think in the positive, uh, it's a, it's a great opportunity for many, uh, chiropractors. Uh, before we dive into that episode, uh, just want to check out our coaching program, you know, go to modern chiropractic, marketing. com. Uh, you can attach our team to yours. Uh, our signature program, uh, is coaching and it's also, uh, marketing done for you.

And so we attach our team, you know, you get a coach, you get a marketing coordinator. You get, uh, you know, other [00:02:00] ancillary advisors around you to help grow your practice and make 2025 a great year for that. So go to check out our coaching programs at modern chiropractic marketing. com. And feel like, uh, stop feeling like you're left on an Island and really help grow your practice with you.

We have over 50 clinics throughout the United States and UK under our program there. That's not including our mastermind, uh, clinics. And so we've, uh, And that's not including our chiropractic success academy. We're getting a lot of great results. We're changing practices. We're doing it ethically. And so maybe it's time to start investing in your future.

So check us out at modern chiropractic marketing. com. All right, without further ado, here is my interview with Michael Silverman.

Dr. Kevin Christie: All right, excited to have Michael Silverman on the podcast here. It's an attorney out of Florida. I'm going to let him dive into some more of the specifics of that, but we're going to have an interesting topic on compliance around integrated [00:03:00] clinics and even some things about W 2 versus ICs and just some of the legal matters that we need to consider.

We're seeing a lot of chiropractic practices integrate and, you know, One form or fashion, and I thought this was a, a timely discussion around this. But before we dive into it, Michael, uh, tell us a little bit about yourself personally and professionally.

Michael Silverman: First and foremost, Dr. Christie, thank you for having me here.

It's my pleasure to, uh, to come before you and your audience and have a chat on medically integrated chiropractic practices. Um, a little bit about myself, my background, I'm personally born and raised in a chiropractic household. So I got to, uh, you know, I got to grow up in that environment and really see my father, you know, back in the early nineties, make such a long lasting impression upon his patients.

He had one of the first medically integrated chiropractic practices down here in south florida. Um, in, in the early eighties and, um, you know, it was really just a matter of not being smart enough in my chemistries in order to [00:04:00] fall on his foot and step to be a chiropractor. So, my next best bet was to become an attorney who specialized in working with health care professionals and medical business owners.

My office is down here in South Florida. That's a law firm of Silverman Bain and. Um, just given the background and the environment that I grew up with, a large part of my practice is involved with working with chiropractic physicians in both stand alone practices and medically integrated practices. And, you know, speaking of the latter, it's, it's coming to be like Starbucks on every corner down here in South Florida with medically integrated practices.

So there's a, you know, there's a lot of do's and don'ts and I'm happy to be here with you and your audience to kind of chat about how folks can be best set up for success here.

Dr. Kevin Christie: Love it. Yeah. And, uh, you know, I first heard of your firm. Actually, I was at an FCA event and listening and it was your partner and she did a great job of, of talking about this subject matter.

And then ironically, you and I have a mutual friend. And so we had drinks and connected. And so it was kind of [00:05:00] came full circle there. And, uh, I really knew I needed to have you on, uh, to, to discuss this. And one of the things I just want to Uh, mentioned to our audience, you know, we're obviously you and I are both in Florida.

We're going to try to Navigate the fact that some things are state based. A lot of things are state based. Some things we'll talk about today will be federal And then some of the state based things will apply to your state as well. You just might need to Talk to your association things of that nature, right?

Absolutely,

Michael Silverman: and we'll do our best to point out what may be more state centric and what may be more No federally applicable to all folks

Dr. Kevin Christie: Yeah. And one of the things I wanted to start out with was just the idea that I know in, in our state, you have to be either a, a dc, an md, or a do to, to own a chiropractic practice.

Um, or, uh, you know, and I think that is in, in a lot of states, but obviously check that or there is the idea of the healthcare clinic license. Right. What, could you, could you bring that up a little bit and keep me up to [00:06:00] speed on that? Absolutely. It's

Michael Silverman: a great question, Dr. Christie. And, and, you know, before we talk about, I guess, who can own a medically integrated chiropractic practice, take a step back and who can own a chiropractic practice focusing on here in Florida.

Oftentimes folks will come to me and it's, you know, Hey, I'd like to open up a practice where I currently have a practice. It's me. I'm a Florida licensed DC, and I've got a New York licensed DC that I want to own or operate it with. Or I went into business with my brother in law here in the state of Florida.

Any business that employs a chiropractic professional pursuant to the Florida Board of Chiropractic Medicine requires that business to be owned as you mentioned, um, solely by an MD, DO or chiropractic physician or a conjunction of family members, immediate family members that are co owners. We're talking, um, you know, a father, a mother.

or one down, um, uh, a son or a daughter or a sibling again, I've had situations where it's a [00:07:00] brother in law and it doesn't pass muster and they're running afoul of these health care clinic and board of chiropractic medicine license requirements, which, which are a felony in Florida. And it's silly, right?

You, uh, you know, so. Um, one way if you are in business with somebody who is not a Florida, uh, licensed chiropractic physician is, is that healthcare clinic licensure that you mentioned, Dr. Christie, um, something that's not needed if you are wholly owned by a chiropractic physician and a family member or spouse.

But if you have somebody that falls outside that realm, that's where that healthcare clinic license would be required. And that's even just for our chiropractic practice before we dive into an integrated one.

Dr. Kevin Christie: Okay. And so then with the, the integrated one, what does that look like and how is that different mostly?

Michael Silverman: Okay. So, um, let's talk about kind of nationwide integrated practices and then we'll focus on Florida. So back a couple decades ago, the, the rule of the land nationwide was this [00:08:00] kind of corporate practice of medicine prohibition. And essentially that, that regulation stood for the fact that any corporation that is looking to provide medical services Has to be owned by a medical practitioner that can provide those medical services to try to take out any undue influence of, you know, corporation into medical care, right?

It, uh, you know, it certainly has its foundation and that from an ethical and medical appropriateness perspective, but that law of the land, while it's still steadfast in many states has slowly eroded over the past couple of years. It's still the law of the land in many states such as California and in New York.

But here in the state of Florida, there is no blanket prohibition on a lay person owning a medical practice. And so essentially, I myself, Michael Silverman, the non medical practitioner, medical professional. I can own a health care, a medical facility, a practice [00:09:00] in the state of Florida, chiropractic aside.

Um, and if that practice does not submit any claims for reimbursement, I don't even need any license or regulation. I don't even need this health care clinic license. If it's providing chiropractic services, I mentioned, you know, thanks to the board of chiropractic medicine and the good lobbying here, protecting chiropractors, not just anybody.

You can own that practice. You need that health care clinic license. But from a medical practice perspective, if it's just cash, no license needed. Um, however, if we're going to submit any claims for reimbursement in that medical practice, Medicare, TRICARE, CHAMPUS, or even PIP for that matter, or commercial insurance, there are regulations that say that everybody in the state of Florida that owns that type of practice needs a health care clinic license, unless an exception applies.

And you'll see today as we talk. Where there's a law, there's oftentimes, you know, 12 exceptions to the law, and the health care clinic license requirement is no different. And one of the exceptions that are [00:10:00] applicable to a chiropractor looking to medically integrate. There's a statutory exception under the Florida license that says you don't need this health care clinic license.

If it's 100 percent owned by the chiropractic physician or an MDDO or a spouse of the chiropractic physician, and there's going to be direct oversight by that chiropractic physician for the services that are going to be rendered in that type of situation, a health care clinic license may not be required.

It's a very intense factual specific scenario, um, and not having a health care clinic license is a third degree felony in the state of florida. As I mentioned, lots of different states have the analogs for the health care clinic license. So you really just want to dive in. Is there an analog and is it required for me?

Dr. Kevin Christie: Perfect. Love that. And so just to get that kind of squared away is that as a chiropractor, I could, uh, own a hundred percent of a medically integrated clinic. Um, obviously I couldn't render and we'll get to that, but I couldn't [00:11:00] render medical services outside of my scope of a chiropractor without the, uh, medical director or, you know, the like, uh, is that accurate?

Michael Silverman: That, that is absolutely correct. As a, as a, um, you know, again, the, the current statute on the books in Florida. And the impressions of that statute would exempt 100 percent chiropractic physicians looking to employ somebody to render those medical services with the health care clinic license in Florida.

There's something called a certificate of exemption. If you are exempt, you can either rest on your laurels and say, I'm exempt and do nothing, or you can proactively apply. To the agency for health care administration for a certificate of exemption from a health care clinic license. That's what I advise all of my clients because the current administration views the exception as applicable.

The next 1 may not. But if you apply for a certificate of exemption, it's it's 100 dollars. And you essentially say. Hey, Dr. Christie, the [00:12:00] owner of this practice, a hundred percent DC owned practice, and we're gonna employ an NP or PA to render medical services, and I want your blessing, and they'll go ahead and issue that certificate of exemption.

So that's certainly something to keep in mind as well.

Dr. Kevin Christie: Okay. So I could, that scenario, I could, I could employ W2 employee, uh, an MP or, uh, you know, something like that. That's not a, a doc. Um, if they are rendering services that are outside of my scope, do you then need the medical director on top of them?

Is that correct?

Michael Silverman: That's a great question. And I want to, I want to, um, make a distinction between the terms medical director and supervising physician because they're, they're oftentimes co mingled, but they're very distinct in the state of Florida. If you, if your business is required to have a healthcare clinic license, the one that I mentioned in Florida.

In order to apply for that license, you need a medical director and that medical director has to be somebody who can [00:13:00] oversee has the capacity to see the scope of services that are being rendered in the event that we decide, hey, we're exempt from that health care clinic license in Florida. Where you don't need it in another state in the state of Florida, you can bring on that nurse practitioner or that physician assistant and they essentially would have a supervising physician and MD or a D.

O. That's the distinction between supervising physician and medical director on the health care clinic license side and that supervising physician would provide. Indirect supervisory services. They don't have to be on site in Florida at the practice, but they essentially have a written and established protocol that they operate under.

Um, keep it on premises at the practice location. It says, you know, the NPA or the PA, they can provide these services, administer these treatments without consulting with that MDDO supervising physician. Otherwise got to consult with them if these other things arise.

Dr. Kevin Christie: Awesome. And then some variations of how you could, I guess, structure [00:14:00] that, uh, let's say the MD or DO, uh, theoretically you could, or legally you could have them as a partner in your business.

I would assume, um, you could have them as a W2 employee, I guess. And then could you also do independent contractor with that, that MD or DO? What are some of the structural things you're seeing with that to make sure you're able to have that nurse practitioner or physician's assistant to do injections and.

things of that nature that are outside of the chiropractor scope

Michael Silverman: generally on the supervising physician aspect of things, you'll have an independent contractor relationship with that practitioner because they're not on site. They're not devoting, you know, work on your, on your, um, practice on a, on a daily type of basis.

So that's generally what we'll see. Oftentimes when you engage. Either as an independent contractor or employee and NPR PA, they already have a supervising physician that they're working with. So that often is a pro to look out for. So you don't have to try to reestablish that [00:15:00] relationship. Maybe it doesn't cost you anything extra, you know, as far as compensation to that supervising physician backpedaling just a hair here on the supervising physician in the state of Florida.

Um, a couple of years back, APRNs, Advanced Practice Registered Nurses here in Florida have begun to enjoy autonomous practice where they do not need a relationship with a supervising physician for primary care services. So, if you find an APRN that is autonomously designated, they've done that registration here in the state of Florida, and you're going to be providing primary care services.

Then you don't even need to worry about that supervising physician relationship.

Dr. Kevin Christie: Yeah, that's really good. Maybe there's some other states that are offering that as well. So again, if you're in a different state, which I know many of you are, uh, look into that and again, just glean a lot of these ideas that are, that we're chatting about that could trigger a, uh, idea or thought.

And then you can check with your appropriate state laws. [00:16:00] All right, good. That was really helpful. Now, what are some of the limitations of that medical director slash supervising physician? What are, what are the requirements and limits you're seeing around that?

Michael Silverman: Great questions. And again, this is what we're going to want to check on a on a fact specific basis here in the state of Florida.

There are limitations both on the medical director side and the supervising physician side, obviously, first and foremost, for either of them, it has to be within the scope of practice of that supervising practitioner. Um, whether it's a specialty or otherwise that they've taken coursework on. So it needs to be within their scope of practice, depending on the types of services that are being rendered, there can be limitations on both the number of individuals that are being supervised, the mid level practitioners, as well as the number of clinics that are being supervised.

And we have to keep in mind that, um, being designated as the medical [00:17:00] director or a healthcare clinic license entity. Um, it creates obligations and liabilities upon that, that, um, M. D. or D. O. Statutorily here in the state of Florida, they need to be, you know, conducting systematic reviews of billings, for example, to to ensure that the buildings are not fraudulent or unlawful.

There's been a lot of allegations by many commercial insurance and PIP carriers in the state of Florida, a lot of lawsuits, allegations that the medical directors are really farces because they're not conducting the reviews that would be required in order to catch the fraud that these carriers are alleging.

And thus, they said that it was a sham health care clinic license relationship and and we shouldn't have paid you unless you had a health care clinic license. And thus, we want all that money back. So we have to make sure we're not just again, whether it's a medical medical director or supervising physician that you're not just throwing an aim on a piece of paper or your wall that they're actively actually doing what they need to do [00:18:00] to both protect their licenses and to help protect your business from, you know, that type of scrutiny.

Dr. Kevin Christie: Yeah, you were kind enough to send me some key information to help me prepare for this because I know it's going to be a lot of good substance to it. And one of the things you talked about was minimizing risk and having the appropriate written agreements, but also implementing an effective compliance program with this, uh, any.

Additional thoughts on that. Are you seeing where you really got to make sure the compliance is squared away? You got to make sure they, you know, written agreements are there. This is not just like running a a cash chiropractic practice What are your what are your takes on that?

Michael Silverman: Heck even if you are running a cash chiropractic practice I have to stress the importance of written agreements and compliance programs again Just to protect everything that you guys are working so hard You know, in your livelihoods and your your licenses in your business endeavors.

Um, let's let's talk about the importance of contracts, right? You always want to do your best to prevent. [00:19:00] He said, he said, he said, she said, she said, she said type of situation. Um, and you want to set forth expectations, duties, responsibilities, benefits, governing law, dispute resolution. Maybe you want things to be privately hashed out in the event of a dispute through a mediator or a binding arbitration, rather going than going through the, the, the, the headaches and, and, and time and, and cost of.

of litigation in the event of employment, um, disputes, but something that, um, that we were, we were chatting about recently, doc, is whether you're a standalone chiropractic practice or a medically integrated chiropractic practice is how rampant misclassification is, um, just in the healthcare industry generally.

And by misclassification, I mean, Is somebody that comes to work for you, should they be a W 2 employee or a 1099 independent contractor? And I have to let all the listeners out there know that it's not up to [00:20:00] you and it's not up to your worker, right? You know, as much as we may want to bring on somebody as an independent contractor, um, to try to, um, not bear the cost of, you know, Some of our FICA taxes and employment related taxes, if somebody is coming and working for you under your direction and your control, they're on your website, you're holding them out as a worker of your business, you're doing your scheduling in most cases, especially if they're working 10 plus hours a week, they're likely going to be a W2 employee and not a 1099 independent contractor.

And the consequences for misclassification, um, you know, you're dealing with, um, not only, uh, the IRS for taxes that could be, should have been withheld, Department of Labor, overtime expectations and payments, and usually every everyone's happy. Everything's honky dory until, you know, somebody's not happy or somebody gets terminated and said, hey, you know, it's a, it's an office [00:21:00] staff manager.

And I was working over 40 hours a week. I should have been paid time and a half. Yeah. So you really want to do that analysis. I wish I could say there was a bright line test or rule. That's, you know, you can say, here's the criteria and yes, or no, there's a lot of different criteria put out by various governing bodies, the Department of Labor, federal deal has a test.

The IRS and essentially, you know, you really got to match up to how much control you're exercising over this individual, whether they can do things on their own, on their own schedule, use their own equipment and then, and then classify them accordingly. And irrespective of how they're classified, you want to make sure you match that classification with a written agreement.

Dr. Kevin Christie: Yeah, and it's such a problem and I know you see it all the time in the chiropractic profession, I'm sure others, but you know, even just think about it, like how you explain the D. O. M. D. Um, medical director supervising physician like that's a legitimate I. C. scenario like they don't, they make their own schedule like, you know, it's just, that's [00:22:00] exactly what it is.

Whereas a lot of these chiropractors that are, um, um, You know, the other thing that's funny is you can even hear it in the language, the chiropractor is like, Oh yeah, I got an associate or a chiropractor that works for me. It was like, and there are 1099, like they don't work for you, even like in the way they verbalize it.

But if you don't mind, I'd like to just share, you had a great slide on here with some of the key things to look at for employee versus independent contractor. Can I just rattle that off real quick?

Michael Silverman: Yeah, please run through it.

Dr. Kevin Christie: Yeah, so the innovative contractor is basically running their own business, uh, paid upon completion of a project Provides own materials tools and equipment works with multiple clients Temporary relationship until project completed decides when and how they will perform the work decides what work they will do I mean obviously Doesn't necessarily all of those, but those are like the characteristics of a independent contractor.

That doesn't sound like many chiropractic associate, uh, job description. Now, an employee would be working for someone else's business paid hourly, salary or by. Piece rate uses [00:23:00] employees, materials, tools, and equipment typically works for one employer, continuing relationship with the employer, um, employee, sorry, employee, or decides when and how the work will be performed.

Employer assigns the work to be performed. I mean, it's pretty clear cut. And I know you mentioned the IRS test. Uh, this is a federal thing. This isn't a Florida thing. This is every state union. And, um, you know, when you're. Whether you're not medically integrated or you are going to integrate, you got to get clear on that.

And too many people are making a mistake. Like I almost feel like I want to make that my goal in life is to get every chiropractic practice to be doing that correctly because there's so many that aren't.

Michael Silverman: If we can share this link from the DOL on this beautiful chart that they put together, you know, when we put out the this recording, it'd be wonderful.

Very helpful again, because there's so much misinformation out there. And heck, even when I brought on an attorney, as much as I wanted to avoid paying those taxes and make him an [00:24:00] independent contractor, I took a step back and I said, You know, what would we be advising a client and me and my law partner, you know, it was, it was certainly obvious.

So protect, protect yourself to that. And, and again, um, you know, the, the contract accordingly that, you know, comes together, um, you know, is, is to tie everything into protect your business and in different states, you know, so your, your APRN that maybe comes on one hour a week, two hours a week, a couple hours a month.

Um, they may properly be classified at first as an independent contractor, but as their role evolves and their work within your organization evolves, you certainly want to make sure that you stay on top of those classification matters. And I was recently down in Miami at the National Association of Chiropractic Attorneys Conference and there were several lawyers from California that were out there and they informed there's a regulation in California that the, the amount of, of.

of work that they do on behalf of your practice aside, if what they're doing is an [00:25:00] essential element of your practice, like a chiropractic, a DC associate working for a chiropractic practice, there's no wiggle room. There's no 1099. It's legally has to be a W2. What California does often, you know, slowly but surely makes its way across the country.

So we'll really have to keep an eye on, on how those regulations change, but that's certainly my mission as well as yours, to help people classify correctly.

Dr. Kevin Christie: And so it's like, if you always reference, uh, California, Florida, Texas, New York, you start to get a kind of a swath of the whole country there, just obviously because of the size of the, of the state.

So, uh, we've, we've been a little bit Debbie Downer here. I didn't want to be that a whole time, but that's, uh, sometimes the nature of the beast. Let's hear some positive stuff. What are some examples of multidisciplinary practices that you're working and seeing and helping out with that are, that are thriving?

Michael Silverman: Yeah, let's um, let's turn the conversation around a little bit. We've given some of the the warning size kind of the do's and don'ts, but why would somebody want to even consider, you know, medically integrating their [00:26:00] practice? It's, it's, it's a, it's, it has so many benefits for you and your practice. First and foremost, um, talk about Oversight of your patient care, right?

How many times do we hear about situations where a loved one goes to a medical practice or a hospital, and there's no communication between their treating healthcare providers and there's no continuity of care. So first and foremost, it's, it's to make the best, Patient outcomes for your practice in your office.

They can receive all of the care that they may need. Um, secondarily, but, um, you know, certainly not not to forget is the increase in revenues to your practice. Right? Um, you know, certainly if. If you're struggling to sell chiropractic services, your theoretical apples, you shouldn't just add on another service category and think that's going to help your business out.

You should focus on selling your chiropractic services and filling, figuring out why you may have an issue there. But if you look and see that. For your [00:27:00] practice, let's say you have a, um, a personal injury, intense chiropractic practice, and you know that your patients are going to get joint injections and other types of pain relieving activities from another office, heck, it may make a whole bunch of sense to bring on that.

And NP or PA to provide those joint injections down here in South Florida, where, you know, sextel cells and everything is aesthetic. Um, there's, there's, I work with a tremendous amount of chiropractic medically integrated practices that serve as med spas, the IV nutraceuticals, the Botox, the aesthetic stuff, a lot of the cash based services.

So what may be good for your chiropractic practice may not be good for your neighbor's chiropractic practice as far as the services that you're going to look to add on. But certainly it is a way to oversee all your patient care, make sure they get the best outcomes and to increase your revenue. So done the right way.

If it's a good fit for you, it's certainly something. To look into and make sure you do [00:28:00] correctly. Oftentimes, folks come to me. I mentioned after the fact, they're in a relationship with a non licensed chiropractor or or a brother in law, we're attorneys, not magicians. We can't undo what's been done already.

We can certainly mitigate things. So the purpose of today for somebody that is looking to medically integrate is really just, uh, you know, as a look before you leap, be aware of some of the rules and regulations that apply and just make sure you dot your I's and cross your T's before you jump on in.

Dr. Kevin Christie: Yeah, I love it. And there's a, a big contingency of our audience are, uh, what we would call sports chiropractors. And, uh, you know, you could do a lot of cool things if you had that integration capability, even around sports medicine and you could, um, um, You know, really take your practice to the next level with it.

And that's an opportunity as well. It's, you know, there's a lot of undertaking. There's going to be associated costs, but you're going to want to do it right. You know, you're, you're probably going to want to save a fair amount of money [00:29:00] to be able to bring on the proper legal team to get it all squared away and done correctly to have a little bit of money put away to compensate the, the uh, MDDO for their work.

And obviously if you're going to be bringing on a nurse practitioner or physician's assistant, there's going to come with that. So you got, you got to prepare for it financially, uh, legally, uh, but even just conceptually with what your vision of your, of your ideal practice would be, which would be cool.

And so thank you for, uh, some of those examples of multiplied multidisciplinary practices. One question I did have, Um, let's say the, the chiropractor is in network with the insurances and they do this. Um, they, they bill it on, is it, they bill it under their health insurance, but under the say MDs, if it's an MD service, uh, they bill it under the MDs MPI, is that correct?

Michael Silverman: That's a that's a great question. And you said you would if you are contracted with insurance providers to provide some of these medical [00:30:00] services, you would essentially on board and get your either MD deals or your mid level practitioners credentialed underneath the practice through their MPI, so that you can build under your organization, but you mentioned a great point as far as insurance, no insurance.

Depending on the types of patients you want to service what you want to service them with and who the payers for those services are, there's going to be less or more regulatory red tape that has to be gone through, especially with, you know, cash based services, less regulatory red tape. Um, when you're billing Medicare or commercial insurances, especially as a chiropractic practice, you're going to want to really analyze your taxonomy and NPI type, whether you're organized as a straight standalone chiropractic practice, or whether you are can be modified to a multidisciplinary or medically integrated practice, because if you are a standalone NPI, Chiropractic practice [00:31:00] and have a taxonomy as such some of the commercial insurance payers may give you some pushback when you look to credential or do some of this billing.

So you certainly want to do that type of analysis. Sometimes it may necessitate opening up a new co a new entity or legal corporation and and slowly winding down your existing business and dumping it into the new organization and operating everything. Through that new organization, there's a lot, you know, there's there's stark regulations involved and kickback regulations.

So you want to make sure how you structure that is correctly. But certainly, you know, you want to look at your organizational setup. Somebody came to me recently in Florida through a. Um, a PLLC, a professional limited liability corporation and a company, excuse me, and they were rendering medically integrated services, but a PLLC in Florida, a professional liability company, it has to be owned by the type of medical professional that can legally oversee those services, [00:32:00] right?

So we had to modify them into a regular LLC because otherwise it'd have to be owned by an MD or DO. So little things like that, again, state laws and nuances that you'll want to check with.

Dr. Kevin Christie: Love it. And I recently had Brandy Brimhall on my show. She's an insurance credentialing specialist for any state and anything.

And she actually has a quite a skill set in in working through some of the details of the insurances, which I'm sure is outside of your your scope of dealing with some of that, right?

Michael Silverman: Oh, Doc, it takes it takes a village as you kind of alluded to, right? You got to mentally prepare yourself. You got to financially prepare yourself and you got to, you know, you got to engage the right legal team, the right accountants, the right credentialing folks, and the right business coaches for that matter, because, you know, myself, I'm, I can give you the rules and the laws, but I'm not a clinical expert, you know, you need some boots on the ground to help you develop those clinical policies, procedures and oversight, um, so that you can Really, you know, be best [00:33:00] set up for success there.

So you're exactly right.

Dr. Kevin Christie: Love it. Well, this has been great. Um, question, you know, obviously Florida, we have quite a few, uh, listeners that are from Florida. Is there any other states your firm is, is able to work with? Um, is there, uh, maybe there's particular, they can even reach out if there's a contact you have, what's the scoop on that?

Michael Silverman: Sure. So, um, my firm, we're, we're licensed in Florida and New York. Um, so we can provide state specific advice and regulations to that. And we work with healthcare business owners and chiropractors. I mentioned on a nationwide basis as it pertains to Medicare regulations, working to enroll them in Medicare B for durable medical equipment, for example.

Well, we also do a lot of transactional stuff, helping, um, Cairo's buy and sell their practices across the country. So we can certainly help there. And as I mentioned, I'm a, I'm one of the attorneys that's a member of the national association of chiropractic attorneys. So if it's something that my office can't help out with, certainly, uh, we can help point you in the right [00:34:00] direction.

We'd be happy to do so.

Dr. Kevin Christie: Yeah, and that's the thing that I love about your firm and why I wanted you on is that there's a distinct expertise within the chiropractic profession, just not a law firm that happens to work with a handful of chiropractors. You guys have really, really got a great niche within our profession and understand all of the nuances of it and speak the language.

So how could they reach out to you?

Michael Silverman: Um, you can. Can go to my website, SilvermanBain. com, S I L V E R M A N B A I N, you can schedule a free consultation with any of the attorneys there. Also has our contact information for our office in my email. Um, again, it's, uh, www. SilvermanBain. com. You know, I couldn't become a chiropractor myself.

As I mentioned, my father still practices locally and has a medically integrated practice. So, you know, it's something that, um, you know, I, you know, even if it's not a client, I enjoy talking about discussing, there's a lot of misinformation out there and to try to help people build practices and practices [00:35:00] successfully.

So always happy to chat about the industry to help anyone that we can.

Dr. Kevin Christie: Well, this has been great. Michael, I really appreciate your, your time today and we'll have to do a part two.

Michael Silverman: Absolutely. I, uh, doc sincerely appreciate your having me on and I wish everybody a wonderful holiday season and a killer start to 2025.

And if you're looking to medically integrate again today, some food for thought as far as how you can compliantly expand your business, take care of patients and increase your revenues.

EPISODE 407: AI Is Taking Over The MCM Podcast!

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. 

Welcome to another episode of Modern Chiropractic Marketing I got a very unique one for you today. You know, um, AI is, is hot and everybody's talking about it. For the last couple of years, last year and a half, uh, at MCM, we, we've kind of sat back a little bit. We've implemented in some of our processes.

We've been doing our due diligence behind the scenes with it, but we didn't kind of rush out and I didn't want to pretend I knew a lot about it. Cause I did it. Uh, but we've been diving into it a little bit more and finding some, some cool, uh, AI strategies. And one of the ones that we've found is notebook LM.

And I had heard about that on another podcast. I. Dabble a little bit in Bitcoin. So I, [00:01:00] I took the Bitcoin white paper and you can Google that and, uh, uploaded the PDF into notebook LM and what notebook LM can do now is it spit out a two person, a podcast episode based on the Bitcoin white paper. And it was like a 20 minute episode.

And I just listened to that to learn about the information in the Bitcoin white paper, instead of going through that. White paper. Uh, so then I was like, you know, that's a cool idea. I wonder if I could upload the PDF version of my book I wrote for five, five years ago and, and see what would come from that on a podcast.

And sure enough, it, it did. And so what you're going to listen to today is actually, um, two AI Voices, uh, that are going to be like co hosts of a podcast that talk about the essentials of the book I wrote five years ago, and that's going to be the podcast that, [00:02:00] uh, you're going to listen to today. And, uh, we'd love your, your feedback.

We're not going to, uh, do this often, but I just wanted to show you the power of AI and you're going to learn basically, uh, in a podcast format, the, the essentials of the book I wrote five years ago. I don't know how many of you have. Have, uh, read that, but this could be a nice little audio synopsis for you.

And before we dive into that too, I just want to make mentioned, uh, if you're listening to this as the day it releases on Thursday, tomorrow on January 24th, I'm going to be doing a free webinar for you, the essential marketing blueprint for evidence based chiropractors and really dive into how you can grow your practice in 2025.

Uh, we're gonna be doing some of these webinars more often for you. We're going to make it action packed a lot of deliverables and, uh, you know, it's free for you. So, uh, check out the show notes for the link it is at www. sites. modernchiropracticmarketing. com. And you do need to register for it and save your spot.

And if you do that. [00:03:00] Uh, we hope you attend. And again, that is going to be on January 24th at 1 PM Eastern time, 10 AM Pacific. So check that out and register in the show notes. All right, here is the podcast episode that I didn't do. And these are two AI guests or co hosts that are going to give you a breakdown of doing it right modern chiropractic marketing, which is the book I wrote, and that was kindly published by Parker University.

AI #1: Welcome and everyone to a deep dive into thriving chiropractors. We're going to unpack Dr. Kevin Christie's book. It's like a cheat sheet to building a practice that flourishes. Timely topic with healthcare changing so rapidly. Chiropractors face unique challenges and honestly, some tough choices about how to stand out, not just attracting patients, right?

Building something sustainable, both financially and ethically. Dr. Christie lays out these struggles, student loans, competitive markets, and let's be honest, the [00:04:00] temptation to compromise values just to stay afloat. That's where his thriving chiropractor concept gets fascinating. Three elements, like a recipe, clinical skill, business savvy, and this is interesting, effective marketing.

Let's unpack effective marketing, because to some that sounds a little salesy, but it sounds like Dr. Christie has a different approach. It does. Less about being a slick salesperson, more about being a trusted voice, like the go to educator for spinal health in your community. That makes sense. And it ties into his personal philosophy, the four freedoms, freedom of time, freedom of money, freedom of relationship, and freedom of purpose.

AI #2: And those freedoms apply to the chiropractors and the patients. Having a practice that lets you live a fulfilling life, but also empowers patients to have more freedom in their own lives through better health. You use a Dr. Mark King as an example. Finds freedom of purpose as a chiropractor, and leading a non profit inspiring.

AI #1: For many chiropractors, it's not just a job, it's a mission. Absolutely. Leads us to the heart of it. Yeah. Ethical and effective marketing. Dr. Christie [00:05:00] sees this as attracting the right patients. The ones who value your approach. Creating a community, not just chasing every client. And when you're the expert, the one who understands their needs, that impacts everything.

You can command higher fees, even step away from low paying insurance plans that tie a practice down. Precisely, creating value, not competing on price. This is where Dr. Christie gets modern. He wants chiropractors to become media companies. Intriguing media companies. So chiropractors having blogs, YouTube channels, podcasts, even becoming authors.

AI #2: Yes. Blogs, videos, podcasts, all those content marketing tools help chiropractors reach more people and share their expertise. He connects this to the six D's of tech disruption. Technology changes the game for everyone, including chiropractors. Digitization makes it easy to create and share content.

AI #1: Demonetization makes marketing more affordable. And democratization levels the playing field for smaller practices. Exactly. These D's are incredible opportunities. In the past, publishing a book was expensive and took [00:06:00] forever. Technology removed those barriers. So chiropractors use these tools to become thought leaders and reach people who need their help.

But honestly, it can feel overwhelming. Where do you even begin? That's where Dr. Christie's Modern Chiropractic Marketing Roadmap comes in. A clear system. It starts with positioning your niche. Who you want to serve. How you want to be seen. Figuring out your superpower. Yeah. What makes you stand out from other chiropractors.

AI #2: Exactly. Then planning. Creating a content calendar, deciding topics, and actually sticking to it. Consistency is key, but it can be a struggle. A lot of our listeners can relate. It's easy to get caught up in the day to day and let marketing slide. But Dr. Christie says make time for it. Like any other part of your business.

Absolutely. He emphasizes measuring your results. The marketing hourglass model. It goes beyond getting new patients. Attracting. Engaging. Retaining. Turning them into advocates. Hourglass. It's a shift from just focusing on that first appointment to thinking about the [00:07:00] whole journey. Building long term relationships.

AI #1: Yes, that community is key. Not just patients. A tribe of people who resonate with your values and approach to health and wellness. He also has actionable content creation tips. What's the investigative reporter plan? It's creating content by interviewing experts in your community. Instead of coming up with ideas yourself, you become a curator of knowledge.

Interview a local yoga instructor about back pain prevention. Or a nutritionist about diet and inflammation. Exactly. Generates valuable content. For more information visit www. FEMA. gov Positions you as a connector and thought leader. That's smart. Then there's the repurposing magic. Take that interview and turn it into a blog post.

Social media posts. Maybe a podcast episode. Precisely. Maximize your efforts. Reach different people. And he believes in the power of storytelling. He wants chiropractors to use storytelling not just to promote their practice, but also to help patients understand their own health journey. He gives an example about a dad who couldn't play catch with his son because of back [00:08:00] pain.

Instantly shows the impact of chiropractic care, not just fixing a problem, restoring quality of life. Exactly, connecting emotionally. Making it more meaningful. He breaks down the seven key characteristics of a good story, and how to use that even in a report of findings. Okay, let's talk about how this reaches people.

Websites, email marketing, social media. Where does a chiropractor even begin? He calls it the hub and spoke model. Your website is the hub. Your online home base. And it should be more than just a brochure listing services and hours. Absolutely. He wants chiropractors to see websites as content platforms full of valuable information.

AI #2: It's about building a resource. So having a blog with regular articles. Yeah. A resource library with guides and ebooks. Exactly. And the spokes are all the channels where you share that content. Social media, email marketing directories, even ads. Each spoke drives traffic to your hub. And he says, own your online presence.

AI #1: Your website is a priority. Not just relying on social media where [00:09:00] algorithms change all the time. That's critical. Build a strong foundation that you control. Creating a digital ecosystem for your practice. Reaching your ideal patients. Precisely. And in that ecosystem, Dr. Christie explores different channels, each with its own strengths and strategies.

Let's take a break from today's episode and announce our first sponsor. This is going to be Propel Marketing and Design. I've known Darcy Sullivan for years. We've worked hand in hand on my websites. I don't trust anybody else to do this search engine optimization. She does a great job. There's, there's so much to it.

A lot of, a lot of the lingo and the words are beyond my, uh, comprehension, but it's just amazing work that she does. And if you're really going to get results with Google, you. You have to make sure your website is SEO optimized. And I really don't want you doing it yourself as a chiropractor. So I, you just have to have this type of stuff done.

And if you're looking to get more organic online traffic that pulls in new patients, Propel Marketing and Design is currently offering chiropractors who [00:10:00] listen to this podcast, a free SEO website review. The free review will help you uncover methods that will improve your website and boost your search engine visibility.

Head over to propelyourcompany. com slash chiropractor and schedule your free SEO website review. You won't regret it. She gets great results. Your website needs this. Your search results need this. Head on over there to propelyourcompany. com slash chiropractor to get your free SEO website review.

AI #1: Okay, I'm ready to dive into those channels. What's first?

AI #2: Let's start with the giant Google. It's the starting point for so many health searches. Essential for any chiropractor. Dr. Christie breaks Google down into a few key areas. First, he says you have to claim and optimize your Google My Business listing.

AI #1: That little box that pops up when you search for a business with photos, hours, reviews, that kind of thing?

AI #2: Exactly. Essential for local search. When someone searches chiropractor near me, Google uses that to see if you show up in the results. [00:11:00]

AI #1: So just having a website isn't enough. You have to make sure Google can connect you with the people searching.

Makes sense.

AI #2: He also talks about SEO, search engine optimization, making sure your website ranks well.

AI #1: So when someone searches back pain relief, your site shows up higher, hopefully on that first page.

AI #2: Precisely. It's complex, but Dr. Christy covers the basics, relevant keywords, optimizing content backlinks.

AI #1: And Google Ads, reaching potential patients who are searching.

AI #2: He says use Google Ads strategically. Don't just target anyone with back pain, get specific target golfers with elbow pain. Send them to a page with a free golf swing analysis.

AI #1: Now we're talking niche down to the right patients, but track results.

Make sure it's worth it.

AI #2: Absolutely. Measure your return on investment. Know what's working.

AI #1: Speaking of social media, let's talk Facebook. What's Dr. Christie's take?

AI #2: He says Facebook is powerful for connecting, but don't rely on it too much. Algorithms change and impact your reach.

AI #1: So that build it and they will come doesn't really work for Facebook [00:12:00] pages.

AI #2: Not anymore. Create content that's engaging and valuable. Share educational content. Patient success stories, behind the scenes stuff.

AI #1: He also talks about Facebook groups.

AI #2: Yes. Connect with people interested in your area. Join a group for local moms or runners. Participate. Build relationships. Become a resource.

AI #1: And of course, Facebook ads to reach more people.

AI #2: They have potential, but use them strategically and target effectively. You can target by age, location, interests. Even job title.

AI #1: Wow. You could target people with desk jobs who might have back pain, or people who like yoga.

AI #2: Exactly. Facebook is always changing.

Stay adaptable. Experiment.

AI #1: From Facebook to Instagram, seems perfect for chiropractors. Showcasing exercises, stretches, patient transformations. Strategies for Instagram.

AI #2: He highlights chiropractors doing well on Instagram. Move you. They have great videos about mobility and movement. A global following.

AI #1: Wow, I've seen them.

They're creative and informative. You don't have to be huge to build a following.

AI #2: Exactly. They embody his six principles for [00:13:00] content. Filling a need. Consistent, human, unique point of view. Not salesy. Best of breed.

AI #1: A winning formula. And then there's Dr. Jacob Harton, growing his practice through Instagram.

AI #2: He was an early adopter of Instagram, consistent with posting valuable content, engages with followers.

AI #1: Impressive. Being early can give you an edge. Oh. He built a presence before it got so crowded.

AI #2: And he experiments with different formats. Videos, photos, stories, reels.

AI #1: Being creative. Standing out.

AI #2: Yes!

Experiment. Find what works.

AI #1: He said have a clear call to action. Engage people, but guide them to the next step. Visit your website. Book an appointment. Join your email list.

AI #2: Precisely. And use Instagram stories, connect personally, give a behind the scenes look,

.

Let's take a short break for one of our great sponsors, Trackstat. It is a new type of software plugin for your EHR that combines patient communication, marketing, automation, and statistics with patient and employee tracking. [00:14:00] Built by chiropractors for chiropractors, it shows your team what to focus on each day.

See patient visit habits, Missing information, unpaid bills, insurance, collection, visit average, and more. Great visibility of data so you can focus on filling your office with your best patients. When you can see what your staff and patients are doing, or not doing, and take action accordingly, your profits naturally grow.

Take TrackStat for a test drive in your office. With our free trial, not a techie, no problem. We can help to get started on your free trial, visit trackstat. org and watch the demo that is trackstat. org.

AI #1: Google, Facebook, Instagram. What about YouTube?

A lot of people think it's just entertainment.

AI #2: Dr. Christie sees YouTube as a valuable tool. He says shift your mindset. It's not just about going viral, it's about providing educational content that complements your strategy. Another spoke for your [00:15:00] hub.

AI #1: YouTube has so much potential for long form content videos about different back pain demonstrating stretches.

AI #2: Exactly. Remember, YouTube is a search engine. Optimize titles and descriptions so people find your videos.

AI #1: And the repurposing magic? Turn that blog post on golf injuries into a video or patient testimonials into a short video.

AI #2: Exactly. Repackaged content make the most of it.

AI #1: Now I'm curious about podcasting.

We're both fans.

AI #2: Yes, often overlooked by chiropractors. A great way to reach a niche audience and build authority. Deeper dives. Longer conversations.

AI #1: I like that he says experiment. Maybe solo episodes sharing expertise. Or interview experts highlight patient stories.

AI #2: And just like other content, Be strategic.

Promote your podcast.

AI #1: You do an episode on sciatica pain? Share it on social media. Your newsletter embedded on your website. Drive traffic to your hub.

AI #2: Precisely repurpose the content. Transcribe it into a blog post. Create audiograms.

Let's take a short break from today's episode to tell [00:16:00] you about the best decision I've made in my clinic in the last 10 years, and that has been adding shockwave therapy to our clinic. The outcomes have been really impressive. Certain conditions we were struggling with in the past. We're now seeing results with, with the shockwave therapy for that.

And second of all, the ROI has been really good. You know, when you make a big investment in something, you want to see a return, and we're seeing that return. In clinical outcomes and in our investment. And that's been really nice to see. I chose Keenest Medical for four reasons. One is the technology is top notch.

You have to have great technology. There's a lot out there that isn't quite up to snuff. The second thing is, is they have a really good clinical training. They have an exclusive partnership with Academy of Shockwave Excellence so that you can become clinically proficient in shockwave. You do need to get skilled at it.

I think that's a big differentiator between practices that are getting great results and seeing the ROI is they have a great clinical aspect to that as well. So you want to get trained appropriately. [00:17:00] Third is they have in house service team for all of your technical support, which is key when you're investing in a machine like this.

And then lastly, They have a very in depth marketing and business support for you so that you can launch this into your practice effectively, that you can get that ROI on it, that you can get the clinical outcomes. And they also have really good financing options if you need that. So go to keenismedical.

com, K I N A S medical. com, mention MCM podcast and receive a free shockwave in practice book with a purchase of a unit. So that's keenismedical. com, K I N A S medical. com and mention MCM podcast.

AI #1: Okay, one last content tool. Free online courses.

AI #2: Showcase your expertise.

Provide value. Dr. Christie says they attract new patients and educate existing ones.

AI #1: What kind of online courses would work for chiropractors?

AI #2: Create courses about problems your patients have. Back pain prevention. Posture [00:18:00] correction. Stress management exercises for desk workers.

AI #1: I love that. Position yourself as an expert.

Help people improve their lives.

AI #2: Think strategically. How to use them. Lead, magnet, nurture patient relationships. Provide extra value.

AI #1: Weave those courses into your marketing. Build those connections. Make them easy to access. Learn

AI #2: Platforms like LearnDash post your courses professionally, integrate them with your website.

AI #1: A smooth experience, easy to access content.

AI #2: Exactly. And as with anything, promote those courses. Let people know.

AI #1: We've covered a lot. Google, Facebook, Instagram, YouTube podcasts, online courses. It's a lot.

AI #2: It can be overwhelming. But the hub in Spoke is a clear framework. Your website is the hub. And you use other channels to drive traffic to it.

AI #1: He says you don't have to be on every platform. Choose the ones that make sense for you and your patients.

AI #2: Right. Focus your efforts. And he doesn't just talk about online marketing. He also talks about community outreach. Real world connections.

AI #1: Online is great. But face to face is still [00:19:00] so valuable.

Especially for trust.

AI #2: Attend networking events. Partner with businesses, volunteer, be an active member of your community.

AI #1: Speaking at local events, a gym, a yoga studio, a community center, get in front of people.

AI #2: Step out from behind your desk, be visible.

AI #1: Now let's shift gears. Attracting new patients, nurture relationships.

But how do you get those new faces walking through the door?

AI #2: Dr. Christie has some interesting ideas. The before unit strategy. Reach people before they even realize they need care.

AI #1: Instead of waiting for someone to be in pain.

AI #2: You're educating them about the benefits. Planting seeds. Position yourself as a resource.

AI #1: Reframing it. How does a chiropractor do that?

AI #2: Content marketing. Educate about common problems. Posture correction. Ergonomics. Stress management.

AI #1: Showcasing your expertise. Being helpful and informative, not pushy.

AI #2: Exactly. Providing value up front. Building trust.

AI #1: He also says use online quizzes or assessments.

How's your posture? Are you at risk for back pain?

AI #2: [00:20:00] Interactive, personalized people love quizzes. Free value. A reason to connect.

AI #1: He even says Host workshops or webinars? Desk ergonomics for a pain free workday? Natural ways to reduce stress?

AI #2: Not just digital marketing connect in person.

AI #1: He says think creatively.

Partner with businesses. Offer lunchtime workshops. Sponsor a health fair.

AI #2: Get your message out there.

AI #1: Okay, attracting new patients is important. What about keeping current patients coming back? Even better, becoming raving fans who refer people.

AI #2: The wow patient experience. Every interaction is marketing.

AI #1: Not just the adjustment.

AI #2: Exactly. A welcoming and comfortable atmosphere. Calming music, essential oils, herbal tea, make people feel cared for.

AI #1: Communication is key. Understanding their diagnosis treatment plan. What to expect.

AI #2: Clear communication. Using language they understand. Answering questions patiently.

Build trust.

AI #1: And go above and beyond. A handwritten thank you note. A guide on stretches. Follow up after an [00:21:00] appointment.

AI #2: Little touches. They show you care. For Don't forget technology,

AI #1: an online tortle, access treatment plans, schedule appointments, communicate,

AI #2: convenience and efficiency,

AI #1: attracting new patients, creating a great experience.

What about people who have stopped coming,

AI #2: reactivating inactive patients, getting those lost sheep back,

AI #1: patients who came for a few visits, saw improvement. But life got in the way.

AI #2: Sometimes they just need a little reminder. Email, marketing, newsletters, tips, updates, offers.

AI #1: Stay top of mind. Keep communicating.

And handwritten notes.

AI #2: That personal touch. Pick up the phone. Call inactive patients. Check in.

AI #1: Okay, let's talk about how Dr. Christie says to structure a patient visit.

AI #2: He breaks down the interaction. Greeting to report of findings.

AI #1: Key touch points.

AI #2: The initial greeting. Greet every patient warmly. Make them comfortable.

AI #1: Set the tone.

AI #2: Exactly. Then, a detailed history. More than just symptoms. Lifestyle goals, concerns, listen, show interest,

AI #1: build rapport, see them as a person,

AI #2: ask questions [00:22:00] that help uncover the cause of pain,

AI #1: tell me about your workday, what movements do you make, how much time sitting,

AI #2: get a full picture,

AI #1: then the physical exam,

AI #2: a thorough examination, physical limitations, and more.

imbalances tenderness, create an effective plan,

AI #1: and the report of findings how to approach it.

AI #2: Remember storytelling. Use those principles. Make it engaging and meaningful.

AI #1: Instead of listing technical terms,

AI #2: weave their story into it. They're the hero. You're the guide.

AI #1: Give me an example.

AI #2: Chronic neck pain.

Don't just say herniated disc. Say, I know this neck pain is frustrating, it's stopping you playing with your kids or running. It seems you have a herniated disc pressing on a nerve.

AI #1: Okay, I see the difference. You're acknowledging the impact, putting it into context, more personal.

AI #2: Exactly. And when you talk about treatment, it's not just adjustments, it's empowering them to heal.

AI #1: We can work together to reduce your pain, get you back to doing what you enjoy. Adjustments. exercises, ergonomic modifications.

AI #2: Yes, it's a partnership.

AI #1: Clear communication is key when you talk about frequency of treatments and recovery [00:23:00] time.

AI #2: Absolutely. Set realistic expectations. Make them feel informed and confident.

He says end the report of findings with a positive message. Remind them of their strengths.

AI #1: And the call to action?

AI #2: Schedule their next appointment. Commit to their journey.

AI #1: Guide them. Reinforce their commitment

AI #2: throughout this process. Build rapport. It's not just a service. It's a relationship, trust and respect.

AI #1: Not just what you say, how you say it. Be present. Attentive invested.

AI #2: Precisely. What it means to be a thriving chiropractor. More than money balance. Clinical skill, business acumen, connect with patients.

AI #1: A practice aligned with your values. Yeah. Passion's purpose. Dr. Christie says it's a marathon, not a sprint.

Continuous learning and growth.

AI #2: He's given us a road map.

AI #1: It can feel overwhelming. The rewards are huge, not just financial, making a difference.

AI #2: Real world examples. Would you like to hear stories of chiropractors using these principles?

AI #1: You know what? Let's get inspired.

AI #2: Yeah.

AI #1: Alright, let's hear about chiropractors who are putting [00:24:00] these ideas into practice and seeing those results.

Real world examples of how Dr. Christie's method can build a thriving practice and a fulfilling career.

AI #2: I'm ready for it. It's one thing to learn the concepts, but seeing them in action is powerful. Absolutely. Yeah.

AI #1: Absolutely. So first, Dr. Joe Danky. His story is about resilience, rebuilding in the face of challenges.

AI #2: Oh yeah, Dr. Danky. His practice was hit by Hurricane Harvey. That must have been so hard.

AI #1: Devastating for his community. His practice was really impacted, but he didn't give up. He saw it as a chance to rebuild, not just his practice, but his whole approach.

AI #2: Wow, it takes determination, a willingness Christie's

AI #1: work, joined the Chiropractic Success Academy, Thank you He says the program gave him the tools and the mindset to not just rebuild, but to create something even stronger.

AI #2: The power of a framework and a supportive community.

AI #1: Dr. Danky's story proves these principles work. Even in tough times, finding opportunity. Having the courage to do things differently.

AI #2: Now for Something Different Movia, they've mastered Instagram [00:25:00] video. Huge global audience.

AI #1: Their videos are so creative, they make complex movement and mobility concepts accessible and fun.

AI #2: They're a perfect example of those six principles for content. Remember, filling a need. Being consistent. Human, unique perspective. Not salesy, top notch quality.

AI #1: A winning formula. You don't need a big corporation or fancy team to create impactful content and reach the world. It's about passion, creativity, providing value.

AI #2: And then there's Dr. Jacob Hardin growing his practice on Instagram.

AI #1: What's impressive is he was early on Instagram. He saw its potential. He's been strategic and consistent. Always valuable content. Engaging with people.

AI #2: Being early can be an advantage. He built his presence before it got so crowded.

AI #1: And he's not afraid to try different things.

Videos, photos, stories, reels. Always seeing what works.

AI #2: That's key on Instagram. It changes constantly. What worked before might not now. You have to adapt.

AI #1: Before we wrap up, Dr. Christy asks, If you were to create content as a chiropractor, what unique knowledge or experience [00:26:00] could you share?

AI #2: It makes you think about your strengths, your passions, the needs of your community.

Everyone has something to offer.

AI #1: What will you take action on? You don't have to be a marketing guru or influencer. Share your expertise. Build relationships. Create a practice you're passionate about.

AI #2: Be authentic. Connect with people. Building a practice is a journey. Take small steps. Experiment. Learn.

Adapt.

AI #1: That's it. Our deep dive into thriving chiropractors. We explored Dr. Kevin Christie's framework, different marketing strategies, inspiring stories. If you want more, check out his book. Tons of wisdom in there.

AI #2: A valuable resource for any chiropractor who wants to succeed in the modern world.

AI #1: Thanks for joining us.

Until next time, keep learning, keep growing, and keep making a difference.

AI #2: And keep those spines aligned.

I hope you enjoyed this week's episode and if you want to make the shift from busy, broke and broken to time free and cash confident, or you just want to continue with the exponential growth, [00:27:00] check us out at modernchiropracticmarketing. com, look at the MCM mastery tab, watch the short video on there and check out what we are doing now for evidence informed chiropractors.

We are equal parts coaching and marketing done for you. Yes, you shoot some videos. We help you with campaign strategies and ideas and really become a thought leader in your community. You shoot those videos. You send them to us. We produce, edit, and brand them to you. Then we distribute them through all of your channels.

We also take them and we turn it into one good blog per month. And every other month we have Darcy Solomon producing a robust blog with a topic that you pick from her database to help with your SEO. So we essentially become your content marketing agency to make sure your practice is always having ethical, elegant content marketing to help grow your practice.

On the coaching side, we also help you with everything from marketing ideas to business, communications, finances, anything, practice growth, and really try to help prevent you from being stuck on that [00:28:00] island. And we hold you accountable. We have a great group of doctors that are just doing amazing things.

And we look forward to help you out to take that next step in your practice. So again, check us out at modern chiropractic marketing. com and learn more.

 EPISODE 408: The Hot Targets of Chiropractic Compliance with Scott Munsterman, 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, excited to have you back and today I've got an interview for you with Dr. Scott Munsterman of ChiroArmor and he is all things compliance and a little disclosure, I've been working with his group for my private practice since the summer of 2024, we've taken on the project of clinical compliance and it's been really good, we've done everything from Building out best practice manuals to, uh, you know, getting clear on compliance, uh, issues and year end trainings and, uh, notes and, and all the things.

I mean, it's really, when you're running a healthcare practice, uh, there is a lot of regulation, as you know, and there's a lot of things that you have to be keeping up with. And it's part of your responsibility to, to do that and start to learn that process. And so I, we did finally, uh, you know, we were piecemealing it before.[00:01:00]

But definitely eye opening to actually go through training and it was kind of like not knowing what I didn't know at some points or sometimes knowing what I knew, but wanted to be in denial about it. And so, uh, it was great. It's been great to go through that and we dive into a lot of the key aspects of, uh, what, um, Dr.

Scott looks for when working with clinics to give you an idea of some of the things you need to be thinking about in your practice and, um, starting to be as, You know, be compliant, whether it's with your state, uh, or obviously the, the U S federal government. And then, uh, you know, if you're, uh, if you're in a different country, which a lot of you are, I know we get quite an audience in Canada and Europe and Australia, which is cool.

I love you guys. Uh, you know, look at compliance, how it would relate, uh, obviously to your country or province and, and make sure that you are. Working towards compliance. All right, without further ado, here is my interview with Dr. [00:02:00] Scott Munsterman.

 All right. Welcome to the show. I got Dr. Scott Munsterman on here and we're going to talk all things compliance and really get you up to speed to at least a certain perspective on what you need to be considering for your chiropractic practice. But before we dive into it, tell us a little bit about yourself, doc.

Scott Munsterman: Oh, happy to. Thanks for having me, Dr. Kevin. I appreciate it. It's an honor. Um, well, uh, Coming up. Let's see here. I graduated from Northwestern in December of 1984. And so coming up on 40 years here, um, I'd have to do the math. Maybe it's 41. I don't know. Yeah, you're getting,

Dr. Kevin Christie: getting there 41 by the time this comes out.

Scott Munsterman: Yeah, exactly. Well, and, and just had just really. loved the career, you know, loved chiropractic, loved what it does for people. Um, and just really kind of found myself through a lot of different phases and chapters of my life, you know, professional life. And just all of that, [00:03:00] uh, was in practice for over 25 years, uh, had a large group practice of six DCs and a PT.

Um, and, uh, we, uh, practiced in a surgery center, uh, that was co owned with pain management anesthesiologist. So learned a lot about Integrative care, you know, how to work with patients, with other providers through the meantime. Um, over the course of time, um, I served 13 years as an elected official, uh, first on the city council within my community.

Uh, then a couple of terms as mayor, uh, then a few terms as a state legislator and chaired a number of committees and, and, uh, was, uh, active in the, in the party and. And leadership within the state and, and over the last probably 15 years now, uh, I've been primarily consulting role, uh, working with, uh, uh, clients, all, uh, chiropractic practices, integrated multidisciplinary practices all across the United States and helping them with their compliance [00:04:00] programs and, and, uh, uh, being a, a, uh, uh, sounding board and, and helping them in their practice management discussions, business.

you know, discussions, all of that. We work also with an electronic health record that, that is worldwide, that, um, is, uh, in hospital and medical clinics. And, and we found that to be very helpful for especially those multidisciplinary practices. And so really have found myself towards the, towards. This end of my career, I'm not saying it's the end no means, but, uh, using a lot of the experiences that I've had, both in clinical practice and, you know, and, and seeing patients and working in, you know, group practice settings and, you know, and all that.

Um, and then. And public policy, and then, you know, more along the lines of, of just the, the experience and expertise that I've been grateful to gain over the last 10 to 15 years in helping other practices. So this is how you [00:05:00] found me today, uh, Dr. Kevin is kind of at this phase at this point in time in my life and, and as always just have felt.

You know, I'm blessed to feel very purposeful, you know, with what I, with what I do. So I don't know if that's the answer you're looking for, but that's the one you got.

Dr. Kevin Christie: That's, that's the answer. And, uh, I'm, I'm proud to say I'm one of your happy, uh, clients here and been working with you, uh, since I think early summer, and this is, uh, of 2024, this comes out.

And early 2025, but yeah, it's been quite a learning experience for me as well. And someone that's, you know, been practicing since oh five and had my own practice, uh, you know, I was a practice owner since oh seven in a partnership and then my own practice in 2010. And, you know, so my practice was 14 years old when, when I took this head on, on the compliance side of things, uh, to, to make sure that.

Uh, we're doing things right. You know, ultimately, uh, you know, healthcare is, is definitely tricky. It's, it's, um, [00:06:00] it's not easy being compliant. It's not difficult, but it's, but there's a lot to it and that's something that I've learned. So I want to thank you for that.

Scott Munsterman: Well, um, two, two things to that. I mean, I've been around long enough, uh, that I knew what it was like before HIPAA.

And, and, and back then, you know, way back, and of course this is before the 1990s, it was all about, you know, confidentiality. I mean, there was just an ethical. No, you did, you know, and, and, you know, likewise with other types of regulatory environments and, and even going way back to those 1990s, I mean, that's where the office of inspector general, um, First had their look at healthcare and compliance.

And it was the university of Pennsylvania that, um, had to learn a 25 million, uh, lesson, uh, when they were doing billings that weren't accurate. to Medicare and the OIG picked up [00:07:00] on it. Well, and then the OIG looked at that and like, holy cow, we have this whole industry here that is like, you know, the Wild West, you know, back then.

And so all of a sudden, then we began to see some of these changes, regulatory systems get put into play, you know, and they kind of, it wasn't so much that it was all in a concerted, concerted, You know, effort, you know, kind of thing, but it was more like, you know, OSHA saw this and of course, then the high tech act came out and, you know, HIPAA and, you know, all of that.

And then the OIG rolls out, here's what we think a compliance program needs to be in healthcare facilities. They published that way back in 2000 and that's really has not changed and is for all healthcare facilities. And so that's, you start looking back, you know, and what's transpired that healthcare environment to your point.

Is highly regulated. I mean, both on a federal level, but then also on a state level, and then we have our state boards, but it's nothing to be fearful of, [00:08:00] you know, it's kind of like the conversations we have with our clients right away. And we typically see them start to relax after about the third visit with us.

Dr. Kevin Christie: Yeah, yeah, exactly.

Scott Munsterman: Gosh, you know, we, we got it covered, you know, we, this, there are a lot of things, but you know what, you build a system around that and you know, when you need to do the things you need to do and, and you're guided, then you don't have to worry about it, you know, because you're just doing the right things.

You have to worry about wondering if you're doing the right thing. Um, and then the second point, um, too, is that there, we, many times docs don't know what they don't know. You know, and so then they become overwhelmed and, you know, they can react to that, you know, too, in different ways. But so, yeah, it's, it is the environment that we're in.

You know, I just think back 40 years ago, you know, when I started practice and open my own practice and all of that. I mean, what the environment was like then is just. It's night and day difference to what it is today. Some, some good [00:09:00] and some that are like, um, are more challenging. I'll just put it that way.

Dr. Kevin Christie: My secret hope is that Elon and the Doge, uh, also, uh, tackles healthcare compliance.

Scott Munsterman: There you go.

Dr. Kevin Christie: And gets rid of some of the inefficiencies, but, uh, no, on a, on a more serious note, you know, it's like, uh, you mentioned docs that might've been practicing since the late eighties, early nineties. You know, it definitely was, has probably been a frustrating process to keep up with all of the additions of, of compliance.

And again, like you mentioned, federal state plus your, your chiropractic board, uh, you know, if you've gone through it for 40 years, I mean, it is night and day, there's no doubt about it. And then on the other end of the spectrum, you know, you get. The young DC coming out that, um, let's just say they open up their own practice.

Uh, you got a lot to figure out just to even make that business, um, actually survive and then trying to understand and go through all the [00:10:00] compliance is something that is, uh, challenging. And then you get the docs that are in, you know, kind of, uh, I would say maybe my, uh, spot of like 20 years of practice where you're kind of both things like you're you know things have changed even in 20 years and you're trying to keep up with that and every administration or something new and You know like one of the things I We might as well make mention That I didn't know about until I was working with you was the fact that this past July and now in January the minimum wage On salaried non doctor employees.

So if you got an office manager that's on, uh, on hourly pay and they are full time, uh, sorry, if they are salaried in full time, there's a minimum on that. Can you, can you explain to that new one that happened in July and then it escalates in January?

Scott Munsterman: Yeah. So the, so the salary, um, and this was, there was quite a few different things that occurred this year.

Uh, that came out and it'll be interesting to see if [00:11:00] anything gets rolled back.

Dr. Kevin Christie: Yeah, I think of some will

Scott Munsterman: a different administration, but it set a minimum wage, if you will, for people that are on a salary. Um, now within the last couple of months, one of the things that, that has been brought forward and some refinement of that.

Is that if you do have somebody on a salary that is below what that minimum wage is going to be, um, then making sure that you do document what their hours are, you know, during the week, um, and that if they go over those hours, that overtime would be paid. And so there are some updates to that, but it'll be interesting to see coming into January and, and if there's going to be any refinements of that, um, whole discussion that.

That it, you know, it'll, you know, a small business has to adjust to a lot of these things. I think there are times where things sound really good on the surface, um, but [00:12:00] how the impact is to a small business can be, I won't say devastating, but it can definitely challenge that business into, into how to continue to do what they're doing.

Um, but yeah, there are regulations like that, that. That will come forward and then it's all about, okay, how does this impact me and what do I need to do and how do I need to learn more? And then as time goes on, there's challenges to that, you know, and then those change as well. I mean, we had that happen with the Corporate Transparency Act this year, you know, and we're beginning of the year.

It's like, you know, we got to have everybody registered. And we even waited, our company waited until June because we thought, okay, this is going to get challenged. And, and then it seemed to like die away and we thought, you know what, we're going to have to start telling our clients they're going to need to do this because the fines were really heavy in January, beginning January 1.

Well, what was it a week or a week and a half ago, Supreme Court [00:13:00] put an injunction on it, you know, but it was like last minute, you know. And so it is a little maddening where you're like monitoring these things and you're reacting to it. And, and yet, you know, you've got to kind of move with the times and that's kind of the world we're living in right now and how to keep up on that as a doc who's trying to treat patients.

I don't know. I couldn't do it. I mean, I would need somebody to help me. Yeah. Yeah,

Dr. Kevin Christie: for sure. And that's the thing is like when you do think about it, you mentioned it can be devastating to a small business and it can, and cause you know, if you're a small chiropractic practice and you're, and you're in network with insurances, not only are you dealing with all the games, the insurance companies are playing with reimbursement and trying to keep up with the.

Billing compliance and insurance reimbursement situation. But then, yes, you do need to navigate the waters of regular compliance. And if you really do think about it, a lot of the things that we have to abide by. With compliance, it actually does hinder your ability to operate your, [00:14:00] um, to grow your business that other businesses can do.

Right? Like a dry cleaner business can offer 25 percent discounts and can offer buy one, get one freeze. And like, I mean, you think about all of the businesses out there that use tried and true strategies to grow. A low margin business, which we're in, uh, they have a lot of things they can do. And then we can't do many of those things, right?

Like you can't even treat your sister in law, probably your ex, something like that. Like what's the cutoff on who you could treat for free? Is it a cousin or something? What, what is that?

Scott Munsterman: Well, um. Couple of things. So I think what you're referring to would be like your professional courtesy.

Dr. Kevin Christie: Yeah,

Scott Munsterman: of what you're going to provide.

Um, and, and really, as a practice, you can, you can set that policy, but it's, it has to be group, you know, like, for instance, um, if, if, if you have a dentist friend and you're treating that [00:15:00] dentist friend for free, Um, and you're going in and you're paying him for his service, but he's referring to patients.

Well, that would go against the Stark law, you know, because there's inducement there and there's, there's like a reward system going on. But if you wanted to treat all the dentists in your region for free, you could do that. you know, because it's not in regards to referrals, you know, that you're doing it, blanket all

Dr. Kevin Christie: dentists.

Scott Munsterman: So, but in a professional courtesy situation, you brought up family, you can extend your family as much as you want, but where the caveat is, is that, okay, if there's. a medicare federal beneficiary Yeah Then you can't give free care to them But if it's your immediate relative, I know i'm going to lose everybody on this now, but if you're relative you have to Give free care to them, you know, um, and so there's just these different rules around, you know, the point that you're trying to [00:16:00] make is that it can be complicated, you know, you're standing between navigating the stark law and the anti kickback law.

And then you got Medicare guidelines. And, and that's why having a policy like, um, professional courtesy as a part of your policy so that you don't accidentally give free care to somebody or charge somebody, you know, that you shouldn't be, you know, kind of thing. Um, anyway. There is good news. No, no,

Dr. Kevin Christie: there, there is good news.

And, and we, we will get to that. But, um, what I want to do is transition into some what you call is your hot targets. You know, you're working with a clinic and you, and you getting started with them. Uh, talk to us a little bit about some of the hot targets you look at right out of the gates.

Scott Munsterman: Oh, and, and we developed this list over.

Years and I even added more to it this year because, uh, one of the things that, that, that we do when we bring on a new client, we have to be as the consultant or as the one helping the [00:17:00] client, we have to really be careful that we don't assume that they come, you know, with a certain level of compliance, you know, and so, you know, beginning with, you know, how are we doing our billing today, you know, and I, and I always make sure that That our clients feel like, okay, if they're doing something wrong, I mean, this is our, you know, come to Jesus moment on everything here.

We want to know everything that you're doing today. And then if there is something that's not right, we're going to work on that to fix it. And so our hot target list really are those. Number of things that that are so integral that we need to make sure we're doing right and they were like rise to the surface.

So NPI's, you know, and how are we billing for our services? What type of services do we provide? And then from the offshoot of that in your state, you know, are you capable or able to do that within your scope of practice? Um, [00:18:00] you know, many times we assume that if we saw it or we bring it in or whatever, that.

You know, we can just go ahead and use it because somebody in another state is using it. Well, that's not necessarily the case because many state laws are built around. If it's taught at a unit chiropractic college, then it's approved or depending on your state, you know, language. So understanding the, the law, your state law and the jurisprudence around that becomes really important.

And so when we ask about services, you know, we're like our radar is up. In saying that, okay, that's a common practice that's taught in universities, or maybe it isn't. And so we call that out. Again, services, what, then if we have certain services, how are we coding those services? What codes are we using?

Are they properly being used? That wraps into our look at CPT code utilization in general, so that we know what's billed, how many times it's being billed. You know, how are evaluation and management codes utilized? [00:19:00] Are they being utilized correctly? Does our client understand, you know, that there's two different ways that you can code an exam?

Dr. Kevin Christie: Yeah. Can you talk about that? Cause I know that was something you taught me. I thought it was interesting.

Scott Munsterman: Yeah. So in 2021, there was, there were changes made to the E and M. Um, coding, um, definitions, the AMA and Medicare actually put a lot of work into that and rolled that out. Um, and the, basically the, the thing that changed is it puts, uh, providers, uh, clinicians in control of how they want to go about coding their evaluation management based on two essential criteria.

Okay. The first one is through medical decision making, and there's actually three categories. Uh, number one is based on the problem complexity, you know, your diagnosis complexity. So let's say for instance, Scott slipped in his garage, fell on his butt and he strained his back and he's got, you know, pain going into his leg.

So we, we know [00:20:00] just by that clinical picture that, yeah, well, he probably has a radiculopathy or he's definitely hurt his back, strained it, you know, it could be some complexity involved. That would be an acute, uncomplicated or acute complicated situation. Which would be that diagnosis code is complex, you know, so number one would be the problem complexity and the number of those diagnosis is number two would be or the second category would be in this medical decision making model or thinking.

is what, how much data did I have to, as a clinician, go through? Did I order any tests? Did I read any tests? Did I interpret any tests that were done outside of my clinic? Um, do I have a written report on those tests? You know, did I get any, did I have to pick up the phone to call Scott's primary care or, or whoever to talk about his case or a specialist?

That would be the complexity of the data that the clinician has to wrestle with, think about. And this is all done in the same day of the encounter. Okay. The same day as the exam, [00:21:00] the third category is what is called the table of risk. And that would be how risky is my procedure that I do? Well, right away off the, you know, we are a very low risk, uh, uh, type of skill or a service that we provide manipulation, very low risk, very safe and what we do.

So right away, that complexity level is. So then it really depends on the complexity of the diagnosis and the complexity of what we did. If we took x rays, we have a written report for the day, you know, then those two things will drive, if that coding should be a 99202, 203, or 204, depending on complexity, so that's one way to go about it.

And if you, um, if, if that's how you're going about it, then your documentation needs to be on that initial visit. Pretty well laid out. With those things in it so that if it's audited, they can see that, you know, oh, this is a [00:22:00] complexity level that's moderate, you know, which 99203 then is. Fine. The second way to go about it, which is the way that I typically recommend, uh, more so in most cases is time.

And so evaluation management time at that date of the encounter, we're talking about the day that you examine the patient. You can add both the face to face time that you spend with the patient for history, for exam. For report of findings. If it's done on that day. Um, any counseling you're doing with the patient.

If you had to pick up the phone and call somebody about the patient, um, you know, on that same day, as well as non face to face time. So let's say prior to the patient visit. You went through their file and it took you two minutes or five minutes. Well, that gets added to that E& M time. Maybe the patient left and [00:23:00] still on the same day, um, you're documenting in your EHR, you know, for that initial visit.

That could take 8 to 15 minutes, depending on how complex and all that. All of that is time that can be documented for that visit that would then equate into that evaluation management code, whether it's a 202, 203, 204, and there are time increments ranges for those codes, as we know. So that's, those are the two ways to document your E& M and typically.

to help. And you can decide it could be one way for one patient, one way for the other. You know, it's not all or nothing there. It's either or. Um, but it's good for the, for the clinician to figure out, you know, what is, what is really going to be the best option? And then you make sure that you document that time, that total time spent with patient a day for evaluation of management services.

Was 33 minutes, you know, um, and I'll, and I'll throw out these tidbits as well. Um, [00:24:00] it should never be the same number every single time for every single patient. Okay. When, when there's audits that go on, one of the first things that is seen is that how can it be 45 minutes for every single patient that we audited?

You know, so we have to really be careful about making sure our documentation is very authentic and is on the mark. If it was 33 minutes, it's 33 minutes, you know, then go to your chart. Oh, that's a 99203. Bam. It's done. Um, so anyway, but that, that, no, I,

Dr. Kevin Christie: I liked it because that question gets popped up in Facebook groups all the time or questions about it and, and things of that nature.

And I remember when you told me about it, it was a lot more, um, different options, like you said. And then. There's the time one I thought was great, because I think a lot of people think it's just literally when they examine the patient, but they don't realize the report of findings, the notes you're doing, if you're going over ice and [00:25:00] heat instruction, you know, that type of stuff, ergonomics or whatever it all is including there.

So thank you for clearing that up. I want to I want to segue a little bit to Um, I know that like some of the hot targets are essentially like the MPI, the billing, the essentials around the EM codes and everything. What about, uh, I just want to get this off the table too, because a lot, there's so many questions about this.

The ABN form. I know this is for Medicare. What is that? When, who needs to fill it out? What are some of the details around that?

Scott Munsterman: And that is definitely a hot target, Dr. Keller. Um, there, it many times is misunderstood. And then use maybe not right or appropriately, um, the very first thing we do. And when we work with clients, we have them produce their intake form to us.

That's what I asked for. And then I can kind of go through, see what they're, what they're going and remind me, I have a story about informed consent too. I want to share that.

Dr. Kevin Christie: We'll go, we'll go from ABN to informed consent.

Scott Munsterman: Perfect. So anyway, with ABN form, number one, [00:26:00] we want to make sure that it's not expired.

You know, and so in the lower left hand corner of the AVN form, you'll be able to say, be able to see the date, you know, expiration date. It should say 2026. Okay. And that's, that would be the most active one. The AVN form technically and primarily is used for covered services. that are not payable because they may be deemed not medically necessary.

So, right from the get go, that's exactly what the ABN form is for. And so, for chiropractic, the only thing that's covered is CMT 989404142 are covered services if they are medically necessary, found to need that patient is found to have a medically necessary condition that is going to respond to treatment and improve their functional ability.

Okay, and when we and I'll stop there because we could get in the weeds of, you know, what is [00:27:00] the initial visit requirements, you know, and all that stuff. Um, and then when that patient has completed that active treatment has reached the end of their episode of care and they've reached their goals, they're released from active treatment.

And if they, and if it is recommended for them to be on maintenance therapy, then they would at that time sign an ABN form because that covered service then would be not payable. And according to Medicare, they're not going to pay for that maintenance therapy, even though they recognize it. You know, and then it becomes the patient's responsibility.

And so that ABN form is that cutoff point, you know, saying that, okay, this care is not going to be medically necessary. It's for maintenance therapy for you. Um, and these covered services will no longer be paid by Medicare and you'll be responsible. So the ABN form acknowledges to the patient their responsibility financially.

And it releases liability from you that, Hey, you told [00:28:00] the patient, they signed the form and there it is now, um, those services will be in that part D section where you'll say it's, you know, chiropractic manipulative therapy, you know, at X amount is not covered, you know, because maintenance therapy.

Further down in that form, you'll see three options, option one, option two, option three. It's very important to understand that that patient is the one that determines what option they want. Okay, so option one, if they select that, that means that you are going to still file a claim to Medicare, even though you know It's not going to be payable, all right, because you're going to put a modifier, GA modifier on it to say that this is maintenance therapy.

And Medicare is going to deny it, okay, not pay on it, then you'll get that back, that EOB back that says that, but then many times a [00:29:00] patient will take that and go to their supplemental plan or whatever, who may or may not pay on it. But that's what option one is, is that the patient chooses that, you're still sending that to Medicare, patient is paying you because.

You know, it's not it's not going to be payable. The second option Basically says don't bother sending it to medicare. You know, i'm responsible Don't waste your time. I mean exactly like that. That's pretty much what it is option three Um basically says that they don't want the care It's kind of a moot point in my opinion, but it's there.

So anyway, but it's very important that the patient is the one selecting those options. It's their right to choose that. And then of course, signature at the bottom, making sure that, you know, that that is that signatures their date, you know, and it's executed appropriately.

Dr. Kevin Christie: Good. So it's, you know, not for if you've got laser therapy and you charge 60 for laser for that patient, you don't, they don't need it.

And the [00:30:00] Medicare patient doesn't need an ABN form for the laser therapy because it's a non covered service. Correct.

Scott Munsterman: So what's what that's technically correct. Okay. But when you're working with that Medicare patient, um, Medicare has told us that it's okay to go ahead and put those non covered services.

On the ABN form, if we want to communicate to the patient what their full responsibility is, you don't have to, you can, but we do recommend that you have a form that does help educate them, you know, if it's aside from the ABN, um, because then they know what their full responsibility is. You know, under, you know, that's,

Dr. Kevin Christie: yeah, that's what we've done because we do act, we're certified in active release technique and we, we do charge for that.

And so we've just used the ABN form to educate them on that charge. And so they're aware.

Scott Munsterman: So, but I wanted to be very clear on the, you know, technically what that ABN form is for, you know, with the covered non payable [00:31:00] covered services. You know, it's okay. And it's really good to make sure we inform the patient, you know, obviously of what their full responsibility, you know, is financially.

Dr. Kevin Christie: All right. Let's, uh, rock our world with the informed consent. What do you

Scott Munsterman: got? So, um, I get, I probably about half dozen times a year, I am out speaking. And, and what I've found is that, um, whenever we get on the topic of informed consent, In the audience that of my colleagues that I'm speaking to, it's, it's really misunderstood in, in several different ways.

Okay. Um, and it's led me into understanding more and, and even speaking more on patient safety and all that. But that's for another day topic for another day. Another time, maybe. The key thing that we find with informed consent is number one, the form. Does it have everything that it needs to have? Does it cover the risk?

Does it cover the benefit? Does it [00:32:00] cover that alternatives have been talked to the patient about? Does it cover what happens? You know, I mean, that the patient would be at risk if they don't go through with treatment. You know, is it signed by the patient and is it signed by the doctor? You know, and so these are really key elements that, that we talk about in informed consent and that the informed consent, depending on the procedure that you're doing.

is really important to build that informed consent around that procedure. So for instance, um, manipulation, you know, it is a specific procedure that carries risk. It carries benefits, you know, what are alternatives, you know, all of that. Many of the other, um, new, especially newer modalities that are out, you know, whether it's laser or You know, the shock wave, soft wave, you know, all that, um, different types of modalities.

They carry with them with on their own specific types of things [00:33:00] that we need to think about and both from a contraindication perspective and a benefit perspective and all that. And so number one would be the form and understanding what services that you're providing. Really, the next thought is like, okay, what's my informed consent for these services?

So that's really important and making sure that it has the pieces that it needs to have. The second thing, which is just as important, is the process. Yeah, too many times our colleagues and, and, and it's not just our colleagues. It's, it is other healthcare professionals, um, believe that informed consent, if you do it once, then you're done and you're not.

And what's really important is to understand that if there is ever a material change in the patient's condition. And I'll give you a couple of examples in just a minute if there's ever a material change in the patient's condition, whether it's maybe a new region, a new [00:34:00] diagnosis, maybe an injury that could have, you know, compounded something or aggravated, you know, a previous condition.

Or maybe there's a change in the type of treatment that you're doing now, a different technique that's different than what they had before, that they were informed of before. Anytime there's a material change, then an informed consent needs to be provided. Okay? And then finally, if you have a patient that is on wellness, Therapy or, or it's like maybe PRM they're in, you know, a couple, three times a year, you know, kind of ongoing or is on maintenance therapy.

Uh, informed consent should be provided on an annual basis for those patients so that they don't, don't ever forget about. You know, and, and the, you create that opportunity for them, um, to be able to ask questions about what they're providing. In addition to that informed consent conversation, what we're finding is really important to do at that time, um, especially with your new patients, because [00:35:00] they're maybe completely new to chiropractic or they are certainly completely new to you and what you're doing, your technique and how you're, you're operating your methodology.

Is to let them know at informed consent. This is how we do the adjustment or this is how we do this. This is what your experience is going to be. I'm going to put my hands on you. I'm going to do this or I'm going to do that or we're going to use this instrument. But that's the time to really talk about that, what their experience is going to be so that they aren't shocked when something, you know, when you begin treating them and they're like, Oh my gosh, I, you know, they had something else going on in their mind, either from previous experience or something they saw or whatever.

So that's a really important part of the informed consent process as you go through that so that you have that shared decision making element that goes along with it, because it's really at that point that you can find out from the patient what their preference is, you know, I mean, you may [00:36:00] have a wide variety of techniques.

And you may learn right away that Sally is scared to death of, you know, of a certain type of procedure or diversified move or whatever, but it's okay to use that instrument or use, you know, a light pressure or whatever. So, getting that all ironed out and informed consent is really important. So my story is this.

Brought on a new client this year. Did the normal intake work, you know, give me all your paperwork, your intake and, and, and it was a husband, wife team and, and got it. And I went through it and analyze it and I made notes and all that. And I noticed that there wasn't an informed consent form in the production that, that they sent me.

And so I had a face to face meeting, you know, them quite well, uh, with me and I'm sitting across and I'm going through the forms and I got through the forms and I said, you know, I, the only thing I didn't see. Uh, was informed consent and, and the doctor was like, Oh yeah, it's right there. And, and I, and I said, okay, well maybe I missed it because hey, I'm human.

[00:37:00] So I'm going back through the forms. There's probably one of 20 pages and he's like, it's right there, you know? And, and, and I said, well, I said, that's your HIPAA authorization form.

Dr. Kevin Christie: Yeah.

Scott Munsterman: And he just turned white as a sheet. And he's like, Oh my gosh. I haven't been giving informed consent to my patients all the time.

He thought that was his informed consent form because he didn't, you know, it was there, it was a form, they signed it, you know, and. And there's stories, I can tell you all kinds of stories about, you know, how things can get missed. And so, very important, the form, match to your services, make sure the form has those key elements in it, and then the process.

And the process, that new patient, any material change in the patient after that, it could be three months later, you know, and the patient's in and they have something different, um, or that [00:38:00] ongoing, you know, maintenance therapy. Um, the last story I'll tell you is that, uh, right now I'm involved in a program, um, and, and I'm, I won't get into it, but.

where I've been doing, uh, a lot of reviews of case studies in malpractice cases. And, um, and the analysis that I just shared this week with that carrier is that, uh, whenever there is a gap of care, uh, with a patient, so let's say Scott comes in, we treat him, six weeks later, he's good to go. Six months later, he comes back.

And it may be for something similar or something different or whatever. What we've learned through our initial review of these case studies is that gap in care many times eludes providers. Um, and maybe even because we've seen Scott before, it was a slow back before, you know, it's the same thing, you know, whatever.

Um, half the time the [00:39:00] doctor evaluated the patient, the other half of the time the doctor didn't following a gap in care. There were no informed consents provided, you know, and, and the doctor missed a material change. Um, and there are some key indicators that should be red flags, which we can cover at some point.

But the point being is that that informed consent is a very important part of patient safety. And there's things that have to occur prior to us knowing we need to give it. And one of those things is recognizing material change in our patient's conditions. And so I just, as a red flag, when that patient comes back, following a gap in care, it could be two months, it could be three months, you could have released them a month ago, and now they're back again.

That should be something that clicks in your mind that says, okay. You know, let's take a look. Let me, let me, let's do another deeper look at this, you know, because is there something going on that the [00:40:00] patient is going to be experiencing adversity, adverse event that could be underway. And yet we're not able to detect that yet and that we should be aware of that.

So, so anyway, I just wanted to share that because. It's a part of that informed consent process that makes us know that we need to do an informed consent is when we love it.

Dr. Kevin Christie: No, that's good. And I know there's a lot to informed consent and that kind of really gives us a good understanding of a lot of the forms and all that.

I want to segue just a couple quick topics on different aspects of compliance. But obviously hip is a whole beast in itself. I just want to have you briefly discuss. The, the business associate agreement, uh, who needs to sign that and what that is. And then we'll kind of go to the third kind of, in my mind, and I know there's more to it, but just overall, like compliance training and the value importance of that in a, in a business.

But let's start with the, the BAA and we'll go from there.

Scott Munsterman: Yeah, great. So business associate agreements, um, [00:41:00] anytime that. that we have determined that we have outside entities. These are people that are not our employees, but people who do work for us. For instance, like a biller, outside biller that you're outsourcing to, your EHR company.

Anybody, uh, consultants like myself that are helping you with the program, may do audit reviews or that type of thing. It's important to have a business associate agreement. And that business associate agreement essentially says that, Hey, Scott, you're going to do this work for me, and I'm going to give you the minimum PHI that you need to get your job done that I need you to get done for me.

But you, you, the business associate, are agreeing to Uh, keep that. PHI secure and you're under the same rules that I am. You the covered entity. Um, under HIPAA. Because they are so basically that [00:42:00] agreement is very important. That says that, look, I'm going to give you this PHI. You know, Mr. Consultant or, or, you know, uh, billing person or whatever, um, and you're agreeing to keep that confidential and that you're going to use the same, uh, protections to, uh, prevent any disclosure or inadvertent access to that PHI, um, and they're held under HIPAA law, just like you are the covered entity.

And so that agreement is very important. And, and if you haven't had an updated agreement since probably, I want to say probably 2015 or 2014, you should have that updated and then, you know, re re have that sent and signed by, you know, those folks that you are doing business with. And so for instance, even like your.

You know, if you're storing your like with your EHR could be cloud based, or maybe you're having it backed up on the cloud and you have a server base. You know, these are all considerations that you need to to [00:43:00] keep in mind. So yeah, thanks for bringing that up because that's another one of those mechanical things that can go overlooked.

Dr. Kevin Christie: Yeah, absolutely. And there's a ton to HIPAA. We could obviously do a whole other episode on HIPAA alone, but I just wanted to make mention of that, but our audience needs to realize there is a lot of compliance around HIPAA that we know about. And so we've so far talked about a lot of compliance around billing, coding your documentation, uh, your forms.

Then there's the whole compliance around HIPAA you got to consider. And then one of the things we're doing right now in our clinic, as we record this, it's in December of 2024, it won't come out until early 2025, but we're doing our annual training, each of our team members, uh, through your program and, and going through that, uh, now.

Is compliance trainings and screenings and things of that nature, is that something that we, we have to do as a clinic or is it a nice to do, uh, as a clinic? What, what give us the, the scoop on all the [00:44:00] different, um, monthlies and quarterlies and yearly annual training around this stuff?

Scott Munsterman: Yeah, you bet. So there are annual, uh, training requirements federally.

So there, it's annual training required as, uh, training is required for HIPAA, for OSHA, for fraud, waste, and abuse. And then most recently this year, as you know, uh, we had the non discrimination health care law that came out, um, uh, which included under sexual discrimination, sexual orientation, and gender identity.

And so we created a training, you know, program for that. But those are the four. annual required training, federally required training that need to be done. Now, from the OSHA side of it, bloodborne pathogen is typically where I'd like to see the focus of of the health care. And so we build out our annual training more towards blood borne pathogen and airborne pathogen, um, as we've had the experience with [00:45:00] COVID over the years, um, and then building any safety or any other pieces around that, uh, with HIPAA, typically anything new that's come about within the last year gets included in our annual training programs to bring, you know, our clients up to speed and their staff, um, as well as some, some of the basic elements and then fraud, waste and abuse.

You know, typically that's pretty standard and, and that's required as, as, uh, practices that are enrolled in Medicare and, and other commercial, you know, payer programs. Um, you know, our other training that we do for our clients typically, um, is through what we call micro learning modules. And we've been doing this for, That's over a decade now with our clients.

Um, in a couple of years ago, the Department of Justice actually made a comment in one of their publications that micro learning is probably one of the better ways to learn and teach, you know, compliance and, and they're just primarily that two to five minute, um, quickie on here's how you do this, or here's how you do [00:46:00] that.

And we release those a couple every month to our clients on very key things that are just basics and they just help remind, um, remind staff and providers how to do certain things. So that's another element of kind of helping build knowledge base. And then the third piece is the role based. You know, so if you have a specific role, you know, billing or whatever, that you can, you know, give that individual more knowledge.

Um, in the chiropractic industry, as we know, many times we hire people that have not necessarily been in health care, but they have a great skill set. They're great people, personality. They're a great fit for our practices, but they don't know the first thing about health care, really. And so we have to begin with them.

And so we've developed programs that help bring those people up to speed on what it's like being in a health care facility. You know that, hey, we have this thing called HIPAA. You know, we can't talk about certain things. We have professional boundaries. We've got, you know, a number of things that just need to be learned.

And, and [00:47:00] so those are, are on the training side, not necessarily required, but, you know, important to, you know, stay compliant in certain areas of your policy. But the annual required training, HIPAA, OSHA, fraud, waste and abuse and non discrimination health care. Those four are federally required.

Dr. Kevin Christie: Love it.

This has been great information. You know, I just want to, you know, challenge our audience. I know it's not always, um, the most fun and exciting thing to, to work through and provide leadership to your, to your team and your business. But once you have decided to. Uh, be a business owner of a health care clinic.

You, there are certain things you've signed up for just like having to do your notes and pay your taxes. Uh, you've got to lead your team on compliance and you know, don't, I think some people feel guilty about. Like the fact that they know it's like they're not necessarily keeping up with compliance or not doing anything about it is never too late.

You know, [00:48:00] it's, it's, you know, you put in the effort, you'll, you'll get there. It's not gonna happen overnight as I've seen, but we've made quite a stride, you know, strides in the last 678 months. So it's been really good. Um, how can our audience find out more information in the name of your business and how they can reach out to you if they're interested in getting this compliance training going?

And that's the thing, just, uh, To kind of leave you with this before we do that is, um, you know, part of the leadership is delegating. Part of delegating is finding experts that, uh, necessarily they can, you can actually attach them to your business. Like I have with you, um, to, to essentially become our compliance team and, and officer.

And, uh, it's been, it's been, you know, peace of mind to, to get that done. So how can they find out more?

Scott Munsterman: Well, um, you can just reach out to us, go to our website, chiroarmor. com and you can You know, shoot us an email and say, Hey, I'm interested in a demo. We even have like calendar links that make it easy for you.

You can click on that. You can find a date that [00:49:00] works for you. And it automatically creates a zoom meeting. Um, and typically what happens is that one of our, uh, folks on our team, uh, We'll reach out to you right away and, you know, introduce himself or herself and, and then, you know, work up to the point where there's a demo and many times I'm involved with that, not all the time, but many times I am.

And, and then just giving, you know, the, uh, doc a good idea of what. Program that, you know, they, or he or she feels best. Um, and our clients range from those that have been in practice a long time, like myself to those that are just starting the practices, you know, and so it's just really a wide range and, and gosh, we just, we really enjoy what we do.

Dr. Kevin Christie: Yeah, no, you definitely do and passionate about it. And one of the other things that was nice to work through was a whole employee handbook with all the specifics we wanted to do. And we had a unique scenario of our first employee, um, taking maternity leave. So we even worked through some of that and [00:50:00] getting that in there.

And then obviously a full compliance training manual and the whole nine yards. So, uh, feeling good about that. And again, thanks for your time today, doc.

Scott Munsterman: Yeah, thank you.

  EPISODE 409: 10 Disciplines to Maximize Your Freedom, Energy, Creativity, Impact and Inner Peace with Gino Wickman

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] All right. Welcome to the show. I got Gino Wickman with us today and excited to dive into something that you may not be expecting if you're very familiar with the book traction and EOS, but we're going to dive into a, a very deep topic today. And that is from the book shine, but Gino, before we really get deep into it, tell us how you bridge the gap from, you know, the business world and really dive into that over the last few decades here into now, shine and, and talk a little bit about that book and let's, let's dive into it.

Gino Wickman: Sounds great. Well, let me start by saying, Kevin, I'm thrilled to be here. And I hope that we will make a huge impact on your audience today. So I'm really looking forward to this conversation. And on your question, what I'll do is I'll just start by creating a context, which tends to help everybody understand the big picture.

Because first and foremost, I am a guy who is obsessed about helping entrepreneurs. Okay. And so now let's take that word. And let's talk about your audience of chiropractors. who [00:01:00] are doctors, but they are business owners. And so what I hope to start right out of the shoot is to shift their mindset that in this conversation, they are not doctors, they are business owners, i.

e. entrepreneurs. And so if they started that darn practice or inherit it from someone else, and they're growing it to the next level, they are entrepreneurs. And so my life is entrepreneurs and I have created five. Pieces of content in the world to serve and help entrepreneurs get everything they want out of their business and lives.

And so very quickly, those 5 pieces of content are entrepreneurial leap for a person that thinks they might be an entrepreneur, but aren't that yet they have not taken their leap. Or they're an early stage entrepreneur. Then there's rocket fuel for when that visionary entrepreneur needs to find their integrator counterpart to take the business to the next level.

Then there's traction and EOS when they're ready to run their business like a Swiss watch. Then there's EOS life for when they're Ready to live their ideal life and then there's shine, which is what [00:02:00] we're going to talk about today. And that's the opportunity to really take it to the next level, implement 10 disciplines in their life to really maximize their energy impact and inner peace.

And then three discoveries for really going deep and and doing some inner work to find incredible inner peace. And so The reason I start there, and I know that's a mouthful and a lot to follow, uh, if you go to ginowickman. com, it's all there. I don't feel like you have to absorb all this, but the point is I meet an entrepreneur wherever they are on their journey.

And what we're going to talk about today is advanced stuff. Because if you think of those five pieces of content, That's really the entrepreneurial climb and what happens for most entrepreneurs as they get to the top of the mountain, they achieve everything they thought they wanted to accomplish, and they thought that they would find that inner peace and satisfaction.

But a lot of them are left feeling empty. And so we're gonna touch on that. And then we'll dig into We'll touch on the 10 disciplines as well. So what led me to that is I am my content. In other words, I teach what I needed [00:03:00] the most. And so when I sold the OS worldwide, I was in that same place where I got to the top of the mountain accomplished every Entrepreneurial goal I had for myself and found myself feeling a bit empty.

And so I did some inner work and inner soul searching. And so there's kind of the jumping off point for what got me here and helping all these entrepreneurs. And then I watched it in so many that I was just kind of pinged to create this content with my coauthor, Rob Dubay. And here we are on this podcast talking about it today.

Dr. Kevin Christie: Yeah. And I really wanted to dive into it because I, you know, I know that Being an entrepreneur is hard no matter what industry you're in. I feel like being a healthcare entrepreneur or a doctor that owns a business, it has a whole other level because when you're caring for people, that takes a lot out of you.

And if you've got some stuff you got to work through, it can impact that. And then you got to put on a different hat and [00:04:00] obviously be an entrepreneur and business owner. And it can be a big struggle for folks. And I do see a lot that end up Um, doing well, right? They do well on all things, right? They all levels of quote unquote success.

They have the things and they've made the income and kids are doing well, all that. And they're just not satisfied. And I get them calling me, uh, I'm 45 years old. So I'm like right in that sweet spot of midlife crisis time. Right. And I get a lot of, uh, docs that reach out to me. It's like, ah, you know, we're.

Revenue is great. All these are great, but I'm just not feeling that. And I'm not an expert in this type of stuff. And I want, I always like to extract out that what I can for people that have that kind of been to that journey like you have. And so I, I appreciate you, uh, with this book as I read it when it came out and it really opened my eyes for some of it.

So I want to dive in, uh, to start out with is the, we're going to, we're going to go deep here. And so the three discoveries to. to really free your true self. Can you [00:05:00] start with number one and work our way through with that?

Gino Wickman: Absolutely. And so again, I'm always a fanatic about creating context, you know, so the audience is following us.

And so that first big piece of context was the five pieces of content. And so now we're going to piece of content number five shine. And I want to create kind of a mini context around shine, because what we're going to do is we're going to go into the three discoveries to free your true self right now.

But what I want to prepare your audience is the second part of the book are the 10 disciplines to maximize your energy impact and inner peace. And what's important to know is when those 10 disciplines are embedded in your life, it creates space and time for you to really dig into these. Three discoveries, but I always like starting with the three discoveries so that they understand the big picture in the context and what's possible.

And so I also try to help clear up any confusion. There's so much terminology. You know, it's like I'm trying to make it make sense as fast as possible for your [00:06:00] audience. And so the three discoveries. I'll start high level what they are and then we'll do that drill down you asked for with discovery number one Uh, but again the three discoveries to free your true self And so discovery number one is the discovery that I am driven and understanding you're driven We'll come back to that in just a second discovery two is understanding that all decisions Are made out of love I'm sorry, love or fear, all decisions stem from love or fear.

And then the third discovery is that it is possible to be driven and have peace. And so I always love to give the high level just so you can kind of see the journey that happens, but starting with driven, and I go back to that point I made a minute ago. chiropractors out there listening, these doctors, you are business owners.

In my mind, first and foremost, you're a business owner. You're an entrepreneur and you are typically driven. And so we driven entrepreneurs, business owners out there, it's a blessing and a curse. And I call it a [00:07:00] discovery because the idea is to really know yourself and realize, wow, I am a driven person.

And the blessing and the curse is that the blessing side is we create more than most. We are superhuman in terms of our energy and the way that we create things. We are about 5 percent of the planet. So it's, it's very unique and rare upwards of 10 percent different studies, but for a visionary driven entrepreneur, there's only 4 percent of us on the planet.

And so what's important to understand is you are an alien. 96 percent of the planet is not like you. And so it's realizing that the curse side is we do a lot of damage. We do a lot of damage to our cells, our bodies and the relationships in our lives because we just leave a black trail behind us as we build what we're building, building.

And so it's just a matter of understanding that and that driven DNA that we have. It's been with us our whole lives. It gets us in trouble and we make [00:08:00] mistakes and we do things and it causes trauma. And then all of a sudden we've created pain in our lives and we're trying to mask this pain through addictions and trying to just hide from the world what's really going on on the inside.

And so Again, discovery number one is just realizing I am driven. It's a blessing and a curse and understanding all the blessings and all the curse so that now I know what I am and we can move to that second discovery.

Dr. Kevin Christie: Yeah, that's a, that's a big one. And I think, um, you know, sometimes I'd love your thoughts on this a little bit of a sidebar on it, but you know, there's a low percentage that are on for newers.

Um, and I think as a chiropractor, a lot of them, Become practice owners, and maybe they aren't naturally in the entrepreneurial, um, you know, spirit of things, but they're kind of forced into that. Um, and that becomes a whole other layer for them. They are driven, but maybe haven't had the tool set to do [00:09:00] it.

But that's where some of your other content comes into play to help with that. Is that correct?

Gino Wickman: Yeah, I appreciate you saying that because that's why I give the big picture context because if we're sitting here talking to entrepreneurs about entrepreneurs and you're an entrepreneur, it's hard not to kind of go back to some of that content.

And so my entrepreneurial leap content, that's a book that I wrote called Entrepreneurial Leap. There's also a website e leap. com where there's an assessment and you take this assessment. And so a true driven entrepreneur has six essential traits. Visionary, passionate, problem solver, risk taker, responsible, and um, um, problem solver.

I think I left out there, but the point is. That is the DNA of an entrepreneur. And that assessment, if you simply take that assessment, you're going to get a score. And if you score 90 or higher odds are really good that you're an entrepreneur. And if you don't, it's a great awareness tool to really know thyself.

And if being an entrepreneur is right for [00:10:00] you, because not everybody is meant to be an entrepreneur. So yeah, I appreciate you. calling on that content to help someone out there that if they're really struggling building their practice, they may not be an entrepreneur, i. e. driven entrepreneur, visionary, business owner, et cetera.

Dr. Kevin Christie: Love it. And then what are some of the pitfalls you see of these driven folks where they really are a hard charger? Um, what are some of the things you see, unfortunately, in this crowd?

Gino Wickman: Well, again, it's that black trail that I talk about. They just tend to do damage to both themselves and the relationships in their lives.

And so the way we do it to ourselves is we are just so amped up, you know, like I have a heart issue, you know, I have a blocked valve. Fortunately, it's going to be manageable. I don't need to stand in like that. But my doctor is convinced it happened to me in my 20s when it was so intense in my 20s. And so we do damage to our bodies.

We create disease in our bodies with this intensity where we just [00:11:00] go, go, go. And then again, with relationships, you know, There are a lot of divorce driven entrepreneurs. You know, there are a lot of friendships that have been destroyed employees that we burn through and burn out. So we do a lot of damage with relationships.

And so again, by zooming out and understanding the awareness of that. You're able to then really address your driven nature, manage it well, and then maximize it.

Dr. Kevin Christie: Yeah, and I hear that a lot from chiropractors where they do have a lot of turnover, because it's typically an intimate setting of employees, right?

3, employees, it's not 200, so you're kind of a close knit group, but they have this consistent turnover, and to your point, that could be part of the problem there. Yeah. And then

Gino Wickman: also, you know, this is why I always like to give a glimpse of what's coming in our conversation, because remember, these are discoveries we're talking about.

And so if you're out there going, what, wait, how do I solve this? Slow down right now. We're just talking about you discovering [00:12:00] this because we need you to discover it first. And so remember, discovery three that's coming is that it is possible to be driven and have inner peace. So it's coming. And then the 10 disciplines are the tools that you embed in your life to help you.

Be driven, have that inner peace and maximize your life as a driven entrepreneur. I

Dr. Kevin Christie: love it. And then moving on to number two, decisions are made out of love or fear. Uh, talk about that a little bit. Yeah,

Gino Wickman: for sure.

Dr. Kevin Christie: I would love to. This is my

Gino Wickman: favorite one of all of it. This is probably my favorite part of all the content.

And I'm going to let you be the gauge of how deep we go here We could go eight hours into this content. Okay. So I'm going to give you like the really high level version of this. And then you let's go wherever you want to go. You know, your audience better than I do, but it just starts again. It's a discovery with you out there, realizing that all decisions are made out of love [00:13:00] or fear.

And so every decision you make. But also thoughts, emotions, feelings and decisions. But let's just call those decisions. Every decision you make when you make it, it stemmed from love or fear. Now let's take those two words, love, fear. If we take it a level deeper, love, fear, love. Is coming from your true self.

Okay. And so we use the term true self in this book, but you can call that whatever you want. You can call that soul, you call that spirit, you call that heart, but it's coming from your body, your soul, your spirit, i. e. true self. So that's love. Fear is coming from your ego, your head. And so if you understand that context, And you now create awareness in your life as you go forward, you're going to start to see clearly whether the decision was made from love or fear, true self or ego, and you will start to discover how [00:14:00] hijacked.

You really are by your ego and what we will find, especially as driven entrepreneurs is our ego is in control and has our true self trapped in a prison and most of our decisions in life have been ego based, fear based, and we've built this structure in our lives, this protective layer to protect us from ever feeling the pain that we felt in the past.

And so we put on the suit armor, we go forward, and it's just a series of fear based decisions. Now, all that said, in that state, you will build an empire. You know, if we go back to the four pieces, the first four pieces of content I created, that's going to help you build an empire in your outer world. I'm just now trying to help you see this amazing discovery so that you can build it.

enjoy it with having inner peace because in the state that I described with your ego, having you hijacked and you trapped [00:15:00] behind that suit of armor, it is not a peaceful place in there. The tectonic plates are shifting. And, and, and so there's the jumping off point in terms of discovery number two.

Dr. Kevin Christie: You know, and I, in my personal, uh, I should say professional development in life, I've been practicing for 20 years now and I heard a person say on a podcast once, and I forget who it was, but he's like, you know, the first half of your life you're kind of building that vessel and in the second half of that life you're filling that vessel, you know, and I 26 years old when I graduate from school, and then you work for someone and I'm not sure if I'm gonna be able to get outta that.

And, and I got into a partnership and then opened my own practice. But a lot of the decisions I made at that stage were for me. Fear base. I had a lot of fear around. Am I going to be successful? Is this going to work out? Am I good at what I do in it? But it did motivate me and definitely had a lot of drive.

And I look back now at 45 where I'm kind of, I've kind of built the vessel now, you know, and now I'm [00:16:00] into that stage where I'm trying to Fill it. And I look back on, on my younger self, and it's kind of a catch 22. It's like I wouldn't want to change too many things, but I'd left a, a black trail for sure.

Um, and there's no doubt about it. And so, uh, it's not wanting to regret things, but. Uh, it was something that I was very fear based and now I'm starting to recognize that and I think I'm developing some of the strategies like your 10 disciplines here to, uh, let's change that. Let's get out of that ego and let's try to do that.

And then one other thing I want to kind of tie this to our audiences. Uh, when you're when you're based out of fear too much and maybe it's professional life, personal life, you're going into that patient treatment room and you are not able to be the best version of yourself for that patient. And one of the things we talk about a little bit is that present [00:17:00] time consciousness with that patient and focusing on them.

And that's what you have to do as a doctor. That's what's so hard is that we have to go into a room and we might have to do that 30 times in a day and be there for that person and out of love. You really want that to be, but we're going in there out of fear of like my payroll is struggling. You know, I've got this going on.

I'm burned out. I'm thinking about, um, you know, The the next hire someone just left the practice and so we we deal with that a lot and that that one for me When I read your book really resonated And I was able to reflect back on the the level of fear that was driving me, but it definitely helped me build something

Gino Wickman: Yeah, and and on that, you know, and again you rein me in if we're going too deep and you've got to manage a clock Here, but you know, I want to first of all make it clear Everything we're talking about is in the book Shine, and I go really deep.

My co author and I, Rob Dubay, go into this really deep, so the [00:18:00] answers are all there, but I want to take you all the way to the end game on this one, just so everybody understands the hope here, because the idea is once you realize this dynamic, Love, fear, true self, ego, the prison that your ego has you trapped in, the protective layer you created, you can shed all of that.

That's what it's all about, is shedding all of that. And I take you through a process where at the end of that process, through awareness, as you said, consciousness, just simply being aware, you'll start to make a shift. From fear based decisions to love based decisions, because you'll start to go to the root of where the fear is coming from, and the fear is a protective layer from some pain from the past that it's important to address if you want to shed all this and experience peace.

But two things number one. If this is scary, just keep working on your outer world. Just keep implementing this content to help you build a great company. Your soul will ping you at the right [00:19:00] time. And what we know is somewhere on your journey at the top of that mountain, you'll confront this stuff. Your, your, your soul won't let you not.

But the power of this is we're trying to help driven entrepreneurs start this as early as possible in the process, because, you know, I know I couldn't go back in time, like you said, at 27 and maybe do this work, but it's becoming so much more. You know, mainstream and the awareness is out there that I think we're going to start seeing more and more 2022 25 year old starting businesses that are confronting this stuff in the early stage so that they experience peace on that whole journey of climbing the mountain, unlike what you and I had to do is experience a whole lot of pain for 20 years and then get pinged that it's time.

But here's the worst case. Worst case scenario. You know, Start your business, build your business, implement the [00:20:00] first four pieces of content, build an empire, achieve all those goals. And you're sitting there at 50 years old or 60 years old, then confront it. Then at least you'll, when you leave this planet somewhere between age 80 and 120, at least you will have achieved, you know, both being driven and have peace, but the sooner you can start the better.

And so I urge you to start today.

Dr. Kevin Christie: Yeah. No, I love that. And, um, what age, if you had to say that you really started to confront it for yourself?

Gino Wickman: Yeah, it's really interesting. Something just happened to me in the last two weeks where I, I, I found the age. So what I would always say is, you know that I got pinged right around age 30.

And so I've been dabbling with this, dancing with this since age 30. I'm 57, so for the last 27 years, and there's no question. I've been using the term shedding layers for decades now, that I've been shedding layers during that time, um, putting a little bit of a dent in this. Um, but for me, it was age [00:21:00] 52 after I sold EOS Worldwide, two years after the sale, sitting in my living room, celebrating my success, and then the universe hit me over the head with a sledgehammer and said, no, no, it's time to wake up.

So it was a massive, the last three to four years was a massive shedding that went on. So it started for me at 30. But what I found is a couple of weeks ago, a poem I wrote, uh, I literally read this on one of our podcast episodes. I wrote it at 29 years old. It was called the facade and it was all about shedding the facade.

So I think that. It was right around 29 when I really started to realize there was more going on than just this outer world stuff. That's there's some inner world stuff that I need to address and the suit of armor, the Teflon shield that I'd created was so thick and strong that it's time to start shedding that damn thing because I was not the real me.

Dr. Kevin Christie: Love it. Love it. And then that takes us to the third one, which I, I really, uh, really [00:22:00] resonate in. What is that third one?

Gino Wickman: Yeah. And so the third one is that it is possible to be driven and have peace. And so now you follow this bouncing ball, these three discoveries. The first one is the discovery that you're driven and the blessing and the curse.

And in that discovery, you thump your chest certainly on all the blessings, but you beat the shit out of yourself with all the curses, right? So you're like, it's almost like it's kind of a bummer to realize and realize all your addictions. Okay. And so. There are addictions and those addictions are there to soothe and numb us from feeling the pain.

And so that's kind of a bummer. Then you get to the second discovery and you realize, wow, there is a process for me to shed, for me to go to the root of what it is I'm trying to numb. It's that thing that happened at age seven for you. And then maybe something happened at 12 and God knows what else, but you start to confront and shed all that stuff.

And you can shed it. We give you 30 ways to shed it in the book. Now, all of a [00:23:00] sudden, but again, that's still pretty scary. So then I take you to the possibility of the discovery, which I hope you will discover sooner than later, is that it is possible to have this incredible drive that is a blessing and a curse, but experience peace.

So I always put my hands under my chin and I talk about the tectonic plate shifting. It is possible to feel incredible inner peace and not that uneasiness in those tectonic plate shifting. And so it is possible. And so in that discovery, and certainly it's the 10 disciplines, as we keep alluding to that are going to help you get there and help you maximize this inner peace.

But I want to say a couple of things to this, because what also happens for us driven entrepreneurs is the thought of peace terrifies us, or at least it terrified me because what I thought was going to happen is if I ever found inner peace, it would zap me of my drive. It would zap me of my superpower.

It was, I literally thought I would lose everything. And the first time I got pinged with inner peace. was when my [00:24:00] daughter was born. I was about 25 years old, and the moment she was born, I felt the most incredible peace, love. I mean, it was indescribable what I felt, and it lasted about an hour. And then I stuffed it back down because it scared the living shit out of me.

It felt wimpy. It felt weak. I literally thought I was going to lose everything. And I just put the Teflon, you know, I put that suit of armor right back on. And then two, three years later, my son was born. I felt that again, briefly for 30 to 60 minutes, I stuffed it back down. And so, so with that, it is possible.

Fear that comes with that for us driven entrepreneurs, but the realization that happens when you do this work is the realization that holy cow, I can be driven, I can have that piece and not only is my drive going to be just as powerful, it's going to be more powerful because what happens is [00:25:00] your whole life shifts.

To an inside out approach to the world, no longer an outside in approach to the world. And the outside in approach is again, when your ego's running the show and you're weighing every decision based on competition, comparison, judgment, you're worrying about what everybody else is going to think about this decision.

All of a sudden inside out says, all I care about is what my true self, what my soul wants, and you will make better decisions. From the inside out than the outside in. And that level of energy is immeasurable. And then that maximizes your drive. And it literally, I don't know the number, but at 10 X is it a hundred X.

I don't know what the number is, but I'm experiencing it. So I can speak from experience and, uh, can tell you it's a lot more than what it was.

Dr. Kevin Christie: Yeah. You know, and it's interesting when I remember reading that part of it, cause what I found for myself when I reflected upon it was that when I would hit [00:26:00] certain periods of inner peace, I would almost feel like, okay, I'm.

I'm being too lazy or I'm not working hard enough. And then I would, I would cover it up by layering on more drive to it. Yeah. So like you said, and so I almost looked at it and was like, Oh, I can't be at peace here. Like there's gotta be something I need to be doing. And, uh, that was a big, big awakening for me, for sure.

Gino Wickman: Huge, huge. And I will say this, you know, so in no way am I saying I've got it all figured out and I'm enlightened in other. And I think about like the scale of zero to 100 percent where there's no way to measure this, but let's pretend, you know, 100 percent is where your true self is fully free. In other words, your soul is free.

Your ego has dissolved it. That's 100%. You know, I don't know if I'm at it. 1 percent or 100%. I'm on this journey with everybody else. And I love sharing the journey and being on this journey with people. So I don't know if I'm at, you know, 10 [00:27:00] percent 90 percent 50. I fear that I'm at about 1%. But I will tell you wherever I am, it feels a hell of a lot better than it did four years ago.

And so it really is a journey because it's this process of again, that awareness was that love based or fear based, realizing it was fear based. Chasing down with the root of the fear was feeling a sensation in your body that does not feel so good and pain comes up from the past, releasing whatever that was, and then all of a sudden you reach another level of freedom because that's another layer that got shed.

Your ego has dissolved a little bit more. Your true self is more online and leading. And so anyway, so there's the process. So where I am, I have no idea. I'm not, you know, saying I'm enlightened and we're all just, you know, on this journey together,

Dr. Kevin Christie: but it's like a golf game, right? It's like, you know, I might not be able to get to a, uh, single digit handicap, but if I can go from a 15 to a 12, I feel good about that.

And that's progression. Would you say that what you found with this work and with working with folks is that. Once they see [00:28:00] progress, that really helps give them some momentum and they feel better and more at peace in general. Even if they go from 10 percent to 20%, it's not necessarily about getting to 100 percent tomorrow, but just seeing the progression, they're doing a lot better.

Gino Wickman: Absolutely. And I would say two things to that, you know, I don't know that the golf analogy is the perfect analogy because what's different about this is you can become a scratch golfer. So what I would suggest is that your true self. Your soul wants to be free can be free. You're the only one stopping.

In other words, it came into this planet. You were born it. You were 100 percent pure and free. I mean, you were your innate self. And then the world got a hold of you. And unfortunately, you built all those layers. So The beauty is you can get to 100%. It's just not easy. Number two is yes, it's all about progress, and it's taking these steps.

And then we describe all the steps, you know, in shine for you. But it's, it's [00:29:00] realizing where the fear is coming from feeling that pain. Releasing what it was. Sometimes you're forgiving someone. Sometimes you're forgiving yourself. However you release and let it go. And then, yes, feeling that peace and that sensation.

And it's a process of just shedding all that stuff. And the, the realizing where the fear based decision came from and chasing down that pain. That part, there's nothing enjoyable about that. But having that experience shedding it and that elation that comes after. There, there then is the feeling of wow, progress because it's all about expanding and what happens is we expand, we contract, we expand, we contract, but you're always expanding.

It's like three steps forward, two steps back, three steps forward, two step back, and it's understanding and feeling the pain and the pleasure and understanding we have to feel the dark to experience the light. And so all of a sudden you realize it's just this, this kind of it. [00:30:00] flow that you're in, but it just keeps getting better and better and better and better.

There's always going to be challenges in life. There's always going to be things to face, but you just get better at dealing with them as you shed that stuff from the past. That's holding you back.

Dr. Kevin Christie: Yeah. And that's where I want to, you know, I, I come, I came across this, um, Whoa. And I, and I heard it on a podcast and the person that said it didn't know who came up with it.

So I can't attribute it, but I, it just seemed very apropos to knowing that I was, you know, uh, going to have this interview with you, but quote, because life is suffering, you need to pursue meaning that justifies that level of suffering. Um, and I don't think people have to suffer in a sense, but what it's saying is that like, life is hard, right?

You're going to lose family members. You're going to. You're going to have bad days. There's going to be things that happen to your kids that you don't, don't want. And you got to be able to, to navigate that. And I think having that meaning and maybe when some of your meaning is just covered [00:31:00] up with a bunch of the crud.

And once you get down to it and really start to understand yourself and your true self, you're able to maybe manage those obstacles a little bit better. Would you agree to that?

Gino Wickman: Yeah. And I, you know, I would say this first, the funny thought that's coming to me is if you would have told me five years ago, I'd be having this conversation on a podcast, you know, Mr.

Business guy, hard charging, you know, the suit of armor, I would have, there would have been a fist fight. Okay. So it's so funny that we're, it's amazing that we're having this conversation and now I'm having it, you know, daily. So, yeah. Hallelujah to that, whatever that means. Number two is yes. And I would say what you said, I'd say it a different way, but it's the exact same thing because there's so many different ways to say this.

And, and words can't describe this. Once you know it, you know, truly in your true self, once you know it, but it's like, Life happens. And the best way I heard that is a saying that says, [00:32:00] see life as it is. Okay. And it's like the matrix analogy. What happens for most of us is none of us see life as what it really is.

We made up a story. We have ourselves so fooled and we're trying to control every aspect of life. And we really think we have control of life and you don't. And so, yes, people come, people go. People die, people are born and it's tough. So life is hard and business is really hard and the less you can attach yourself to all that hard stuff and just kind of float above it and observe it all and see life as it really is.

What you realize is they are all lessons. That just keep helping us evolve and grow and ascend, and I just love that word ascend, but it's growth. It's like what I realized my whole life is I'm a grower. I just want to learn. I've been through so much. I've gone through so much. I keep growing. I mean, I'm a, I barely graduated high school with a 2.

3 GPA. I did [00:33:00] not go to college. I was a derelict. And so when I look at all of the learning and growing that has gone on, I'm just here to grow, but it's like, We're all here to grow. And so if we can kind of rise up above that stuff and see life as it truly is, they're all lessons. They're all here to help us grow.

We're all getting our own lessons. And so I hope you see the connection to what you said, because that what I just said is exactly what you said with a different set of words. But at the end of the day, there are no words to describe this thing because it's all just a knowing once your true self and your soul really sees it.

Dr. Kevin Christie: Yeah, I love it. And one of the things I always appreciate, appreciate about books is when they, they give you a lot of the deep stuff and contextual, sometimes theoretical or the research or whatever, but then they transition to applicability and actual strategies that you can do. And that's what you did in this.

This book and we obviously won't be able to dive deep into all of the the 10 disciplines and people can can pick up the book to do that and it what I loved [00:34:00] about as you went through the the 10 and i'm just gonna have you kind of Share the the 10 and and kind of the the overview of that one But in the book there's actual description of the benefits of this, the actions to take for it, and how you can really actually, you know, implement it in your life.

So let's start. What's, uh, what's the first discipline of the 10?

Gino Wickman: You bet. And as always context, I'm going to bring you back to kind of a mini context here, but, you know, I want to, as we go into this, as we come out of the three discoveries and we go into the 10 disciplines, you know, this, I, there's this thought that always rings in my head as I think about your audience, you know, I think about.

They're all sitting going, what does this have to do with business? You know what, this conversation you and I just had for the last 30 minutes, like, what does this have to do with business? And my answer is always everything. I mean, this, if this is grasped, your business will be better. You will be a better entrepreneur.

And I just want to share. What my family, friends, co [00:35:00] workers have said about me as a result of this work, because this is my wish for all of you out there. And then we'll get into the 10 disciplines for how to do this. It's I'm told that I'm more calm. I'm more patient. I'm more loving, open, freer, happier, more present.

I receive love. I'm more inspiring. I'm less judgmental. And so my point is when you are that. You are just a better driven entrepreneur for all of your people and everything's better. And so with that, I just wanted to say that as we shift now to the 10 disciplines and the context here is I always love to actually give all 10 just a really high level of all 10.

Just so people got to get a sense of what we're about to talk about. And then I always just urge you, you know, your audience better than I do. I'd love it. If you just pick the one, two or three that really jump out at you, that will help them the most, and then we can dive deep into those, but at really high level, here are the 10 disciplines to maximize your energy.

Your impact and your inner peace. Discipline number one is [00:36:00] 10 year thinking. Discipline number two is take time off. Discipline number three is know thyself. Discipline number four is be still. Discipline number five is know your 100%. Discipline number six is say no, dot, dot, dot, often. Discipline number seven is don't do 25 an hour work, i.

e. if you want to make six figures or more. Number eight is prepare every night. Number nine is put everything in one place. And number ten is be humble. And the little setup to this I want to share is just These are the 10 disciplines that I have lived by for more than 25 years in my life and have had an incredible impact and people will ask, you know, you seem so passionate, you have so much energy, you know, it's, I'm not making that up, you know, I didn't get lucky.

I didn't get the lucky energy card. It's just, I live by these 10 [00:37:00] disciplines and your energy will go through the roof. You will make a bigger impact and you will experience the inner peace that we're talking about. You're welcome. Because they create a foundation and a platform where stuff comes up and I'll leave it at that.

And you tell me the one, two or three that you want to talk about.

Dr. Kevin Christie: Yeah, let's do a, let's do a few. The first one is the, is the tenure thinking, cause this is something I really. have gotten good at for myself. Uh, and I try to tell chiropractors like, look, you know, you're, you're not thinking longterm enough.

You're not giving yourself enough runway. And so you're getting real squeezed. I feel like from a compression of time standpoint. So, uh, what are some of your thoughts on the, on the 10 year thinking?

Gino Wickman: Yeah. So each time I teach a discipline, I always start with what we call a bold statement. Okay. And so the bold statement, what that is, is that is if you would just give me blind faith and just do this damn thing, you will get all of the benefit, but unfortunately, most human beings resist that they need to be sold.

They need to be taught. They need to be conveyed. They need to be swayed. So here's the bold [00:38:00] statement. And then I'll share with you the benefits. And then hopefully that'll prompt some questions and a good conversation for you and I to have. So the bold statement around discipline number one, 10 year thinking is to simply shift your mind from short term thinking to thinking in 10 year time frames.

Now, if you will do that and give me blind faith, here are the benefits you'll experience. Time will slow down, a piece will come over you, you will make better decisions, you will get there faster, wherever there is, you will have more clarity, you will have more alignment with everything in your life, and the old saying, go slow to go fast, you'll literally slow down and actually go faster, it's the most incredible, complex, funny thing with those two competing things, but it's true.

Dr. Kevin Christie: And what I found was actually reflecting back on the previous 10 has been very helpful to then understand what you can get done in the next 10. And so [00:39:00] I remember when I turned 40, I looked back at age 30 from 30 to 40. I was like, wow, I opened up my first practice actually at age 30. And it was amazing the growth I had.

And then I looked back. It's like, wow, from age 20, I was, uh, you know, getting drunk at college football games at Florida State University. And then by 30, I owned a practice. You know, and it was like, wow. So then I said, okay, what am I, what's life going to be like at 50 and now I'm kind of halfway there and I'm already gotten a lot further than I expected.

And so I definitely found looking back at the previous 10 on what you can get done helps me set a big vision for the next 10 and it allows me to decompress a little bit and say, okay, I don't need to do it. Next year or tomorrow.

Gino Wickman: Yeah, you know, it prompts a couple of things I would share and I'd love what you just shared there.

I never really heard somebody say it so well that the power of looking back to go forward. So so well done there. You [00:40:00] know, there's an old quote that says it's a business quote that talks about we overestimate. What we can get done in a year, but we greatly underestimate what we get done in 10 years. And so if you'll shift to this 10 year thinking you will get so much more done.

And the way I like to describe it is think of it this way. Just make every decision that you make going forward a 10 year decision. Every decision you make little things like what you're going to put in your mouth. In other words, what do you want to look like 10 years from now? Well, that piece of cake you're about to put in your mouth, that's probably not the best decision that will lead you to that 10 year.

And so just make 10 year decisions. It's like when I created EOS, I created EOS to last a hundred years. That was my goal. It has now lasted over 20 years. So what I know though, is however long it lasts, let's pretend it only lasts 30 years or 40 or 50. Will have lasted longer because I created it with that 100 year thinking in mind as opposed to just [00:41:00] thinking about this year.

And what is the entrepreneur world need this year? And so the point is just shift everything to long term thinking because Frankly, 10 years is just my way of tricking you and some people really struggle with 10 years. I'm trying to get you to 20 year, 30 year, 100 year thinking, ultimately to realizing there is no time and there's enough time to accomplish everything.

But that's where it starts to get really heavy right now. Just start thinking in 10 year timeframes and make every decision a 10 year decision.

Dr. Kevin Christie: Love it. And then the next one I want to cover real quick is, uh, number five, know your 100%. I think that's something that a lot of people do not get in touch with.

And it's, it's huge. What are your thoughts on that?

Gino Wickman: Yeah. And this one's near and dear to my heart and it freaks out most driven entrepreneurs, but it's a belief that I have. And I've been living this one for more than 30 years. Um, but it's understanding that you have. a perfect amount of time that is your perfect energy [00:42:00] output.

And so here's the bold statement again, if you would just do this, and that is decide on and commit to the perfect number of hours per week and weeks per year that you will deliver your craft to the world. And so for me, my entire entrepreneurial life. I have been a 55 hour a week guy and I work 40 weeks per year, or at least the last 20 years for sure.

Always kind of been a 55 to 60 hour a week guy that has actually shifted for me in 2024. Just last year. My goal was to get down to 40 hours a week, which is really crazy. Yeah. Uh, you know, excuse the French edited out, but a mind fuck. I mean, it's literally makes it my tectonic plates. My central nervous system did not like that because I have been conditioned for that, but I overcame the shift and I got there.

So, but let's go back to the 55 hours a week, 40 [00:43:00] weeks a year. That was what I did for the last 20 to 30 years building EOS worldwide. But the point is that was my maximum energy output. And everyone has one. And what that means is one more hour per week, you will start to burn out one less hour per week, you will start to get bored.

And so here are the benefits. And let's see what this prompts for you. And so the benefits of doing this is that your boundaries will be clear. You will make a bigger impact. You will have more fun. You will increase your income. You will maximize your energy output. You will vibrate higher as a human being.

You will get back your most valuable asset, which is your time. Because think about this, you know, one of the disciplines is don't do 25 an hour work, but once you know, you're a hundred percent in that is your work container. All of a sudden when the job gets bigger [00:44:00] than that, there's your opportunity.

There's the boundary that says, oh, I don't work this much. You need to delegate something and rule of thumb delegate a $25 an hour, $50 an hour work that you shouldn't be doing. Low energy work, low income work. Just keep delegating, delegating, delegating, and stay within that and you'll continue to delegate and elevate.

Delegate and elevate as we talk about and teach in EOS and my book Traction.

Dr. Kevin Christie: Yeah, I love that. And I just was kind of the connection I was making was like, if you really know you're 100%, it then allows you the boundary to know what you need to delegate to people. Uh, and again, I like how sometimes it's elevating.

It's not like it's a bad thing to be doing. Someone's really skilled at that, but you're not. And I, and I think that really helps clear that. And a lot of, um, chiropractors struggle with the delegation side of things and they put too much on their plate. And so they actually know they're a hundred percent.

I love that. They can know what their plate can handle. Then they can start to look at the things, um, to, to delegate, which [00:45:00] is, which is great.

Gino Wickman: Yeah. Let me give you a great example. As we're sitting here, you and I doing this podcast, there's a perfect example staring at us. So again, if, if your audience is tracking with us.

Once you know that 100%, you're never gonna, you're never gonna go beyond that. And so when something comes, all these beautiful opportunities to do more come, you say, Oh, here's my boundary. I'm going to now delegate that. And then what happens is you start then delegating the low energy, low income. Doing more of the high energy, high income stuff.

So now the quality of work you're doing is much higher quality and pays you more. And so just like we're sitting here doing a podcast right now, I could do 200 podcasts this year and I'm not doing that. Most I did in a year was 100 and I'll never do that again. But I'll probably do 10 podcasts this year.

Okay. So I just handpick and that's all I have the capacity for. There's 190 that I could do. I have to say no to all those. And when I choose a podcast, I have to choose the podcast that's going to make the biggest impact. And [00:46:00] so kudos to you, Kevin, for building such a successful podcast. But that's an example of.

Okay, so now here's my work container. I can only do 10. Let's pretend 20 podcasts, whatever the number is, that's it. So I have to say no to every single other one. And then I delegate that to my coauthor or other people that can do them, but I'm not going to do it because it's not high impact. And so that's just one great example where you out there have to get good at making tough decisions and saying no, if it's not high energy, high impact.

within your work container. And what most driven entrepreneurs is they just keep saying yes, yes, yes, yes, yes, yes, yes to everything. They're working 70, 80 hours a week, killing themselves so I can go do the other 90 podcasts. But unfortunately, I'd be working, you know, same thing, 70 hours a week. I'd have to start working 41 hours a week.

And I also, you know, I also take time off and we, that's one of the disciplines, which. Helps restore your energy to be great inside that work container. Hopefully that's what

Dr. Kevin Christie: I really [00:47:00] appreciate about the 10 disciplines was they, they feed and they connect to each other. And it's not, you know, it's like if you just did one of them, it'd be amazing.

But then the, once you do one, it leads to the next and it leads to the next. And when you really get this strategy down, you now have that framework to produce at a high level, You know, get pair. I think too many entrepreneurs get paralyzed when they get overwhelmed, and that's a problem or burned out one way or the other.

And these are these have been great. And I just highly recommend people get the book, go through each one of those tens and actually, like, actually apply them. And that's what I loved again about the book was there was actual steps you can do to apply them. But if someone wants to get really deeper into this, obviously, Yeah.

Let us know where they can get the book, but what are some other ways they can reach out and even dive further into some of these learnings?

Gino Wickman: Yeah, great. I appreciate that. And I invite you all on this journey. And so I'll start by saying I love what you said there because the 10 disciplines, [00:48:00] they all stand on their own.

You know, you could implement one in your life and get benefit, but there's a synergistic effect when you implement all 10 in your life. So I urge you to implement all 10 and the book absolutely is a how to manual for doing that. All content I create is very practical, very how to. So I'd urge you to get the book, you can get it at any major retailer.

You can find it through our website, the10disciplines. com, and that will take you there. On that website, there are a few things to offer you. What I would urge and start with is something we call the True Self Assessment. Takes just a few minutes to fill out, but the result you're going to get, it's going to show you how free your true self really is.

It's going to be a beautiful starting point for you. And so please take the True Self Assessment. And then if you want to go much deeper, You can certainly do this all on your own using the book, but we offer a self study. If you want some help in implementing these 10 disciplines in your life, we offer group coaching if you want that.

And we also have a [00:49:00] mastermind. If you really want to start to go deep, we call it the true self mastermind. Cause that's when we're really going deep into those three discoveries. And so those would be the resources. You can also download a free chapter of the book from the website. If you just want to get a taste of like the first.

27 pages and see if that pulls you in. So there's a free option for you to put your toe in the water, but those are all the wonderful places to start to embed these 10 disciplines in your life.

Dr. Kevin Christie: I love it. And we'll put all that in the show notes and get that out to everybody as well. And, uh, I know that I've been talking with Rob about, uh, getting involved in some of that, so I'm excited.

and I really appreciate your time today, Gino.

Gino Wickman: Yeah, it was a blast, Kevin. So well done, brother. Great questions and great stories on your end. So, uh, hopefully we made a huge impact today.

 EPISODE 410: The Great Game of Business

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. 

[00:00:00] Welcome to another episode. Excited to have John Williams join us today, and he is Uh, certified coach from the great game of business and a little bit of background on that. There's a, you'll hear it during the episode, but give you some context. There's a book called the great game of business by Jack stack.

And it's been instrumental in some of the mentors I've had and people we've had come speak to our mastermind group and, uh, webinars we've done. And it's, uh, it's just a phenomenal way to have your business run and there's certain principles to it. And we dive into the framework, um, today, and I'm excited to have John.

He's going to be kind of our headliner in New Orleans at the end of the year. What we've done with our mastermind group is, uh, we have an East group and we have a West group. We meet three weekends a year for the East only, and then three weekends a year for the West only. And then we combine the two groups for a fourth meeting.

So there's seven meetings total, it used to be eight and four and four. So now we do a three and [00:01:00] three and then we meet together. Uh, at the end of October and this year in 2025 will be in New Orleans and 2026 will be in Dallas. Um, but we're we're all squared away this year for the mastermind, but it put it in your calendar for 2026 i'll be promoting that in the summer But john will be joining us in new orleans And diving into the details of great game of business and how that works to really get your team Enrolled in the idea of growing the business and making a game out of it and uh, he dies dives into that today It's a phenomenal framework.

It's, uh, he, he's very knowledgeable in different businesses. He's got quite a background with dentists, which is very applicable to the chiropractic profession. You're going to get a lot out of today and some of the wisdom that John has. So, uh, without further ado, here is my interview with John Williams.

Dr. Kevin Christie: All right, excited to have John Williams on the podcast today. We're going to dive into the great game of business and, [00:02:00] and that, uh, that body of work. But before we do, John, tell us a little bit about yourself professionally. Uh, sure. Thank you, Kevin. Uh, my name is John Williams. I am a certified great game of business coach, which we'll talk about here in a few minutes.

John Williams: Uh, but, uh, my background, I have around 35 years of manufacturing and distribution experience. Uh, I, um, I started off as a frontline employee working in maintenance, uh, years ago and slowly got into leadership and then in January of 2006, uh, I, uh, was reading the newspaper as most people did back then, which they don't do very much now, not anymore, but just reading through the classifieds, uh, You know, I was currently working for an aerospace company in Tulsa, Oklahoma, and I seen this little block ad that said, wanted leadership, fast growing [00:03:00] company, and normally you don't pay attention to those type of ads if they don't give it too much information, but for some reason I sent my, uh, emailed my, um, resume in.

And, uh, 2 or 3 months later, January 30th, 2006, I was sitting in Northwest Arkansas in a little town called Arkansas, which is just south of Bentonville as central states manufacturing. And, uh, that was my introduction to the great game of business central states, uh, manufactured metal building components, steel roofing.

Pre engineered metal buildings, uh, their employee owned company. Uh, but. I can remember it very vividly and I wrote a blog in 2020 about that first day at work in 2006 called how a book report. Changed my life. So I sit there my first day ready to [00:04:00] fill out all my paperwork and, and, uh, all of that, uh, or my benefits and, uh, the lady that hired me, she was the VP of ops at the time she came in.

And I said, okay, what do I do? Here's my driver's license. Here's my social security. She said, don't worry about any of that right now. Said, here's what I want you to do. I want you to read this book. Uh, I want you to write a book report on it, . And in two weeks I want you to give a presentation to management about what this book means to you.

And that book was The Great Game of Business by Jack Stag and, and that was my first introduction. And even in that blog. Uh, I put the book, the, uh, uh, copy of the book report in that blog. So, uh, so that was my first introduction to the great game of business. It was my first introduction to employee ownership, not just an [00:05:00] ESOP, but also, uh, An ownership mindset and an ownership culture central states was formed in 1988 and they built their entire business model off two books.

1 was good to great. And 1 was the other was, uh, the great game of business. They had been practicing their great game of business, uh, since, you know, probably around 1992 when the book came out, even before there was, This great game of business coaching and consulting firm and, and, and all of the things that that great game of businesses today.

But, uh, the owner at the time just felt that the concepts fit in. With an ownership culture, which is what he was trying to, uh, to, uh, implement in, uh, in the business, uh, you know, to go along with the other part, uh, of good or [00:06:00] great. So, yeah, you know, and that's how I came across. Good. Uh, great game of business was, was through the book and it was actually from Dr.

Dr. Kevin Christie: Ray Tuck, who was on my podcast maybe three years ago or so. And then, uh, the first thing this was when we were just chatting, um, to prep for his call and he, he, said, you got to get this book. So I got the book, uh, read the book and then we had a great episode. And then he was kind enough to come, uh, speak to our mastermind group in January of 2023 on he's a chiropractor had, uh, 11 clinics.

Um, unfortunately has, has passed away since, but, um, still the clinics are, are operating fully, you know, because he implemented this structure and framework. And, um, he talked a lot about how it helped him grow and scale his chiropractic practices during the mastermind group, uh, which, which you're, uh, going to be speaking at our new Orleans group here in 2025, which is [00:07:00] exciting.

We're going to have the east and the west groups converge together in new Orleans and will be. Diving into this in detail, but that was my first experience with it was through Dr. Tuck and then reading the book and just kind of diving into it. And I was like, you know what, this, this really makes a lot of sense.

And so I want to, I want to dive into kind of the framework. for it, and I'm just gonna set the tone a little bit and have you kind of dive into each a bit. But you come up with a critical number, and that is a confluence of what you call think, act and feel. Could you could you dive into? Would it make sense to start with a critical number or maybe dive into think first?

John Williams: It would probably be just it would probably be best just to look at the model of great game of business or What are you trying to accomplish? What does the end goal look like? Because when I talk to people about it, they've [00:08:00] read the book and they said, okay. Well, how do I implement this? How do I do this?

What's the critical number? What's the stake in the outcome all of this? And I said, well, let's first Let's understand what you're trying To accomplish because all of those little pieces that I just mentioned are tools. Uh, to help you get to this point where you want to be as a, uh, as a great game of business company and or as a company that's going to implement great game of business principles, but yeah, so really the great game of business, it's really a system or a process that teaches employees, uh, how to think, act and feel like owners and it does it in the concept and it's very important, uh, that, You share information first that you're transparent with information because if you're going to teach employees the [00:09:00] business Okay, they have to have the data.

They have to know the score. They have to know what the score means, where it comes from. So this whole thinking like an owner part is the teaching them about the business. Be transparent with the information. And when I say be transparent, you don't have to be transparent with everything. For example, salaries and wages.

My opinion, you should never, uh, share salaries and wages with others. There are certain entities or businesses where, uh, some of the work they're doing is confidential. They're doing work for the government, or if you're in the healthcare industry, there's certain things that you can't share, uh, and, and that's fine.

You don't have to share that. The only thing you need to share is so that the individual can connect with what they're doing every single day with the outcome of the company. Like, how do they [00:10:00] influence that? So, things like, uh, if you're looking at it from financials, from a P& L perspective, uh, you, you could just share the revenue, and you could share the cost of goods sold, and that may include, uh, direct labor, material, uh, and then, you know, the, uh, revenue minus the COGS equals your gross profit, and then you have overhead.

Gross profit minus overhead, uh, That's your profit, right? Before taxes, so it can be that simple. At least they can see and understand where those numbers come from. How do I affect them as an individual? And is the company winning or losing against a target? So that's the, that's part of the thinking part.

Dr. Kevin Christie: Yeah. And one, one question on [00:11:00] that. I agree with you about sharing individuals salary compensations. Could you give a, I could you give like maybe this is the total payroll of the company. So you're not actually like. Teasing it out, but they can see like, oh yeah, payrolls a lot more. When you talk about taxes and overall payroll costs, they get the ideas like, wow, that's more than I thought.

Cause one of the things we see in chiropractic practices, it's a very intimate setting typically, right? You're, you're, you're talking two, three, four, five, 10 employees, and you've got an owner chiropractor, who's not necessarily. Totally business savvy. And then you got an associate and there tends to be a associate chiropractor, there tends to be a disconnect.

And a lot of times the associate doctor thinks the owner doctor's making so much money. They have to bury it under their mattress. Right. And cause they just may see what's coming in the checks, the revenue, the batch reports, but then they have no idea with the overhead. And that's a big problem I see is many.

Many associates don't understand [00:12:00] how much it costs to really run a practice that can actually afford a second doctor. And then on, on the flip of that, the owners don't do a good job of teaching the doctor, like, look, this is where we're at on, on what it takes to operate this. You know, and, and I think that's a big.

A big issue, so you could share overall payroll. Sure. And you would even in small businesses, you know, and especially service type businesses, whether you're in the medical field, whether you're a chiropractor, whether you're a doctor, uh, you have a dental practice, whatever that is, you know, they're, they're pretty much.

John Williams: Structured the same from a business standpoint, so you may want to put a salaries and wages line and include everything in there. You know, maybe include health care and their benefits and their vacation and whatever as 1 total line. Now, if you're a small practice with 1 location or 2 [00:13:00] locations. Maybe the, the owner or the doctor that owns the company, maybe they're below the line or below the profit before tax because most of the employees aren't influencing that number.

You know, sometimes that's done because that's, uh, that amount is usually a big portion of that total if you just have a few people, but yeah, you could. You could put it all together because they do need to see that because in service type industries, salaries and wages are by far the biggest line item and the biggest influencer of profitability, right?

Dr. Kevin Christie: Yeah, no, absolutely. Okay. And so the, the think part of that is kind of, you know, know and teach the rules and really give them a lot of clarity on business. It sounds like, which is rare. Yeah. And financial literacy and it doesn't have to be me. Okay. Difficult. You're not trying to make them accountants.

John Williams: You're just trying to get them to a level of where they can understand how they're [00:14:00] impacting it. And it can be as simple as what I just explained. Uh, it's easier said than done because for years and years and years, business owners have kept this information from employees. And because I think a lot of it is for control, you know, uh, some of it is for fear, uh, and, and then they use excuses to support those fears, right?

Like, oh, if my employees, I don't want them to see how much money I make and then they'll. Then they'll want more money. Well, no, that's not true because most employees think owners of businesses are making a whole lot more money than what they actually are. So I tell owners, what are you scared of? Why don't you just tell them the truth?

Because it's much less than what they [00:15:00] already think. If you don't tell them the truth, they're going to make up something and it's going to be based on perception So that's one of the fears that you'll hear. So and uh, yeah, and another thing is is the idea of profit. Um, another person that I we've done some work with is greg crabtree who is an accountant and I think he's got a pretty good background with the Great game of business and he talks about you know, your profit margin and he's a big proponent of the the owner Uh, paying themselves what you should pay yourselves, right?

Dr. Kevin Christie: So if you're a, an owner, a chiropractor, you would want to pay yourselves what the going rate of a, uh, of a full time chiropractor would be to replace yourself. And so then you, you add that into your overhead, obviously. And then he talks about having at least 15 percent profit after. All that, uh, obviously the more the better, but you want to be at that 15 percent profit and, uh, just some, uh, for my audience, some car prices make the mistake [00:16:00] of saying, Oh, you know, it's like, no, your price should be 50 percent profit.

Well, they're, they're actually counting. They're not counting what they pay themselves, right? That's right. And it's, that's a big difference. I want to tease out for chiropractors. So let's say we get that 15%. And then the other thing that Greg Crabtree talks about is, then, you know, even when you get that 15 percent profit, even if it's a, if, even if it's a big number, let's just say it's 10, 000 in a month, which isn't a big number, but let's just say for sake of argument, the, your employees may think you're just taking that all that profit home.

And they don't realize that uncle Sam's going to. Take, you know, I think he says to put 40% towards that, give or take and mm-hmm . That might, you may not need all that, but that's, that's gone. And then taking another 30% and reinvesting in the business. 'cause that's the other part that I think employees don't realize is that all those things you need to buy into and, you know, maybe implement a new marketing strategy and all the different things to reinvest to grow the business that's coming from profit typically.

And, and then you get [00:17:00] to take, the owner takes its. The 30 percent per se, uh, so I think even, uh, breaking that down for team members can be very helpful to realize like, look, even when we're profitable, it doesn't mean all this is just cash that I get to take home. Right. It is. And that's an important part in teaching the employees the financial literacy of a business.

John Williams: 'cause they 'cause the p and l uh, and profitability has nothing to do with cashflow. You know? 'cause you can be profitable for a long time. If you run outta cash, you have no business. You know? So, uh, so it's teaching them that and, you know, the way the great game business came about 'em and why it was called Great Game is Jack Stack thought I can't.

When he started SRC in 1983, he was trying to teach the employees financial literacy about business and they couldn't grasp it. So we had to find [00:18:00] something that they already knew that was just like a business and everybody understands the concepts of a game that has rules. It has winners and losers. It has an objective.

You keep score. You know if you're winning or losing and all of that. Everybody understood that and he related that to business. And I think when you teach financials, it's the same way. If you come at it from a business approach, most people are just going to shut down because they already have a preconceived notion it's too hard.

But if you, if you teach them that a business P and L is no different than your personal P and L, like I get gross pay, I have these deductions, which are personal cost of goods sold, then I have my take home pay, which is my personal gross profit, and then I have rent, gas, you know, all this other stuff, which is my expenses, and that's my take home, [00:19:00] and then you ask them how hard is it for you to make money as an individual, what do you put in your pocket at the end of the day, Yeah, it's just like that in a business and the cash and thank you.

Dr. Kevin Christie: That's a great comparison. Yeah. And the cash is your checkbook. Yeah. What do you have in your checking account? That's your cash flow and you can have a lot of cash in there, especially if you have a wealthy uncle who's giving you money all the time and not have any money left over from your personal P and L from working.

John Williams: And you can still pay your bills, right? Yeah, it reminds me of the, it's a quote from Wes Cape and it's, uh, volume is vanity, profit is sanity, cash is reality, right? To your point on your QuickBooks may read X on the profit, but what is your what does your operating account read, right? Yeah, and in the medical [00:20:00] services businesses, you know, it's about collections.

That's, that's the cash coming here. That's the, that's what, uh, you pay employees with. That's what you pay the bills. That's what keeps the door open. Awesome. So the second part is, is called act and it's follow, follow the action and keep score. What's the, what are some of the details of that? Sure. The acting like an owner.

So you've, you've taught them all about the business, financial literacy. You, you've taught them who their competitors are, who their suppliers are. You've taught them about their industry and their market and all of that, but it doesn't stop there. So now they have the knowledge. Now you have to let them be part of the business.

Include them in decisions, uh, I coached about 5 or 6 dental practices over the past year and implemented great game of business. And here's the example I give on acting like an [00:21:00] owner. So imagine this scenario that if you're a dental practice and you want to buy a new x ray machine. And the owner goes out and buys the x, x ray machine, brings it to the office and plops it right in there and said, okay, x ray technicians, here you go, I bought you a new x ray machine.

Or imagine doing it this way. You meet with everybody that's going to use it and say, okay, all of you know our x ray machine is old and we've had issues with it. Okay? Uh, here are three different types of x ray machines. I would like for you to give me your opinion on what you think we need. Now realize, here's our budget, okay?

And also, after you give me that, they're having a industry trade show next week [00:22:00] here in town that they're going to be displaying these models, and I'd like for all of us to go look at it. Give me your feedback. They give their feedback. Maybe the owner goes with it, maybe he doesn't. But now when the x ray machine goes.

comes up, they're already bought in. They're part of the process. If something goes wrong or if it doesn't start in that first example, uh, well, nobody asked me what to get and they're and they're going to blame the owner on why it's not running right. But if they do it the other way, they're bought in.

They're more inclined to find out why it's not working and get it working. That's the acting. That makes sense. And then, um, keeping score, is that just like, you know, monitoring certain KPIs, some leading indicators, things like that? Sure. Everybody, every, well, it's embedded in every human that they [00:23:00] want, they want to win.

Okay. But they need to know what the target is. And that target is a critical number. That's the one number, the most important number in the organization that everybody is rolling to. Now, there's individual KPIs at the departmental level that those are drivers that affect that critical number. Okay, but, uh, yes, and so that's the target.

That's the objective, but they, you have to constantly be updated on where you're at. So imagine this. So, uh, and whether or not anybody's a Kansas City chief fan or not, I'm going to use Patrick Mahomes as an example. So imagine Patrick Mahomes and the other 10 players on offense show up on the field, ready to run a play, and Patrick Mahomes is the [00:24:00] only one that knows the play.

The other 10 players on offense don't know what the play is. What's going to happen? You know, a lot of it. Well, somebody may think they know the play, but they don't somebody's just gonna sit there Nobody told me to play Patrick Mahomes is gonna get killed, you know, I mean, he's gonna be out of the game hurt They're gonna so all of these things could happen So now let's say we fix that and all 11 players know the play, but there's no scoreboard They don't know what down it is.

There's no down marker. There's no play clock. There's no yard field markers. Nothing Well, what happened then? And most people would say nothing. I said, would anybody come to watch the game or watch it on TV? No. Every game that's played in the world keeps score. And it has winners and losers. From checkers, to [00:25:00] chess, to ping pong, to football.

It doesn't matter what you're playing. Because most people would say, Well, that would be crazy to not keep score and not know who's winning or losing at any point in time. Then, my reply to them is Well, why are so many businesses in the world ran that way, where there's only one person that knows the play and only one person that knows the score and everybody is either sitting there or making up something that they think they need to be doing.

Dr. Kevin Christie: So it's very, very important. I love that makes a lot of sense. And that leads us into feel, which is provide a stake in the outcome. Can you, can you dive into that for a minute? Sure. A stake in the outcome. Most people see this as just a bonus or something, and that's part of it. Uh, but it can be a lot of things and it's very much up to the [00:26:00] individual.

John Williams: On what they perceive as a reward or a stake in that the outcome for the job that they've done. Now, that can definitely be your regular pay. Whatever that is, uh, but it also can be more of, uh, it can be a benevolent cause where you're doing something good for the community are in the medical field.

You're making people healthier and, uh, you know, or it can be, you know. Your grandpa and your dad and your uncle were all chiropractors. So I Love the industry, you know, but it could be your health care. It could be you know, uh, the people I work with uh the person, uh, My leader my manager it can be all of these things But the number one thing that I think that [00:27:00] feeling part is is having purpose at work You know, and all of those things I've listed fall into that, but if somebody can go to work, and they feel like they have purpose, they feel like they're making a difference as an individual, then they're going to feel better about that, and they're not going just to be concerned about, hey, and benefits, and healthcare, and all that, all that stuff's important, it is, but what ties them to that, and what's going to motivate them, uh, to do the best job possible, Is to have that purpose, and that's the feeling like an owner part.

Now the bonus part, it needs to, the incentives need to match their, their frame of reference when it comes to time. So what I mean by that is, if you're managing the office, your frame of [00:28:00] reference on time may be, okay, what do I get to get done this week? What do I get to get done this month? Where the front line employee is, What have I got to do today?

What have I got to get done? What's in my little world right now that I have to do? So the closer you can tie those incentives to their time frame, uh, the more impact it'll have. Because that's the way they think. So bonus programs, uh, you know, a lot of great game of business companies that use these principles, they may set up an annual bonus that's paid quarterly.

Dr. Kevin Christie: Okay. So the annual incentive will be based on your critical number, whatever that is as a company, but you're paying a little bit of it quarterly to keep them engaged and keep them thinking about it because the shorter term thinkers. Okay. It's still an annual bonus. It's paid on a year to date basis. [00:29:00] Uh, but you're giving pieces of that bonus if they accomplish some quarterly targets along the way.

John Williams: Gotcha. So you said the quarterly target, get the quarterly bonus, but it ultimately adds up in summation to a yearly bonus. Sure. Sure. So you could miss all first three quarter bonuses, but hit the year end and you get all of it. Right. So it's not one of these, uh, lose it. So let's just say if you have. 10 offices and you're the CEO of all of these, all these chiropractor offices, then maybe they're staking the outcome should be something three to five years.

Maybe it could be based on the value of the company, or maybe it's, uh, based on a return on investment or return on assets or something like that. So you have a longer term incentive out there to make them think more about the sustainability of the business and not so much. [00:30:00] Focused on giving them a bonus every quarter.

Dr. Kevin Christie: And you mentioned something briefly ESOP. Could you tell us what that is exactly? Sure. And he ESOP, uh, stands for employee stock ownership plan. This is where, uh, uh, you know, a lot of owners, uh, of businesses in several different industries. They're facing a, a huge challenge now to where, you know, 50, 60 years ago, it was passed on to the family.

John Williams: Right. And then the family took over the business and they ran it for years. Well, what's been happening over the last 30 or 40 years is no one in the family is taking over that business, you know One of that I think is just there's more options out there. There's more things to think about more things to do I don't think families are having as many kids as they used to, so, so that lowers the options of them taking over the business.

So one of those [00:31:00] succession plans is to sell their company to the employees. You know, you can go, you can sell it private equity. Or you can sell it to the employees. The um, the uh, It is a defined, deferred plan, so it falls under ERISA, and the benefits. So what you actually do, you would sell Your business to the ESOP, which is really a trust if you look at it from a legal perspective and that and it has a trustee that oversees that trust.

So inside that trust is the owners of the business, which are the employees. Okay, so the ESOP purchases the company, uh, from the seller, uh, and over a period of time, every single year, a contribution is made [00:32:00] into each one of the employee's accounts. Uh, and that is, uh, put in their account and, and it relates to so many shares.

Of stock in the company. Okay, nice. So yeah, so you could have under that kind of having a stake in the outcome. It, it could be an esop, it's probably a little bit of a bigger company maybe. Yeah. Uh, obviously it could be benefits and I, and paid quarterly, like how you talked about that. Um, I mean, and then I've even seen some, and, and we're working through this as well, is, is maybe a profit share with some key employees, right?

Dr. Kevin Christie: Yep. Um, do, are you seeing that a lot in this model? Uh, yeah. You can, like, like I said, it, it, With some key employees, you may look at some medium term incentives, you know, and maybe they're not just profit sharing, but they're based on some key metrics that you want, you want, uh, that you want to [00:33:00] look at to drive your business.

John Williams: Okay. But so for example, SRC, which is the parent company, a great game of business, they'll all, they'll do the short term incentives, like the annual bonus paid quarterly. Now with some, uh, management director and executive levels. They may have a medium term business or bonus three years or so, and then there's the long term of equity in the company through an ESA.

Okay, so you have a short term, medium term. Oh, love it. And then those three things think, feel and act like we just broke down. That becomes a critical number. So I assume that's one number. And what are some examples of what that could be? Well, it is, it is one number. And I get this question all the time.

Well, we're trying to do three things. And I said, well, here's the problem with that. And, uh, [00:34:00] and I understand that all three are important, but the problem is when you pick three critical numbers, people are going to go with the path of least resistance, the one that's easiest to get. Okay, so two of them may be very hard.

So they're going to do the easy one first. Well, the easy one may not have as much impact as the other two. So that's why it's important to get to that one. that is the most important number to the company over the next 12 months. So that number in 2020 when COVID, uh, was here, a lot of that. Those critical numbers changed from a profitability number to a cash number.

Mm hmm because they wasn't worried about profit They were just looking to survive So maybe they their critical number was revolved around more of a balance sheet [00:35:00] item whether that was cash cash flow DSO, whatever that whatever that is collections, you know in and in the medical field so But most of the critical numbers you see are based around profitability.

You do see the ones that have been doing this for a while. Look at other things like return on assets. If you're heavy manufacturing, where you have a lot of, uh, equipment and you're going to have a lot of depreciation, you're going to have a lot of inventory, uh, you know, that makes sense there. Uh, and then, uh, some people over the last five years, they've been looking at employee retention.

Because it is so hard to, to hire people. Uh, so instead of just hiring all the time, focus on retaining the ones that you do have. And so I've seen that number a little bit, but most of the time it's a [00:36:00] profitability. It's around net operating income or profit before tax or, or those types of things. Now that a percentage are usually an absolute number they try to go for.

It's usually it depends. Uh, you know, I think for a lot of businesses that are just starting out doing this, they want to do something that the employees can understand and they can relate to and they can tie how what they do as an individual into the outcome of the company. And usually that's simple.

Profitability number, so it's going to be your net income or your profit before tax as you start to mature. Then, you know, margins become more of a, uh, of a measurement tool. So, whether that's the gross margin or whether that's net margin, uh, you know, they'll start to to look at that and that because, you know, that's going to take out the effective revenue.[00:37:00]

Dr. Kevin Christie: That'll be exciting to work through when we, um, we have you at our mastermind to kind of get really clear on that. Um, in the dental industry and the dentist office you've worked on, has it been anything other than profit for them? Has it been collections? Has it been new patients? Has it been anything in particular?

John Williams: Well, it, for the most part, I would say most all of them use collections, you know, and they're paying monthly incentives and stuff like that, collections. Collections is fine, but in a dental practice, you know, most of the dentists are, you know, they're, they're being paid at a variable rate. So they're being paid for the procedures, not a base pay.

So that's fine, that's going to go up and down with the collections or the revenue generated, but the staff is the largest overhead number in a lot of those places. So they, so when you just do it on collections. You don't take into account [00:38:00] the cost and you could be paying some incentives, paying a bonus, think you're doing great, and your net operating income is negative.

And you start to have cashflow issues and all of it. And that's what was interesting. Uh, that was one thing we learned from, uh, Dr. Tuck and our mastermind a couple of years ago was the problem of bonusing on collections. Uh, and, and historically a lot of chiropractors will bonus. And I ran into this in the past, um, but they'll bonus the associate doctor on.

Dr. Kevin Christie: On what they bring in, right? What they collect and the thing that that just doesn't measure is your costs of running a business going up, which obviously we've seen over the last few years, and that could be a staggering number versus obviously profit and net profit and things like that. That's that's actual.

Money that's there that's in the, uh, that takes into consideration the cost of, of, of stuff going up. So, and I've seen it happen in dental practices where if the doctor is [00:39:00] being paid a bonus on collections, the way they can do more is that they have more staff. So hire me. Two more assistants, one more assistance.

John Williams: And meanwhile, the profitability of the practice keeps going down, down, down, and their collections going up, up, up, and they're like, Hey, what's going on here? What's, what's happening? Yeah, no, it's, it's fascinating. And I've been diving into it quite a bit and obviously starting with the book and, and, and that's why I wanted to have you guys come speak to us to continue to, To, to really lock it in because it's, you know, it's a lot and that's what, um, uh, but once you figure it out, it really makes a lot, uh, uh, set like makes a lot of sense.

Dr. Kevin Christie: It provides more clarity for yourself as the owner and also your team members. And then you just get on the same page. And, um, I'm excited to keep on diving into this stuff. Yeah. And, and you have this, you have this, uh, you know, [00:40:00] variability of scaling. Yeah. A medical practice business, whether it's chiropractor, uh, especially in the dental practice where, oh, you grow your business.

John Williams: You've got maximum profitability with the market, you have the staff, you have the dentist, you have, and then you want to go hire another dentist. What happens when you hire that dentist goes down and that dentist has to produce a certain amount. To get it back up because the dentist that new dentist requires more staff and so on so you're up down like this So dentist have to say Okay, well, I guess if I just stay at this level right here and some choose to do, because every time I go hire somebody, my profitability goes down.

Dr. Kevin Christie: Yeah, and that goes back to what you talked about as far as educating everybody around and we see it all time where and Greg Crabtree did tell us like, okay, yeah, 15 percent profit margin is ideal, but you can go down to. [00:41:00] 10 percent or so if you do bring on a new doctor or something, that's a big investment.

And then tell me like being able to show that to that new doctor and say, Hey, look like we're, we're taking a considerable hit on profit by hiring. Cause there's always an onboarding and ramping up of that doctor and building their book of business. And, and obviously you hope that that happens sooner than later, but if that.

Ramping up takes too long. It, it can really be a, a practice killer. And I'm sure there's a lot of variables to figure out what a normal, uh, how, how many months does it take for that doctor to pay for themselves and get your profit back? And then, you know, obviously they need to be a profit center, right?

You don't, you don't hire just for, for, for fun. And so, but I think if you. If you lay that out and that will spur that doctor along to realize like they got to take ownership of this and they got to start doing things to build a practice. Otherwise it's gonna they're gonna because because I, you know, I think a lot of [00:42:00] times the new doctor coming on board and oftentimes they look at themselves as an asset to the practice, right?

And at some point that's what you hope they are. But in the early phases of that, they're, they're not an asset to the practices yet. They're really a liability. And the sooner they can turn from liability to asset and do the right things that happen, uh, the better everybody's going to be, be. And I think that's a big sticking point in our profession.

John Williams: Yeah. And I think what the great, what these principles of great game of businesses think, acting and bill, what it does do. Is it teaches, especially in the medical practice, and it did this with the dental practices to be more efficient with your staff to use systems and processes instead of adding people to, you know, to get some, to get something done.

Uh, and that way, when you do hire that doctor, it doesn't require extra staff because their systems and process [00:43:00] because it's. The way a doctor becomes fully utilized and the most efficient has everything to do with scheduling. And in the dental practice, I start off by telling them, I said, uh, all of you are important, but I'm going to tell you who the most important person is in the entire office.

It's the person that that patient first sees when they walk in the door. The person sitting at that desk who's doing scheduling, that's the first person they see. They have a smile on their face. Don't underestimate how important scheduling is. Yeah, so that changes their mindset and that allows them to do more with less staff or the same amount of staff that they had because the staff, yes, their support, you couldn't do it without them, but you're paying them whether you have zero patients or 20 patients that day.

So which is, yeah, there's a, I'm not sure if you're familiar with the company, the scheduling [00:44:00] Institute, they work with mostly dentists and some chiropractors, but their whole thing starts training the front desk and they, they have a particular bonus system. I won't dive into today, but it's based on a new patients for the, for the front desk.

Dr. Kevin Christie: That's like the critical number for the front desk person. Uh, because psychologically, um, they actually spoke at our mastermind as well. And he said during there, psychologically, if you don't have an incentive around. the new patient or the scheduling, um, they like new patients is extra work for that front desk person.

It's more paperwork. It's insurance verifications. It's all this stuff. And if there's no benefit to them or they don't see the benefit to them, uh, then they may not be that excited to. Get that patient on or smile that, you know, or when john's checking out and says, I need to get my son in here, isn't that eager to get the sun on the schedule?

Right? And so there's a lot of, um, you know, like you said, the front desk is a gatekeeper in a lot of ways and getting that schedule busy. Well, [00:45:00] another thing that we found in the dental practice was the, was tracking the hygienist, uh, time per. And some of them, I remember an example where they were taking like 60 or 65 minutes and the process of actually cleaning the teeth was only about 20.

John Williams: And so what are they doing? Well, they're checking a man. They're going through their paper. So why is a hygienist doing that? The hygienist is a producer. Get that done before they come to the office or somehow and that way you can be more efficient. So these examples and these principles, but you're teaching all of these employees how what they do impacts the business.

Dr. Kevin Christie: And then ultimately that critical number. Well, John, this has been great. And obviously it won't be the last time we speak. We'll see you in, uh, I believe it's October, New Orleans for our East, East meets West mastermind, and we'll be really diving into [00:46:00] this stuff. And I know as a group, we're excited, but if any of our audience wants to reach out, how can they find you?

John Williams: Uh, sure. Well, uh, you can certainly email me at John Williams. at elucidate resources. com. Uh, or you can, uh, check me out on LinkedIn. Uh, just look, search for John Williams, elucidate resources, and you can pull me up there and all my contact information is there. Feel free to reach out to me, email me.

Dr. Kevin Christie: Perfect. And we'll put that in the show notes. Everybody has that. Well, John, I appreciate your time today. Have a great rest of the day. All right. Thank you, Kevin.

 EPISODE 411: Capacity Block Breakthrough

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] Hey docs, welcome to another episode. Today I got a solo episode for you, where we're going to dive into something I think that is all too common. For chiropractors, and that is these capacity blocks that you may be facing in your practice and, uh, it's something that is really kind of stems from my work with strategic coach and their concept, the ceiling of complexity and breaking through that ceiling of complexity.

But like I try to do, uh, when I learn from outside of the profession is to then really bridge that gap into what we face as, as chiropractors. And so today I'm going to go over, uh, nine. potential capacity blocks that you face in your practice to to growth. Sometimes these capacity blocks are going to be, uh, things that are really hindering you.

Um, and then sometimes it's going to be things that are just an opportunity, right? You're not, you're not hindered. Uh, but you could grow more and be even better. [00:01:00] And I, I use that word even, uh, we use it a lot in our, we just got back from our West Mastermind in Park City, uh, as I record this episode. And um, we talked about that in way back when the first five episodes of when I started this, it would be probably April, May of 2017.

I had, um, hall of fame, public speaking coach, Joel Weldon, and I recommend listening to that. But one of the things that he talked about in that is using that word even, and we mentioned it over the weekend in the mastermind. And, uh, it's a bit, it's a big word, right? Like if you said, uh, I want to try to get you better.

Um, you might take it as like, Oh, well, I'm fine. I'm, you know, I'm, I'm good now. I'm not, I'm not in a problem, but if I said, I'm going to get you even better, um, that is something that just shows growth. And you could even, you know, apply that to your patient, right? If they're feeling pretty good, you can say, we're going to get you even better or feeling even better.

Um, [00:02:00] and that's what we're trying to do. Uh, when we work with chiropractors is, you know, a lot of you are doing. Just fine doing great, right? But you want to, you know, you're a, you have a growth mindset and you, um, you want to be even better. And a lot of times these capacity blocks are preventing you from being even better.

Sometimes they are obviously preventing you from thriving and being successful in general. And, and you can kind of sort through that, right? So, but the, we, we developed the tool, um, the capacity block breakthrough. We, we utilize this in the 30k per month online course that we did, which was a huge success.

Um, keeping a lookout for that, we will be offering that as an evergreen. Uh, it won't have a handful of the things that the original cohort had, like all the live zoom calls that we had and things of that nature, but it will still have a lot of the material. And, uh, obviously we won't have the, uh, early bird, uh, pricing, but we use this capacity block as one of the lessons in [00:03:00] that course.

Uh, we're using it with our clients. Now we did it at our mastermind and we've gotten a lot of great feedback from this particular tool that we utilize. And, and what I'm going to talk about in today's episode is, is kind of two things. I'm going to run down. what the nine capacity blocks, the potential capacity blocks are.

And then we're going to take one, um, and show you how sometimes there's some underlying blocks that are happening, um, with that main block that you think is, is the main thing, right? Kind of like when the patient has a knee pain, they think it's a knee problem, but you find it's a hip problem causing knee pain.

And it's a similar situation here with these capacity blocks.

All right, so let's dive into the first one. Um, You know, the first one could be you are, um, lacking the support team members to reach your goals. It could be you don't have any, or you're just short one, or you're short two, or you're short half of one, right? You could use a part time help [00:04:00] and you don't have the support team members internally as part of your team, or even maybe outsourced like a VA or something of that nature.

Right. And so support team members is a common, uh, block and a lot of people are afraid to make that investment in a, you know, you got to look at support team members again, whether it's internal or external, um, as investment, not a cost. And if you, too many chiropractors think of the support team members as a cost and it really is an investment and you need to make sure you understand that.

And that you are willing to invest in team members. And that if you onboard that, if you hire appropriately, onboard them appropriately, train appropriately, you will have a team member that will produce an ROI for your business. And so you got to check if you have a support team member. So as you're, you know, if you're listening to this, obviously if you're driving, don't, but sort of jotting down, if you think you may have any of these nine that we.

Discuss the next [00:05:00] one is a term I first heard from the Scheduling Institute and they call it clinical duplication. I think in our, in our world, it's the associate chiropractor. Um, it could be, um, you know, maybe a mid level. Some of you have integrated practices. Uh, so you could definitely have, you know, some of that type of stuff, like nurse practitioners and, and things of that nature.

Maybe you have an athletic trainer, there's some clinical duplication there, uh, doesn't, you know, it could be a registered or well trained CA that's able to handle many of your modalities. Um, but for the sake of argument, I'm going to put some of those. in the support team members, whereas a clinical duplication, I'm saying they could duplicate exactly what you do, uh, which is really the associate chiropractor with the DC license.

And I obviously a lot of you fall into that you're like, I, I just can't find good help or can't keep good associates, or, uh, I don't know if I can afford one, but I could use one. And so clinical [00:06:00] duplication is typically a big block for sure. Um, and, and, um, you know, breaking through that, that ceiling of complexity as strategic coach talks about.

And also there's another one, uh, had a really good episode. You could just Google search it, uh, with Jason Holm and that's H U L M E. Uh, where he talked about a very similar topic on our podcast and he had some really great insights on that. So I recommend listening to that episode. Uh, the third one we'll talk about is space.

I think this is a common one that people run into is that you, um, you're growing out of your, there's two things here that could happen. There's probably more. But. We'll keep it simple. Um, you're growing out of your space, right? You don't have enough, uh, treatment rooms. You don't have enough rehab space.

You don't have, uh, enough space to hire a second front desk person that you need because the front desk isn't set up for that. Uh, there's all kinds of things that can happen with your growing out of your space. The second is an opportunity cost, which is [00:07:00] different, right? If you're just, you know, if you're running out of space.

And you're, um, you're hindered there with, with seeing particular patients. That's definitely just a loss of revenue. Uh, and, and it's, it would definitely fall into that opportunity cost. But then sometimes there's more, uh, opportunity cost that isn't so direct and obvious. And that is, say, you wish you could add the clinic gym hybrid, but you don't have the space for the gym.

Um, that would obviously be an ROI. Or you don't have any rehab space at all and you, you could be billing. Rehab, if you did and you would be doing it, uh, maybe you would, uh, I would offer a shockwave therapy, but I don't have the space for it. Right? So those are opportunity costs, uh, that you'd haven't necessarily, you're not bursting at the seams per se, like the first example, but you would love to grow and add different services, but you don't have the space for it.

Right? And that's, that could be a [00:08:00] whole, you know, I may, I may break down some of these and do their own solo episodes, uh, over the year, because that could be a whole, uh, episode, which, um, many people would benefit from next is equipment, right? Um, this could, this could definitely look like a couple of things, right?

Don't, um, you, you, you have a, uh, particular table that costs 10, 000 and you love it. And you really, and you have another treatment room. And you'd love to have that another table like that, uh, or maybe you don't have the treatment room for it. And you'd love to have a table for that. You got an equipment and a space problem there, right?

So, so you can see how some of these can be, uh, deeper rooted and that's what we're going to dive into in a little bit on this episode is how there's some usually deep rooted, um, problems that fall into why you have a block there. Uh, but equipment can be that, or maybe you're just, your laser therapy is just.

Blowing the doors out and you got his bottlenecked and you got a line and you need a second. Um laser, right? And that could have its own You [00:09:00] know, it's kind of like hold on one one second becky need some water there um, it's kind of like uh something I learned I forget what it was, but you got to watch out for When you decide to buy something and it's just say your personal life and because it can lead to like 50 other purchases It's like, if you buy the house, you know, like you just scraped together the money to buy the house.

And then you realize, Oh shit, I got to furnish this house. And then when you get in there and you furnish it, it's like, Oh, well, I kind of need more, uh, you know, pillows for the couch. Oh, we need more blankets for this bed. Like it just, it ends up one, one decision leads to like 10 others. And sometimes that happens with equipment or any of these, like, okay, um, let's, uh, I need a second laser.

But then if I, uh, get a second laser, I need a second person to operate that laser. If I get a second person, uh, that, that leads to more, uh, cost and, you know, and, and, and then you got more, [00:10:00] uh, management to do. Right. But that's part of leadership and that's part of growing and you can, you can figure those things out for sure.

Uh, but what, you know, do you have an equipment block? Is it a. Is it a situation where, uh, you need that second laser or, um, you, you would like to have that shockwave but you're not sure if you can afford it, again, that would be one, there's a underlying block to that equipment block, but many chiropractors have this and it's something that I want you to make sure, uh, you work through.

All right. Next one is mindset. The reality of it is, is a lot of you have mindset blocks. You have poverty mindset that's preventing you from growing. You have a fixed mindset instead of a growth mindset, pessimistic about things. You're pessimistic about the profession, about insurance companies, about your town, about the economy.

And you don't have a, any level of optimism around growth and, uh, that is, that is a problem. And the good thing is, is there's a book called learned optimism, which you can read [00:11:00] and realize you can get better at that. There's a book called growth mindset, which you can read, which realize you can get better at that.

There's plenty of books on poverty mindset. And escaping that commoditization trap, um, some of you are worried about being too stressed and that and growing would cause more stress. And so a lot of times there's a lot of mindset issues. And that's something that, you know, ironically, I never thought I would get into with people when I started, um, MCM as early on, just helping people with marketing, but now as we've evolved and we do business and practice growth, coaching and masterminds, you start to realize like a lot of it.

Is mindset stuff without being all woo woo, it's just certain things of, you know, maybe it's even lack of confidence in certain areas. And so you have to be honest with yourself. Is that your, is your limited growth, a mindset issue? Do you need guidance in that? Right. And that's all kind of mentioned on the mindset thing.

Uh, the next is time. Maybe you have a time block or just too busy. Uh, right. I, we have a kind of a phrase that we use with MCM [00:12:00] as we, we try to get a lot of, we try to get chiropractors from busy and broke to cash confident and time free or time rich. And, um. That's a big one. A lot of you are busy, busy with patients, busy with admin stuff, busy with family, uh, but you're not seeing the financial gain that you expect.

And so a lot of you, um, have time blocks that need to be, you just need to reallocate that. That's one of my favorite things to help chiropractors out with is time. As long as the person's open minded, it can be solved almost in all circumstances. And that kind of leads to another one. Another block is delegation, and a lot of times people don't have the time because they, they have a delegation block.

So that would be like a sub category of time. But yeah, there could be a block in delegation. Maybe you don't know how to delegate strategically, you need help learning how to delegate. Maybe you feel guilty about delegating because you have a wrong mindset around delegation. Maybe you don't have the support team members to delegate [00:13:00] to, right?

So you can see how that can lead to that. But a lot of you have a delegation problem. You're doing too many things and you're not, as Josh Satterley would say, is you're not. maximizing your DC license. Right. Um, and that's something to, uh, consider. Um, the next one is profit and cashflow. A lot of you do have a profit and cashflow block, and that's a reality.

And that leads to a lot of these other blocks, right? It's like, yeah, I'd get the shock wave, but I don't know if I have the profit or cash. Obviously we can work through that and there's options, there's financing, and there's also sinking funds that we coach our clients on how to. Uh, save for things or, you know, cut things and, and be more profitable, what, what good profitability looks like, what good cashflow looks like.

A lot of us never learn that. That's something that we, we typically dive into a lot, uh, with our, with our clients. And so you might have a profit or a cashflow block, um, that can lead to a lot of things. And then lastly, you might have a marketing block and that's what I want to, I want to tease [00:14:00] out a little bit here for you today.

is you just realize your clinic is not doing enough marketing. And maybe you built your practice and it's fine, you didn't know marketing, but it's just you, uh, and you want to bring on another associate, or you brought on another associate and you realize now there needs to be marketing to fill two mouths versus one.

And there's a lot of chiropractors that have a marketing block. And that one can have, um, probably more than this, but three key, um, subcategory of blocks that we find. And, um, one of those could be support team members, right? It could be support team members and you don't have the support to do marketing internally or externally, right?

That can be one that you could outsource for sure. You may. Not have that you might say to yourself. I don't have the time to do marketing the time to get out in the community and Do some public speaking or workshops or running events or whatever [00:15:00] meet people. That's a common one You might have a profit in cash flow.

You don't know how much you can spend on marketing You're concerned about spending on marketing because what if it doesn't work and I wasted money and that could be frankly a mindset I I you know, I'm only gonna go through kind of the three Here, but, or, you know, let's just, let's add mindset, you know, cause there's a couple of things with mindset.

You might, there's a few, you might say I'm a doctor. I shouldn't have to do marketing and that's wrong. That's a mindset problem. Uh, you might not think you, you have enough money or you're scared to send, spend money on marketing and that's wrong. You got to get that figured out and you should be spending money.

Now, do you need to spend. 10 percent of your revenue. Like some people say, no, you work your way up to a certain healthy percentage, but you do need to invest in, uh, you know, ROI driven marketing. You got to have that. Um, and that, and that's a, that's a problem for sure. Right. You might have a delegation. Uh, you know, and you don't know [00:16:00] how to delegate because you don't want to delegate to people or you're feel guilty about it.

That's a, you know, if you feel guilty about delegating, that's a mindset problem and you got to get rid of that one as well, uh, to overcome this lack of marketing that your practice has. And that's what we like to try to dive deep into it. And so what we do is we go down, we, we work with someone and say, okay, what are these challenges?

Um, to, to your marketing, your lack of marketing. And I, and I have like five here, I'll, I'll rattle off. But, uh, one is I don't have enough time to do a lot of community outreach. Like I mentioned, two is I'm unsure of how much I can spend on marketing. Three, I don't know what good marketing looks like and how to do it.

Four, I'm an introvert. Five, I'm doing too many tasks in the business because I'm a bit short staffed. Right. And so that's that support team member. And so those are some of the challenges that you have to do that are preventing you from doing good marketing. And the good news is you can overcome that.

Um, you may have, you may need help, uh, you may need guidance and, and you can do that and you can sit down and build out a logical plan to reverse [00:17:00] engineer this and, and tackle these obstacles, right? Like, like Ryan Holiday wrote about, the obstacle is away. That's what is good about doing this tool and looking at what the obstacles are and, and saying to yourself.

You know what? I can overcome this. It's not going to be easy or I don't have the wherewithal right now, but I'm going to find someone that does have the wherewithal to help me get through these. And I always like applying another strategic coach concept, which is the four C's, which is making a commitment to something right, making the commitment to overcome whatever block you have.

Um, and then having the courage to reach out to someone for help, to work through it while it's difficult. Uh, just like you did when you work through it to get graduate through four years of chiropractic school and take all those exams and graduate and have the courage to start actually treating patients.

And then when you do that long enough, you, you end up with a capability. And [00:18:00] so you might have a marketing issue now, but if you. Make the commitment you have the courage to do what it takes You then in your clinic will have a capability of marketing when you do it long enough. You'll have confidence In doing marketing for your practice that is elegant and ethical and is actually driving the roi Into your practice and so you may feel uncomfortable Uh and not have a strategy of overcoming some of these blocks that we talked about today but if you apply the four c's and and probably Uh, seek help for this and coaching, uh, you will get better at it as long as you do the work and, uh, that's what we do for a lot of chiropractors in a lot of different realms.

And so if you feel like. You've had any of these blocks and you could use some actual work to get through this to break through that ceiling of complexity that you have or you just know that you have a level of growth you haven't achieved yet that You'd like to your practice is amazing right now, but you want to get even better We're here to help you out.

So just reach out to us you can go to our website [00:19:00] modern chiropractic marketing comm fill out a form hop on a call with one of us and See if we're right fit to help you out with These blocks and many other things, anything, practice, growth, finances, marketing, business, communication. Uh, and then obviously we, we do marketing for chiropractors.

Like we'll do your marketing for you, but it's not canned content. And so reach out to us if you're interested in that. And we can plug our team onto yours. So you do have the support team to help you with marketing and all the other aspects of growing a practice. So that is our episode for today. And I hope this resonated with you and you are thinking about a couple of blocks that you need to work through.

And I have confidence that you can do that. Have a great week and we'll talk to you soon.

 EPISODE 412: Redirecting Healthcare to Compete in Today's Marketplace

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] Hey docs, welcome to another episode of Modern Chiropractic Mastery. Today, I've got a guest, Dr. David Berg is a chiropractor, but more of an entrepreneur at this point. And I had the pleasure of having him on my original podcast that you may not have heard about. I started my podcasting world, uh, with the Modern Desk Jockey.

And that was in, um, about, you know, mid, mid, uh, year 2016, we started with that. And that was, um, Uh, 82 or 83 episodes, but he was on that early on. And I know Dave from. Uh, strategic coach and he's got quite a company he has built called redirect health and he is going to dive into what that is and what that means to you and I think you're going to get a lot out of it, whether it's for your practice in the sense of, um, you know, having patients that have redirect health, the idea of it.

Um, things you could even offer for your employees, but also just thinking outside the box and thinking big and taking advantage of opportunities as [00:01:00] you see that. And David does a great job of kind of telling his story of how he got to where he is now. And, um, he is still part of strategic coach and we run into each other.

Every so often, but, uh, definitely a big thinker. And, uh, I encourage that for you as well, before we dive into that episode, uh, we are offering the 30 K a month course. Again, this is actually going to be. Uh, more of an evergreen. Um, you know, when we launched the first time we had, uh, it was a six week course that had zoom calls and a bunch of other things.

Um, so the, the evergreen course of this, you're not going to have the zoom calls with me. Uh, like, like they did, uh, but you're going to get the lessons and the material, and it's going to be on a good platform that will drip to you and you'll get the same material. Um, and so check that out. Just go to our website, modern chiropractic marketing.

com. And you can see that we will put the direct link in the show notes. Uh, as I record this, we don't have it yet, but it is on the website, [00:02:00] www. modernchiropracticmarketing. com. And so you could take this course whenever. And, um, Get, get a lot of the information out of that. It just won't have a lot of the Slack channel we had with the first group and, and the zoom call Q and a, and some other aspects of it, but you'll still have plenty of value.

So check that out. All right. So without further ado, uh, this is my interview with Dr. David Berg.

All right. Excited to have Dr. David Berg on the, on the line here. I've actually had you on my, my modern desk chalky podcast back in 2016 when I first started podcasting. And we had, we did meet a couple of times, uh, at strategic coach. I've been a member there for a while and I know you have as well. And so it's been exciting to, uh, see what you've done with redirect health.

But before we dive into that, uh, just give us a little bit of an overview of yourself. Yeah, sure. And strategic coach, um, has been part of my life for about 25 years now with Dan Sullivan for 23 of it. So it's, uh, [00:03:00] it's embedded in me as I'm sure it is you. Um, a lot of the principles that Dan Sullivan talks about.

There's not a strategic thinking coach for entrepreneurs that is better than Dan that I can think of. He's the best. I've been there 11 years, so I'm catching up. Yeah, see, you got it. You got it. Um, so my story. So I moved to Phoenix, Arizona with my wife, uh, uh, in 1995 from Canada. And, uh, so I was used to the Canadian healthcare system, which is not very robust, but it does have this.

It has a lot of peace of mind. People are not worried about the Canadian healthcare system. Um, and even in places where they should be worried because the wait lines are too long, et cetera. People just don't generally go about their day being worried about it. Um, and the they, uh, uh, but they are in the United States.

We have great healthcare here. But the worry and the lack of peace of mind around it, or especially around the affordability of it is incredible. Um, so my wife, who's a family doctor and, and I'm a chiropractor, um, [00:04:00] uh, we moved to Phoenix in 1995 and, uh, it was quite a culture shock for us. Just to see just how great the health care was here, but how worried people were about accessing it like Worried like no peace of mind over the most basic stuff that was formed to us So, we were trying to figure out how to make money in the American system and there are a lot of things just didn't make sense to us.

It was too. It was very complicated compared to the Canadian system. And there's a lot of what we eventually discovered that the confusion that was out there. It was very beneficial for a lot of people, a lot of parties, stakeholders, in order to make money. The more confusing it was, the easier it was for the system to make money.

And there were a lot of hidden costs, hidden transactions, hidden fees. It could be hidden costs of time, even, or hidden costs of frustration. But money, obviously, too. So we had to figure this thing out in order to make money. Um, in our business, and, uh, we were one of the, I think we were the, the first, uh, chiropractic family practice, [00:05:00] um, joint practice back in 1995.

There might have been one other chiropractor working with an orthopedic surgeon at the time, so it wasn't very common. Um, but we had to figure it out for our own business, but then we had also After about 10 years, I recognized I still wasn't able to figure out how to make health care work and affordable for my hourly employees And 10 years later, I knew how to make money in the system, but I didn't know how to make it affordable for Uh me to provide it to my employees and my employees to be able to afford it It was just too much time wasted time wasted money Uh in uncertainty, so I created a new system that was just common sense in a lot of ways But it was designed to reproduce that peace of mind that we experienced in canada But to experience it here with my own employees.

I had no intention neither my wife to ever Commercialize it sell it help other businesses and uh when the recession happened, and, um, I really started about 2006, but 2008 is when I launched it. And then, um, we had, I had a [00:06:00] bunch of friends in the, uh, business world, um, through Strategic Coach or Young Entrepreneurs Organization.

Um, Vern Harnish of Entrepreneurs Organization is a huge, is a great friend of mine. Um, so I've been part of those two organizations now for 25 plus years. And so I knew a lot of business owners and they were struggling with health care, but I had solved it from my own business. So I just started helping friends and I probably had about 15 of them that I was helping them with their business.

And we'd lower their costs by 30 percent when the insurance company was trying to raise them 20, 30%. We just lower them 30. And it would help them, uh, compete for labor, um, help them retain employees, . And, and for some of my friends who had a lot of injuries at work, or they had exposure to that, it would, the byproduct was injuries at work.

The work comp costs went down tremendously. That was just the byproduct. We didn't even design it for that. But it gave my friends businesses huge competitive advantages for hiring and retaining and workers comp for the [00:07:00] construction, uh, friends of mine. And a matter of fact, uh, two of the friends of mine, the brothers, uh, one was a former, former mayor of Phoenix, still is the former mayor of Phoenix, if he's not there, uh, and his brother, home building and drywall.

And, uh, the Paul Johnson is the former mayor of Phoenix. He is, uh, now my business partner also. Oh, wow. But we just saw just huge benefits by controlling health care costs by doing some common sense things and . But what happened is it started spreading around Phoenix in a freeway and then, uh, meaning we didn't charge for it.

And then Paul said, Hey, what are you doing? Like you're helping my business so much, my brother's business, and he's a dozen other businesses. You got to start charging for this. And then in 2013, we started Redirect Health with no intention ever to, like, do anything but start charge entrepreneurs and our friends in Arizona.

And then by 2018, it grew to, uh, small businesses all over the country. We're in all 50 states now, and hundreds of brokers [00:08:00] are, uh, pitching our stuff, selling our stuff and our solution. But in a, in a nutshell, Uh, we're, we're, we're a platform with technology logistics platform that helps make any health plan work better just by applying common sense principles, mainly around primary care and routine interventions that chiropractic would be part of, but so would labs and so would routine x rays.

And so would primary care. So would urgent care. It's that routine stuff that we use 90 percent of the time for 90 percent of our conditions. Um, yeah. That it just by helping that part of healthcare work better in, uh, in a more streamlined way, uh, it just helps eliminate a lot of the unnecessary activity and spending in the more expensive hospital systems, health systems.

So take me back to your, you know, go back to 2005 or so it's your business. You were doing this for your employees only. What, what exactly were you doing for them to? To corral this [00:09:00] healthcare system. Yeah. So in, in 2005, I wasn't doing anything different for my employees than everybody else was. I was having, like my HR person manager work with a broker to mm-hmm

Go figure out whether Blue Cross at a better price or Humana at a better price, united at a better price. And I'd shift, I'd switch every year or every two years when I got less of an increase. And when I got too much of an increase, I just raised deductibles back then. It's from $250 a year to $500 a year.

That irritated everybody when I did it. Um, now we're at 6,000, $7,000 deductibles all day long and then double that for families, but back then it wasn't. So I would do the normal things in 2005 and I'd do the normal things in 2006, and then when I got to about 2006, my deductibles were a thousand dollars.

And the big corporations in my neighborhood, say like Honeywell, American Express, Discover Card, the hospital systems, the insurance companies, the banks, they all had [00:10:00] deductibles that were still at 250 or 500. So when I'm at 1, 000, I can't be competitive. And I found that my very best employees, um, they could get jobs anywhere.

Because I would teach them how to do the customer service and everything a chiropractor has to have. nailed in order to have a successful business, the customer service, the empathy for the customer at all stages from finding a parking spot to receiving a bill and everything in between. Um, and the phones, right?

We understood what customer service look like. Well, what that meant was that any of my people could get a job paying a little more money at a big corporation with way better health benefits. So there are many of my employees. When I say many, it might have been 10%, but it's always the best ones. They would peel off when they wanted to start families.

Or they were getting married or they're, you know, that kind of thing. And I wasn't able to compete with the Honeywell across the corner, literally across the corner, uh, with their health benefits. So me figuring out how to compete with Honeywell and [00:11:00] American Express, these big corporations in order to retain my employees and be able to hire the best employees for what I, the customer experience I wanted to see in our practice.

It's what stimulated me to say, okay, I've got to figure out a better way. And that better way was to, uh, um, just help people get things taken care of over the phone so they didn't have to miss work. Help them take, get, get, uh, things taken care of, the routine things taken care of, without the nickel and diming of a 5 copay, a 10 copay.

That kind of thing. So once I figured that part out, um, I just created a plan that I then offered to my employees that met their needs exactly. And then I went re insured, I self insured and then I re insured if the cost got bigger than I thought. But what I realized is the cost never got bigger than I thought, um, if we did really good routine care.

All the things I included, it's not just primary care. It's not just [00:12:00] chiropractic, not just labs, not just x rays. It's not just physicals, not just mammograms, not just colonoscopies, but all those things, the routine things that we need. Um, if we did those things, well, um, we didn't waste money. in the bigger health systems, um, in the emergency rooms, in the urgent cares, and, and, uh, we started noticing some, um, huge price differentials between everything.

I mean, a baby in one hospital, um, could be 3, 000 back then. The same baby, same doctor, same mom in the hospital two miles away is now 17, 000. Now, so that doesn't even make sense to a, you know, a Canadian coming down here. It doesn't make sense. When I buy a TV or a pair of shoes, the price differential isn't that big.

Um, and we, but we started seeing that, um, there were tricks of the trade, billing tricks and coding tricks in the hospital systems that we never even imagined existed. So if we could do really good routine care And then help [00:13:00] people avoid or eliminate that, those coding tricks or the, the, um, complication tricks or the, the charting tricks.

Um, I call them tricks because two hospitals could do them differently and two doctors could do them differently. It's not usually in the doctors, it's the billing office that's coding the notes, the chart notes. It's not even the doctor coding them. So we started learning those price differentials. Um, it, we started seeing patterns and I started creating a logistics technology platform around those patterns because it's, and I initially I thought I could just teach people healthcare consumerism.

I learned after about two years that it was way cheaper, less expensive for me, probably a tenth of the cost. If I just did it for them, then try to teach somebody else how to do it. A tenth of the cost to do it myself than to teach you how to do it. Um, but there's everything we did. Any one part, anyone could do it.

It's common sense. However, if you've got 10, 000 of these things, and you're experiencing it for the [00:14:00] first time, it's very difficult. But if you've got 10, 000 of these things, and you're experiencing it for the 100th time, or the 1, 000th time, or you've got technology, and now you've got AI all over it, um, it's powerful.

Um, I'm gonna give you one example, really drive home that price differential and that common sense thing. If somebody has high blood pressure, really high, high blood pressure, you've got to get it down or they're at risk of a stroke. We have to. Um, to manage the high blood pressure, in the best case, it's about 21 a year of medication.

21 a year. Now, here's how you get that, though. You go to a grocery store and you get a tablet of a generic. Now, here's what surprises a lot of people. That same generic medication At a corner, big brand, big box pharmacy that's in a capsule format is now 3, 500 a year, 295 [00:15:00] a month versus 1. 71 a month. It doesn't even make sense.

All we did is change the form from a tablet to a capsule and from the grocery store to the retail pharmacy. We didn't even go to the brand name. You go to the brand name, you could be 10, 000. Right, so let's see if you can take the brand generic out of the place. So a lot of people didn't know that. I don't, I didn't know that.

And now when you, we've got, there's like, the coding, they're called ADC codes, there's like, I think it's 80, 000 codes. So, And there is probably hundreds of thousands of pharmacies. So in order to have the pricing for 80, 000 codes times 100, 000 pharmacies or whatever it is, it's insurmountable. So number one, you need the knowledge, you need to know the principles in place and where the tricks are and where the patterns are.

But then you need the technology to have the database that changes. It could change every quarter. It could change every day, really, but it changes every quarter, meaning one form of medication at one location is 1. 71 this month, but it's 4 next month. [00:16:00] And there's patterns that it's always 290 at this store in a capsule form.

So we, we, I just gave you one example of, of one condition, high blood pressure, where we can eliminate tremendous amount of costs just by understanding the logistical considerations. of the healthcare that's required. Um, chiropractors don't experience this a whole lot. But they do, in that if they could avoid the orthopedic surgeon, or the post surgical rehab, and the expensive D& D that happens afterwards, Chiropractors could be a big part at the front end, and they are in our system.

So, like, essentially, the example you gave with the tablet versus the capsule, that's you educating the consumer on their options with that high blood pressure, just like what you compared to with a chiropractor. Yeah, like, we talk about it a lot, obviously. It's like, that person goes with shoulder pain, and they go to the orthopedist, they go for the MRI, [00:17:00] they find something that Maybe it wasn't even related to the pain they're having in the shoulder and recommend surgery.

They end up with surgery and, and not, and not. Well, first of all, Kevin, where I'm going to, I used to think exactly what you said, that I could just teach the consumer. What I've learned is I can't, they don't believe it. It's too egregious. Like, what do you mean? 21 a year versus 35. You're, you're, you're wrong.

It's no way that could be true. It took me 10 years to believe that was true. Yeah, I just I couldn't believe it because I didn't experience that in Canada. Um, so I we just do it for them We tell them hey the price is twenty one dollars if I can lock in your brain The like anchor twenty one dollars is the cost.

That's what I have to do I have to anchor twenty one dollars because that way when you experience fifty dollars, you're a little upset and you come back But so there's a lot of anchoring of the right price in our members minds so they can help us

I think it's safe to say there are very few scenarios where it will ever make sense from the patient's perspective for a [00:18:00] chiropractor to send somebody to the orthopedic surgeon without doing the MRI first. Here's why. Many of the orthopedic surgeons either own their own MRI centers or they work for hospital systems that own their own MRI centers.

MRIs at a hospital system can charge out at 9, 000, 10, 000. That same MRI across the street can usually be done for 250, 300, definitely under 500. So the cash price of an MRI outside of a hospital system is always under 500 everywhere in the United States. If I'm a chiropractor and I send to my friend, the orthopedic surgeon, who happens to be at a hospital system, that orthopedic surgeon now is removed from the charging of the MRI.

They just send to their MRI center that's very convenient, owned by their employer, basically, or their partner, um, or who they're renting space from. And now that MRI price, [00:19:00] they wash their hands with it. Yeah, they charge whatever they want to. But that charge is In a hospital system, we're going to be 3, 000 to, I've seen up to 12, 000.

I've seen 9, 000 a couple of times now. I didn't see that two years ago, by the way, two years ago, my record was 8, 000. Now I've, we've blown by that in the last two years. Well, you can eliminate that unnecessary spending. Yeah, that's where you're the name of your, yeah, the name of your company redirect health is you're kind of redirecting the decision making and the knowledge and obviously the choices of their health care.

Is that correct? Yeah, it was, it was really on the concept of the logistical. Um, angle on rethinking, like just pausing and go, let's think through the thing through this. Let's make this make sense. What's the common sense here? 21 3500 9, 000 MRI, 300 MRI. Are they that much better? Maybe you can make an argument [00:20:00] that the one MRI is better than the other.

But it's not 20 times better. Yeah, it's just not and so the sense doesn't make sense But then we we wanted the spin of the logistics what we discovered is the thing that drives health care costs in america Not in Canada, so that was different. So maybe that's why I saw it a little differently and it was more obvious to me.

So I didn't see this in Canada ever. I just didn't notice it might be there. I didn't notice it. But logistical considerations could drive the cost of health care by hundreds of times. Like whether it's a tablet or capsule, that's the logistics to me. That's not healthcare. It's the same chemical compounds, the same disease, same person, same doctor, same everything.

But logistical considerations of the form of a medication. Or the, whether it's a grocery store or a big brand. I'm trying not to say the name because I don't want to get sued. I get it. I get it. Right? But they're, uh, that's logistics to me. Like, where do I go is logistics. So what [00:21:00] we discovered is logistics controls cost.

Healthcare does not, the need for healthcare does not even close to, um, match the impact of managing logistics on cost. And if we believe that the, as we do, that the problem with American healthcare, the thing that's stopping people and robbing their peace is cost, and the cost is getting in the way of their belief of access, in access.

Then we have to address costs. If we don't address address costs, we're not doing anything to solve the problem. If we're not using data to address costs, what good are we? If we're not using ai, the new technologies to to control costs, what good is it? I tell you right now, the system today is using data and they're using AI to figure out how to increase costs.

That is what's happening. And now it's also figuring out how to create a marketing message a brand message that says we're not If you put a [00:22:00] billion dollars on a message um Any message that message is going to stick if you put a billion dollars on it You might be a great dog. You might love dogs and hate cats, but you give me a billion bucks I'll convince you to love cats exactly If the system right now is using the new technology To do what it should do meaning what it's you should expect it to do their producers to their shareholders to increase revenue increase profits Increase reach to figure out how to sell more.

That's what their job is. That's our producer. They're all publicly traded companies so So, using AI, using data, using, uh, technology to, um, eliminate unnecessary activity and spending by addressing logistical considerations to deliver the healthcare people need, that's our focus. So, redirect. Health, uh, redirect was about just to remind us that we were focused on logistics as well as health.

I love that. And then let's say I'm [00:23:00] an employee and I've got a redirect health plan. Do I also need to have a regular insurance plan for the emergencies and that type of stuff? And how is that? If that's the case, what's the marriage between having a redirect health plan and a traditional health plan?

Yeah, so Redirect Health, in its essence, is a logistics platform. So it'll make any health plan work better. It's the starting place. It's all virtual. It's the technology. It's the AI. It's the data. It's the common sense built into it. It's the price differentials, knowing them on the spot, having teams of people that can help navigate through the, uh, you know, the last inches of the healthcare system where it's needed.

That's the platform. And the platform probably takes care of by itself, I'm going to make an estimate, contextually, 50 percent of what people need. But there's still other stuff that they need to, um, so other health plans can be added. It should be added in order to take care of the next 20%, the next 30%.

[00:24:00] The real expensive part is that last 2%, right? That I have to go to Mayo to get that special proton thing for my brain cancer. That's in the 1 10th of 1%. That part, that's where it drives up the healthcare costs is that those last percentages. Our platform. We'll take care of all the stuff in front of that and make it easier to access and less expensive.

And so we have, uh, clients that just have our platform and then they have their fully insured Blue Cross United Aetna Cigna plans and then our platform makes those plans less expensive. Because we'll help the uh, their employees make an insurance versus cash decision, right? If if I can get your blood pressure medication for 1.

71 At the grocery store, why would you want to pay your 20 copay with an insurance company? So we'll help with those decisions. So our platform makes that insurance plan work better for the people We have clients that are self insured and [00:25:00] so now the Employers are paying the claims. So now the employer Um, we help make their risk layer less or less expensive.

We take away the employer's risk so their self insured plan works better. We have some stop loss carriers that appreciate our platform so much that they waive huge, huge chunks, like 40, 000 per person in, um, in deductible that the employer would normally take on as risk. The stop loss carriers will waive.

A big portion, if not sometimes almost all of it, um, if our platforms in place, you know, that's, we got to prove ourselves that our platform is going to save money for the employer and for the stop loss carriers and for the people, um, because they, and I like that world because now we have actuaries who are looking at the data.

And quite often we get to, I get to have a conversation with them and say, I don't understand this data. It's too low. The costs are too low. And the part [00:26:00] that I've come to really appreciate from the actuaries is there are lots of things that we get to zero by not letting them happen in the first place that the actuaries are not used to ever getting to zero.

An example, a 9, 000 MRI in a hospital system. They're looking at our data and goes, there's no hospital MRIs. Why is that? Oh, good. Because we, our goal is to have none. Or if there are, if one sneaks out, no big deal. If it's 1%. But if it's You know, 20 percent, it creates incredible costs. So, I love working with the actuaries, with the health plans.

Your question was, do they need to have other insurance? Our platform by itself works really well for, um, for what it is. But people should have health insurance for the more expensive things. We'll help people pay the cash pay rates. for the routine things. I don't, personally, don't think anyone should have insurance for the routine [00:27:00] things.

That's like, to me, it's like having my car insurance pay for a flat tire, or my car insurance pay for windshield wiper fluids, or, or, uh, yeah, fluid or the wipers. Um, it just doesn't make sense. It drives up the cost of the insurance. I would rather the insurance was just there for the high dollar unexpected things.

Yeah. The ACL, the ACL tear plan, recreational soccer, things of that nature where you need surgery. So, um, we'll give an example as well. Like, uh, let's say I have a regular insurance plan. Now does that person that has the redirect health also, do they tend to then get cheaper insurance plans with higher deductibles because they're not going to use it too often because they're not just every time they go to the.

primary care or, you know, get this, that, and the other thing, an x ray, they have to go towards the deductible and it costs them a lot more. Is, is that accurate? Well, they should expect that they're going to spend less money out of [00:28:00] pocket. They should, I used to think that if they didn't, if they were really good healthcare consumers, that their, uh, healthcare, health insurance rates would not, would go down next year.

I used to think that. No, never happened. Um, and I also thought that it would stay level. Next year. Nope, never happened. Um, the best I've seen is instead of a 23 percent increase, you might get a 15 percent increase, but usually you're going to need a really good broker. He's got a lot of other business. It seems rather arbitrary to me.

Um, the system is designed to raise rates every year. And so by putting our platform in front of a regular insurance plan, it doesn't help the insurance company long term or even next year because they want to sell more insurance. And if we eliminate a lot of the big, the cost, they have less reason, you don't need as much insurance.

And so our platform is not going to be well received by, it's going to [00:29:00] be ignored for the most part, but I wouldn't, I wouldn't tell anyone to expect their insurance rates to go down next year. Unless they're self insured and they're an employer, right? If now, the employer is paying the claims costs, I'd expect the claims costs to go down.

Therefore, you're buying less insurance to start with. Because you're buying less insurance, just catastrophic. Maybe over 40, 000, maybe over 100, 000, right? That's what self insured companies do. So, everything under the, that's called the specific deductible. Everything under the specific deductible, the employer has to pay.

The insurance company pays only if it gets above 40, 000 or 100, 000, those two situations. So in our world, we rarely hit those specific deductibles because of the work that we're doing, which means the employer, uh, their risk layer is smaller, goes down, their claims costs go down. And it also means that the stop loss carrier doesn't have the same ammunition to increase their rates next year.

They still do, but they don't, they might [00:30:00] increase it 2 percent or 4%. They don't increase it double digits. Like we're used to all business. Yeah, no, that makes sense. And now let's talk about the small business world. Let's say a lot of our audience are small business owners. Uh, and I wanted to have this for my employees.

Uh, what, what does that look like? How, how does that work? Uh, so the best easiest thing to do is go to our website and, uh, just. Sign up and we'll have somebody call you and somebody who's going to ask about your business. See what you're trying to accomplish Every business a little bit different, but there's a lot of similarities, right?

So I always want to know like what are your business objectives and what are the constraints if your constraints are? I'll give an example if you're a law firm and your constraint is hiring the best legal assistants and lawyers I'm gonna say don't like just go buy a like the Cadillac plan And then put our stuff in front of it if you want, but that's not even that necessary Um, go [00:31:00] pi concierge primary care DPC for all your lawyer all your people.

It's a better way to manage your health care of that very high paid workforce if you're a construction company and you've got 10 managers or executives or managers and you've got 50 hourly workers That can drive up costs because of work injuries. Oh my gosh, let's go put it on them. And, and right, that's what, and you want to recruit those people.

Let's make sure that we've, we're doing the employer contribution. So our job ads can say free health care to recruit those people. So I can recruit over my competitor. Um, and if I really want to get, um, I mean, one of the best ones I heard was, uh, we had a maid company, a franchise, and, uh, they discovered that, um, Uh, when their, their franchises that had an average age, I think it was 26, uh, did better than average age, uh, [00:32:00] than the others that were like 21, 22.

And, um, so what they decided to do is put our stuff in place and pay for, uh, moms and children, 100%. So then their job as they put free health care, you and your children. Well, what happened is they attracted an older maid 26 years old who had children and that was their thing if they if they Got the older maid they tend to have children if they got them young that when they had children they would leave They would wouldn't be a maid anymore.

So they wanted to find people who want to be mates more as a career Um, so they need them a little bit older. And so they, they strategically said free health care, you and your children. So I'm giving you this example because we want to understand what the strategic need for health care is for the business.

And the only way to really know that is to have a phone call, a conversation. We do it over the phone. And then we've created some reusable building blocks that we put on top of our platform. Everybody goes on the same [00:33:00] platform. Nobody gets nobody's if you don't need our platform it you don't need redirect health And then we add different levels of coverage on top of it Depending on your workforce and then we also advise on different Employer contribution for different groups your company in a non discriminatory way there are laws around it We got to make sure that we abide by so that our health plan Cost the employer the least amount for the best result.

Now, sometimes you want to pay more, but you want to get a much better result if you pay more. So if you, does the, um, the employer get to pick and choose different providers that they would be able to cover? Uh, like I'll give you an example. If I'm a chiropractic practice owner, I probably wouldn't need a.

chiropractor to send to, you know, my employees too, because they could just get it chiropractic work done in my office. But maybe I just have a primary care doctor that's they're able to use for redirect health. Is that accurate? Yeah. So people [00:34:00] can go see pretty much anyone they want to see. We use a, we start with a really broad network.

It's called P H C S multi plants, like 700, 000 practitioners. Yeah, it doesn't really matter because when we do the enrollment our technology our platform We ask people what conditions they have what medications they take ones What doctors are they seeing all that stuff? We're asking it because we want to do a whole population health um blitz on that company to make sure that we're getting ahead of Um, the clinical need people might have the financial exposure, they might be, you know, probably going to walk into high probability of walking into or even we'll start to pick up where people are afraid of things and the fear is a is an incredible driver of bad decisions in health care that are very expensive.

So we, we will reach out to people and find out what their needs are in a prioritized way. And then if their doctor's not, we don't have a relationship with the doctor, um, [00:35:00] or they're not on the PHCS network, we'll just call them. We have a whole system for doing this and, and we've never talked to the doctor.

We talked to the staff and we just basically, it's a two page agreement. We call it a usual customer and reasonable agreement where they agree to usual customer reasonable billing and we agree to pay them within a week. They seem to like that. Yeah. No, I, I had experience with that. We had, uh, uh, one of your, uh, friends, sons, it was Indian and it worked out really good.

We got paid well and we got paid quickly. I guess a question on that would be is, um, all right. So the employee, the employer is paying redirect health for this plan for their employees. The employee goes in, sees that primary care doctor. Um, and, and let's say it's a, uh, It's a 210 bill for whatever the whole thing is.

Uh, redirect health is sending that check to that, that primary care doctor for that. Um, now does [00:36:00] the employee like say me have to pay the 210 or is that just part of the premium I'm paying to redirect health? Yeah. So, so for primary care, there's zero copay. We just don't want to manage the administration of like who owes that last 10 like that.

That it cost you 50 bucks, just figure out who owes the copay. Mm-hmm . And to, for everyone to collect it. So we've made that zero copay and that tremendously decreases the administrative costs. Which to everybody? Yeah. Uh, to us, to your, to the doctor, to the member. Like nobody likes opening these EOBs, this mail that says, this is not a bill, but it sure looks like one.

Um, right. And, and then you get a collection notice later because you thought it wasn't a bill. It's just nobody likes it. So for the routine things. We make it all zero copay, the routine labs, the chiropractic, the, um, the primary care, the urgent care, zero copay. And what happens, plan A is there's, we have a payer ID number, electronic payer ID number.

So the vast majority, say 90 percent of the [00:37:00] doctors, um, know how to use it. And they'll send us a claim and then we'll reprice it according to the usual customer reasonable. And we'll send them a check for a hundred percent. They don't have to collect anything from the patient. They love it. You've, you've got that 10 percent that want to be outside the system and don't want to use computers still.

And, uh, so there's always a chance that they'll just mail us a paper bill and then we'll do the same thing. There's always, that's plan B. Plan C is they might go, I don't want to do this, you just got to pay me patient. And the patient will pay. But now we're talking about probably 2 percent of our membership.

And then we have a way on our app to snap a picture of the receipt and everything. And then we reimburse them. Uh, usual customer and reasonable, which is almost always, almost always, um, um, exactly what they paid because they're usually paying the self pay rate. Um, so plan A is they send us the claim electronically.

Plan B is they mail it to us. [00:38:00] Uh, plan C is they make the patient pay and they. sent to us and then we have a whole system for reimbursing them in four days. I love it. No, it's been great. I had a good experience with it as well. And, um, I'm excited to dive into it more. So I, I really appreciate your, your time today.

What, how can they find out more information? Uh, recorrecthealth. com is the easiest way. Perfect. And I'll put that in the show notes. This is great. . Do they have any other special questions? I've got a, I've got a great team and, uh, I'm happy to help where I can and also to bring somebody else in if, uh, uh, if the, if the question or the, the need is a little greater than what I can provide.

It's cool seeing a chiropractor do big things. I appreciate all the efforts doing that and I know for a lot of chiropractors We are trying to compete and getting good talent and this could be one of those things to help you do that So yeah, and chiropractors are very important part of our system And that's why we make it free is because I don't want people to have to make the decision do I pay a 50 copay see a chiropractor or a 50 copay to see a physical [00:39:00] therapist or a Or a orthopedic surgeon, we know that if we can, we know chiropractors, we make our money before surgery, physical therapists and orthopedic surgeons, they make their money because of surgery, right?

So we know that and I'm not saying they're doing anything wrong with that, but I just, that's the basics and logistics matter. So if I can get you to a chiropractor first. Some percentage, significant percentage, will then not need the orthopedic surgeon and the post surgical physical therapy. Right? Some percentage will not.

Every chiropractor will tell you story after story how they've prevented. Uh, back surgery or knee surgery or shoulder surgery or neck surgery. Um, it's what we do. And, uh, so I, I, I appreciate having make it really easy logistically than a zero dollar copay as a way to get people to chiropractors so that they only need to see orthopedic surgeons and physical therapists when the surgery has to happen.

Absolutely. Have a good one, [00:40:00] doc. All right.

 EPISODE 413: Creating Until You Reach The Tipping Point

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. 

[00:00:00] All right, excited to have Jared Wadsworth on our podcast today, and we're going to dive into, um, you know, really consistently hammering your niche and doing it in a way that's elegant and, uh, with a content marketing twist, whether it's in person, uh, or through video and online marketing, something like that.

So before we dive into that, Jared, tell us a little bit about Uh, professionally, personally, whatever you want to give us on this 30, 000 foot overview. . Jared Wadsworth. Uh, I've been in, I'm in my ninth year of practice after school and wife, five kids from ages two to 12 turned 13. I live here out here in the West, a new time.

We love it here. Um, open up my own practice almost 3 years ago. So it's over 2 and a half years ago. And it's been great. Yeah. Where'd you go to school? Uh, University of Western States. [00:01:00] Masters in sports medicine as well. And then it's kind of dove into all the sports stuff here. Uh, moved my family's here in Utah, my wife's town in Idaho.

So we stayed out here. Um, we would love to stay in Oregon, but family's closer to my family. So yeah, you're, you're in a good spot. Uh, and so when did we, you were one of my early, early coaching clients. Uh, what year was that? We started working together. So we started. It was 2019, and that's when I was an independent contractor with another office, and I was, I started out at school.

I knew I, um, kind of want to run my own thing, but wanted to work some of this in the sports field.

I was able to build my own clients under that, under an independent contractor situation. And I called you, I heard about you from your podcast. I contacted you beginning of 20 2019 'cause I needed some help, uh, knowing how to do all the [00:02:00] marketing stuff that mm-hmm . Know how to grow business because I didn't know how to do that.

And it helped. Yeah. Yeah. It's been, it's been fascinating over the years of, um, yeah, we've had MCM now with the podcast and such for eight years and, and we were doing. Uh, certain things here and there. And then we, we launched it, the formally launched the coaching in 2019, early 2019. And I do think you were one of that early, uh, cohorts, but I had been mentoring chiropractors over the years a lot through, um, preceptor ships and internships all the way back from probably 2009, 10.

And, you know, it's, it's been, I've been practicing for 20 years now. And then, and then kind of mentoring some chiropractors through that preceptor ship. And then obviously into coaching. Uh, for, for about 16, 17 years and it's been interesting whether it's, uh, you know, my own career or seeing other chiropractors career now that I'm getting a little bit more long in the tooth here and seeing some of the [00:03:00] preceptors I had 13 years ago and where their careers have gone.

And, you know, so many of them, you know, the ones that have done things consistently, um, it's been impressive to see where they've, what they've done and where they've gone. They're just, there's so many, unfortunately, that, um, that don't put in the work, you know, and they, and they expect a different outcome.

And that's something that's always, it's just kind of like when we're treating patients, right? Where we're, we're hoping and expecting them to, uh, do what they should be doing to get better and what you're guiding them to do. And the ones that do typically have really good outcomes, the ones that don't struggle.

And you're just like, why can't you do this? And it's the same way. with chiropractors and opening practices and it's my kind of long winded way of saying that one of the things that stood out for the six years that you and I've worked together is the fact that you've You've digested what we've talked about and you've put it into To consistency [00:04:00] and doing it kind of day in and day out and week in and week out and to see you go from You know be an independent contractor in a unique situation.

It was fine to then Moving out, open your own practice, your own space and having the, uh, exponential growth that you had. What was your your growth that you that you had in 2024? I remember you gave me a percentage of growth. What was that? Um, about 40 percent growth in office visits and then like 45 percent growth in revenue, which was great.

So I attribute that all to what the work that we've worked on together and I knew it worked. It started in 19 and it showed it worked in 2020 when COVID happened and a lot of offices were suffering. But I grew a lot that year. Actually, I grew a lot in that year. Myself, I had a lot to, I was at the very bottom, so I had a lot.

I could grow anywhere, , but I grew out there, but then this has helped me open up my own office and then stay [00:05:00] consistent with all the marketing we've done just helped it grow that much last year. So, yeah. And, you know, one of the things I remember it was unique when we. the coaching in 2019 and then, um, we get punched in the face with COVID and a lot of our coaching went from getting people to try to keep growing or grow to, Oh, let's stable stabilize this ship so it doesn't go under.

And um, the ones that, one of the things I remember saying was like, let's throw out the, yeah. Uh, trailing indicators. Like, let's not worry about how many new patients we get in the middle of COVID or office was like, well, let's just focus on the leading indicators. And that was one of the things, honestly, if people do that, even in normal times, that's the thing to do.

And that was what you do. You just kept on plugging away and you were able to navigate that. And then once got on the other side of COVID to be able to grow and it's, and it's, it's a good, there's a couple of reasons I wanted to have you on the show today. And we'll get to the, the really cool one, [00:06:00] but it's just also the idea of the tipping point.

You know, it's a great book by Malcolm Gladwell. I read it back in the mid aughts. I think it might've been 2006 or something like that. And it just talks about where you just plug away, you plug away, you plug away, and then you reach a tipping point and then you have this substantial growth. And like you said, you graduated nine years ago, I believe you said.

And you just kept on plugging away and it didn't happen overnight. And it was a slog sometimes, but you never, uh, you were resilient. You were very resilient and keep on doing what you needed to do. And then you've reached a tipping point. Obviously you're not necessarily totally where you want to be, but you're still young and you've only been doing it for nine years.

Uh, there's these like different levels of tipping points. And I even feel like, um, I'm, I'm 45 now. And, and, and again, 20 years in practice in our, in the practice I own right now. We're in our 16th year, we've kind of hit another tipping point. So you have these different tipping points throughout the career.

So it doesn't mean once you had one, like you're kind of in, [00:07:00] now that this is it , but you just kept on under the surface creating content, getting out in the community, getting better clinically just doing those things. And you've had the growth in your, in your clinic and um, you. We're going to segue into kind of a niche, and I want people that are listening to realize you can apply what we're going to talk about today to whatever niche you're in.

But, um, you know, Jared got clear on one particular niche. And again, doesn't mean that all his patients are in this niche, but it just definitely hammered this one pretty hard and continue to. And what, which one is that, Jared? So I chose to mention golf and, um, I think you're right. People ask why they like being chiropractor.

And I mean, one reason is You can choose anything you want to and you can build a business around anything. So I chose golf early on. [00:08:00] I, I knew I wanted to focus myself into something separate myself from other offices.

I do, I got a master's in sports medicine at Western States and so I want to do something sports cause that was just my life growing up. So I wanted to choose something that I like to do first of all, and something that could grow a business. My first thing was actually basketball cause I love basketball.

I played on all the time. I still play it. Um, but then looking at like a culture of basketball players here, we play a lot, we play, there's churches everywhere. We play in church more of every church here, you go early morning, there's probably a group playing basketball somewhere from the evening in the church.

Um, but the culture here, if you get hurt, you just ice it, you stop playing for a bit, you ice your ankle, you ice your. Take a take a week off and you have to play. . Nobody seeks treatment. Once they get older, they just stop playing and they pick up pick a ball or something else.

When I chose golf because of I knew about TPI, I knew that [00:09:00] People like to play golf for a long time. They probably played sports growing up and didn't change to playing something else. And so I wanted a sport that you could play for a long time. And that's one sport that I know people will pay to play more if they're hurt.

They want to play more if they're competitive and put the money down to support the effort to get better. Whether it's. their hair, they'll actually take, take care of it. And the other thing was in my area, there was nobody like focused on that niche itself and that was the other aspect of it. So they kind of checked off all the boxes of one could supply.

Business to a business to grow a business. It's something that I liked to do. I took lessons growing up. Um, and I could see myself doing it more. I just couldn't help grow it. And nobody had touched the niche in my area. Um, I could see when, because it's Utah and you get a lot of wind, snow in the winter, [00:10:00] it's cold.

And, uh, I can see that, but I could, I had a thought that or some impression that. Um, Utah golf is actually really good and it was something there that nobody's really touched on. So I jumped on it early in 2018. Yeah, beautiful place to golf for sure. I was just out there in Park City, not for golf because it's winter time, but went skiing and, but yeah, plenty of golf there.

And yeah, so you, but 2018 kind of picked up the niche of golf, um, similar with me. That was a big one. I'm, I'm fully TPI certified, uh, for our audience. I actually had. Uh, Greg Rose on, um, middle, like late, late 2024, maybe it was October. So check out that episode. He had a lot of great, he had a lot of great wisdom on if you're going to try to tackle the golf niche, or again, you could apply what he talked about or what Jared's talking about to whatever niche you want.

And, uh, that was, that was very [00:11:00] eyeopening for sure. And so you've just been really doing a lot of content and also doing a lot of. Uh, community outreach stuff around the golf, um, explain to me what you've been doing consistently in the community to try to position yourself as an expert with golf. Yeah, so I've done a lot of content.

I'll choose with your program. We decide each month what the content is going to be. Not every month. Stop off. I do a lot of other things just help with growing a business with all the other pieces patients that we do see. But at least every other month, every 3 months or so, that's something. Around golf, whether it's golf injuries or how to prevent them or just little things.

This one next, we'll be putting out as a, you know, pre season warmup, which you guys can do before the committee outreach, I just kind of followed what. Greg Rose would teach and what he did a TPI. Cause I went through all the TPI training, fully TPI trained for medical [00:12:00] and some fitness stuff, um, but did what he did and he's just went out to talk to all the golf pros he could in the area.

And so I just try to reach out to all the golf pros. There's a dozen public golf courses in my Valley that I'm in. There's a few private golf courses that I, that I, uh, that are in my area. And so I first on went took some of your advice and put together a little workshop and went to every golf course, try to talk to all of them to put together a workshop for their men's leagues or their members, a workshop of just injury prevention and just what we could do.

I just, the content that I wanted to provide for them was something to help. Provide value to their members or their golfers. So they would walk away with something. It's going to do what Greg Rosen would do. And so always to provide value to them so they would see what I could bring to them and just educate them at all.[00:13:00]

Um, so work that started with a lot of workshops and some courses did it, some did it, um, and then it led into, joining a men's league and sponsoring the men's league in the close to my office. And that got me to meet a lot of cool people and just getting my face out there to talk to people and then meeting up with the private club members and the private club head pros.

And, uh, then that got me into getting with the local Utah section, the PGA, do local tournaments. So like the Utah Open, uh, some other opens that I go work at where I'll set my table up and I'll treat the golfers beforehand. Or the local private clubs, they have their member guest tournaments. So I'll go do a same pre round stretch table or treat them beforehand, just get them prepped beforehand to help the members and their guests at their [00:14:00] club.

 Yeah. You know, it's interesting. We, when we try to coach our clients and, you know, we. We try to make them understand that, um, you got to get out in the community, but there's a lot of ways you can do it strategically.

That's credibility enhancing, not credibility detracting. I think a lot of young chiropractors or even chiropractors that were my age. Got a little jaded with the community outreach stuff because they thought about the, the spinal screenings and the, all the different things out there that maybe wasn't what they imagined themselves doing to build a practice.

And there is a whole lot of cool things you could do out in the community that is credibility enhancing. It's going to position you as an expert and you'll feel good about doing that. And that was what. We try to guide chiropractors on, uh, the second thing we try to guide chiropractors on and is, is obviously content marketing.

I would say content marketing is the strategic approach that we really try to teach chiropractors and you can apply content marketing to the in person like you're [00:15:00] talking about, or you can obviously do it online, kind of a total web presence. And that's something that you, uh, how did you, you've shot a lot of videos.

Over the years now, you've kind of, you know, gotten in your groove and been doing that for, for quite a long time since we started working together. Now, uh, how did you originally feel about shooting videos and getting on video and getting content out there as consistently if you have online? Uh, I was very, uh, scared, very, I was never good.

Cameras. Uh, I always thought I could never really talk very well. Telling stories was hard for me because my family, like my dad and my brothers tell stories really well, but I was never at their level. And just growing up, I was always shy and didn't talk a lot. So that was definitely opening up a whole realm of things that I was not comfortable with.

But it was just early on taught me that once you just do it, just. Just do it and then you just [00:16:00] get better with it, you get comfortable and then once you're comfortable and then you get confident and it just spirals upwards and it just gets better. Yeah, you kind of referenced the strategic coach four C's that we love to give them credit for and it's amazing and it's essentially whatever, like there's just.

There's certain things we know that if we did, we would get results, right? Like, so many Kybers out there, they have this vision of what they want their practice to be, and they know in their heart of hearts if they actually did X, Y, and Z, they would probably achieve what they want, and then just can't get out of their own way.

And, um, one of the frameworks that I learned from Strategic Coach quite a long time ago, Was the four C's, which is, you know, making a commitment. So that's your first one is, is committing to something, right? You committed to go to chiropractic school, and then you have the courage to stick with that commitment when it gets hard or uneasy, or you feel weird about.

It or just not. You're out of your comfort zone [00:17:00] and you get that courage. So like you did, like people did, uh, to to stick through three and a half, four years of chiropractor school and actually go out and start practicing. And then you had a capability to become a chiropractor. So that's a third C is you develop a capability.

And when you do it long enough and consistently enough, you then have confidence in it. And it And it's, um, it's just something that I always, when I know I need to do something and want to do something, and I know it's going to serve my vision, I really think through that four C's and realize, okay, what is the.

What's the fear that I have around it and try to work on that to, you know, have the courage, we all have the fears and some people have the courage to, to, to kind of go ahead, head into the, into the fear. And some people just retreat and that's something you have my people have to dive into sometimes.

And frankly, we have those conversations with, with our clients and, you know, sometimes, uh, you know, some of our, it doesn't work out with some of our clients cause they just can't. [00:18:00] Overcome and I'm not talking about just video but just some certain things. It's like and we're not and we don't put chiropractors in a box We we don't like have them do these crazy long care plans or anything that a lot of people are concerned about it's it's all ethical based and evidence based chiropractic stuff, but You just really kept at it and that's why I wanted to To to chat with you about a little bit because you know some people I think For them to get on video or to go out and do public speaking like you do and all that they need to be This like a list celebrity actor skill set with you know, dripping of charisma and communicating like ronald reagan, right?

So it's like it doesn't have to be that way. We're not trying to turn people into um You know, world class, um, international speakers. And we're trying to become experts in our community. And, um, anybody can do that because that's a chiropractor that, cause you have a wealth of knowledge and people will get that and they, and they can relate to you when the [00:19:00] video is relatable and you're providing with, with good information.

And you've, you've done that over years and it's helped, um, build your. Your, your practice now, um, so you've been tackling the in person, you've been tackling the content marketing, you've been getting at it. And I want to, I want to kind of spotlight the cool opportunity that has come your way recently.

And I'll, I'll have you obviously dive into a little bit, but you've been working with a professional golfer that a lot of people would know. Uh, we won't mention his name, but. And, um, you been working with him because how, how did that happen originally? You just, was it because of the connections you were making the community because of the legwork you were doing around the community?

Um, not exactly. No. Um, when I was lucky or once the old verbiage of you put it out in the, in the universe and the universe will buy it, I guess. So something like that. Um, it was actually my old office when I was an independent [00:20:00] contractor about five years ago, just over five years ago, the other guy I worked with was an old, uh, big college and worked with the college as an athletic or team chiropractor for the football team.

And this golfer was actually referred to him first when he was out of town. And so I was. Taking everybody who was needed it at that time. So he referred to me and so I saw him a couple of times and then I just where it started and then from there I just kept in contact with him and didn't push anything.

He maybe once a year when he's in town and supporting with some of the stuff that he put out in the state in the area and, uh, we'll just keep in touch here and there. And then so that's 5 years ago. And then recently, uh, just a few months ago, he. Uh, reach out to me, see if I'd entertain working with them full time.

And [00:21:00] I, uh, obviously couldn't say no. So I jumped on it. And, um, to all the, I could provide and help them and just be available. And so then he's asked me to travel a few times. So I've traveled to a few PGA events and a few more planned this year and just, uh, keep healthy. Yeah. And it's a, it's a cool opportunity to, you know, keep on working on your niche like you have.

And then you get someone that, um, you know, recognizes your value and your expertise and working with golfers. And again, you know, your, your marketing and stuff that you've been doing around golf wasn't, um, without substance, you, you know, how to work with golfers, you did the TPI stuff. You've been really.

Honing your skillset on that. And so that when you did get the opportunity to work with someone of high level, you had the chops to do it. And obviously do well enough to where, um, now he's having you, uh, travel with him and, um, on, on a lot of the events, how many events are you going to do per year? [00:22:00] Uh, we're planning like eight to 10.

Yeah. Eight to 10 events and got some cool ones going to be at the masters this year. I'm jealous. And, uh, it is something we navigate was to be able to do this because usually you leave Sunday or Monday and you're there all week and come back on Sunday. So there's definitely a travel component to that in your, um, but you put yourself in a place clinically in your, in your practice where you're able to bring on another doc here soon to cover a lot of those weeks that you're out and that way the practice isn't completely shut down.

Um, you're also getting compensated. That's I think something I won't mention the exact number, but it's in the, it's in the, it's in the low six figures that get compensated from this golfer to, to be able to travel for eight to 10 weeks. That's, uh, that's really, that's a game changer financially, which is cool to see the, that impact for you and your, your family, which is awesome.

Um, and that's going to be, be great. [00:23:00] And now you're also kind of stepping into that new level of leadership to where you're gonna bring on another doctor to help out the clinic to, to cover that. And so it's exciting to see you be able to work with a high level golfer, travel to some really cool golf tournaments and, and get paid very well.

And I think. When as a chiropractor, you continue to position yourself really well, you can get some really good opportunities and command, uh, really, you know, really good money. And I think we all deserve these opportunities, um, to do that. And so, um, what are, what are some of the things you're excited about this year, um, with adding that and also kind of maintaining the clinic growth that you had from last year?

That's going to be the, the threading the needle, right? Yeah, so. This, I told you this, that bringing on a new associate is, this opportunity jumped that for three to five years earlier than I was planning [00:24:00] for a three to five year plan. So I jumped it up early, so I'm excited to see how much that helps. And help this grow more and have some another person in here to help the growth that I had last year to just continue on and also to see how much, um, maybe not out there and working with new golfers and this has opened up opened up my world to a whole new aspect that I didn't even want to think was.

Yeah. You might find yourself, uh, getting some referrals of some other golfers. That's oftentimes how it happens, which is, which is pretty cool. I, I traveled on six events, five or six events in 2011 and it was, uh, it's fun. It's a, you know, it's a lot of work and it's, and working on someone like that, it's a.

You know, high, high, uh, high stress, make sure that they're doing well, but it's a cool opportunity. And one of the things, another thing I learned from strategic coach, I obviously give them a lot of credit [00:25:00] for where I've gotten as an entrepreneur and helping chiropractors, but is the idea of strategic by product, right?

So obviously. You know, if you're in a particular area and you work with golfers, you may not come across an opportunity to work with a pro golfer, but you never know. Um, but the strategic by product concept is the fact that you never know what by products are going to come when you put in strategic.

work consistently. It's not a fluke. Like you've been strategically, um, creating content, position yourself as a golfer, getting better at treating golfers, doing all the right things. And then there just happened to be a chance to work with a guy, but you happen to also be prepared, right? It's for that, that saying when opportunity me.

Meets preparedness and that's where you were. And then this was a, this wasn't in your vision maybe six years ago, but it's a strategic by product of the vision that you did have that you were strategically [00:26:00] taking consistent action on. And I, and that's what I want the chiropractors to get out of this episode is that you need to be taking strategic, consistent action.

What you envision five or 10 years down the road is not going to come out exactly like that. A lot of times it comes out better because of these offshoot byproducts that happen. And the, the other thing is like a lot of people have excuses, but you know, Jared mentioned earlier, he's. He's married and has five kids.

Um, I'm sure there's not all the, uh, extra time in the world. And I know for a fact, you're a great family man. So it's, uh, it's not like they're just, you're swimming in extra time. And a lot of people will give me a lot of excuses about time and I get it. We all have time crunches, but what you have done is strategically utilize your time and prioritize, um, building your practice because now you are.

At a young age and really [00:27:00] being able to provide for your family, which maybe you didn't fully vision envision three to five years ago, as far as now, this opportunity, um, and how and I bring up that, um, with the byproducts. And then also just the fact that, you know, you are a family man and all that. Um, how do you, how do you manage the time?

Get up early, stay up late. What are some of the things you do or just schedule yourself? Well, uh, I do get up early. Um, my wife thinks I probably work too much, but I get up early. I just kind of kept with the schedule where I, Tuesdays, I don't see a lot of patients in the office. I just do some marketing.

I'll do that at home. Um, we'll do some, um, computer work at home, I'll do calls with you at home on Tuesday or I'll just get up early or do some of my outwork on Tuesday, but try to be home for some evenings with the kids and as much as I can, I try to coach one of them, if they do a sport, so I'm coaching my son's basketball team right now, try to coach all my kids in some basketball, [00:28:00] soccer or something that they want to do to be there for them, and then I, family is a big part of me growing up, it's part of, a big part of our religion we're, we're part of.

I always take Sundays off before we go to church. Um, I always, you know, say prayer nights together as a family. That's a big part. So. Well, as I said, you put, you put family first. Yeah, you put family first and then you, but you work hard. And I know like one of the things, and I work hard. I don't have five kids.

I have two young kids. And, um, and I am, I am blessed that my, my wife can stay home and, and, um. And manage the house and our kids and she does do some work for MCM as well. She does all our, I gotta give her, I gotta give her a shout out here, all our mastermind event planning. She does and all are like the locations, the hotels, the dinners.

So, uh, she enjoys doing that. But, um, yeah, it's, uh, I want my [00:29:00] kids seeing me work hard too, right? And that's something I've said. Quite a few times. It's obviously there's a point of no return. You don't want to be a workaholic and have no time, but you, you've done it to where you've been able to be very present with, with family, but still work hard.

And, uh, yeah, I mean, when you own your own business, there's going to probably be a little higher level of working than, than not, um, but it's been pretty cool to see you again, thread that needle of working hard, doing things consistently, have these strategic by products, but also still maintain your. Yeah, I'd say that I really wanted to be Become a chiropractor.

Cause it's more covers are run their own business and I wanted to run my own schedule. So I do plan a lot. I schedule things out my life and I always do a planning every week, every Sunday night. It's always planning for the week to see what she needs for me and what I can do to help and what I have going on.

So we plan around it and. And, [00:30:00] uh, I always wanted to run my own schedule. So that's why one reason why I chose this, this meal. So it is, it is a nice thing, even though we work hard, you do get to choose it. Uh, I have a buddy who his kids are in baseball now, and he goes in and gets the schedule from. From the kids baseball.

I think basketball too. And, uh, you know, let's say he, he has hours until 6 p. m. on a Thursday. Um, but let's say one of the kids has a game at 5 p. m. on a Thursday. He knows this in advance because he gets the schedule and he goes in and he blocks off. He gets, you know, that, that particular Thursday he's done at 4 45 and that's the priority that he has.

He, he, he might make up an hour somewhere else or he may not. And he's got an associate doctor. He's built a practice that serves him and his family. So, um, Yeah. Awesome, Jared. This is exciting. What's that? I do the same thing where if I know [00:31:00] ahead of time, I'll block it off. My wife wants to leave town and I'll, should we go to Idaho oftentimes in the weekend?

So the short weekend trip, we'll walk off on Friday afternoon and I'll sleep early. Yeah, you can do it. You can, you can definitely do that. You can carve it out, get ahead of it. I, I think one of the best things a person can do is get at least three weeks ahead on your schedule. And put on things in there that are the priorities, whether it's family stuff, sporting events, dinners, uh, even gym time, things like that, get that on the books, carve out things and work around that and, um, and work on your business.

And I think that's something that you've done and starting to pay off. And I, I commend you for overcoming any, uh, fears you had with. Getting out in the community or shooting videos or when you felt like it was getting challenging and overcoming that. I, I commend you on, on just continuing to, uh, put in the hard work and it's been cool to see the results.

So good stuff, man. Thanks. Yeah, it was challenging. There's probably a few [00:32:00] times where I thought, I mean, Utah, I probably should stop the golf stuff and focus on skiing or something, but yeah, no, it's worked out and, uh, yeah, no matter where you're at in your career, there's challenges and you just got to overcome it and, and realize we're all, uh, solving problems all day, every week and you're doing it, man.

Good stuff. Well, um, Yeah. And we'll, obviously thanks for all the stuff that you do as well as the coaching and your coaching's great. And it's been help a time. So, uh, it's been, it's been fun and it's been fun working with you. And, uh, I know we will see each other every week here and get on, on calls and stuff as you navigate, uh, this exciting new, um, adventure.

And so I, uh, I will expect my ticket from the masters in the mail soon. No, I'm just kidding, Chad. And, uh, I'll, I'll look forward to maybe having you on again to, to let us know how this year went. As you do this. Will do. Thank you for having me.

EPISODE 414: Managing the Emotions and Chatter

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, Doc's got a solo episode for you today. And we're going to talk about how to manage your chatter and your emotions. And occasionally, uh, I come, I come across a book I read and I do read a lot. I. Combine, I do three things. I listen to a lot of podcasts for sure, but I also listen to audio books, but then I do physically read books and always have a book that I'm physically reading.

And about four months ago, I heard about a book called chatter, the voice in our head, why it matters and how to harness it. And I decided to read this one physically and it's written by Ethan cross and he is a. A Ph. D. researcher out of the University of Michigan, so he He comes at this, uh, from a psychologist standpoint, but more on the research side, not a, a clinician in psychology.

And so he has a ton of research, which I think you'll appreciate is a lot of the concepts [00:01:00] that he writes about aren't just, um, motivation or hearsay or, or things like that. It's, uh, it's really based on the research. And I read this book and, you know, as, as, as you could probably tell with the subtitle, the voice in our head.

Why it matters and how to harness it, uh, pretty compelling. And it was a really good book. And I even did a coaching call, a group coaching call on this. We do occasional book reviews and really dive into the material. And what I liked about this book at the end was he laid out like 24 different actual strategies, uh, for this.

And, uh, that was good. I'm going to dive in a little bit of that. Uh, then he, uh, it was, it was actually pretty cool. I read the book chatter. I did the coaching call and then right around that same time, his second book came out again from Ethan Cross. And this one is called Shift Managing Your Emotions So They Don't Manage You.

And as [00:02:00] you can imagine, that's compelling as well. And I just think. As chiropractors, um, you know, we, you know, whether we're just, whether we're students, whether we're new in practice, we've been doing it for a while, whether we're an associate, a partner, an owner, different layers of all this, um, whether your practice is doing great.

Or struggling. We have a, we have to manage that voice in our head. And we also have to manage our emotions and being able to, to do that and having certain strategies will benefit you. And I don't know if it's, uh, you know, because I'm, I'm aging, I'm 45 now, or maybe it's lower testosterone at 25, uh, but I'm getting better at this, but I have put a lot of work into leadership and I think a big part of.

Leadership is being able to manage, you know, your self talk and certain things like that. And also your [00:03:00] emotions and being able to communicate effectively when things are stressful or when, you know, having a bad week in the office or a patient comes in, can't walk in hard to walk out, you know, different things like that we deal with.

It's, uh, we, the more we can have a narrow bandwidth of emotions, uh, the better not, not to say you shouldn't be. You shouldn't have emotions and he talks about that as well, but you definitely need to be able to, to manage that. And so I'm just going to dive into a few things, but I just highly recommend starting with the book, uh, Chatter.

And I'm just going to kind of read you the inner, inner flap here, right? So you can get an idea of what we're talking about. Um, you know, here we go, quote, tell a stranger that you, Talk to yourself and you're likely to get written off as an eccentric. But the truth is that we all have a voice in our head.

When we talk to ourselves, we often hope to tap into our inner coach, but instead find our inner critic. Uh, when we're facing a tough task, our inner coach can [00:04:00] buoy us up, focus. You can do this, uh, but just as often our inner critic. Sinks us entirely. I'm going to fail. They're all going to laugh at me.

What's the use of this? In Chatter, acclaimed psychologist Ethan Cross explores the silent conversations we have with ourselves, interweaving groundbreaking behavioral and brain research from his own lab with real, real world case studies. From a pitcher who forgets how to pitch to a Harvard undergrad, negotiating her double life as a spy, Cross explains how.

These conversations shapes our lives, work, and relationships. He warns that giving in to negative and disorienting self talk. What he calls chatter can tank our health, sink our moods, strain our social connections, and cause us to fold under pressure. But the good news is, is that we're already equipped with the tools we need to make your inner voice work in our favor.[00:05:00]

These tools are often hidden in plain sight. In the words we use to think about ourselves, the technologies we embrace, the diaries we keep in our drawers, the interactions we have with our loved ones, and the cultures we create in our schools and workplaces. Brilliantly argued, expertly researched, and filled with compelling stories, Chatter explains how the conversations we have with ourselves shape our lives and give us the power to change them.

And that's the inner flap of that book. Just highly recommend it. I mean, as I read it, I was kind of thinking about how we as chiropractors face Challenges all the time and why do some people thrive really well and some people continue to struggle I know there's a lot of variables But there's a lot of people that have positive self talk have confident self talk not all the time but the majority of the time and they're optimistic and they're they They feel like they can overcome that struggle.

You, you know, you tell them that insurance reimbursement is going to be [00:06:00] cut. They're going to figure out a way to overcome that they, uh, they have a bad month. They're going to figure out how to overcome that there, uh, you know, there's a snowstorm and you miss a week of work because of it or whatever.

They know they're going to overcome that. And there's others that every little thing. Big middle thing becomes setback that they, they ruminate on consistently, and then ultimately they have a career of rumination on bad self talk and I, and I, and I know you can get better at it. I think that's the thing is no matter where you are on the.

You know, the continuum of self talk all the way from terrible to great, uh, you can improve and go from there. It doesn't mean you're going to be a Navy SEAL per se, right? I'm sure their self talk has to be pretty on point to get to where they have. And we're not trying to get to that level as chiropractors, but you get the, you get the point, you need to improve this and you can a few things that stood out to me in those kind of 24 strategies that he.

He gives, was using, uh, [00:07:00] distanced self talk, which I had heard this before, but he breaks it down really good in the book. And I'm just going to give you a little excerpt that he talks about, uh, on using distanced self talk. Uh, quote, one way to create distance when you're experiencing chatter involves language.

When you're trying to work through a difficult experience. Use your name or the second person quote you to refer to yourself doing so is linked with less activation and brain networks Associated with rumination and leads to improved performance under stress wiser thinking and less negative emotion That's why a lot of times your athletes will say, you know something like come on tiger, right?

You've heard Tiger Woods. I was like a whole thing. He would always call himself Tiger When he was struggling and hit a bad shot. And, and that's an example of doing that. Instead of saying I or me, you're saying your name or you're saying you like you can do this. And, he gives an example in the other book shift, , he [00:08:00] kind of circles back to this, using distance self talk and gives an example that, um one of the tennis players, Novak Jovi, talked, uh, did when he was losing, he lost like the first two sets of a match, Wimbledon, and he lays out how he took a break. Said it was a, a, a bathroom break, but went in and just looked in the mirror and was just using the word you and, and a bunch of other things he talks about in the book.

But using distance self-talk is a big thing to overcome this chatter. Uh, another one he talks about is it. Imagine advising a friend, quote, another way to think about your experience from a , distance perspective is to imagine that you, what you would say to a friend experiencing the same problem as you think about the advice you'd give that person and then apply it to yourself.

That takes the emotions out of it. And he talks a little bit more about that. Uh, I feel that's been something that's helped me. Uh, being fortunate enough to coach a lot of chiropractors is that I still go through my own shit as we all do. Um, but I, I [00:09:00] do have that, um, experience of coaching chiropractors and being able to kind of reflect on that and say, okay, what would I tell another chiropractor that's going through this?

And so that's pretty cool. Um, the other one is, uh, broaden your perspective. Chatter involves, quote, chatter involves narrowly focusing on the problems we're experiencing. A natural antidote to do this involves broadening our perspective. Instead of that narrow focus, and we get in the weeds in and we ruminate, a natural antidote is to, that involves Broadening our perspective to do this, think about how the experience you're worrying about compares with other adverse events you or others have endured, how it fits into the broader scheme of your life and the world and how and or how the other people you admire would respond to the same situation and putting it in perspective.

You know, it's like when how You have a bad day in the office. I mean, he'll say it could be worse, right? And you got to have kind of [00:10:00] reflect back on that on some of the things that people are actually going through now, obviously, if you're going through something massive, then then I get that. But a lot of the chatter we have a lot of the rumination in the grand scheme of things are not that big of a deal.

The next and last one I'll talk about in that he gives is one called reframe your experience as a challenge. Quote, A theme of this book is that you possess the ability to change the way you Think about your experiences. Chatter is often triggered when we interpret a situation as a threat. Something we can't manage. To aid your inner voice, for example, by reminding yourself how you've succeeded in similar situations in the past or by using distance self talk. That is obviously something that helps as you progress through this career and you've been doing it maybe for 20 years like I have is that.

And when you come across obstacles or things in practice, uh, you've had enough things you've overcome in 20 years that you're able to [00:11:00] reframe your experience and know that you can get through that. But those are four of, of many strategies he has, uh, which are really good. And I just, I recommend the book, uh, it just was a really good read, easy read, but definitely has the research.

And then he gives you some actual stuff, which I. Which I like and then next

from the book shift. There's a few things. I'm not going to dive into Too many of these but one is he talks about the idea of self efficacy, which I really enjoyed and I'm just gonna kind of read an excerpt from that but to be able to manage your emotions Having some self efficacy is going to be really important.

Dr. Kevin Christie: So, I'm going to read a little excerpt here, and , Bandura's historic research helped him uncover the power of a concept he would call self efficacy. The idea that you believe you're capable of reaching a goal, that very belief plays a pivotal role in helping you reach it.

It's not that the belief is [00:12:00] some sort of magical elixir, it's that the belief itself puts you in a better position to make your goal a reality. A weak sense of self efficacy, that is a lack of confidence in one's own ability to create change in a particular area of one's life, leaves a person unable to help themselves because they don't believe they can in the first place

 so you know, it says there, you know, this last little line I really like is leaves a person unable to help themselves because they don't believe they can in the first place. You got to believe that you can help yourself. And this book talks a lot, a lot about that.

And different strategies around that. But the self efficacy really stood out to me. I think I run into a lot of people who just don't believe they can have a successful practice. Don't believe they can manage their emotions. Don't believe they can lead people. Don't believe they can, um, you know, do whatever, you know, get better at marketing or public speaking, right?

There's a lot of things [00:13:00] that. Um, they struggle with on that and I, and I don't, um, I don't want you to fall victim to that. And so self efficacy is a big thing he talks about in here. The next one is sensory experiences and he dives into what music can do and change your mood. Like. If you're in a bad mood and, or you're, you're not, you're kind of in your feels as it, as the millennials or Gen Z say now, um, turning on particular music, you really like can actually shift your emotions.

And I think we've all experienced that before. And so he talks about other sensory experiences you can do to do that. Sometimes it's food and smells and, uh, nature, uh, but music is a quick one. You can do, I mean, we all have it on our phones. So sometimes you might just need, you know what I'm having a shitty.

Morning in the office here, but I got five minutes. I'm going to go in my personal office and turn on a couple of songs. I really like and get out of that mood. And that's something that, that I've experienced over time. And it's a strategy. I haven't implemented, uh, like say [00:14:00] intentionally, I think we've all done it somewhat intentionally, um, but I'm going to start doing that for sure because that'll be, that'll be helpful.

Um, and then lastly, he talks about in here, uh, that I, that I like is, um, it's the ABC model, uh, of really, um, you know, impacting your, your emotions. And, uh, there's a, he learned this some, some years in, in school there. And really what it is, is that A equals adverse events. So you. You have the adverse event, for example, uh, you know, a scary health diagnosis.

And then B is the belief, you know, for instance, it's over, my kids won't have a father, um. deserting them. This is what he wrote. It's not me. And then C is the consequence. For example, anxiety, stomach, churning, nausea, sadness, all the things we get into our emotions. And then, uh, I'm going to read this just real quick here.

Quote, the most important thing about the ABCs is that if you can change B, then you can change C [00:15:00] because not surprisingly negative thoughts often drive negative emotions. So while you can't do anything about a scary health diagnosis, you can modify your thoughts about it. For example, maybe it's a false positive.

And even if it's true, I can still get treated, which according to this formula should in turn allow you to handle the situation better. So you're always going to have adverse events. So A's are going to happen in your life, no matter who you are, no matter How great you are, um, no matter how easy of a life you have, there's going to be A's, which are adverse events.

And then the B is what you need to really catch. And you need to be able to flip that belief from something negative to something positive, which then will in turn change C, which is the consequence. And I think that's where people who are very effective in managing their emotions. I think that's where they get it right.

They're really able to, um, change that B and have a better C that follows it. And so that's, um, just a few [00:16:00] key aspects from the book shift, managing your emotions so they don't manage you. And that's something that I really want you to, um, look into. And as far as read, uh, the other thing I want to, I'm going to leave you two other things.

It's, um, not from the book, but definitely. Um, kind of apropos for this and I, I, I read another book or I should say, I listened to this one, which was set the table by Danny Meyer back in like, Oh, six or Oh, seven. He wrote that, but it was the first real book on hospitality by a restaurateur. There's been another one recently, but he had a lot of really, it was, it was like a five and a half hour, six hour listen, which isn't too bad for an audio book.

So it was really smooth and enjoyed it. He had a few really cool concepts, and one is the 51 percenters. And when you hire and when you build a team, um, he has a, a quote here, 51 percenters have five key emotional [00:17:00] skills necessary to provide excellent hospitality. Now I'm gonna read. I'm going to read this and I'm going to read it, the five emotional keys.

And this is what you want your team members to have, but I also want you to self reflect and see where you are as it pertains to these five. Okay. And so, um, let's give a little quick read here. Okay. In the following exclusive excerpt from a chapter called the 51 percent solution, Meyer explains his core philosophy on hiring, recruiting, and managing the people who run his restaurants.

Okay. We don't believe in pursuing the so called 110 percent employee. That's about as realistic as working to achieve the 26 hour day. We are hoping to develop a hundred percent employees whose skills are divided 51 to 49 between emotional hospitality and technical excellence. We, we refer to these employees as 51 percenters, right?

So in our world, [00:18:00] You know, you would have 49 would be the technical, which would be your being a doctor, the chiropractic, what you do, and your healing, and the 51 percent would be your emotional hospitality. Uh, so to me, this is Danny Meyer speaking, to me, 51% ers have five core emotional skills. I've learned that we need to hire employees.

With these skills, if we're, uh, to be champions at the team sport of hospitality, they are, uh, one is optimistic, warmth genuine kindness, thoughtfulness in a sense that the glass is always at least half full. Number two is intelligence. Not just smarts, but rather an insatiable curiosity to learn. For the sake of learning, three is work ethic, a natural tendency to do something as well as it can possibly be done for his empathy and awareness of care for and connection to how others feel and how your actions make others feel.

And in five is self awareness and integrity [00:19:00] and understanding of what makes you. tick and a natural inclination to be accountable for doing the right thing with honesty and superb judgment. So that is the five keys and ask yourself, are you following that? Are you hiring for that? And I thought that was.

Uh, really good and something that, uh, I took away from that particular book and how it kind of rolls into this podcast episode. And then lastly, uh, I'm going to just share an audio from a Facebook reel that I've found and it talks about, are you a thermostat or are you a thermometer? And I'll let you just listen to the audio as we kind of end this show here.

So have a great week. Here's the audio. And I want you to think, are you a thermostat or are you a thermometer? when you were walking to work every day or when you walk into the patient room.

 Two types of people in this world, thermometer people and thermostat people, and which one you are will make all the difference as far as what kind of experience you have [00:20:00] in this life. What's the difference between a thermometer and a thermostat? A thermometer tells you the temperature in the room. A thermostat tells the room the temperature.

There's one kind of person who goes through life as a thermometer, however his environment is treating him, he will react in kind, and his emotional state, whether he's happy or not, is going to be a direct Reflection of everything that's coming at him from outside of him. That's the thermometer. The thermostat is the one wakes up and sets his setting on joy and gratitude and emanates that out all around him to the environment around.

If you're a thermometer, you are doomed to be reactive. You don't even get to choose whether or not you have a good day. The way people that you don't even know will treat you is going to determine whether or not you had a good day and you add up good days or bad days. And you have either a good life or a bad.

life and you were never in control of it. It was just the way that life treated you, completely passive, a victim thermostat says I can have a good life and a good [00:21:00] day because I choose that whatever my circumstances may be, I can always be productive. I can always be of service. I can always do something for someone else and thereby have a good day and add that all up a good life.

 EPISODE 415: Hiring Assessment Tool for Associates

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] Hey docs, welcome to a solo episode of Modern Chiropractic Mastery. I'm your host Dr. Kevin Christie and today we're going to talk about an assessment tool when hiring an associate. We'll talk about some ancillary things as well. On what to consider with this. And I think if you're a practice owner, um, with an associate, without an associate, this is going to be appropriate for you.

Uh, if you're a look, a doc looking for a job, um, or you are a student at some point, this is going to be good. Whether you're on the doctor hiring side of things, or you're on the doctor looking to be hired side of things. And, uh, you'll get a lot out of this episode. And at least I hope you do. And, um, You know, it's a challenge.

I think historically in our profession, the compatibility of owner doctor and associate doctor has been challenging for many reasons. I've, I've, you know, dove into that on previous podcasts. I'm not going to harp too [00:01:00] much on it, but I do think oftentimes there's just a mismatch of expectations. And then sometimes there's a mismatch of, uh, frankly, uh, skill sets that a, uh, an owner.

is looking for in an associate and in what that particular associate has that they hired. And sometimes there's no right or wrong, right? People are different. Skill sets are different. A certain skill set of a, of a, of a chiropractor working for another doctor could be great in one setting and not great in another setting.

And there's nothing wrong with that per se, but we want to try to have some compatibility there in this assessment that I'll dive into. And a little bit on this episode, we'll, we'll help with that, but there's definitely a challenge. And I, you know, we've talked about it on a previous podcast. Uh, and it was also on an interview there and there's, uh, you know, kind of like three buckets of, let's say a good associate chiropractors.

Uh, there's a bucket of bad, which is just, if you've got someone that is not good [00:02:00] clinically, not up to snuff with that, or their values are, are no good. not a good person. You know, there's, there's nothing good about that, but there's that bucket of just, you know, bad chiropractors. And so we're not going to dive into that, but the three that are in the bucket of good, but just different, uh, would be, you know, you'd have your clinician, a doctor that just wants to be a doctor or just wants to.

Come to work and treat patients and do notes. And that's, that's what they're looking for. And, and as a career as a chiropractor, um, and then the other is what we would consider a builder. And that's, uh, someone said it, um, as kind of like an intrapreneur, uh, which is. They're kind of entrepreneurial, but within the framework of someone else's business or systems around that, uh, but they're a builder and I've heard Brett Winchester say, uh, you know, you give that person one new patient and turn it into 10, uh, you know, you got a bad situation when you give them 10 new patients and they turn them into one.

Uh, and so that's that builder, [00:03:00] which I think is a really good sweet spot. And then frankly, what we did when we helped build this assessment with a company vision spark, which I'm going to dive into a little bit more. Uh, we focus on that category. And then the third category is really your, your kind of hunter, your entrepreneurial chiropractor, the one that's more than likely, uh, unless they have some kind of ownership into your practice and partnership or growth or buyout potential, um, they're, they're going to start their own thing.

Uh, they're real comfortable with that. Um, they're able to just build, um. Relationships and take risks at a high level. And I think Steven Franson on our show last year said that, um, maybe seven or 8 percent of the population in the U S population are entrepreneurs, but he thinks it's higher amongst chiropractors because it kind of self selects and it might be in the teens, but it's not a lot.

Uh, and then it doesn't mean that you can't be a. Uh, [00:04:00] a non entrepreneur and build a practice, but it's, uh, maybe not as natural and you need a lot more help to, to get it done. Right. And so those are, you know, kind of three types of, of chiropractors. And I think sometimes what happens is the owner is looking for a builder, but hires a clinician or is looking for a clinician and hires a entrepreneur and it just doesn't work out and it's just a compatibility issue.

And so we want to get clear on that. And I think the, I would say many of you. If you're trying to hire a chiropractor are looking for the builder, and I think many of you that are listening that maybe are associates or students or looking for a job, probably fall into that builder category is probably the broadest.

And so we decided to kind of focus on that. And so, as we talk about today. That's what it is. And I'll, and I'll give you the background of this, uh, tips assessment that we're going to talk about today and the, it's a, it's called talent impact profile. So that's the [00:05:00] tip TIP talent impact profile. And I'll break that down in a minute, but what we.

Uh, we had vision spark, who's a company that runs this assessment and it's a, it's a longstanding assessment and they, we had them come speak to our mastermind group in April of 2024 when we were in Nashville and they did this assessment for all of our practice managers, office managers, and they had had our team take this assessment.

It's like 60 minutes long, did a whole thing on it. Uh, complimentary to have our, our, um, each of the mastermind members, office manager, or, or kind of key person, non clinical, uh, take this assessment and then, uh, taught us it and then how, how to look for it, how to use it for, for office managers. And then ultimately I asked them, I was like, you know, is there anything, I knew there wasn't, but I was like, is there any, how do we do this for associate chiropractors?

And, you know, and it's like, well, we have a way. Where it takes some effort, [00:06:00] um, and some financial resources to actually build a tips assessment that is specific for hiring an associate chiropractor. And so what we did was, uh, we, each year we allocate some of the revenue from the mastermind into projects to try to help the profession.

And so we decided to allocate some of the money to do this and build out a talent impact profile for associate chiropractors. And we. Decided to do it on that builder, uh, category, that intrapreneur per se. And, uh, what we, one of the big things to do that was we needed 10 associate chiropractors to take the general tips assessment and do that.

And, and what we did was we. First took volunteers from within our mastermind who could answer the question, you know, if you had, if they had an associate and they'd been there for, you know, at [00:07:00] least a year, uh, we had a couple exceptions for that, but they could answer the question, knowing what, you know, now, would you hire that associate again?

And if they could answer that, cause a lot of you can't answer that with that. Yes. Right. A lot of you are listening to this, that have an associate and, uh, you're saying, yeah, if I knew what I do now, great person and all that, but it just hasn't been great. So we wanted people that could answer that question.

Yeah, absolutely. If I could hire this guy or gal again, I would. And that would, we, we then opened it up to some people outside of our mastermind and we got 10 associate chiropractors to ultimately take this assessment. It's 60 minutes long. And then it was a whole process from there, which was great. And, and I was Uh, a big part of helping facilitate it, uh, but they, they would do the, each of the associates would do the 60 minute assessment.

Then they would get on a phone call with the folks from VisionSpark, then ultimately get, I'd get all the results, we'd see [00:08:00] it, um, then what we did was, um, review. All of it, uh, I kind of, they interviewed me as well, and like what are the things that you're looking for, for this type of associate chiropractor, and it was like a list of certain parameters they had, and I kind of helped guide that, then we, then we had the 10 people assess, take the assessment, then we noticed a few things were Kind of outliers that we, we changed some of the parameters a little bit to suit that.

And then we ultimately came out with a, a tips assessment, but, uh, just want to go over a little bit of what the talent impact profile is. It's, it combines mental aptitude measurements with personality traits and also validity scoring all in one tool, which is nice. And they can actually measure if someone is not.

Um, if their assessment isn't valid and we had a couple of that and they dive into why that may be and tweak some things and so that's, I like how that was as well. Um, [00:09:00] so it kind of, they can actually see if someone is. Maybe gaming it or answering how they think they would, someone would like, but we also coach them on really taking this assessment, um, appropriately.

And so that is, is, is what the tip assessment is, you know, so you're going to really look at three key things on a person. Um, maybe there's more, but, um, this is, uh, some information from VisionSpark and you can check them out at visionsparksearch. com, visionsparksearch. com, I'll put that in the show notes as well.

Um, but you're looking at three things. You're looking at the cognitive. when you're assessing someone and that's going to be your learning speed, attention to detail, memory retention, and communication skills. Obviously, those are some things you would like in a doctor. You're going to have the affectives, A F F E C T I V E, affective.

That's going to be the values, behaviors, and personality. And so the tip assessment measures those two things, the [00:10:00] cognitive and the effective. What it doesn't measure is the cognitive, and that's going to be instinct and drive. That's what the Colby assessment is. K O L B E. Anybody that ever goes through our coaching program, one of the things we do is we have them take the Colby because we want to know how what their instinct and drive is.

And it's also really good when you're hiring. And so Uh, that would be a nice little package of having someone take the talent impact profile, but also the Kolbe and so then you would get the person's cognitive, affective, and then cognitive when you're assessing them. And I think it really, uh, plays well, uh, for that.

And some of the things that you're, uh, when someone takes the assessment on say the mental aptitudes, it's measuring learning style. It's measuring business terms. Um, it's measuring marketplace awareness, vocabulary, numerical accuracy, mechanical motivation. Um, that's on the mental aptitudes and it's got, [00:11:00] you know, like for instance,

so on one hand of the spectrum for learning style is going to be hands on. The, on the other end of the spectrum is going to be conceptual, right? And so we've kind of, that was one thing that when we did the assessment, he's like, you know what, a lot of our chiropractors are probably going to lean towards the hands on learning, uh, as you can imagine if you're a chiropractor.

And so that's something that's unique to the profession that maybe isn't in other ones, right? Now on the personality dimensions, we measure, there's measures of energy. And that's, uh, on one end of the spectrum is action oriented versus on the other end of the spectrum is calm. Uh, we got process orientation, organization, communication, sense of urgency, assertiveness, competitiveness, audience sensitivity, questioning, tendency, and motivation.

And so those are the things that they're measuring under the personality dimensions. And so you're. Uh, looking at, and then it, uh, gives you this really awesome report once someone does take it. And when someone takes the, [00:12:00] uh, tip assessment, you're going to get this really detailed report that breaks it down, which is nice.

Um, there's going to be a 60 minute one on one call, uh, with VisionSparks team to, to do that. Um, and so that's nice as well. So you really work through that. I wouldn't, you know, obviously I, you know, this is for an associate. When you're hiring an associate, you're going to. You're going to take some time doing that.

You're going to allocate some resources doing it. It's only about 400 to offer this assessment. So it's not that bad. Um, you're going to not, you're not going to run someone through this tips assessment before you would actually interview them to make sure. Cause you know, in your, in your regular interview process and having their CV and certain things like that, you're going to weed some people out just naturally like that.

So this would be after you've. You've had a fair amount of your interview process going to then take this tips assessment. And that's where, um, [00:13:00] you know, I think it's, it's really important to have a, a really good process. And one of the things, kind of a sidebar topic is, you know, when you're looking to build a great team and you're looking to build great culture, it's really a four phase approach to getting there.

And it's something that we kind of workshopped in, and I think our West mastermind this last time in Park City was that when you're hiring, and let's say you're trying to hire a doctor, you're trying to hire an associate, the, the big part of that early aspect is talent acquisition, you know, what end of the pool are you fishing from?

Right? Um, do you have good talent acquisition? If you're not affiliating yourself with entities that are producing great talent, whether it's MPI or ART or FTCA or particular schools, particular aspects of schools, particular schools of thought, [00:14:00] um, you're not going to get to good talent. And so you got to have a talent acquisition plan.

If you're looking to hire an associate in a year from now, start now with finding talent, start getting involved with those, uh, the schools that are by you with the, with MPIs of the world and things of that nature, like you got to get good talent and especially if you're not in a. Let's just call it sought after area and there's nothing, you know, your area is probably awesome.

But there, you know, if you're in, um, you know, Nashville, Tennessee, yeah, people are wanting to go there all the time, but that's not, not everywhere as Nashville. So if you're in an area, you got to do some stuff to have a talent acquisition plan. That's part one. And then part two is you have to have a really good hiring process and that's going to be multifactorial and I'm not going to dive into it all today.

But this is where the tips assessment would fall into that. You know, some of the things you might have in the hiring processes, you know, obviously, you know, collecting their CV, having a phone interview, flying them down, having them shadow [00:15:00] you, having them adjust you, having them take a tips assessment, having them take doing a background check, having them do, um.

You know, a Colby index and, and going through that process, that would be the hiring process. And that's where this tips assessment would be. And then once you do have the hiring done, you know, part of the hiring process also is an offer letter is working through agreements and salary negotiations. Like it's, it's a lot to hire a doctor.

It's, uh, it's not a two week thing and get your hiring process down. And this should be part of it, this tips assessment. And then next is onboarding. Once they do start, like what's your onboarding process like to get them integrated and click into the clinic and start, um, being productive as soon as possible.

And then frankly. The thing that goes, it's just not done enough is, is continued training. What's the continued training like to look like that? Some of you get the talent, right? And you get the hiring, right? And you hired a great person and they come on and they weren't onboarded appropriately. And they're not, [00:16:00] you know, you're not, you're wondering why they're not doing well and you don't have continued training.

And then you say like, Oh, you know, he didn't really pan out. Like I was hoping he would. Well, is that his fault? Maybe, but maybe it's not. Maybe you don't have an onboarding continued training and that's a problem. And that's why maybe your culture of your team is not good because you're killing it on talent and hiring, but you're not on onboarding and training.

Or maybe you're, you know, your talent acquisition is, is bad. And so you're, you're not getting good talent and you, you're settling in your hiring and then you try to onboard and train them. And it doesn't go well. So it can go, it can go wrong on one of these four things. Some people get it all for, uh, but it could go, you want to get all four, right.

And if you got one, you know, weak link there, it can, it can spoil the whole thing and then ultimately spoil the whole team and the whole culture. And so make sure that you've got that right. And on the continued training standpoint. Um, I read a book, kind of talked about it a lot, uh, especially in our coaching groups and [00:17:00] stuff, but the salt shaker theory of leadership, I think is really great is from Danny Meyer and his book set setting the table, but what you got to look at, um, I'm just going to kind of read this really quick from this, uh, aspect of it.

And, um, basically Danny Meyer had a coach and they were talking about, uh, Danny was talking with his coach about how frustrating it was to continually try to. Put out fires with his team and his team is doing things that maybe they shouldn't be. And so, um, this is a little excerpt from, uh, from the book quote Pat pointed to the set.

Pat is the coach pointed to the set of table next to us. First, he said, I want you to take everything off of that table except for the salt shaker. Uh, go ahead, get rid of the plates, the silverware, the napkins, even the pepper mill. I just want you to leave the salt shaker by itself in the middle. I did, as he said, and he asked, where is the salt shaker now?

Uh, right where you told me in the center of the table. Quote, are you sure that's where [00:18:00] you want it? I looked closely, the shaker was actually about a quarter of an inch off center. Go ahead, put it where you really want it, he said. I moved it very slowly to look, to be smack dab in the center. As soon as I removed my hand, Pat pushed the salt shaker three inches off center.

Now put it back where you want it, he said. I returned it to the dead center. This time he moved it, the shaker another six inches off center. Again asking, now where do you want it? I slid it back, then he explained at this point, listen Lova, That's how he says it. He calls him lover. Uh, your staff and your guests are always moving your salt shaker off center.

That's their job. It's the job of life. It's the law of entropy until you understand that you're going to get pissed off every time someone moves the salt shaker off center. It is not your job to get upset. You're you just need to understand that's what they do. Your job is to just move the shaker shaker.

back each time and let them know exactly what you stand for. Let them know what excellence looks like to you. And if you're ever willing to let them decide where the [00:19:00] center is, then I want you to give them the keys to the store. Just, just give away a fucking restaurant, he says. And so that's kind of a, one of the things he talked about.

As far as the salt shaker theory of leadership became a cornerstone of Myers managerial style, which is a style he now describes as, and this is what I really love about the book and this idea, is a leadership style which he calls constant gentle pressure. Constant gentle pressure is about setting high standards, holding team members accountable, and correcting them.

Repeatedly, enthusiastically, and with kindness when they start to drift from those standards, it's also about accepting the infinite nature of this work. If you lead a team, this nudging and reminding literally never ends. Okay, and I'm gonna leave it at that, like it literally never ends, and so you need to have a training program for your team as well, and you need to have [00:20:00] meetings, and you need someone to be leading that, and maybe you get to the point where your associate doctor is, is fully on board, and they're leading a lot of the, You have direct reports and so you're not necessarily having, this isn't about micromanaging.

This is about keeping things excellent and into the center. And a lot of you don't do that. And I found this to be a compelling idea of constant general pressure to make sure that your team is performing at a high level. And so that's what you need to have a, an A team and have culture and make sure that yeah, okay.

Yeah. I got the hiring, right. Got talent, but Everything looked good. We on boarded well, but then all of a sudden the wheels fall off after a couple of years. Why is that? Because maybe you are not applying constant gentle pressure to your team. And that is something that, um, you know, I failed that for many years still probably to this day.

I'm still working on it. And it's funny because when we coach clients, it's something that we I would feel [00:21:00] like we do and I think that's what I think that's why it works is that we apply constant general pressure to our clients to keep on being excellent and remarkable in their clinics and we don't have if you're the leader and you're the owner of your practice and you don't have someone that is applying that constant general pressure to you you get off kilter you lose your center and you lose kind of your you know your you're off your vision a bit and no one's holding you accountable and that's a problem and that's why I think it's it's good to Um, honestly, if you're, if you're looking to hire an associate, we do a lot of helping our clients with that as well.

Uh, there's a lot of facts, facts, factors to it. Even the financials of it, we help them with that to get ready for it. So if that's something that you, uh, feel like you may need, just obviously go to our website. modernchiropracticmarketing. com and you can fill out a form there. You can go to VisionSpark as well and, and the tip assessment is there.

Um, reach out to them, let them know you're looking to hire a [00:22:00] chiropractor. Maybe let them know that you heard them from this episode and they'll know exactly what to do to help you out with that. Um, but take it serious, take hiring an associate serious. It's, it's, uh, it's a big, big, um, step in many chiropractors careers.

And you want to do it thoughtfully and with a plan. And so again, just to reiterate, four phases, talent acquisition, hiring process, onboarding, and continued training, or that constant gentle pressure. And I think a big part of the hiring process is to have a great assessment. So that way you pair that up with a Kolbe

and again, you've got, uh, the cognitive, effective, and cognitive covered when you're hiring that doctor. So I hope that was helpful. Again, that's the Talent Impact Profile by VisionSpark. Uh, you can go to visionsparksearch. com and, uh, it was fun working with them. It was, it was detailed, took about six months.

We put a lot of effort into it and financial resources. Uh, I don't have any [00:23:00] tied to it financially, but I wanted this to be out there for you chiropractors to hire great associates and make your practices even better, have a great week in practice. And we'll talk soon.

 EPISODE 416: The 5 Pillars of Profit

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. Today I've got Naota Hashimoto. He is a chiropractor and entrepreneur, and we're going to dive into the five pillars of profit. He has founded the software TrackStat, which many of you know, and we are going to talk to you about how you can really apply technology.

to improve the five pillars of profit. And we, we dive into some of the nuances of being a chiropractor and how to turn a profit in a practice we have decided to, you know, do as a, as a living. And, you know, I think that the takeaway is, is you have to monitor this. You have to know what good profit margin is.

You have to have strategies to increase the top line and decrease the bottom line, and that would be the margin, the differential between those, and, and what is good profit margin? And what are some of the strategies you can look at that are outside the box to improve that? Because, let's face it, things aren't getting cheaper, and insurance isn't paying better.

But there are strategies where you can thrive, and I know a lot of really good [00:01:00] patient centered chiropractors implementing these strategies. Providing world class care and making a professional living and I think you want that as well And you shouldn't be ashamed of that and so without further ado here is my interview with Naota Hashimoto

 All right, welcome back to the show. None of this, I think will be our third time. And, uh, we've got a fresh topic and excited to talk about your ideas around the five pillars of, of profit. But before we do that, what's new in your world? What are you excited about? It's, it's, uh, Q1 of 2025 as we record and release this.

Naota Hashimoto: Um, I'm excited about all the AI stuff that we're working on and like new integrations and new kind of like partnerships. It's uh, it's been a long road. I just remember kind of like when we got going, I'd reach out to certain like EHRs and they just kind of like blow me off. And now like ChiroTouch is like flying me out to San Diego, wining and dining me and other EHRs.

Like, I'm going to Parker and people are wanting to set up meetings before I get there [00:02:00] versus like, when we first started, no one wanted to block off time for me. And then I'd have to go meet them at their booth and just continue, like, doing good work for clients. So it's, um, yeah, it just, it's exciting where.

You know, like I feel like people are now wanting to like work with us. So I'd say that's the biggest difference.

And, uh, and I, um, you're not practicing now. You've, uh, closed that chapter, right? So practice and you're, you're all in on tracks that, and what's that been like to, to make that transition? Uh, how many years did you practice?

20 ish,

Naota Hashimoto: 17. It was. It took me a few years to get to it. Um, I talked about doing it for a few years, but like I have my identity wrapped up as being a chiropractor and helping people and it just. I'm like, it seems so easy, but it was hard. Like, I scaled myself out of the practice for a while where it wasn't treating patients, but it was like that last step of, like, just [00:03:00] closing that chapter because, like, I knew if I was scaled out in, like, a phase 2, where I'm like.

Doing other stuff in the business and I'm not in the day to day, I could always go back to being a chiropractor. But now if I wanted to get back into practice, I'd have to start over from scratch or like go work for someone. And so it's like, it felt like. That door kind of closed quite a bit. So it took me, I'd say, an honest two years to kind of be ready to sell.

So now you're, you burn the ships behind you and you're, you're ready to go, uh, forward. And, uh, I think a lot of our audience at this point is getting familiar or is familiar with what you're doing at Trackstat. And I know it's always evolving and some people might be asking. What does five pillars of profit have to do with what you're, you're doing?

And we'll make that connection as we go along here. But, um, let's, let's dive into the five pillars of profit. I think, you know, in general, I have conversations around profit [00:04:00] with our coaching clients and with other chiropractors and some of our mastermind members, and there's a lot of. You know, good knowledge around it.

They have good basic fundamentals, but, uh, then it kind of stops there and they may not understand how to prove profit without, uh, you know, sacrificing quality and things of that nature. But what's your overall context around this five pillars of profit?

Naota Hashimoto: Well, it just sell for more, sell more often, kind of like automate or like reduce your operating costs, reduce your accounts receivable and finish your projects.

So, yeah, that's pretty much it. .

All right. Let's, let's dive into the first pillar and we will, we'll kind of have some conversation around each one.

Naota Hashimoto: Yeah. Um, one of the things, yeah, it took me, you know, the first year I was out working as an associate, like, you kind of give away your services for like way too cheap.

And it's just like, it seems like it's so easy, but like, you know, if I was [00:05:00] an electrician, an engineer, or like a. You know, like a cardiothoracic surgeon, it's really easy for them to do that thing. So it's like, just because it's easy, should you give it away for free? And it's uh, just selling for more.

That's your price elasticity. That's gonna be your margin. Now, like, some people on the call might be saying, Well, I do primarily insurance. How can I, how can I charge more when I'm in network with all these insurances or all the people in my area are low income? They can't afford it. And, um, we, you know, it's like, I tried to generate early on in practice, like, at least 5, 600 an hour.

And I know you're telling people, like, you got to hit like 300 an hour and 300 hour, I'd say is the bare minimum. If you want to have a team, because it's, you can't make the math work. Right. And, you know, So it was like, if you charge more for what you're doing, you don't have to kill yourself. Like, I just remember when my wife was seeing all these ASH [00:06:00] patients, we were like new in practice, we ran the numbers and she could lose 75 percent of her patients and still make the same amount of money.

And she didn't lose 75 percent when she got out of network, she only lost like 25 percent of the patients. So like she was making way more per hour. So it's like something if someone's. Doing primarily insurance, you might think of what other services can I do that are not covered by this insurance plan that I can offer?

So it's like, if you did just like, let's say you're doing like a 20 up service and you had 100 visits a week and you did that for a quarter, um, like 25 percent of the people, that's a couple grand a month. Right. Or if you had a decompression table and let's say you're charging 75 a visit and you got up to 50 decompressions a week, that's an extra 15 grand a month.

So it's like [00:07:00] it adds up. It doesn't have to be from you doing a better rehab or better this, um, just come up with creative things to add value to your customer. Right? So you don't want to rip them off.

No, exactly. And I think that's one of the misconceptions is a lot of. chiropractors out there. They, they find what their bread and butter is and stick with only that.

And then they don't have reasons or excuses or, or blocks of to why it wouldn't work for them or why they don't want to do that. And, you know, it could be anything from, like you said, adding a service, like, you know, maybe it's decompression or dry needling or it's shockwave therapy, which is what we've done.

And it's been a huge. benefit to our patients and our outcomes, but also, yeah, to this number one pillar that you're talking about. Uh, or, you know, the other thing that we did some years ago, more like six years ago, and we're in the state of Florida, is we diversified a little bit and said, okay, you know what, um, I don't want a personal injury practice.

Uh, we're a sports based practice and we wanted to maintain that, [00:08:00] um, The essence of our practice is that, but I was like, you know, we could do three to five new auto cases a month and it would not impact the, the essence of our practice and it would significantly increase some revenue because personal injury pays 200 percent of Medicare and you could do four or five, six codes in a visit if you do those things.

And it just pays really well. It's kind of like the last thing that still pays good from an insurance standpoint. And so you could look at diversifying, like, is there some types of potential patient bases that do pay a little bit better if you're insurance based and things like that. So that's some of the stuff that we've done.

Naota Hashimoto: Like, 100 percent on that, adding, adding a modality is an easy way of doing that. Uh, but some people might say, I don't have the space or I don't have the money. Now, I'd say like, if you have the space, the decompression is a no brainer, like a decompression, like you could do zero marketing. We never marketed for decompression and we're doing, I don't know, like 150 decompressions a week without any [00:09:00] marketing.

And that was super easy. Patients loved it. A lot of people benefited from it. Obviously, if someone's not a candidate for it, you don't offer it, but like even someone like just chronic neck or back pain, you could put them on for like 5 treatments. You don't need to put them on a 30 visit package and then like some people might say, well, I don't have the space or the money to buy a modality.

P. I. Is not good in my state. And then you say, it's like, okay, well, then I tell people be someone to someone, like, let's say, like, I know you've had like guys on there. There are golfers or tennis people. Like, if you're in a golf community, you could be the expert golf guy. And now, instead of charging insurance for the exam, you could do a special golf eval for 300 bucks, 500 bucks.

And, you know, you got to be someone to someone, but that means that. Yeah. You're going to post stuff on social media. Your website's going to say you're going to be about golf. They need to understand that this is a thing that you do and you're an expert and now you could charge more for that thing. So

I love [00:10:00] it.

You know, margin is something a lot of people don't understand. They know what profit is, um, but they don't understand profit margin. Uh, it's a difference to an extent. Um, you know, there's other vocabulary out there, like obviously. Uh, cash flow. And I think that's a big thing that people struggle with as well.

Uh, but the profit margin is something you have to understand. And part of that is to obviously increase the patients that are coming in, increasing the revenue on those, on those patients. Anything else on, on Pillar 1 before we move to Pillar 2? Um,

Naota Hashimoto: I'd say at the very least, just start tracking your dollar per visit average.

Right? You get your, kind of like what you collected over your visits. And then just track that one thing. And if you start measuring it, you'll start slowly increasing it. So,

and go to your point. I'll put a bow on it. Um, you know, you know, whether it's 300 an hour, 600 an hour, your capacity, um, you can, you know, if you're in middle [00:11:00] America, you can probably get away a little bit lower and I'm, you know, the 300 number is kind of like a baseline.

You definitely want to get higher as you go along. And, and you can, if, if you can at least hit that, and I'll give you an example, like there was a point early in my practice where. We averaged about 72 a visit and I was kind of comfortable with four, uh, you know, so what is that about 280 to 300 an hour?

Uh, then now we're at , a one, a one, a visit. And I can see six in an hour. Um, so, you know, like we're at 600 an hour for myself as my capacity. Uh, and that's why, you know, if you think about say a high volume chiropractor, even if they charged 55, but they saw 12 people in an hour, which a lot of high volume can easily do.

the math works. And so I know a lot of the evidence based chiropractors don't want to go that model. Fine. But you got to find the way where the math works. And I think the other part of it is you got to be cognizant of the fact that yeah, you could theoretically price yourself out of the [00:12:00] market as well.

And maybe you're only getting Five new patients a month that are willing to pay you for, you know, like if you like, we have some coverage that spend an hour with a patient and they charge 400, 500 for that hour there. You might only have so many absolute people like numbers of people that will do that in a particular month.

And so, yeah, your, your hourly capacity is good, but your actual revenue is not for the month. And you're struggling there because you just, it's not a product market fit essentially.

Naota Hashimoto: Yeah, and I honestly feel like 20 percent of the people are going to be buyers, right? If you have this upper level service, 20 percent of your patients, no matter where you're at in the country, they're going to buy it.

And if you have that upper level service, it makes your regular service look cheaper. So, like, at the very, you'll see companies do that all the time. They'll have, like, good, better, best, and, like, they only know that a small percentage will buy best. And what they're really trying to sell is better. So they'll have that higher [00:13:00] thing to kind of set an anchor to make the kind of middle pricing look better and look cheaper.

And it's psychology. It works. And yes. If you have more profit, you can hire more people, hire better people and help more people. But yeah, getting into the other model, which you're already talking about, like, I'd say selling more often increasing your volume.

Pillar 2 is more people in the door. Right? Yeah. Yeah. I think I got something to say on that for sure. Is that, um, you know, Sometimes people will get a number, you know, like they see an 84 a visit. Is there is there patient visit average or office visit average and like the first thing that is like, I got to get that higher.

I get that higher and I look and it's like, well, you got a ton of room on your schedule to, um, you know, you're not, you're not busy enough and if you actually got more people in the door. And, and there's a certain level of where you can without increasing your overhead at all. [00:14:00] And so you just need to focus on getting more people in the door at that point.

And then we can, we can kind of curate your patient base, right? We can then be like, okay, now we can raise our rates. Now we can cut this shitty insurance out or something like that. Uh, is that some of your thoughts on that part? Yeah,

Naota Hashimoto: and you go after different stuff. Like things that I did early on in practice is I targeted kind of like, um, We'll call it a retirement community because like the problem is I was like, when I first got out, I wanted to work with a bunch of athletes and I was like, fixing them in like 2, 3, 4 visits.

And it's like, it's way too quick versus I take like Mary Anderson, who's 67 years old with like some chronicities. Um, it'd take her a lot more visits to get stable and. She wasn't as good with her home exercises, so she'd come in, like, once or twice a month for, like, preventative care. But, like, you have your pillars of getting more new ones, getting them to start care and finish their plan, and then getting them to do some kind of maintenance.

I know [00:15:00] maintenance is, uh. Dirty word in some people's mind, but like musculoskeletal costs are in the billions of dollars in this country and a lot of us are doing very unnatural things, staring down on our phones, sitting on the couch. I'm sitting here working on a computer talking to you and it's just those aren't unnatural things.

So, you know, maintenance on your teeth, maintenance on your car. Why not maintenance on your body?

I've seen a shift in that with just a coffee shop the other day and it was these two, um, they look like seniors or juniors in high school getting coffee before school and one girl was just like kind of bad posture or whatever.

And she's just like, Oh my God, I, I got going to kill to go see my chiropractor. I got to get in there. And I feel like I'm, I'm hearing a lot more from the younger generation of going to see their chiropractor. Because I mean, they're just, they're in bad spots, which, you know, they're, they are physically not ideal right now with the way they're sitting and looking down and things like that.

And so I think we, we definitely serve a big, [00:16:00] big, um, part of trying to solve that issue.

Naota Hashimoto: Yeah, no, definitely. And It's, you know, not everyone had to do it. We just did a very soft thing. Like they kind of get to the point where he's like, Hey, it's okay. You're golfing three times a week. We focused a lot on golfers and eventually pickleball as it got more and more popular.

But it's like, Hey, you're doing this three times a week. Great. And here's some exercises. Now you're probably going to do some unnatural things. You're probably going to drink your wine and keep doing these things. So if you want to maintain those gains, we have a membership where you get like kind of x, you could get up to x per month for just this much per month.

And yeah, it's, it wasn't a huge part, but like we had like 16 to 20 grand coming in on the 1st of the month, just like that. And it was.

Um, and if you look at like, Netflix and gyms and all these other subscription businesses, like people are used to it and then getting people in the door is 1 thing. And [00:17:00] I haven't looked at it lately, but like, I remember. Earlier on when we had, like, probably a little over 700 chiropractors in our system, when they started with us, I looked, they're kind of like average rate where they dropped off is like visits, like, 4 through 6.

It's just kind of crazy.

We actually now coach our clients and just visit for conversation. I think there's three times a doctor really needs to like sit down and have a conversation with their patient. Uh, you know, there's, there's sometimes there's more, but the framework of it would be, yeah, your report of findings is going to be number one.

You do that. Number two is a visit for because either they're out of pain and they want to stop coming in, but they haven't improved their function or they are not getting better like they thought they would. And you need and they might fall off at that point because of that. And so you need to just kind of plan on and it's not exactly before, obviously, but around around there, start thinking about it.

And then I would say, at the end of discharge [00:18:00] and try to get them to go from acute care plan. To maybe maintenance or performance care. I think if you have a framework of those three conversations, you're going to do really well with adherence and obviously just growing a practice.

Naota Hashimoto: Yeah, like we did that.

Like, uh, we did like a day 1 day to, uh. We did kind of like a mini, not quite an on the 1st visit, and then we kind of close them on the 2nd visit. But some of the people we would treat on the 1st visit, but, like, we're in a vacation area. So, it's like, I used to treat on the 2nd visit, but, like, a lot of people there.

In pain, they're on vacation. They want to get better. So we just ended up doing that. And then 3rd visit, everyone would have a laminated recipe card. What happens when you quit taking antibiotics early? So, and that prompted a conversation, walk into the stall and you see, they have kind of like the pink laminated thing and just say, hey, Kevin.

Oh, it's like, if you were taking antibiotics and you say, Okay. [00:19:00] Yes, it's like, do you know what happens if you quit taking early? It's prescribed for 10 days. Let's say you get off in like 3 to 4 and then you just have that conversation. Then I just say, he's like, well, can you treat it with the same kind of antibiotics?

It's like, sometimes. Yes, sometimes. No. And so I did this right after they prepaid for their treatment plan. So, on the 3rd visit, we would resell them on why they're doing this. So he said. Kevin, you came in here, you said that you're only golfing once in a while, your back hurt, you had to take medications, you want to golf three times a week, you got this trip to Italy in the summer that you want to go on with the kids and the grandkids.

So even though they paid, we resold them on the third visit and just reminded them. So, and I just said, there's three things you have to do. You got to make your visits, you got to do your home exercises, and we got to break the bad habits. That's good. I like that. And then just say it anytime that you want to change your goals.

I'm happy to change the treatment plan, so if you don't want to come in as often and do as much work, and you don't want to go golfing three times a week, and you don't want to go to [00:20:00] Italy and carry your grandkids, um, no big deal, right? I'm okay with it, and I just have that conversation, so they just prepaid for their whole plan, and we resold them again on the third visit, and then when I sold the practice, um, just kind of like fell out of that.

Um, but like that, that helped a lot. And then we just have automated kind of like messages that go out to different parts in their journey. And the old school table talk thing does work. So, but

no, absolutely. Uh, all right. So what is pillar three,

Naota Hashimoto: uh, just reducing labor and we kind of like touched on that.

So it's like, I just. So I just find a lot of people don't know where to start. So I just say start with your repetitive low value tasks, right? And if there's a way to automate that or way to outsource that, do one or the other. And then, you know, like insurance verification, that's [00:21:00] an easy thing. Um, if you have software that's not talking to each other and you're doing manual entry, that's something like answering service.

Patient onboarding, educational email, automated reactivations. Those are all things. And like, I think eventually it's just going to be AI answering, answer, schedule appointments. And

I just attended virtually the abundance 360 summit, which is out in Santa Monica every year, three and a half. Three and a half days worth and I attended virtually watch recordings and one of the things they talked a lot about.

And I also heard I forget the CEO of LinkedIn, but is it Benny off and talk about agents and amount of money being invested in agents and then ultimately. Curating that AI agent into, you know, like you would train that AI agent in your business like you would train a human being, right? It takes time to onboard them, but essentially, that's what you're doing.

And I'm [00:22:00] excited about that. And I think there are going to be ways where chiropractic practice already there already is, but there's gonna be even more kind of crazy out there ways . I mean, I'm even looking at the idea of, you know, the robots that are coming, you know, whether it's the Tesla robot or the other.

I think four or five companies that are developing these robots that you'll be able to have in your house, but theoretically could have in your office. And, um, you know, I think a lot of futuristic stuff coming, but obviously, for the time being, there's a lot of things you can do. Like you said, outsourcing.

I mean, one of the things we did we have now, and we have some clinics that are doing it is Um, we have a lot of clinic in our office. We have someone that's at the front desk, a human doing all the human things with the humans in the office and being there front and center for the patients in the office.

And then we use a company called AvinMed to do all the phone answering and handle that type of stuff. And they also can do like, um, you know, patient callbacks, they can do insurance verifications and all that. And it's at a much reduced rate than if you hire a United [00:23:00] States, um, like full time. Person in the office with employer taxes and benefits and all the things that go into that.

Um, so there's a lot of ways you got to start looking at reducing labor

Naota Hashimoto: and for some people that have multiple locations, like, and they have a physical staff person, like, I think, honestly, in the future. Um, and people are already doing that. And I have clients doing it. You'll go have like multiple locations.

Patients going to just walk in. They're going to have a card on file. They're going to check in in their kiosk and you're going to just have CA and doctor. Right? And you'll have these little dock in the box type things. And I have clients that are doing that with like, uh, virtual assistance, but things that were like, Working at adding in is like, kind of like you call and this one's like, relatively easy agent and then scheduling that and putting into the system.

Another thing that we're working on is like, um, I would love to work with like, everyone 1 on 1, but it's just not [00:24:00] scalable. So, like, more AI and showing them like, hey, here's where you need to focus. Focus here. The people that you need to call today. Hey, by the way, this is how your front desk is doing. And this is how they're comparing against other front desks or here's how you're doing what your dollar per visits here.

How here's how you're comparing to other chiropractors in the state of Georgia, right? You know, like, so it's that kind of stuff is the, they're the things that we're doing. A lot of the EHRs are busy working on, um, tying an AI into soap notes and billing, which if I was an EHR EMR, that's what I would be focused on.

So we're kind of like coming at it from a different angle because, like, for us, we just view ourselves as more of a marriage, like a partnership. We don't try to be the EHR and yeah, it's I've seen 1 of my clients. He did this. Kind of by he had to he was in like downtown Denver and he has a virtual assistant in the Philippines at his front desk and they have 2 monitors.

They have 1 facing the patient and 1 facing where they [00:25:00] work off. And if they have someone that's struggling or having problems, she just turns on her camera. Talks to him. You put in your card over here. He's seeing with just 1 CA in the office. And like, I swear to God, like four days a week, like probably like 230 visits a week.

So it's, it's very

Naota Hashimoto: efficient.

It kind of reminds me of, um, you know, Michael Michalowicz, uh, talked about in his book with Profit First is, is if you really start with a profit margin number, right? Or if like Great Crabtree wants a, a business to be a 15 percent profit, and that's after the owner doctor actually paying themselves.

A real professional salary. If you start with what your profit margin needs to be or profit needs to be. And then like what Michael McAuliffe talks about is then from there is you can reverse engineer and really make. accurate, but sometimes challenging decisions on like, no, we, we need to be able to do this at this cost.

And we need to find a way to do it at [00:26:00] this cost. We can't just, um, blow through that and, and, and have cashflow issues consistently because we think we need all these people or all these other expenses to, to handle it. And I think that's something to consider.

Naota Hashimoto: Yeah, no, it's, um, reducing costs overhead by outsourcing and automate is good.

I think a lot of times people will look there first, right? And like one of my mentors always said, like, you can't save yourself into a profit. Now, I agree that you do have to control your costs, but like, I always just looked at, okay, how much can I increase? My price last city by increasing the value or increasing the volume.

We weren't high volume, but like we definitely were higher volume than the majority of practices. So a few 100 visits a week, but not like 1000 visits a week.

Love it. Love it. And then pillar 4.

Naota Hashimoto: Uh, just reducing your accounts receivable, like, for people that are cash only. It's easy, right? Because you're collecting up [00:27:00] front, but when you're doing insurance or personal injury and some of these things, like, we would just take a look at all the visits that are coming in tomorrow.

And then seeing who owes money, and then just popping in a note. And then if people were receiving services that day, and, you know, like, when we're doing, like, some bigger ticket medical ones, we collect an estimated amount. Every single patient had to have a card on file, right? Um, that was a non negotiable.

We had occasionally some people say, I don't want to have a card on file, but like, um, it was like, very rare. It was like, just whenever things you're going to have a card on file, we're going to do an estimate and we're going to try and. Collect it sooner, because, like, I remember at one point we had, like, 240, 000 in AR, and it was just, like, this is, like, ridiculous.

So, it's, like, we started doing that, and then we cut it in less than half. Yeah, no, it's

It's huge, and I think, you know, you definitely got to collect. You know, a lot of these doctors are in network with insurances, and they have a [00:28:00] network deductibles or coinsurances. So it's it's not just a straight 30 copay like a lot of times it used to be, and the visit might be different, but you should have some form of a calculator.

Uh, we, we put together a spreadsheet that actually had the fee schedule for the different insurances. You could plug in, you know, okay, doing these three codes, then the co insurance at 20, 30%, and then it would spit out a, they owed whatever. And I know the software does that now. This, this was like, I was in network with insurance like 12 years ago.

So you would want to collect from that patient. But yeah, there's going to be times where there, there is money owed or codes are denied. And I think one of the things that's pretty cool, and I know your software could be used a lot for this, but, um, maybe the days of mailing, like physically mailing a patient statement to that patient goes out the window, or at least early on, and that's something we've been talking a lot in our mastermind where we're talking with one of the particular clinics is like, look, you know, what we do now is Utilizing the different softwares we have, but we use cash practice software and we can [00:29:00] actually create a unique link if that patient owes 43.

15, actually create a link that they click on it and it says, here's 4315 and they put their card in and pay, um, if they don't have the card on file, but if they do, and we, we will give them a courtesy email and say, or even a two way text, however you want to slice it and say, you know, there's balance of 4315.

Do you mind if we run the card on file? Or, or like more like, okay, in 24 to 48 hours, we will run the card on file. We had your approval to do that and give them a couple of times email back if they want to do something else, whatever. But now you don't have to sit there and mail out a hundred statements per se, and you'll get a lot more people paying that way.

What are your thoughts on that? Uh, yeah, it's just a waste

Naota Hashimoto: of time and money to print and mail statements. I, yeah, I'd say like having the card on file. And then like, obviously, I was a big fan of prepay. So it's like we did that. Um, but, uh, for people that aren't doing a [00:30:00] lot of prepays and doing a lot of insurance, I'd say you'd have to have a card on file.

You should like get like some kind of estimate and collect something. Even if it's not the full amount, you have an idea of what they're going to pay. And if you over collect, you'd always like refunded to them, but we just collected a little bit under, but we collected a large chunk of it. And then, yeah, having cash practice or Fortis or one of these other things to do an e pay that's great.

Uh, we have an integration with cash practice. We also have one with Fortis and you'd be able to see all the people coming in tomorrow that owe money. Uh, you can look at all the people that left last week that owe money. And then we're adding a thing, which we're just about done where you could just bulk send it where they just click it and you could do a e pay statements from there.

So actually, by the time this podcast is live, it's probably going to be done. So

good. Good. Yeah. So the days of trying to get money out of people with paper statements are good. Now, you might still have to send them a collections, but that's a different story. All right. Pillar, uh, pillar [00:31:00] five for

Naota Hashimoto: just say, finish your projects.

Right? It's just like inventory sitting on the shelf. Um, You know, like, if you have 10 partially finished projects, it's not done is like, get something done. Some people could only get 1 project done at a time. Who cares? Right? If you can only focus on 1 thing at a time, work on it, get it done, get it shipped.

Good enough. It's like, I'll work on like 3 to 5 simultaneous things. Um, it's no big deal. It's not bragging or anything like that, but like, I don't work on 10 simultaneous things. It just for me, I just, um, I try to get something. Done good enough and get it shipped and get a minimal viable product, not a minimal product because like you can't do it super half ass and get a minimal product out the door, but like.

Yeah,

yeah, I want to connect the dots on that a little bit and how it might relate to, you know, like a lot of chiropractors are just struggling with volume in a sense, like they're just [00:32:00] not getting enough new patients or offices in the practice and and that's why they have a cash. Uh, they have a profit issue is because that could be the only thing, right?

Like, they could be as lean as possible. They might be all that, but, you know, finish the project might mean. Like, go do the marketing, you know, don't wait till it's perfect. And you're like a savant at community outreach and MD meetings and this and that. Go just do it. You'll get better at it. And that type of stuff, focusing on those leading indicators to get out there and actually do the work of marketing and getting out there and position yourself as an expert https: otter.

ai More people will allow you to charge more money and will help with your profits. So, uh, yeah, like you said, just ship. It is kind of an analogy of just like ship your ass to the local gym and talk to that trainer or ship your ass to the MD and have that meeting and just start doing it because no one's going to do it for you.

Naota Hashimoto: Yeah, it's, um, and I think a lot of docs out there [00:33:00] are working too many hours now. I know it seems counter intuitive because we talked about seeing more people, but if your schedule isn't that full, um, just close it down part way through. So for us, uh, like, before we had kids, I had a wider range of hours, but like a cluster.

But like, when I saw patients, and I was seeing younger people, older people, and then as we had kids, you can relate to this. It just, like, it's like I wanted to be there for things. And I was, like, feeling like a missing thing. So, like, I focused even harder on that older demographic is like, when I was early on in practice, working for 1 of my mentors, like, downtown, like, that 1030 ish.

Through like, 233 ish was like a really hard slot to fill, but like with the retirement community, it was easy now filling up things after 4 PM when it starts getting dark. That's a little harder. And, uh, but like, they wanted to come between 9 and like, 435 and it was [00:34:00] like, perfect for us. I could start a little bit later, leave a little bit earlier.

And yes, we missed out on, like, the working folks, but it just, it was better for my personal and family life. Yeah. Yep,

and I just we'll leave it with one little tip for some of our newer docs Yeah, like schedule the medicare patients at 10 30 a. m Not at 7 30 a. m. When you're you're you're working crews trying to get in there, right?

book particular types of patients You know don't fill up your 5 to 6 p. m With medicare patients save that for the folks getting out of work and need to get in before you close

Naota Hashimoto: Well, yeah, like and I have um You know, like one of my friends, he feels bad because like, there's no one, everyone's opted out of Medicaid in his area.

And he wants to serve these people. It's like, well, it doesn't mean you have to serve them at all times. So just say, Hey, you have, he has trouble filling up is like 1030 to 12 and is like 2 to 4. Great. That's, that's the time that he's going to see him. So he still gets to serve those [00:35:00] people. He still gets to help them because he's complaining that he doesn't have time to see these other patients.

It's like, just see them during certain hours. Like there's, okay. I like that. I don't think there's a discrimination and I don't know this next part, but like, I have some clients that do this and they say, if you want to go in these other hours, you have to be part of our membership. So, I'm not a compliance person, so I'm not going to say that's allowed or not, but I will say that I know people doing that as well.

Well, Dodo, this was great. I always love having you on. I like having, uh, chiropractors on that have been in the trenches and then are entrepreneurial and have a lot of wisdom. And you certainly, uh, check those boxes. So thanks for your, your time today and your, and your ideas.

Naota Hashimoto: Thank you for having

me. Yeah.

And tell us, uh, how, how can they reach out to, uh, um, learn a little bit more about, about TraxApp. How, how maybe, what, I guess, what are a few things that your software does? that would help them with [00:36:00] some of these aspects.

Naota Hashimoto: Uh, a lot of things, right? So, most of the time, the cost of their appointment reminder system is ours, right?

So, like, that's, that's an easy thing, online scheduling, integrating in, like, things like Cash Practice or Fortis. Because Cash Practice or Fortis is gonna be the merchant part, and it's gonna post payments back, but it doesn't have visit information. So, we're tying the two together, so you can manage a membership.

A lot easier. I wish we had this track stat back when I was in practice, you could manage like a are a lot easier. You could manage those E statement part easier. If you're doing a lot of social media advertising, you find that half of your patients are no showing something that they could. Do with that is they could drive them to a free phone consult or paid 1st visit.

So that way you get rid of that no show problem. And if they know show, it's only a 10 or 15 minute phone consult. Uh, you know, you teach doing metrics like KP eyes will automate that. We just we make it really easy for [00:37:00] frontline people. Or solopreneurs to know what to focus on, and we just automate everything else.

And with AI and stuff like that, we're just really busy adding a lot of that. And our goal is to take a really busy office and get by one front desk instead of two or three and taking a solopreneur and just allowing them to be a solopreneur for a lot longer. So like AI, I don't think it's ever going to replace people, but like, it's going to allow like.

An A or B player to get like 100 times more work done

yeah. Trackstack. org. But yeah, uh, the saying is, is human plus AI is better than human and it's also better than AI. So. Human plus AI is where it's at and it's what's cool about having softwares like yours where it's integrating that AI and now your team that you do have is going to be that much more efficient.

So and they can do like demos at the like schedule. Yeah, they can

Naota Hashimoto: use it for free. They could. Go to tracks that dot org, go click, watch [00:38:00] demo. There's a video, they could schedule a call and get a more detailed thing. Um, and then, yeah, from there, if they like it, they just do a free trial. And pretty much everyone just moves forward at that point.

Cause like once they see all the revenue opportunities that they're missing out on, not even just the automations, it just, instead of a nice to have, it becomes a must have and, you know, like. I would love this profession to kind of move forward. I feel like I owe a lot to it. Um, getting chiropractors to agree on like anything is difficult, right?

There's a number of your, it's like number of listeners in this camp that feel a certain way. There's a number of listeners in another camp that feel a different way. And I think everyone could agree whether you're a straight or a mixer or different kinds of chiropractors, um, that. Having more money in your bank account at the end of the year is going to be something that all of us could agree on.

Yeah, my whole thing is trying to get evidence based chiropractors to realize [00:39:00] they can be really great patient centered chiropractors and not have a stigma attached to actually doing well financially. So, um, Well, thanks Stota. I really appreciate everything again, and we'll have you on in the near future.

Okay? Thank you very much for having me. I always enjoy it.

Naota Hashimoto: Take care.

  EPISODE 417: Utilizing Playbooks to Build Your Systems

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 we're gonna dive into playbooks and we're gonna do that with Craig Huston, who has, uh, worked as you'll hear, uh, with many different types of businesses and leadership. And we're gonna dive into the idea of playbooks for your practice based off the book Pinnacle, and how this can be really helpful for your practice.

Not only in. Uh, onboarding new employees or, uh, following certain procedures appropriately, uh, even to the point of having increased profits and selling your practice at a, a better rate at some point down the future. And why playbooks? I. Are instrumental into your practice. And honestly, they don't have to be.

Uh, so daunting and it's something that we've helped out, uh, our practice and our clients a lot is trying to get together some playbooks to where, you know, whether it's a, a patient experience playbook or a marketing playbook or a front desk, you know, there's a handful [00:01:00] that you're gonna want to have. And we also in this episode, dive into how you can make it a little more digestible.

And how you can store this and, and document it, and certain softwares you can use. So, um, start taking your business serious. Doesn't have to happen overnight for you. It's a little daunting to say, I got, I'm out of the time to do, you know, 14 different playbooks. But you do, if you plan it over three years or a year or five years, whatever it is, uh, and, and you keep on making forward progress in this, in no time you will have a practice.

That is documented well, and ultimately, like what Strategic Coach would say is a self-managing business. So without further ado, here is my interview with Craig Huston. Alright, welcome to the show, Craig Huston. I'm really excited to have you on. We had a great coffee some months ago diving into all things, uh, uh, business, which, which was interesting. But before we dive into, uh, our topic t jour today, [00:02:00] uh, tell us a little bit about yourself personally and professionally.

Craig Hutson: Yeah. Thank you Kevin. Uh, that was a great coffee by the way. I thank you for the time. Absolutely. I enjoyed that. Yeah. So, uh, I come to the table as a pinnacle business guide, and I think that was what originally connected us. Yep. And, uh, before that I spent quite a bit of time. I'm not gonna say how old I was, but it was quite a bit of time and, uh, the corporate world, uh, in aviation mostly, uh, but always in leadership.

So running and leading companies, divisions of companies. And then, uh, left that space and started my own. Consulting company back in, uh, 1998, so a little clue to my age. Uh, from there, went into the nonprofit space, did that for quite a while, still in leadership, and then left nonprofit world to go back into aviation to help a friend of mine run his business while he was, uh, building a hospital in Africa.

Wow. So did that and once that wrapped up in 2016, uh, trying to decide what I wanted to be when I grew up, I, uh mm-hmm. Started Summit [00:03:00] Achievers. The whole purpose of Summit Achievers is to help business owners maximize the value of their greatest wealth generating asset, which is their business, and especially that lower, lower middle market, um, companies that I have a real passion for companies that are struggling in that 1 million to $3 million range, sometimes even below a million dollars that, mm-hmm.

Have a tough time getting through that ceiling and figuring out how to do the next, next big thing for themselves.

Dr. Kevin Christie: Yeah. And I think that's a big topic and it's something that I try to convey to chiropractors. And unfortunately, um, and too many of them, we have a saying that, you know, they die on the table there giving their last adjustment.

And, um, there really was no exit strategy or plan in place if that were to happen. And, and, you know, I was actually just, uh, a little bit of a sidebar topic, which we do often in this podcast, but, um, I was just in my strategic coach meeting, uh, last week and someone in our group had. Unfortunately passed away at, at, at a very young age, 50.[00:04:00]

Um, but we talked about how he built a self-managing company and his family is fine. Um, in regards to the financials, obviously they got a lot of grieving to handle. Sure. Um, but the money side is not an issue. And, uh, 'cause he had done a great job of building a self-managing, uh, business that can operate without him and then ultimately sell and not a, a fire sale.

Right. And obviously that's an extreme example, but, um, that happens. We know that happens often, unfortunately, as far as passing away too young. Uh, but then on the other side of it is, uh, you know, if you want to have a natural, normal exit strategy, you need to have a business that can sell for a, a fair amount and actually be a big part of your retirement.

And too many chiropractic practices are, are never really a substantial part of, of one's retirement. It's, it's definitely an issue.

Craig Hutson: Yeah. And you know, to your point, 80% of businesses, privately held businesses, [00:05:00] 80% of them will never sell.

Dr. Kevin Christie: Uh,

Craig Hutson: you used the analogy of dying on the table. Um, there there's a lot of reasons that, that, that happens.

Mm-hmm. Um, most of which are preventable. I mean, an early demise of somebody that's unpredictable, uh, can, you know, if they don't have stuff already in place, obviously it's, it's a little too late. What I find is people, once they get to a certain income level, tend to have financial managers around them, wealth managers, attorneys.

They start to get some good advice around estate planning, the thing that happens is they forget about doing it in their business. Mm-hmm. And the family side is okay financially, but the business side could be a train wreck. And so just, it's not that hard, uh, getting people to do some things. We found that there's really, you could boil it down to eight things that drive business value.

Mm-hmm. And if, and my goal is to get business. Owners to focus on those eight things. Mm-hmm. And, uh, when they do that, uh, we can put some other fences in place to [00:06:00] de-risk the business and, and help them protect themselves from exactly something like that. Yeah.

Dr. Kevin Christie: No, that, that's a, that's amazing. And I'm a, you know, one of the things that I'm always, you know, chiropractors always talk about systems and, and we, we kind of harp on it a lot and, and, uh, there's a, a term that we use in our profession when someone is trying to sell their practice and it's a turnkey Right.

And I'm sure everybody's heard that. Yeah. Where it's like, oh, I got a turnkey practice. And a lot of times those practices aren't really. Turnkey. Uh, but theoretically, uh, that's where you, you want to get it. And, um, you know, I, a little bit of backstory on how I came across, um, playbooks and, and, and Pinnacle.

Uh, I was actually like on a webinar and, and one of the person there, um, had the book in the background and then I asked about it and then they mentioned it and I was like, oh, I gotta buy that. And, and I read it and then, and that book is, uh, is, is Pinnacle. Can you give, uh, our audience a little bit of a.

30,000 foot overview on that book.

Craig Hutson: Sure, sure. So, [00:07:00] uh, pinnacle, we have, uh, 150 Pinnacle Business Guides, uh, around the country. Uh, one of the things that makes Pinnacle unique is it's invitation only. These are, all of us are people that have owned businesses, run businesses. Uh, many have exited businesses and exited them well.

Uh, many have exited them poorly and learned some valuable lessons. Mm-hmm. So we all have some, uh, interesting experiences, but Pinnacle is really a, uh. An organization that I would say is a little bit bespoke because we're, we are, uh, taking the best of what's out there and putting it into a framework, I like to say, the right tool for the right problem at the right time for that particular business.

Mm-hmm. Um, all business owners like to think they're a little bit different and, uh, in some ways they are. Uh, but at the end of the day, uh, we all do the same thing. We get work, we do work, and we get paid. And so if we can think a business that way, organize around that, uh, things happen to go much, [00:08:00] much better.

And, um, and we get there. So Pinnacle, uh, brings to bear over a hundred different tools. And again, it is a framework. We work on strategy and people, uh, people first we believe in, uh, purpose that you gotta have that culture and all these things, by the way. All tie into driving business value, right? Yeah. Uh, a great culture results in, in highly engaged employees, which results in highly satisfied customers, which results in a nicely performing organization.

Mm-hmm. Uh, we focus on playbooks, uh, which is what we're talking about today. That is a very significant piece of what truly makes a business turnkey, to use that phrase. Mm-hmm. Um, and then we focus on measuring performance. You know, what are the, the, the vital few KPIs that you need to have that, that drive your business.

And of course, we believe that results not only in better profits, but a better multiple if you decide to sell in the marketplace.

Dr. Kevin Christie: No, it makes sense. And then if we could, um, spend a little bit of time on, on [00:09:00] playbooks, what exactly is a playbook? What, what's different between a playbook and maybe a, an SOPA standard operating procedure or, or a quote unquote system?

Same thing, different name or, or what are some of the nuances around what a playbook is?

Craig Hutson: Yeah, it's, it, it can be the same thing with a different name, that that's part of the problem. Uh, if I pulled you aside and I said, Hey, describe what an SOP is to you. Mm-hmm. And I grabbed another business owner and said, what's an SOP to you?

Uh, you might show me your 45 volumes of three ring binders down to very finite detail of every single thing that you do, and every possible task that that can be done. Uh, the other person's gonna gimme a checklist. And say, we just make sure we do these things for this function. Um mm-hmm. We don't really prescribe a specific how, but we know the whats and we know the order of the whats.

And if we get that done, we, we know we're doing well. So, uh, the biggest thing about a playbook is it's the thing that makes you consistent. It makes [00:10:00] it repeatable, it makes it scalable. Uh, it does everything good for a business regardless of how you do it. I, I would say the one cautionary note that I have, I lean more towards, um, just from a lot of experience, I lean more towards the checklist version than I do three or four levels of detailed SOPs.

Yeah. And for all of our Myers-Briggs and disc people. And, um mm-hmm. Performance index people out there, their personality index, there's uh, uh, those, those high Cs, those high, uh, compliance people kinda shutter at that, uh, because they wanna dot every I and cross every t. But the most important thing is that you're doing the right thing at the right time and order.

Yeah. And that it's, it's repeatable and that itself is something that buyers look for. Mm-hmm. Uh, think of McDonald's and Hamburger University. You know, highly scalable. There's a process. They repeat that [00:11:00] process every time they open up a McDonald's. The whether you like McDonald's or not, I'm not advocating McDonald's.

You can use Chick-fil-A, you can use whatever your favorite one is. But any franchise organization has a standard playbook and they're able to replicate that in any geographical area.

Dr. Kevin Christie: Yeah, it makes sense. And I think what happens to, and I'll speak to chiropractors, but I guess business owners in general, is they hear standard operating procedures or, or manuals or, or, uh, you know, systems and, and they do think, oh my God, like I don't want to write a 500 page book on our standard operating procedures.

Right? Like, it's just so daunting. They never. Kind of cross that chasm. And I think what's great about the playbook is it, it, it really takes it down to a digestible way of actually having. This for your business. And, and I'll give an example. It's like you could have a, a patient experience playbook, you know, and it, it doesn't have to be this 20 page document out writing out a, a, a novel on what your [00:12:00] patient experience is.

It could be, you know, here's, uh, when patient calls the office, this is our, how we answer the phone, uh, when Pat, you know, then we send them the online forms and like just kind of boom, boom, boom, boom, boom, going down that list and then, okay. And you would have maybe. Different phases of that patient experience.

Like, okay, when they're scheduling their appointment versus okay, their first visit, what's the playbook on that first visit? And again, it doesn't have to be this long thing, but it could say, okay, stand up and greet the patient by their first name and get their insurance card and driver's license. You know, just really nice concise thing that a person could, could follow.

And that's what I. I took from reading about the playbook and then obviously mm-hmm. Um, getting a note a little bit. Is that accurate when I say it? Kind of like on a, if, if you were to apply this to say a patient experience Yeah.

Craig Hutson: Right. On the money there, there's the, the two most important playbooks, I think are exactly that client or customer experience and employee experience.

So what's that employee experience from the time they apply for a [00:13:00] job? They go through an interview process. Mm-hmm. They're accepted. An offer's made, they say yes. What happens, what does it look like on my first day of work? Uh, is it, here's your desk. Have a nice day, uh, figure this out. Or do you have a really nice robust onboarding process that makes it easy for them to get, uh, integrated into the culture, introduced to people, feel like they're part of the team, and be a highly engaged, uh, participant in the organization?

Dr. Kevin Christie: Yeah. I love that. And I think it's, um, I think the other thing that I've noticed in our profession is people get concerned about cookie cutter systems, right? It's like, and I, and there's been some coaching programs out there historically where it's like, okay, you sign up for their program and you get this massive, like eight binder volume set of, of all of.

Their systems that they're saying, you should just do this. Right? And it's, it's a little bit too cookie cutter. Um, you see that happening often in, in companies and it's, and it's just really almost there. They're, they're kind of going through the motions, but they're not really [00:14:00] applying any of it. But then they're saying, oh, I've got, I've got these binders of systems, but they're, they're like 400 other dry cleaning offices are using the same one, right?

Craig Hutson: Yeah. We call that bookshelf jewelry. Um, so it just kinda sits there. I, I think there's two aspects of that. There's, uh, there is that overzealous person. That creates the, like you said, you know, it's this 500 page document, um, and you're really creating failure for yourself. You become your own worst enemy because one, nobody can find anything in that document.

It's usually not well indexed, um, not well organized typically. I mean, there's somebody out there always that can say, wait, wait, wait, look at mine. Uh, but that is the exception, right? That's not the rule. And in addition to that, um, people just don't look at it.

Dr. Kevin Christie: Yep.

Craig Hutson: It's like, I don't have time for that. So Kevin, tell me what I'm supposed to do.

Mm-hmm. And you and I work together and you tell me what to do.

That may not be right. Uh, but it's the way you learned it and you learned it from somebody else who learned it from somebody [00:15:00] else. And so that's the system that gets put in place. And what is, what gets perpetuated by, uh, just proximity mm-hmm. To somebody else in the office that you asked the question to.

Nobody's looking at. A big SOP binder set of binders. Mm-hmm. Um, the other aspect of it when it comes to the program or the toolbox, I'll say

Dr. Kevin Christie: mm-hmm.

Craig Hutson: Is that there, there are some really good systems that are out there. Um, and every one of them has some really good traits. Every one of them has some flaws as well.

Mm-hmm. Um, the, the downside comes when you have a limited set of tools. You're trying to force yourself through a tool because you have a tool.

Dr. Kevin Christie: Yeah.

Craig Hutson: Or because you have something that somebody showed you to do, but it doesn't quite fit and it doesn't quite work. So you're trying to push the proverbial, you know, square peg through a round hole.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: Um, and it doesn't work without a lot of damage to the square peg, um, or [00:16:00] to the whole in the, in the board. So, uh, being able to customize

Dr. Kevin Christie: mm-hmm.

Craig Hutson: Every single client's needs, um, and meet them where they are, I think is the most powerful thing anybody can do.

Dr. Kevin Christie: Yeah, I think that's, that's great. And I know one of the things that, that I've done, I've, I've, um, built out some playbooks, you know, like say a front desk playbook and, and you can, you can tell me if I'm wrong and, and how we've done this, but, um, you know, we've used say a Google document and then, um.

If something says, you know, reference X, y, z, it would link to maybe a little training video on there. Mm-hmm. So if, uh, you know, front desk playbook and let's say we Okay, reference the how to, how to answer the phone appropriately, then it could go to an audio of that or, or a video of it, or even just a written out script to it to where you're not making that playbook really dense and confusing.

But if someone does need to. Reference something. You have it there. Is, is that a, a [00:17:00] decent way of doing it?

Craig Hutson: It is, it is. And I'm a big fan of video as well. Mm-hmm. Um, in addition to documents, with links, like you said, could be to a video, uh, there's some great platforms out there. I happen to personally use one called Vid Guide, uh, because it integrates to anything that you have with Chrome or, uh, any other web browser.

Um, and it's very situational specific. So if you have somebody in bookkeeping that needs to send an invoice out mm-hmm. And for, as an example, with a lot of smaller companies, they might use QuickBooks. So I'm, I'm not choosing any one over the other, just using that as a common example. Mm-hmm. Um, how do I issue an invoice in QuickBooks?

Well, with a vid guide, you actually video that particular activity. You could do voiceover, you could do just screenshots, however you wanna do it. Uh, but it comes up when the person is on that page in that, um, application. Mm-hmm. So it's very specific. To that particular action. In other words, that video never [00:18:00] shows up anywhere else to confuse people and they don't have to worry about where to go find it.

It pops up when they need it. They watch a two minute video and Oh, I got it. Mm-hmm. The reason I like that is I could describe to you what to do. Yeah. And I'm gonna invariably leave something out.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: And when you watch the video, you're gonna see me check a box that I didn't mention. And you go, oh my gosh, I forgot to check the box.

I didn't even know that box was there. You never said anything about that box. But in the video I see it and I see you do it. Uh, so it just really accelerates everything. And then, then what you wanna do is have your team start creating those videos. Anytime there's, there's a change for the other team. So the best way to learn something is to teach it to somebody else.

And now they have full ownership. And again, this is owner independence, right? This is you separating yourself from having to do the day-to-day stuff. And your team's taking ownership. No, I love it.

Dr. Kevin Christie: Yeah. And I think an, another tool that may be a very similar one is Loom. LOOM might be like that. Um, yeah, [00:19:00] we've used that.

Craig Hutson: Yeah. Very similar. The, um, the, again, I, I'm just, I'm not pushing vid guide, I'm just saying No. Yeah. I'm just getting the, the reason I use that, I like that, and I've, I've had my clients just create nightmares based on my recommendation mm-hmm. Of videotaping stuff, because then it's, where do I put the files?

How do I index the files? How do people find them when they need them? Mm-hmm. And, um, you can create Frankenstein if you're not careful. So, uh, using something like Vid Guide, again, I, there's other platforms out there, uh mm-hmm. That you can Google and check out Yeah. That do these things. And so it's already indexed for you.

You don't have to worry about that. And nobody has to worry about where they go find it. That the, anything that you can do to make it easy on your team. Mm-hmm. Uh, I think is a win.

Dr. Kevin Christie: It is. And, uh, another resource for people is, uh, you can go to Scribe how, uh, mm-hmm. I think it's dot com. I don't think it's dot org.

I think it's dot com. And it's pretty interesting. Uh, if you were doing [00:20:00] what you just mentioned, let's say you're on your computer screen and you, you click through all these different things showing how to, to do payroll or whatever, um, it actually generates a PDF. Uh, in other documents, but A PDF with, uh, written and then screenshots of you, like, okay, clicking that button.

And so now you also have a PDF version of exactly what you did on your computer screen to pair with that video. And then you could obviously have that Yeah. Uh, stored. Now is there a particular, um, platform you use to. To store all these things or do you, I know there's certain things out there, or do you use Google Drive or anything?

Any uh, words of wisdom there?

Craig Hutson: Yeah, there's so many, so many different things. So many, right. There's, uh, uh, and so again, without overly disrupting an organization mm-hmm. Use what works for them. So if they're Google Docs, Google Sheets, Google Drive, use that. Mm-hmm. If they're OneDrive and Microsoft and teams use that.

Mm-hmm. [00:21:00] You know, if you're a Dropbox, use that. Uh, there's so many things that are out there. Train is, uh. Is an organization that has a place for playbooks and all the things we've just talked about. They consolidate, that, have training, and have a platform. So there's, there's again, so many different ways to do it.

It's finding the thing that is the path of least resistance for your team, and oftentimes that's the least amount of change. Possible. Uh, so that adaptability is high. Yeah. Or yeah. I think that's, that's,

Dr. Kevin Christie: that's such a good wisdom there. And because I think sometimes we go into things with best intentions and we, we sign up for Process Street Orran or something, and then mm-hmm.

You know, you're paying X amount of money a month, but you, you just don't ever really. You know, put the time into really using it. What, for what it's worth, it's kind of like if you were a, uh, you know, a $500,000 a year business, signing up for Salesforce may not be the, the wisest thing for [00:22:00] you, because you just may not have the bandwidth to actually learn how to use it.

For what it costs, right? Yeah. I've talked to organizations that have rolled out, uh, a platform like Salesforce and it's amazing, but you better be willing to invest some time and money and coaching almost on just that thing alone, right? Mm-hmm. Oh yeah. It's sometimes you gotta have. What's the least resistance?

And if, you know, if you're a smaller or a moderate size chiropractic practice, you know, Google Drive might be good. I mean, even on our, on our, uh, coaching side of things, we've, um, you know, we have a lot of content, a lot of, uh, coaching calls and we, I. I put together these little lesson packs for our clients.

Like, look, tell me what, what's your biggest problem? Is it, uh, burnout right now? Okay. I got a little pack I put together of four lessons or things we've done in the past that, uh, that tackle that thing, and then they, it's a document they get click on. It goes right to the video or the lessons within. It's all done in Google Drive and it's, it's kind of amazing what you can do with that.

And I, I envision [00:23:00] that with chiropractic practices and, and playbooks.

Craig Hutson: Yeah. And the, the nice thing about any of those, those platforms like that Google Drive or, or Dropbox or anything like that, is their platform independent. So if somebody's on Mac in one place and somebody's on PCs in another place, it doesn't matter.

Mm-hmm. Uh, and you can collaborate there. There's some, you can, you can control access to documents if somebody can edit or just view and, uh, it, it's a, it's a really powerful. Yeah. Powerful place, uh, to collaborate for sure. Yeah. So I think, you know, first of all, uh, why playbooks? I mean mm-hmm. Some people out there are probably listening to this going, I hate playbooks.

I've tried it before, it didn't work. Mm-hmm. Why do I even care about this? I mean, number one, especially for smaller companies, is they need to understand that the playbooks are gonna fuel growth for them. Uh, and it's like, well, Craig, how does a playbook fuel growth? Well, number one, uh, you have consistency and we [00:24:00] know mm-hmm.

Things done over time consistently compound, right? Yeah. So you get repeatability. Repeatability leads to scalability. Much faster onboarding and training. Mm-hmm. Uh, there's not a business owner out there that hasn't spent a ton of time and effort, sometimes a lot of money training an employee. Mm-hmm. And, um, and, and this turns into a key employee that you're relying on and that employee leaves.

You're like, oh my gosh, I gotta do this all over again. That's a very painful experience. It's not just expensive dollar wise.

Dr. Kevin Christie: Yeah.

Craig Hutson: Uh, but just the time and the investment and the loss of productivity in the office is incredible. Uh, but if you have playbooks, it's super easy to onboard the next person because it's easy for them if the playbooks are well done to figure out exactly what to do.

So it speeds that process up. Well, and by the way, um, a lot of people will say, well, why train them? You know, what happens if you train them and they leave? And well, what happens if you don't train them and they stay? Yes. That's one of my favorite. That's, [00:25:00] that's even worse, right? It's way worse. Yes. Yeah. So, uh, so we do wanna train them, but this, this makes it, um mm-hmm.

Good. And then it's a way of replicating success. Right? How, how do the big companies do it? Right? The Fortune 500 companies and people like this, if, you know, they'll hire a large consulting house mm-hmm. And that, and they'll say, Hey, we need to improve productivity in an area or whatever. One of the things that most consulting houses will do is they'll come in and say, well, who are your best people?

And you'll say, oh, you know, Kevin's amazing. Okay, well, let's go look at Kevin and we're gonna watch what Kevin does, and we're gonna sit with Kevin. We're gonna interview Kevin. We're gonna see what his process is, and basically I'm oversimplifying it. So if you're out there and you're a consultant, just don't take this deal.

My name is Craig and I'm your friend. Uh, but what they're gonna do is they're gonna say, here's what Kevin does. Go have everybody else do what Kevin does.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: Uh, but they'll have documented it and they'll [00:26:00] have written up a profile. And this is what. What it looks like to be Kevin. And you're not trying to create clones.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: Right? You're, you're trying to create, uh, repeatable excellence and, and staff your team with a players. Mm-hmm. Uh, I like to say that a players are free. Because one A players can outperform three B players every single time, and their, their increase in productivity is gonna more than make up for the salary that you're paying them.

Uh, so sometimes you do pay more. Mm-hmm. But, but you need fewer of those people when you're hiring the very best people that are out there or training up the best people. Um, the second thing it does is this has a direct tie to your business value.

Dr. Kevin Christie: Yes.

Craig Hutson: Right. So first it fuels growth and success, but the second thing it does, it helps you maximize your business value.

So back to our initial discussion, you know, how much is a business worth and, um, it could be worth, especially a smaller [00:27:00] company. Mm-hmm. Uh, it's gonna be some multiple of. Probably a smaller company that talk about sellers discretionary earnings. Mm-hmm. As opposed to ebitda. They're gonna be maybe a, a small multiple on revenue.

Uh, but some numbers, somebody's usually buying that business to expand their reach in a demographic market. Right. Or, or they're hiring your staff. Right. They, they want access to your staff and, and to your customers. Uh, so that would be a reason to do that. But it's transferable knowledge. Mm-hmm. It's owner independence.

Um, not that the owner is independent financially. Mm-hmm. Which is what we want, but the business is independent of the owner. Yeah. Uh, in other words, if you're out for three months, the business continues to run without, without interruption. Mm-hmm. Um, it reduces over dependency on that key employee, right?

Yes. So one person who has a secret sauce in their head mm-hmm. And they've never shared it with anybody and nobody knows what they do, nobody knows how they do it, and something happens to that person or that [00:28:00] person leaves. Mm-hmm. Um. Everybody's left scratching their head, trying to figure out how do we get there.

So that's important. And then, mm-hmm. Efficiency, right? It's operational efficiency. Again, you're just, it's repeatable, it's scalable. Um, and one thing about that is, um, which ties to the next point, which is improving cus or employee engagement, is a lot of people think. That. Uh, and here's this is entrepreneurs, right?

So most of us entrepreneurs live by the phrase, you are not the boss of me, right? Mm-hmm. So we don't wanna work for somebody else. We wanna have our own business, and there's a certain freedom in that. And we feel like this could sound a lot like rules and constraints and. This, this, I don't like this feeling.

It's kinda like making me feel claustrophobic. Uh, but the reality is, uh, in a way it's a lot like ai. If AI is used properly, what it does is it frees people up [00:29:00] to focus more on revenue generating activities mm-hmm. Than doing stupid administrative things. Right, and trying to figure stuff out because there is no clear process and I'm wasting so much time.

And if only I had known that all I had to do is X, Y, Z, I could have been done with this an hour and a half ago. Mm-hmm. And then that hour and a half gets freed up to focus on those revenue generating activities, which could include client experience. I can spend, instead of having my head down, typing away at my computer when somebody walks into the reception area mm-hmm.

I've got time to stand up, greet them by name with a smile. Ask them if they want a glass of water, a cup of coffee. You know, make them feel really welcome. Make them feel really special. Like I see you, I acknowledge you. Uh, you're not an interruption to my day as I'm typing away at my computer and barely noticing you out of the corner of my eye.

Uh, so it does really have a positive effect on the business by freeing people up instead of constraining people. So just throwing that out [00:30:00] there. For all the entrepreneurs out there that feel like rules are a bad thing, it, it's not about that. Yep. When employees have clarity and confidence, it frees them up and empowers them in their decision making.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: In, in crazy ways. Uh, it's, it's really amazing to see what people can do when they step up into. A more productive space because they're not bogged down with all this other stuff. The second thing is it empowers 'em, which we just said, and it's an opportunity for professional development. If I have playbooks, uh, throughout my organization, I can begin to rotate those people that I see as emerging leaders.

Uh, somebody that's gonna rise up, I can start to move them from place to place, and they can get a broader experience. Uh, in your case, they might get a broader experience of the practice. What, what does it look like? Not just to do this one job in a practice, but what does it look like overall to run a practice?

And maybe you're developing an office manager all of a sudden. Mm-hmm. Uh, who could take a huge burden [00:31:00] off of you to free you up to do the things that, that you wanna do and that you do best. And then lastly, it reduces turnover. One of the biggest things is, uh, your onboarding success. You know, what does that experience look like?

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: I, it's one of the things that companies do very poorly, especially small companies. 'cause everybody's busy. Mm-hmm. And nobody has time. So we, we throw you into the mix. You're in the deep end of the pool. We hope you survive. We don't really spend a lot of time with you. Uh, maybe we do lunch with you the first day.

Uh, maybe we walk you around the office, introduce you to everybody. Uh, but we don't really get to know you. We don't spend a lot of time with you because, hey, you know what? The building's on fire. It's crazy. We need your help. Just jump in and do this. Uh, we'll talk next week and next week never comes, right?

Mm-hmm. So, uh, that's a big one, the cultural alignment. Uh, there's a old phrase from Peter Drucker. Um, culture eats strategy for lunch. Uh, and it really [00:32:00] does, right? So we wanna be intentional about the culture that we have in our office, which our clients feel. Mm-hmm. Right? Part of that client experience.

They understand what it, what does it look like when I walk into your reception area? Yeah. Is everything cluttered? Is it messy? Are the floors dirty? You know, are the restrooms dirty? Is is, is it dead quiet? There's no music playing. Um, you know, just. The smells, the, the paint colors that like, like there's this whole experience that, that you're in and that's part of culture.

Mm-hmm. How people treat each other is part of culture, how we show up, do we dress professionally? Um, how do we work, how do we support each other? Mm-hmm. Do we collaborate? Are we a bunch of independent people? So it really helps cultural alignment. And I think one of the biggest things is, uh, ties, it kind of weaves through this whole thing, is it really reduces frustration.

Yeah. And, um. If I'm not frustrated and I enjoy coming to work and it's a great place to be, mm-hmm. Then I'm highly engaged. And we know from Gallup and decades of [00:33:00] research that highly engaged employees, those businesses perform in the top quartile of all businesses. And there's huge differences in profitability and revenue and growth and satisfaction and client satisfaction.

Like all the dials go the right direction. Uh, when you have an engaged team.

Dr. Kevin Christie: Well, yeah, there's a few touch things I wanna touch on there and, and I'll start right, what you just talked about hiring. It's, it's fascinating 'cause a lot of people will complain. It's like, oh, I, you know, I, I keep on hiring the wrong people.

And, and that could be, you know, if you don't have a playbook for hiring, that could be a, a legitimate thing. Uh, maybe your talent acquisition is off. I, I, I kind of look at it four phases of, of really having an a. Player, and obviously talent acquisition is one. I think hiring a really good hiring process is two and onboarding is three, and then a continual training is, is four.

But a lot of times people might have hired the right person. It wasn't a hiring problem, they just had a severe onboarding issue and, and mm-hmm. Like you just said, and, and so you had no strategy to onboard this person. And they came [00:34:00] into a in chaos and said like, I don't wanna work here. Some of these.

Especially these chiropractic clinics can be really busy and, and, uh, if they just get thrown into the fire, you might burn them out quickly and say they can't imagine being there for a year, five years. Yeah. Let alone another week. Uh, so people gotta, gotta really get clear on, on that part of it. The other thing I wanted to mention is we had a couple.

We had a kinda a real life scenario with how important a PLA playbook can be. Is, is our front desk slash practice manager. She went on, uh, maternity leave for her first, uh, child. And, but you know, obviously the good thing about, uh. Maternity leave is, you have quite a few months to prepare for it, right?

Mm-hmm. It's not like someone leaving, uh, putting in their two weeks notice. Like we, you know, we had a good six months and, and over that six months we built out a really good playbook for that front desk and all the tasks, and we were during her few months of, of not being with us. Um. And we, we had two to three interns [00:35:00] with us during that period of time, and they kind of covered doing the front desk and they had this, um, playbook on, on all the things to do and 'cause it was really important to us, uh, especially the first, uh, couple months of her maternity leave was not to reach out to her about work related stuff.

Right. Really wanted to, um. You know, protect her, her, her maternity leave there in that, in that regard. Yeah. And, and it really worked out. And so you might have situations like that where, um, it's important and you may not always have, 'cause I, I'll be honest, we didn't have an updated playbook for the front desk until that, but we were blessed with the, you know, six months of, uh, or maybe even seven months before she was on maternity leave.

So that was pretty cool to see how that did work.

Craig Hutson: Yeah. Yeah. That, and that is a great point. And, you know, um. And even now with paternity leave too, right? So mm-hmm. Uh, it's not always the the person you expect to be gone. It's other people that are gone and now Yeah. Uh, having, [00:36:00] again, you get some notice, which is great.

Mm-hmm. Uh, but you have to do something as you did proactively with that notice. Yeah. What a lot of people do is say, oh good, I've got time. Uh, and they forget about it until that person walks out the door and it's like, oh my gosh, what are we gonna do? Uh, write down everything that you're doing. Uh, you know, and, and oftentimes they will.

I mean, a conscientious, uh, employee's gonna write everything. Here's what I'm doing, here's what needs to be done, and all that kinda stuff. But sometimes it's very clear in their mind.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: What they wrote down. But somebody reading it for the first time doesn't understand it. Yeah. And so that person's gonna get a lot of calls at home.

Mm-hmm. Uh, hey, I know you're on maternity leave. I'm really sorry we're, you know, I just have a couple quick questions for you. Is it okay? You know, uh, but having that time ahead and being intentional about it mm-hmm. And documenting what they're doing. And,

Dr. Kevin Christie: and it can be simple too, right? Like an, an example, like one thing that might be on our particular front desk [00:37:00] is, um, is we use a, a software called cash practice Systems for our merchant processing and, and such.

And, uh, on there just needs to be, okay, here's a, a tutorial on that and here's our main contact person from that company. 'cause most of these types of, whether it's your EHR or whatever, has a a point of contact. And so yeah, that's our resources, if any, if. If shit, it's the fan. We have someone to, to talk to.

Outsource there, right? Yeah. Uh, ed, I I wanted to touch on one more thing. You mentioned about like, obviously the sellability of a practice and the value of a practice, and that's one thing that we've tried to also convey to chiropractors is, is, is our company, m mc m if we've developed like a playbook of marketing that we actually do for chiropractors and, um, and I've actually, I've actually asked that question to, uh, crystal Meisenheimer, uh, she owns a.

A, a practice sales company, uh, for chiropractors, uh, particularly, and, and asked her that question. I was like, look, does a practice that has consistent and historical marketing being done over time, does it increase the [00:38:00] value? She said, of course, yes. You know, people want to buy something that has had marketing being done consistently for, for a long time.

And, and so marketing would be a playbook that your practice needs to have. Mm-hmm. And if you can have that done consistently, not only is it gonna. Uh, drive practice, it's going to increase the value because it's like you are now a practice as fully developed marketing and been going on for some time, and it's been, um, adding value to your practice.

And so that's another example of a playbook that would be need to be done consistently for a practice that would obviously drive results currently while you own it, but also again, make it more, um, sellable.

Craig Hutson: Yeah. Ab a hundred percent. And, uh, you know, and what is the process? What's the sales playbook? So marketing generates the interest, generates the lead that turns into a contact with the, with the practice.

How does that practice turn that into an actual visit? Mm-hmm. Um, and then how do you turn that visit into hopefully a, a long-term [00:39:00] client, right? Yeah. So, uh, that, that's all the kind of things people are gonna look at is what is your, you know, what's your customer demographic? Um. And I don't mean that financially or anything else, but how many clients do you have?

What percentage of of your revenue is tied to a smaller portion of clients versus more? Obviously, the more diverse you you are, the more valuable the company is. Um, anybody that's tied to one particular client, right. You you'd like to say that? Uh, a, a person who's in the, uh, process of looking for a company to buy.

Never wants to see customer concentration greater than 15%. Um, now in, in a medical practice or a chiropractic practice or mm-hmm. Some of these others, uh, that are, that are B2C directly, you know, going to a customer, you have a bunch of individual clients, right. You might have a hundred clients. I don't know how much the average practice has, but

Dr. Kevin Christie: mm-hmm.

Craig Hutson: You have a lot of different ones, so you don't have to worry about that. Um, only [00:40:00] when you're small and starting out. You know, don't get over reliant on mm-hmm. One or two key people, but also on suppliers, you know, key suppliers. We learned the hard way. A lot of companies learned the hard way through covid.

That when the supply chain is disrupted significantly, and you're overreliant on one or two key suppliers that can have tragic consequences for your business. Yep. Yep. Right? Abs and then they're, they're looking for overreliance on one or two key employees. Right? So this whole overreliance thing, uh, is a, is a big deterrent.

Well. I'll give you an

Dr. Kevin Christie: example of over reliance on, on a chiropractic practices. Some practices are over reliant on that owner doctor's relationship, like personality and, and some of the referrals to that particular doctor. And it's not a diversified, uh, referral source of new patients. And so if you go to sell, too much of that business is gonna leave and that can decrease the, the value.

And that's something that we, we always know of for sure.

Craig Hutson: [00:41:00] Absolutely. And, uh, having, you know, having, uh, that culture mm-hmm. That client experience mm-hmm. Yeah. Having a, a client experience that is top shelf independent of the doctor.

Dr. Kevin Christie: Mm-hmm.

Craig Hutson: Yeah. Right. Or doctors. Right. Um, and, and even slowly bringing additional doctors on.

Yep. So that. There's less and less and you're able to hand off patients over time. Yeah.

Dr. Kevin Christie: Yeah. And we could do a whole part two on that.

A lot of chiropractors, I try to explain why it's so important to have really good profit margins and be able to hire other team members is because ultimately that's how you're gonna have something that is, is sellable. Um, but, uh, Craig, this has been fantastic. Uh, I really appreciate the wisdom on, on playbooks.

Uh, I hope, um, this kind of kick starts some folks and realize they need to build a, an actual business and they can still be a great doctor. Uh, there's always a misconception. It's you can't be a great doctor and a great business person. That is false, and there's certain things you can do that [00:42:00] are, uh, going to help you in that.

But how can they find out more about what you do and, and your coaching and different things that you offer?

Craig Hutson: Yeah. Thank you Kevin. I would say, uh, the easiest thing to do is to, to visit, uh, my website, which is summit achievers plural, summit achievers.com, or they can, uh, look for me on LinkedIn and it's just Craig Huston, H-U-S-T-O-N.

Dr. Kevin Christie: Perfect. And I'll put that in the show notes, and I really appreciate your time today.

Craig Hutson: All right. Thank you so much.

 EPISODE 418: Exponential Thinking for Long Term Success with The Wrights

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. Uh, today I'm breaking on a couple, Dr. Tyler and Dr. Laura Wright. Uh, they are part of our West Mastermind group. They were also part of our coaching before that, and we're gonna review the last year. They've had, it's been a wild ride, but ultimately wanted to bring them on to, you know, kind of share their story to make you, uh, realize or, or have you.

Uh, realize you can take on big things. And, and I'm not saying you have to go as big as they did in how they decided to, uh, change their course of their, uh, clinic situation, personal life, where they wanted to live and make a decision like that. But I want you to take the essence of what they talk about in this podcast and apply it to things that might be, you know, hiring your first associate, becoming, uh, an owner.

Uh, for the first time, or, uh, maybe it is something big like moving or it's just, you know what, I want to take on a challenge [00:01:00] to get even better clinically or from a business standpoint, uh, or you're just running into obstacles in your clinic. Um, you can overcome it, you can do hard things. And, uh, the rights have, have definitely done that.

And so I wanted to have them on. Uh, to, to share their story. And, uh, we kind of start where the first weekend of our, uh, 2024 West Mastermind Group. You know, we have an east and a West, and 2024 was the first year for the West group and, uh, we've had quite a growth in that group, um, into the 2025 as we speak now.

Um, you know, if you're interested in 2026, we will be in the next couple months. Um, opening up the West group for more members. Uh, so you can email me, Kevin, at modern desk jockey.com if you're interested. And we'd like to know some of the basic details. Right now, we, we don't have all the, uh, finalized details for 2026, but we're close, but we can get you on a list and kind of let you know.

But, uh, this group is, is just really special. [00:02:00] Uh, so is the East and, um, people are doing big things in there and, and having a high level of success and camaraderie on that. So check that out. And in this, um, episode we're, we're gonna dive into some of the thought process of what they took on. And, uh, now that it, a lot of it is in the rear view mirror, some of the things that they learned.

So, uh, here is my interview with Dr. Lo Wright and Dr. Tyler Wright.

Alright, welcome to the show. I got Laura and Tyler Wright, and we are gonna dive into a, a whirlwind of a year and a lot of fun and a lot of challenges. Uh, it's been fun to, to see it all lay out and , but, but before we do, uh, give us a little bit of a background on yourselves.

Tyler Wright: Yeah. So, uh, Laura and I, uh, we met in chiropractic school back in. Well, we graduated in 2017. We met back in like 2016. Uh, dated for a little bit, got married, moved across the country, started a practice in Jackson, Wyoming, all within the span of a.

Yeah. Um, [00:03:00] when we originally moved to Jackson, Wyoming, I had never been there. And Laura's uh, I guess selling piece was, it's great, but when it gets too busy or too expensive, we'll move to Alaska. And, uh, I held onto that firmly.

Laura Wright: I had said that as a joke, but.

Tyler Wright: And, uh, we know we, we, we had a successful practice. We, we grew every year. We were doing really well. Um, seven, seven and a half years into practice. It was very clear that the environment around us had changed and that our longevity was, um, was compromised. And we had to, we had to commute. We were commuting upwards of an hour or so each way to get to work and to get home.

And once our children who we now have two. Uh, once they started school, they'd be going 45 minutes in the other direction. So, um, all of this kind of culminated about the same time we joined the MCM Mastermind group and we had gone into this group thinking, oh, we need, we need ways to strategize and how [00:04:00] to grow and how to make this really difficult environment work.

And, um, almost exactly a year ago we went to Arizona thinking that's what we were gonna do. And along the way we decided that we were going to completely uproot our family and our business and move about as far away as you can move and still stay in the continental USA. So,

Dr. Kevin Christie: yeah. Anything to sprinkle onto that Laura?

Laura Wright: Yeah. Um, one we didn't meet in 2016 and do all in 2017. We met early 2015, so it wasn't like one year, and then the next year we were getting, getting married and doing all of of that. Um, yeah, I think like I, I thought we'd be in Jackson forever. And so we lived just outside of Jackson and Alpine, Wyoming, and that's why we had the commute.

Um, and. Yeah, I think it came evident from a work point. Like this doesn't make sense for us. Jackson just blew up with Covid. Um, just insanely expensive. The saying there was the billionaires are pushing out the millionaires and I think like we could have made it work. We just would've [00:05:00] spent our life grinding and we looked at what we wanted to build, which was a bigger clinic, multidisciplinary.

We wanted to have a gym, small group classes, and just with, um. Commercial real estate, that was going to be very, very difficult there. So I kind of think of my ourselves. I made a analogy the other day. I have a little like, uh, potted plant.

Mm-hmm.

Laura Wright: There was us in that pot trying to grow with. Basically like seasonal water.

And Jackson's very busy in the winter and the summer, not during the off seasons in this tiny pot. And now we've, you know, moved up here and there's, so, there's so much more opportunity for us and that's really what brought us up here. And that's what we realized in that first mastermind is we, we could make it work there, but if we have the means and we're willing to go, like, why not go where there's more opportunity [00:06:00] for us?

Dr. Kevin Christie: Yeah. And so, uh, a little bit of a synopsis for our listeners. We went from Jackson, Wyoming to Anchorage, Alaska. Um, you know, you guys had done some coaching with us in the, in the past and then joined. The first year of the West Mastermind Group, and we were in Phoenix, Arizona with Jay Greenstein as our lead presenter for that particular weekend.

And like you said, we're going in there to, to, to build some things and do all that. Instead, you blew up some things. Is that, is that accurate? That's very

Laura Wright: accurate, yeah. Yeah, absolutely. Yeah. That was a year in some ago, early February, February went to the mastermind. Two and a half weeks later, we flew up to Anchorage, Alaska.

It was Tyler's first trip up there. I'd been several times. My childhood best friend lives up here. It was my first trip in like the dead of winter. Um, Tyler was sold right away on it. And then I think I, I liked it, but I was. More nervous to move. Very much so. Um, but talked about it, went back home, [00:07:00] put our house on the market, started all of the process to sell our business mm-hmm.

In Jackson. Um, I made us visit a fair amount of other places just to compare them before we finally settled on. But we basically, yeah. In less than a year sold our home. We didn't end up selling our business, we ended up packing it up and bringing it with us.

Dr. Kevin Christie: Yep.

Laura Wright: Um, but yeah, it's a lot.

Dr. Kevin Christie: Yeah, it was, and it, and it was cool.

We're gonna dive into a few things, but um, I'd like to actually tease out a little bit the thought process of. Like you mentioned, packing up your business and going with you. Um, people are like, well, how does that work? Yeah, but obviously you could sell a practice, but then when you do sell a practice, you're selling everything and that's your, uh, you know, your email list, just everything.

It's gonna be your equipment, it's gonna be all the different things. And so what was the thought process? Obviously the timetable of a selling of practice can be a year to two years, so there is probably that opportunity cost and the time of it. But what are some of the [00:08:00] things that. You felt benefited you by just quote unquote packing up the business and taking with it.

What were some of those things?

Tyler Wright: Yeah, I think you nailed it with the, with the timetable for sure. Yeah. Um, we wanted to do it while our kids were a certain age. Gotcha. Um, you know, they were one in three at the time. And, and getting here prior to starting school and really making those bonds with friends was important.

Mm-hmm.

Tyler Wright: Uh, the other, the other thing that really stood out was. Um, the equipment and the cost of shipping things to Alaska, um, you know, we could sell the business and, and lose all of our equipment at a, at a reduced value and then have to pay more for it, plus, uh, an upcharge just to get it to our clinic.

Being up here, um, you know, we, we ordered some gym equipment up here and it does cost a little bit more to get product up here, and we see that both in the cost of groceries and just, just getting things delivered.

Yeah.

Tyler Wright: So yeah, and I think,

Laura Wright: right, we, I mean the email list didn't make such a big difference, but we, we have a great YouTube channel.

We had a great website. We did end up redoing the website as of [00:09:00] right now. We'll see if we still lose them or not. We had brought all our Google reviews with us, so it was building, rebuilding, all of that stuff, reordering things for the office that like. Maybe we would've had time for, if we didn't have two young kids, it would've put us back and we needed to take all of that with us so that we could more hit the ground running than trying to rebuild and the opportunity cost, right.

We're getting started in a new place. We could have come here six months a year later, but we would've been that much farther behind in building here. So we just, yeah, we opted for that. Getting here and building.

Tyler Wright: Yeah, maybe just comfort level too. 'cause you know, having everything that you've had attached to you for seven years is, there's some reassurances there.

A little bit of motivation that we can do this 'cause we have that support system

Dr. Kevin Christie: in place. That's true. And I wanna touch on the opportunity cost thing for a bit. 'cause a lot of people don't, um, realize that, but yeah, like the time of it, uh, we'll probably chat a little bit in, in, in a bit, but. Um, you all, you guys bought a commercial piece of real estate.

If you would've not moved there and maybe you waited [00:10:00] to sell, you might not have had that opportunity to buy a space that you did, which was a great opportunity. Mm-hmm. Um, you know, quality of life, opportunity cost. So sometimes just, you know, just saying like, okay, this isn't the easiest decision, but uh, it's not worth the X amount of money we might've got for it.

When you actually take all the opportunity cost into the equation, not just the physical or, you know, the, the, the. The numbers you see on a screen as far as what money came in and what didn't. Um, and so that's, uh, definitely something to to consider as well. Now, uh, let's go back. It's, it's, um, it's February of 2024.

We're leaving Arizona. You guys are, uh, gonna make this decision, um, to, to do it. Uh, one of the things that I keep on chewing on a little bit since last week when I was in my Strategic coach meeting, I was having just a lunch with one of the members and. It was, he was telling a story about his kids and stuff, and he had the phrase, you know, sometimes you gotta do, uh, hard things worth doing.

And he said it a couple times like [00:11:00] that. That makes sense. You know, and, and in life there's gonna be things that are hard, very hard. Mm-hmm. But. But worth doing, uh, like having kids, right? Yeah, absolutely. So that's, that's, that falls in that category, no doubt. But from a professional standpoint, sometimes you really have to be able to take on something really hard because you see the, the worth in, in doing that.

Um, were you, is that kind of, would you say what happened? You, you, you both got really clear on. The value of doing this from just your, your own lives as a, as a family, um, and then it allowed you to go through all the challenges to actually make it happen.

Laura Wright: Yeah, I mean I think it was hardworking in Jackson for one.

Mm-hmm. And it seemed like it was, it was just going to continue to be hard without a lot of like, great outcome from that. And here it's a like hard and very humbling to have to like go back and rebuild and be a new business. Um. [00:12:00] Knowing that there's so much potential for what we can do here, we can see like, wow, if we can build what we'd like to build here and we're on, you know, in the process of building it, there's just, it's worth it.

Dr. Kevin Christie: Mm-hmm. Yep. Absolutely. And then it was cool 'cause then we kind of went through the year last year and um, then we were in Denver and. It seemed like it was gonna be a little more of a reality, like I think by Denver Mastermind weekend you guys were doing this.

Laura Wright: Yeah, yep. Yeah. Everything was listed by that point.

Dr. Kevin Christie: Everything was listed by that point. Yeah. Gotcha. And yeah, I think it's as cool as, I feel like you guys definitely burned the ships once you made the decision, which is what's gonna have you get there and, and do it. And then we, we actually had our. Third week in Mastermind in Jackson, which was ironic.

Yeah, right. Um, I'm glad you guys hadn't moved yet, but we had a great weekend there and, and doing that. And obviously at that point it was gonna, it was gonna happen. But, um, you know, I think our audience, we all face challenges. We all face [00:13:00] hard decisions. It doesn't have to be as drastic as. Is moving. Um, but it could be, uh, opening up your own practice.

It could be, um, deciding to hire another doctor for the first time. It could be buying commercial real estate. There's a lot of things that are very challenging and once you decide to do that, I. You gotta roll with the punches a little bit, but what were some of the biggest obstacles from when you said, okay, we're doing this, things are getting listed to when you actually, like, what are kind of some of the things that stick out in your mind as like, oh shit, that was hard.

Laura Wright: Yeah, I think, I mean, the whole process, I remember like, we actually signed a piece of paper once we finally, like I admitted that we were moving to Alaska, um, in July that says like, you know, barring obstacles or of which we have quite a few to surmount or radical opportunity, we will move to Alaska in the fall of 2024.

Mm-hmm. Um, and at that point our house was listed, nothing was happening. Right. The real estate market was very slow [00:14:00] with the upcoming. Election. It might still be, I haven't followed it since then. Mm-hmm. Um, nothing was happening with our business sale, so we were just sitting there like hell bent on moving, but with no way to, um, kind of make it happen.

Right. You can't find the buyers like you, to an extent have to find you. So I think that was, those were big obstacles. There was, you know, a lot more as we started packing up and moving and. Lots of issues with like moving trucks and getting our stuff up here as well and getting started. Mm-hmm. It's a long up up.

Dr. Kevin Christie: It, it seemed like, w correct me if I'm wrong, but like the big domino was finally getting the house sold. Yes. Yeah. How long did that take about for that to happen?

Laura Wright: I, I guess not that long. It's sold in mid September and I think we put it up in mid April. Mm-hmm. So I guess in, you know, in the, in the whole scheme of things, in the whole scheme of things, not very long, just very close [00:15:00] to our, like, timing when we wanted to get out because when you're under

Tyler Wright: pressure, it seems like it takes longer trying

Laura Wright: to get up all your stuff up.

The al can, um. In the later fall or winter, um, didn't seem like a good idea. So we were That makes sense. That makes sense. Before that, that makes sense. And the house was the critical factor because Right. Jackson had blown up. Alpine had prices, had increased. Yeah. Um, a great deal. So selling our house was what enabled us Yep.

To move because of the increase in real estate. So that was the key factor otherwise, right. We couldn't have afforded the move up here because moving's expensive in general. And moving up here is. Quite expensive.

Dr. Kevin Christie: Yeah. And it obviously allowed you, you having the equity in the home and that would being the big domino, it gave you money to give some security.

It also allowed you to say, okay, we don't have to sell the practice now, I'm assuming. Um,

yeah. And

Dr. Kevin Christie: so you could leave and say, okay, we can take all our equipment, we take all our stuff, we can close the practice, and we have enough [00:16:00] security to move up. There, uh, I, I think you guys rent rented a place to live.

Um, right? Yeah.

Laura Wright: We, we won't be buying a home for a little while because it's gonna take some time to get that down payment because we put it all into this commercial property.

Dr. Kevin Christie: Yeah. Yeah. So now let's fast forward. Okay, so now things are starting to work out. We, you know, obviously it was not easy and that unknown, like you said, having a timeframe of like October to get up to Alaska and in the.

The house isn't selling right away, but in the grand scheme of things, it sold in a, in a, in a fair timeframe. But you, you gotta get this done. Uh, so that was the big domino that we started getting the things going in our favor, uh, moved to Alaska. And then, um, what were you guy, how long did it take to find something to do up there for work wise?

Give us a little bit of that story. I,

Tyler Wright: I think initially we were a little bit nervous, uh, because we got here and we were putting feelers out, trying to find a, like a little one room that we could put a table in and start. Yep. Um, and it did take a little bit longer and it was a slower start than we anticipated, but we did find a great place to ultimately get [00:17:00] started.

Get started in, within,

Laura Wright: within, within, I think five weeks. Yeah. Yeah. We, yeah, I would say. Mm-hmm. Yeah. I think we expected things. I especially expect things to happen even quicker than they happened. Mm-hmm. But we found a spot pretty quick. Um, got started. We are still working on getting a network with insurance in Alaska.

They have one good reimbursement. To a lot of expectation for you, you to take insurance. And in Wyoming we'd been a cash practice. So this is a whole new ball game for us. Um, and so that's the part. We're still working on the credentialing, but it's, we're expecting it all within the next couple weeks at this point.

Um,

Dr. Kevin Christie: I think, uh, real quick, I, you know, I gained, you gained some perspective when you look back on it. 'cause obviously when you were in it, it felt like selling the house was taking a while or it felt like finding a place to work in Alaska was taking a little while. It, you know, but when you then look back, it's like, [00:18:00] oh shit.

We did all of that in. Exactly right. Six months, seven, eight months. Uh, and, and, and it's just like, it's realizes like a lot of times we have to give ourselves some credit. We have to like, okay, this is a process. Mm-hmm. You know, I know I want it to happen sooner than later. Mm-hmm. Uh, but, but don't get, um, you know, just discouraged as you're doing this different steps in a hard.

Project or a hard situation like this. 'cause then when you do end up looking back on it, the compression of time is like, oh wow, that happened really fast.

Laura Wright: Right, right. It's, I'm not known for my patients. Um, but then looking back I'm like, oh, we did do a lot. And I, you know, I thought it was gonna take less time for some reason, but.

It takes some time.

Dr. Kevin Christie: It does, and it's just like if you, if, if our audience is listening and you open up your practice, like you're not gonna have a hundred patients in month three. Right. Maybe there's some freaks out there, but usually like it's gonna take some time and then when you look back it's like, oh, you know [00:19:00] that, that.

That was a pretty quick couple years where we actually got going pretty good. And, and so you gotta give yourself, uh, a little bit of understanding of how the time compression, uh, works in, in these scenarios. 'cause now we, um, we, we started, you started working, uh, at a place there that didn't go as, as planned.

Uh, which then leads you to another kind of contextual standpoint of like sometimes. You have a strategic byproduct of what happens when you thought you had one thing happening and that kind of was a bad situation that didn't ha happen. Uh, not, not anybody's fault, but just it didn't work out. Mm-hmm. For that space to be able to, I think you're gonna rent the space maybe and maybe, yeah.

We were, you

Laura Wright: know, gonna rent to take over their lease and potentially buy, it was a regenerative medicine business that we were still letting from and yeah. That didn't work. And that's what. Sent us back looking out for commercial property. And then we stumbled on this place, which we'd actually seen and like looked up driven by when we visited last year, February.

So we basically, we saw the [00:20:00] space Thursday morning, I was like, Hey Tyler, we should see if our real estate agent, um, can have us like, look at the space Thursday afternoon. We saw it, um, did a tour. Friday morning, we put an offer on it. Monday morning our, we accepted their counter offer on it, and then Monday afternoon we got a 30 day notice for the place we were renting because they actually, someone else buying the business that they'd been doing kind of undercover, um, who didn't want us in this, didn't want chiropractors in the place.

They were redoing it. So it was like, okay, we have a commercial space, but we're getting kicked out of our current space. Um. It was, it was good timing though. I was like, I got the 30 day notice and I just like started laughing and so then we worked really hard to compress the timeline of moving into this space so that we didn't have a gap.

Tyler Wright: So what's

Dr. Kevin Christie: what I'm saying is like if we were to like rewind and just. Look this past year, like it all, it was all perfect.

Great. That's great. Yeah. Yeah. Looking, [00:21:00] looking that

Dr. Kevin Christie: did it didn't feel that way, but I mean it just, again, like it, you had a situation where you thought you were gonna be able to lease this space for long term, which would've been cool, but it didn't work out.

And then you got to buy a space, which is. 10 times better. Right? Absolutely. And you get to do with the space what you want to do with it. And, and now you're, you're moved in. I mean, and, and I think about it, if you didn't start looking for a space and then you got a 30 day notice, it would've been really nerve wracking for sure.

So you, I think it's a, it's a kudos to you. Like you, you guys were well prepared at each step, um, and, and, and pushed through, and then it worked out.

Laura Wright: I don't know if we were always well prepared as much as we were ready to like, you know, pivot and look, you know, we thought we were gonna do one place and then start to get in the heebie and we're like.

Let's look and it was just in time. Maybe

Tyler Wright: listen to your stomach. We have a great support system that helps us adapt like that too, right? Like we're pretty supportive of each other and through all decisions and we're able to kind of adapt and, and swing [00:22:00] like we need to.

Dr. Kevin Christie: Yeah, no, absolutely. And um, it just, I think I, I want the audience to, to listen to the story and I'm not saying everybody needs to go and like do what you guys did right.

But you, I think you, there was a lot of good communication around it. Um, you just weren't in a unique situation where Jackson, I mean, it just really did get out of hand, right. Um, at least for

Laura Wright: us with little kids. I,

Dr. Kevin Christie: yeah. In that, in that regard. And it just realized that this was best for you and you were able to make a hard decision and then work through it strategically realize it wasn't gonna be easy.

Be able to roll with some of the punches. 'cause I think that's the thing is no matter what a chiropractor's gonna do, that's a big thing is you better learn to roll with the punches and realize like, okay, just another problem we need to solve and we just need to overcome that. It's not always gonna be the stray perfect line of from A to Z it, it can get ugly sometimes.

That's true. Um, was there any particular [00:23:00] strategy that either of you relied on to kind of deal with the, the obstacles? Was it, uh, I don't know, journaling, meditating, exercise, uh, talking to people, uh, go, whatever. Was there anything in particular? I.

Tyler Wright: Yeah, I think exercise for sure. Yeah. I can

Laura Wright: say exercise is probably like our go-to for stress relieving.

That's why we're building a gym here. Um, and I think also just like we've got a very much, I think the line that we probably say the most often is, we'll figure this out.

Yep.

Laura Wright: Because there's always new things for us to figure out and we just, we know that we don't know, like we've gotta get a commercial construction loan.

We don't know how to do that, but we'll figure it out. Um. So I think that just knowing we can't figure out and then persistence, I think has been a huge thing. Yeah, absolutely. Throughout this, we've just, you know, even moving up here, I don't know if it's true everywhere. Like nobody calls you back. You gotta call 'em three times.

You gotta email three times. Just everything we do. In order to, you know, succeed in business, it's not [00:24:00] about being, you know, the smartest person out there. You just have to put in the effort. Mm-hmm. And know that other people will, you know, not call back, not do exactly what they say, and you just have to.

Persist.

Dr. Kevin Christie: Yeah. And I, another word I love, and I, I forget who said it on a podcast. She, she came up with the idea, or at least I think she did, and it was in her book, but she used the word resilient and, and I'll say you guys have been very resilient. And the way she described it, which I really love, is a lot of people would describe it as bouncing back.

Um, okay. Mm-hmm. Yeah. She described it as bouncing forward, which I really liked. Where it's like, okay, when tough things happen, like, okay, you get, uh, the, the space you thought you were gonna be able to lease the regenerative medicine you thought you'd be able to buy. Um, when that fell through, you bounced forward and you mm-hmm.

Found a commercial space to buy and you weren't jaded and you just did the next thing. And so you were very [00:25:00] resilient, um, through that, that process. And, and then your other part, you mentioned figure this out. I think that's a great skill for people to develop and I think sometimes it takes experience.

You know, it takes a little bit like when we're 26, it's a little more challenging, but as you go along. And for our younger audience, like, you will get better at this, but having confidence in yourself or like for you two and and each other, and each other and, and yourselves, that you will be able to figure it out so that when, whether it's that challenging situation with an employee or it's a child or it's whatever, you'll have the skillset to figure it out and then that's what you've been able to do, which has been cool.

Yeah. Any words of wisdom going through something big like that, other than that was wisdom as well. But yeah. Anything else?

Laura Wright: I mean, I think also knowing that like right, it will be hard and it's not always just like physically hard, like the move that we make was [00:26:00] emotionally hard, right? Mm-hmm. Mm-hmm. We left Jackson, which is where I'd lived before chiropractic school.

That was where like all of my best friends were. You know, we planted an apple tree in our backyard. I was like, but we're gonna live there forever. We're gonna have this many apple trees. Um, and Right. Leaving our patients like you get so attached to your patients. Yep. Like when they were crying, some of 'em were crying at the end.

Like, it's hard not to cry. Yeah. I don't have Tyler cried, like I'm sure I cried more. Um, and moving to a new place is also hard. Like there's still. There's, there's grief and the, you know, friends that we miss, the place that we thought we'd be, the patients that we had. Um, as well as, like I said, like the humbling of like we, we, you know, we built ourselves up well over seven years and here we are looking at, you know, a less full schedule and being like.

Oh, I thought we'd, you know, I thought we'd be farther along, you know, three months in than we are. Um, [00:27:00] so,

Dr. Kevin Christie: um, one of the things that I just was thinking when you were chatting was, it's like you guys, you're kind of now at a, at a blank canvas, and I think sometimes I, you know, one might say like, three months ago you were at a blank canvas, but I would say probably like three months ago you didn't even have a canvas.

Um, yeah, I would've completely. And so now you've actually got the canvas 'cause you've got, you're in Anchorage. You, um. The kids are in school. You mm-hmm. You've got the space. It's, it's not fully built out yet, but it's damn near close. You got the practice, like I would say. Now you're at that blank canvas.

So tell us, give us the vision of what, uh. Okay. I want, actually, I want to, I really, you guys are really good at naming. Clinics. Um, I like that. I got your back country hat still that you had in Jackson, and now you guys have rebranded to Ascent Health and Performance, which, which I just love that. Um, but tell, give us someone, one of you two, give us the vision.

What's this practice gonna look like in three years when we're re rehashing this last three years, and how quick it went.

Laura Wright: [00:28:00] Yeah, I wanted to talk about, yeah. And the rebrand to Ascent then.

Tyler Wright: Yeah. So we decided to go with Ascent Health and performance, um, backcountry, like a lot of people here do go into the backcountry and ski and hike.

Yeah. It's just not, at least from what we've heard is prominently talked about as the backcountry. It's more just like getting out in the hills or the mountains and adventuring. And so we wanted something that was more about the journey and the adventure. Um, than just, you know, this current point in time.

So ascent kind of represents both your journey through health, your journey to get more fit to more strength, more strength, and then also our journey from where we were to where we're at now and, and mm-hmm. Ultimately where we're going. So yeah, I think it's

Laura Wright: forward progress. Forward, forward progress.

Right. Yeah. It really is. I love it. And our patients, right? We're not just trying to get them, you know, better back to where they were. That's why we're, you know. Gonna have rehab. We've had rehab assistants at our office in Jackson and personal training, and then small group classes. Mm-hmm. The idea that they can keep getting better.

Mm-hmm.

Laura Wright: So it's like we can [00:29:00] all keep getting better, you know, as people, you know mm-hmm. In business and fitness. And so that's where like, I feel like the name Ascent really means like, let's build, let's move forward, let's, you know, onward and upward, and that's where we're going. Yeah. With our business and going to,

Tyler Wright: let's climb that mountain.

Dr. Kevin Christie: I love it. And then you guys are gonna have a kind of the, the gym clinic gym hybrid type of scenario and um, you guys offer shockwave things like that. That was also the thing you got to bring with you, right? Right.

Laura Wright: Yes, exactly. Got the shockwave of focused shockwave. Yeah. Which is wonderful. I mean, yeah.

Our vision here, we've got. We have just over 3000 square feet.

Yep.

Laura Wright: And so we'll have a thousand square foot gym. We'll be running small group classes out of there. Um, we'll have, I believe, five rooms. Currently. We just have one big room we're working out of as we start the build out. So having room for us, room for, you know, an associate room for massage therapists or other therapists will have.

Rehab [00:30:00] assistance. Again, as you know, we do the chiropractic and the soft tissue work and then sending them on to somebody who excels at guiding the patient through rehab. Um, and then when they're, you know, through rehab and don't need, you know, that I guess as specific care. Mm-hmm. Um, then, uh, sending them towards group classes where they can continue to strengthen.

And grow with a careful, watchful eye over them. You know, if they're returning after disc injury, shoulder injury, I, we just don't wanna send 'em right back into the wild. Mm-hmm.

Yeah.

Laura Wright: And let them get injured again. So yeah, that's our vision, kind of building. More here in the space. We, you know, now that we've had that one, um, foray into potentially having a regenerative medicine business, we might wanna do that someday.

Mm-hmm. I can see the, uh, sure, I can see the enticement there and how it's a similar clientele. Who would like that, you know, if you don't have to have knee surgery because there's something else [00:31:00] that might help it. Um. It's fascinating and would be helpful too. So, yeah,

Dr. Kevin Christie: that's cool. And you know, you can create what you want.

And I, I can say this 'cause I, I built a practice back from like 2007 to 2010. I was in a partnership and then I, I sold my part of the partnership back and, and opened my own in a different city. And it was, you know, looking back on it, that would've been 2010 i, I started this practice. Um, ha having it be like the second time.

Was helpful. You know, the first time's always hard and not that you wanted necessarily have to do it a second time, but when you do, it's like you've got your sea legs under, you know, how you did it the first time and you can try to replicate that. And so it's, uh, you, you guys will do just fine. Well, thank you.

That's exciting. And then, uh, we'll see each other in, in Boise here, coming up in a yes, in, in a couple months and can't wait to, uh, dive into some more of the details there. And it's been cool to see. I would say the mastermind [00:32:00] group, um, help out. I think, uh, you know, whether it's been sometimes a, a shoulder to cry on or just some ideas and support do that.

I think we've all, we've all needed that within the mastermind groups, uh, over, over the years. It's been really good to, uh, to do that and excited to, uh, continue the year with, with you two in the mastermind group.

Laura Wright: Yeah.

Tyler Wright: It's been an amazing group. We're excited to be a part of it.

Dr. Kevin Christie: Yeah. It's a good group. We, uh, we, we, we learn a lot.

We have fun and we, we hold each other accountable, so

Tyler Wright: Yes. Yep.

Dr. Kevin Christie: Alright, well listen, this has been awesome. I really appreciate you coming on and, and kind of telling your story and I think a lot of people can gain a lot out of this. Not that they're gonna, uh, move to Alaska, um, but, but it's

Laura Wright: nice. If you want to, we'd welcome you up here a hundred

Dr. Kevin Christie: percent.

It is beautiful. It is beautiful. But I think it just gives people the context of like, look. You know, you, you can do something. And again, you, you know, you guys right in the middle of the prime of your careers when you did this. You had a great practice in Jackson and you had [00:33:00] family and you had the house, you had all that and you just saw an opportunity that was gonna be better for the long run of your family.

And you took that. And I think people can resonate with that on other things in their life and be able to take the necessary steps and and, and do that. So thank you. Yep.

Tyler Wright: Thank

Dr. Kevin Christie: you all.

 EPISODE 419: AI and Search

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] Hey doc, welcome to a solo episode where today I'm gonna talk about AI and search and what that's going to mean for, for our practices. I think it's, um. We're hitting that point, and, and I'll kind of come right outta the gates with a story of that. I actually had a, uh, 69-year-old patient who came in, new patient and I asked him, as we always do, how he found us.

And he had mentioned he found us through GR and I was like, oh, wow. That's, uh, one, the first, uh, new patient I've had, say they got us from AI search and two. I was surprised he was 69 years old, uh, and, and being the first one to tell me that. Uh, but I was intrigued. So I asked him, you know, what did you prompt, uh, grok to to that found me?

And so he told me. Uh, so I'm in Boca Raton, Florida. Uh, there's a particular chiropractor up in West Palm Beach, Florida about 45 minutes away, and his daughter was seeing that chiropractor. And his daughter raved about that chiropractor, but he didn't want to [00:01:00] drive that far. Uh, so he prompted gr and just said, uh, you know, find me a chiropractor like Dr.

First name, last name in, who's in West Palm Beach, but I want that chiropractor to be in Boca Ratone, Florida. And that's how he prompted gr and it's, it's bit me out. And it was very accurate 'cause that particular doctor I know and is a great, um, provider up there and does very similar techniques as me and trains similar stuff.

I've actually taken a course that he hosted at his office, um, or he didn't te teach it, he just hosted it there, an a RT one. But, uh, yeah, so it was accurate in who it had fed to him, and I was, uh, very, very intrigued by that. And so, uh, that was our, uh, first, uh, new patient from Grok and, uh, not, not our last hopefully, but I think it's gonna change things.

So I'm going to, uh, read a couple different prompts that me and, uh, uh, another team member had did here. And so the. The [00:02:00] first prompt we did was, and this was to gr you can, you know, plug in whatever, uh, Chad, GBT, or Claude, any of the different ones. Um, but it was best Sports chiropractor near Boca Raton, and this is what it spit out.

Uh, quote, I don't have enough current data to definitely crown the best sports chiropractor in Boca Raton as of March 12th, 2025, but I can point you toward some highly regarded options. Based on available information and patient feedback. Here's a rundown of standout contenders, and the first one happened to be us, so here he goes.

Hopefully chiropractic and sports recovery gets a lot of buzz for its focus on athletes led by Dr. Kevin Christie. This practice emphasizes sports recovery with services like adjustments, manual therapy and rehabilitative exercises tailored to performance and injury prevention. Uh, patients, including triathletes and NFL players, praise its role in boosting recovery and reducing pain recurrence.

It's a solid pick if you're into a comprehensive athlete centered approach. Uh, for a more personalized [00:03:00] recommendation, I'd need specifics on your needs, say the type of sports injury. Or the type of sport injury or therapy preference. If you want me to dig deeper into X posts or web reviews for real time sentiment, just say the word based on what's out there.

Health fit seems to lead the pack for sports specific expertise, but all these options have their fans for a reason. Who's, and so that's, um. That was the prompt, uh, that we did, and that's what it spit out, which was favorable for us. Um, we also had done a second one, which was Best Shockwave Therapy, Boca Raton.

And this, um. Was its response. Uh, I was your, uh, I assume you're asking about shockwave therapy in the context of sports related care. Given your earlier question about sports chiropractors in Boca Ratone. If I've got that wrong, let me know and I'll pivot accordingly. Uh, since Shockwave therapy is often used for musculoskeletal issues like tendonitis, plantar fascitis, or sports injuries, I'll focus on providers in Boca Ratone that offer it.[00:04:00]

With a sports lens as of March 12th, 2025. Here's what I've, uh, found based on available information. And then it lists us first, uh, which I thought was good for us as well. Um, and we had done, uh, a really nice, and we've gotten some good results on it, but we did a great shockwave page, uh, on our website, very robust.

And, uh, you know, it, it was, it's just interesting to see. That people are going to, people are starting to, um, use the AI searches to find their providers and, um, what are we gonna do to try to be first on those answers? I think for us what benefits is we've been creating content and testimonials and reviews and just a lot of total web presence for like 10 years now.

And I think that's helped, uh, feed the, the search prompts. And then shortly after [00:05:00] that, uh, you know, Parker Vegas was. Was held. And, uh, Gary Vanerchuk, Gary V uh, who many people know, he was one of their, um, keynote speakers. I wasn't there, but one of my friends was there, one of our colleagues. And he said that Gary V talked about this, uh, subject in depth about AI in search and how it's going to impact Google Ads, how it's gonna impact Google search, and that you need to be consistently creating content.

To be able to, uh, you know, really, uh, be the, the best answer, or at least in the top answers of, uh, the chat GPTs and the Groks and the Claudes of the world. And there's other ones, and he just talked about, uh, those who are gonna create consistent, valuable content. Over time is going to do better in the AI search world.

And I, I feel like it was like a, uh, a great [00:06:00] moment, um, because I've been preaching that for, for a long time now, ever since I learned about content marketing, uh, about 10 or 11 years ago through the Content Marketing Institute. And it was all about creating content to position yourself as an expert, which you still need to do.

Content marketing for Google search. But now those that are creating consistent content, which we've been preaching for years now, um, are going to do better in AI search. And, and that was what Gary V was talking about. And, and that was kind of the whole basis of his talk. And so you need to be. Uh, creating that, you need to be doing that for sure.

Um, and so I then went and I asked Google because if you notice now if you, if you type things into Google, it gives you an AI answer on the top from its ai. And um, I. And so I asked, uh, you know, is, is uh, AI going to significantly change search? And it answered, yes. AI is significantly changing search by enhancing algorithms, [00:07:00] understanding your intent better, and potentially leading to more personalized and conversational search experiences.

While also impacting SEO strategies. Here's a more detailed look at how AI is impacting search. One. Enhanced search algorithms and user intent. AI powered algorithms like Google's rank brain analyzer. Uses queries in context to provide more relevant and accurate search results.

Semantic search is becoming increasingly important where AI helps search engines understand the meaning and context behind search queries going beyond simple keyword matching. So, you know, Google search or search in general over time has been about keyword matching. Uh, AI is gonna change that. It's gonna be a lot more complex than just matching keywords.

AI can analyze context, synonyms, and even the emotional tone of a query leading to more accurate and personalized results. [00:08:00] Number two, RI rise of AI driven search experiences, AI powered search engines and chatbots. Offer a more conversational and interactive search experience, allowing users to ask questions and receive answers in a more natural way.

Uh, generative AI tools can summarize information, provide explanations, and even generate content, potentially changing how users interact with search results. AI overviews are being introduced by search engines like Google, offering AI generated summaries and links to relevant sources, which can be more helpful for complex questions.

Number three, impact on SEO and content creation. Um, so this is a big part of what we preach and what we, uh, do for our clients, uh, content creation and such. Um, alright, so number three, impact on SEO and content creation, SEO strategies need. To adapt, to focus on understanding user intent and creating high quality, [00:09:00] relevant content that resonates with users rather than just keyword stuffing.

Uh, I often, when I present on content marketing, I give the definition of content marketing from Joe Puli, and the words creating high quality, relevant content are in his definition of. Being a great content creator. Uh, so you gotta, you got, it's just, it's just all coming together. I think for those that have been creating content or those that are gonna start creating content, uh, it's been pretty cool to see this, uh, come to fruition as AI is becoming obviously more prevalent.

All right, next part. AI generated content is becoming more prevalent, but it's important to ensure that it meets the same quality standards as human written content. I wanna reread that 'cause a lot of people are gonna just start creating AI generat generated content. And I want to clarify, if let's say you shot a five minute video.

That's your information. [00:10:00] And then you took that video and you took the script of that video. You ran it through something like the script, and you took the transcript and you ran that through, uh, a, uh, ai and you asked it to create a blog that is not ju that is not purely AI generated content that is actually AI plus human created content versus if you just said, create a blog on headaches for me.

And you asked it to do it, it would do that for you, but that's just purely AI generated. Okay. Um, organizations need to focus on producing content that is distinct from AI generated content, which just summarizes what I just told you, uh, as a chiropractor, and this is where I think our. Um, marketing done for chiropractic program is separates itself, is that we teach you to actually shoot four videos or give us audios and then we produce all the content for you.

Uh, yes, in some ways leveraging ai, but in some ways not, but leveraging it. But it's [00:11:00] your voice, it's your content. And so as it says right here, again, I'll reread it. Organizations need to focus on producing content that is distinct. From AI generated rated content, emphasizing a personal approach and unique perspectives.

So you don't wanna fall into the trap of saying, no, I'm gonna have marketing, but it's all gonna be AI generated. You can leverage ai, but we need, uh, your unique perspective.

Number four, potential challenges and considerations, the accuracy and reliability of AI generated information. Are important considerations as AI can sometimes provide incorrect or misleading answers. The impact on traditional search engines and websites is a concern as AI driven search experiences could lead to users spending less time on individual websites.

Yes. So that's the thing, right? I still think your website needs to be your hub. There's website. You need to have a website. You need to make sure it's a living, breathing entity with content on it. [00:12:00] But you, we should, we, we, we probably will start to see websites not have as much impact on SEO, but if you're creating content consistently, um, you are gonna just offset that with more AI search results.

And then lastly, the future of search is likely to be a combination of traditional search engines and AI power tools with AI enhancing the search experience rather than replacing it entirely. And so that was me asking me prompting. Google and then Google giving me its AI generated answer, which was in fact telling us that yeah, Google, traditional Google search and what we know is search and SEO and all the other things are gonna be impacted as we go.

And so I want you to be ready for that. It doesn't have to be, uh, complicated. Right. So, you know, my advice is, is whether you're. I think sometimes, uh, chiropractors get frustrated 'cause they, they start to create content. They don't turn [00:13:00] into influencers or they don't see a ton of engagement per se. Uh, or they don't have a direct new patient said, oh yeah, I saw your video on YouTube or your Instagram post.

And so they stop creating content. My advice is you gotta, and this goes back to Gary V he said this years ago, is you gotta consider yourself a media company. And I consider my practice a media company. In a, in a sense, and we act as though that is, we get so much content out there in our community. I consider it MCM as a media company.

I try to get as much content out to you as possible. Um, and you gotta consider yourself a leading educator in your community and kind of like a media company, and you just have to continue to consistently create. Content and get it out there, right? And, and, and just make it part of your practice and business development as a chiropractor.

And if you're a business owner, you gotta look at it as you are a. A doctor and you're an [00:14:00] educator and your content that you're creating isn't gonna turn you an influencer. Most likely. Maybe it does, but that's not the point. It's to have a total web presence. If you do that consistently, it's going to, uh, help your practice grow over time.

And yeah, you gotta look at ways to, um, make that load easier for you. Right. So, uh, and you, maybe you do have to spend some money on marketing, right? And I think that's another misconception that a lot of car is that. They hang their hat on, not spending money on marketing, but almost all good businesses spend money on marketing.

It doesn't have to be 10%. Some people say that if you get to that point, that's fine. If it's working, spend more money and spend, uh, if it's got an ROI. But don't just blanket throw 10%. And anybody that says you have to spend 10% of your revenue on marketing, um, isn't giving you all the facts. You, you work your way up to that, uh, or you don't, you know, if it's that good and it's compelling or you, you're just really getting a lot of referrals, stuff like that.

It's, it's something to [00:15:00] determine, but you have to spend money on marketing. You just have to, uh, chiropractors, we've just become so notorious for just not wanting to spend any money on anything and expect to grow. And then we'll, we'll kind of hang our hat on. It's like, oh, well, my, my, you know. My overhead's low.

I was like, yeah, but your revenue's really low too. And we, there's a give and take there. You gotta spend money to make money at certain points. And so you gotta be doing marketing. You gotta spend a little bit money on it. Not a ton. Um, but yeah, maybe you do wanna run some ads or maybe you want to offload this, uh, some of this to it, you know, and I, I, our clients are offloading a lot of it.

They're, they're shooting four videos. They're getting it to us, and we're posting this on everything from Instagram to YouTube, to Google Business Profile, uh, to emailing their patients for them every week. Um, blogs every other, uh, month. I mean, we're doing a lot of things and getting a lot of content for our clients.

And ultimately, if you do this consistently, um, uh, you know, you're [00:16:00] going to grow your practice and it's gonna be a lot easier for you. And so you don't have to worry about doing all the production of content and distribution. You'd have someone like us do it for you. Uh, and you get that out there, and then you can focus on the things, um, you know, like treating patients and running business and community outreach.

Like that's some of the things that. I, I love about our program is not only we do that marketing for you, but we also have the coaching component to you. And we're giving you a lot of strategies to help grow your business outside of just content. 'cause you can't, you can't build your practice and build just a killer practice by sitting by a computer and creating content.

Either that's not how it works. Like you gotta be really good clinically and you gotta communicate well and you gotta be a leader and we gotta, you know, coach you on those types of things. You gotta get you in the community a little bit. Um, you gotta have team meetings and what that looks like to develop your team, you gotta hire, right?

There's a lot to it. Um, and that's why you need someone in your corner to help you with that. Um, and that's why we're, we're, we're helping chiropractors do that, but [00:17:00] too many of you aren't doing any content at all. And I think, um, over the next coming years, those who are, and those who are doing it consistently are gonna start seeing five to 10 to 15 new patients a month.

From AI generated search results, and I wanna make sure you are getting those and not falling behind on it. And it, it's not gonna be complicated, but it's about creating content and leveraging AI to help grow your practice. So that's where we're at. I'm gonna be also having an episode. Uh, in the coming weeks with, uh, Darcy Sullivan on this topic as well and getting her perspective of it.

But just wanted to give you a, a, a kind of rundown of what we're seeing and what some other chiropractors are talking about as well on AI and search. So, uh, if you're interested in our, what we're offering in our programs, go to modern chiropractic marketing.com. We got all the information there, and we are here to help you out.

Have a great week in practice and talk to you [00:18:00] soon.

 EPISODE 420: Leadership in Private Practice

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 our show. This week we have Jeff Moore, who I'm excited to have on. He's a physical therapist from the Institute of Clinical Excellence, uh, other otherwise known as PT on ice. And, uh, also has a franchise model of physical therapy clinics. And we dive into the topic of leadership and, and Jeff's definitely a dynamic guy and, and brings a lot of great insights into leadership and leading.

A team leading your patients, uh, leading your family. Even if you apply some of these principles, and it's not your kind of cliche stuff and your, uh, charismatic leader type of things, uh, but he has a lot of good insights on what it takes to be an impactful leader and you can get better. And I think that's a, a big part of this as you can get better and we have a great conversation on some of the things.

Uh, that they're doing in the physical therapy world and how they're, uh, changing the, the model in a sense and in how they, uh, lead other providers and then teach those [00:01:00] providers to lead their patients and their teams. And we, uh, dive into that. And it was a, a very fun conversation. We had a great time, I thought, and I, I know I learned a lot, uh, from it.

I just thought he had some really good answers to, to questions and, and I've, um. Discussed this topic, uh, quite a few times over the eight years of this podcast, and I thought, uh, leaving this interview, I, I was better for it and definitely heard different takes on what leadership is. So, uh, this isn't your, uh, typical, uh, conversation about leadership skills and styles.

So I think you'll get a lot out of that. So, without further ado, here is my interview with Jeff Moore.

Alright, welcome to the show, Jeff. I really appreciate your time today and excited to dive into, uh, leadership in, in private practice. But before we do, I wanna set the context for our audience. So, uh, tell us a little bit about yourself first, and then we will dive into your company and what you guys do.

Jeff Moore: Yeah, you bet. Kevin, thanks so much for having me on. Uh, I'm from Fort [00:02:00] Collins, Colorado. Uh, kind of been a physical therapist for the past, uh, 12, 15 years in varying levels of, of focus, um, on that part of my career. As other things have kind of grown. You know, we started the teaching company in 2012, so that'd be, you know, over a dozen years now.

Um, it's called the Institute of Clinical Excellence, and it trains wide variety of rehab providers, uh, PTs, OTs, chiropractors, physicians. Um, we have coaches that come to some of our fitness athlete courses. So kind of a, of a broad range of, of targets there. And as that got busier, like 20 17, 20 18 really started taking off, you know, where we were doing multiple courses a weekend and getting a lot of traction, we found that a lot of the folks that we were, uh, training.

Weren't able to implement what we were teaching because their clinics, you know, didn't have a squat rack or a run of kettlebells. We do a lot of fitness focused stuff and uh mm-hmm. That was a problem. Ka It was kind of depressing. I mean, these folks would reach out and say, Hey, I love the courses, but I can't do this stuff.

And we said, well, okay. In 2019. We decided, let's just start opening clinics, you know? And that way if [00:03:00] someone is in an environment where they can't do this stuff, but they want to, we can create homes for them. And that was kind of the, the genesis of Onward Physical Therapy. We put the first one in Charlotte in 2019.

I think we have 42 locations now, um, across the country. Um, and again, a lot of it comes from. Folks will take ice physio courses, get really fired up and take a few classes and be like, man, I really want to practice like that. Then they'll reach out and say, can I jump into one of these onwards? So they, they kind of grow each other, I guess, from that perspective.

And nowadays, Kevin, that's what I do. I, I spend time mentoring clinicians at Onward and then mentoring faculty over on the ICE side. I'm not out there actively teaching anymore. I go to a lot of the classes and give notes and try to make sure that our curriculum is. Is synthesized well together and symbiotic across no matter what course you take.

And, um, and day in and day out. That's where I spend my time. Ah, love it. And, uh, you know, I'm sure 42 locations and also a teaching program is real easy to lead. Yeah. Nothing to it. Nothing to it Every day is, is [00:04:00] calm and no issue. Yeah, exactly. Um, is there, if there weren't, you'd have problems, right? If there was no issues, then you know you're not doing enough.

Dr. Kevin Christie: Uh, that's right. Are, are these franchisees locations the onward? Yeah, so we started off in a licensing model and then we converted, actually, we're actually actively locking up right now. The very end of that process, you know, we can offer a lot more in a franchise model, you know, with a licensing model.

Jeff Moore: There's some state by state restrictions on kind of how much support, um, that you can actually leverage. And so realizing boy. Strength, the size can really do a lot for these locations. It just made sense for us to convert over, and so we went from a licensing model over to a franchise model. Perfect. I just wanna tease out a couple of aspects of each company and then we'll, we'll dive into the leadership, uh, topic.

Dr. Kevin Christie: But from the, the teaching company, what, what are just some of the, uh, pieces of equipment you'd love a clinic to have? You mentioned squat, rack, and kettlebells. What are some of the other things there? Yeah, those are big ones right there. You can do a lot with a squat rack and a, and a good set of kettlebells across all ages and stages, right?

Jeff Moore: Mm-hmm. And that's kind of how ICE is designed. Like we've got [00:05:00] certifications for a fitness forward approach for every age and stage. So whether you wanna work with. Older adults or the pregnant and postpartum individual and athlete, or the recreational fitness. We have a series of courses that develop your skillset to really over deliver for that population.

And the two things you just mentioned, I mean, if you get a really nice squat rack and you get a good run of kettlebells and you've got some rubber flooring where you can drop these things and really get to work, I mean, that's gonna be a big part of it. Beyond that, we need some level of cardio equipment, a thing like an Echo bike.

Um. A rower is a bonus. Mm-hmm. But the echo bike or the, or the assault bike goes a long ways to be able to get the heart rate up and do interval training. And it tends to be a very approachable piece of equipment compared to like, if you're looking at every age and stage, the treadmill is probably not as applicable.

Um, as maybe something like an echo bike and then a really nice manual therapy table because we do a lot of body work, a lot of cupping, a lot of needling, a lot of manipulation, mobilization. People need to be comfortable, and as you probably know better than I do, really be able to work around [00:06:00] that person's body and, and get the job done from a hands-on perspective, I.

Dr. Kevin Christie: Yeah. No, absolutely. And, and I first heard about your, your, uh, training programs around all this because, uh, Dr. Ashley Jordan, who is one of our associate coaches for our company, and then also her partner, um, her partner Brittany, they talked about 'cause they wanted, started going and they've done a lot of clinical things, right.

So it wasn't like this is the first thing they've been to. And so they've been to a lot of different types of clinical aspects and they said they, they, uh, they never come back more fired up than when they come to one of your, uh, I think she calls it ice. Is that an acronym you guys use? Yep. Right. Yep.

And that's for the institute of, uh, clinical education, uh, clinical excellence. Yep. Excellence. Perfect. Yep. And so I actually calls it and she's like, they're just fired up when they come back from that. And so we were chatting about it and then we kind of dove into the idea and conversation around leadership with you because, you know, it takes a level of leadership to be able to have other coaches do a lot of the coaching, like you mentioned too, but then also to replicate what you have in the clinic.

Give us a little bit of with [00:07:00] onward, um. I'm assuming it's physical therapy based, but is there any other, uh, what is it like a front desk person, physical therapist, uh, maybe a PTA, uh, trainer. What are some of the, the, the essentials of what these clinics are like? I. Yeah. Yeah, that's a great question because when we first started this, you know, we thought, you know, we don't need to do this.

Jeff Moore: Right? It's kind of a passion project, and the whole idea was what does perfect look like to us? Right? So meaning the amount of time with patients, the clinical environment, the way they interact from the moment they see your first Instagram post or hop onto your website to the moment that. They're feeling like a million bucks, like that journey.

How do we perfect as many time points along that as possible, and for us, at least for now, the model is very, very simple there. It's one-on-one with a physical therapist for 60 minutes and there is no front desk person, right? The beautiful thing. Now we use Jane as our EMR or electronic medical records.

Super, super streamlined. I've known the Jane founders and friends over there for [00:08:00] years up there in Canada. They do an incredible job, but what they allow is. For there not to be any sort of interface or necessary interface with, you know, we don't bill any insurance, right? So we're a hundred percent cash based across, across the board.

So no third party payers, that includes federal. So it's literally a 100%, no exceptions cash based clinic, which again, we thought we want to create a model that is where we think the future's gonna land. I'm not trying to say that other models don't work or shouldn't work or be utilized, we're just trying to look way out there and be like.

What can we do to prove the future, if you will? And to us it was a one-on-one, 100% cash base, completely patient provider interaction only. We have no assistance, no techs or any other disciplines. Yeah, yeah. No, it makes sense. And obviously with technology now, uh, it, it makes it a lot easier. We're very familiar with Jane.

Dr. Kevin Christie: They've definitely, um, they're big into the chiropractic space as well, and so there's a lot of capabilities there. And you know, now with certain technologies like two-way texting and obviously there's softwares out there where you. Store the [00:09:00] credit card one time and you Yep, you do that. Uh, even if you run a recurring revenue model, that's easy.

Now with technology, one of the things I'm excited about, uh, as it keeps on going is I, I, I keep on diving into the AI stuff like everybody else. Uh, it is almost becoming cliche, right? There's people diving into the AI stuff and then there's people like really actually diving into AI stuff. I'm kind of like.

Kind of, kind of diving into the AI stuff, but the thing that fascinates me is the idea of the AI agents, and I'm not sure if you've looked into that much, but I know like LinkedIn founders talking a lot about it. Or Salesforce founders. Sorry. Uh, just the idea that at some point we may have these AI agents that you would train on your systems and, and your, you know, model just like you would a human and they just do all the stuff for you essentially.

Jeff Moore: Yeah. Yeah. I have not dove deep. I certainly keep an eye out. I, I'm curious what folks are doing. You know, our, our system is logistically light, for lack of a better way of putting it. You know, we see five or six people a day. [00:10:00] Our documentation is simple because we're not justifying anything to insurance companies.

We're just keeping track of folks and making sure that we know what we're doing. Mm-hmm. And obviously have a record ready if it's ever needed. Um, but because of all of that stuff, and no front desk person, no insurance to bill our like. Logistical demands mm-hmm. Are quite low at onward. Yeah. Our interpersonal demands are incredibly high, right?

Like everything is in person. The follow-ups are consistent and thorough, and there's a lot of them. We tweak programming. There's a lot of hands-on with the person, but very little like logistical, busy work, if you will. Yeah. No, it makes sense. And I think that's something that, uh, obviously allows for more margin, right?

Dr. Kevin Christie: That's always the, the killer of a lot of healthcare industry, um, models, whether it's the hospital or, or a private practice. And so you're kind of able to have better margin, which is nice 'cause we all, we've all. Seen 'em, you know, clinics that generate a hundred KA month, but spend 99 KA month. Right, right.

It's, it's the saying that I love, and I think [00:11:00] it's Westgate, is, uh, it's volume is vanity, profit is sanity, and cash is reality. Right. Ooh. And, uh, he came up with that one. I, I steal it from an often and it's just true. Right. And so you people, I think. Uh, I think, uh, clinic owners and, and, and doctors need to start looking at ways where we can streamline things so that we can maintain a, a level of margin.

But I want to dive in. You, you, you mentioned a phrase or term I really liked there, which was interpersonal demand. And I want to, maybe that ties into my, my kind of first question on leadership for you. But, um, over your years of working with a lot of different types of providers and different scenarios.

What are some of the, and, and you may start out with that interpersonal uh, skillset, but some of the qualities you see from your doctors and physical therapists, um, as far as leading these, um, businesses and these practices, what are some of the qualities that you see in these effective leaders? Like you said, we're in the business of humans.

Jeff Moore: Right. So the [00:12:00] interpersonal thing is a non-negotiable. I mean, if, if you can't work well with people and build relationships mm-hmm. Not only your patients, but in the community, you're a non-starter. Right. So I, I think like that's baseline across the board that has to be there. But when you look at what makes people exceptional, you know what I've found, and like you said, the datasets pretty thick now, watching providers try to be successful.

It's the people that themselves believe in what they're selling the most. Yeah. That's the number one thing. So like when people call me all the time like, Hey, what are the criteria for, you know, becoming an onward clinician? And I'm like, well, you know, you gotta get some ice training. You know, that's kind of our standardized system.

Mm-hmm. And yada, yada, yada. But what it really comes down to is. How much do you actually believe that putting fitness on somebody is the elegant solution to chronic disease and most of the plagues that are sweeping across this nation, like how much do you really believe it? Do you live this way? Like do, are you about it every single day?

Like, are you leading from the front? Are you in the gym? Are you getting other people into the gym [00:13:00] with you? Are your kids in the gym with you? Do you believe that this solution is urgent? Awesome. And can you show me a track record of that? Over the past 10 years, like people that believe that they will infect other people with that belief, but if they don't.

They won't be able to sell. What I mean, they'll find ways to kind of eek by, but they'll never get into that flow state where they're selling naturally because all they're doing is exuding what they sincerely believe to be true authentically. Yeah. That conviction is so priceless, and I think a lot of times there's some people that are able to override what they believe and have a level of conviction or kind of.

Dr. Kevin Christie: Uh, snakey that way. Uh, but you typically, I think what we see in a lot our niche of chiropractic is the evidence-based chiropractor. Um, that's who we are. That's our audience. That's who we work with. And a lot of them do struggle. I believe they, they kind of get in the Miro of the evidence and they want to cross their, [00:14:00] uh, t's and dot their i's on every like inch of evidence before they will think.

That it's something they want to provide for someone. And I think they get in their own way a little bit. And I, again, I'm not saying they should, uh, believe or have conviction in something that they don't believe in, but I think that's something that a lot of the chiropractors that I, I, you know, talk to and see that are struggling is they haven't sold themselves on what they are are and what they do.

And like you said, being about that, and ultimately that just permeates the whole. Office, the team members, the patients, and they wonder why they can't get buy-in from everybody. Yeah. No, that's a great point. I've seen, I've seen different versions of that, you know, over the years. Yeah. Where that belief is incomplete.

Jeff Moore: You know, where, where you see it the most complete is people that have lived that way, but also people that have banged themselves up living that way. Right? Like you start going to competitions, whether it's CrossFit or high rocks, whatever you're doing, you're gonna get tweaks and sprains. Well, if you smoke your own dope, for lack of a [00:15:00] better term, and, and, and you go and see a high quality manual therapist, right?

You get manipulation, mobilization, soft tissue, and you get some great exercise prescription and it helps you and you feel like, dude, thi this stuff's real. Like the more that you challenge yourself, bump into hurdles, find ways around it, get back up on top. The more you go through this process, when you're looking at that patient saying, we're gonna get through this.

That has a completely different level of meaning to that patient when they can see in your eyes, like, because I've done that, I've been here before and I we're gonna, I'm gonna hold your hands as we move forward. It's, it's just so much different. Yeah, so when you're, a question I keep on wrestling with, and maybe you have some insight on it, is if you find that person that's, um, got a lot of good skill sets, you know, personable, good bedside manner, uh, good person, you know, let's call, they'll say they're, um, intrinsically motivated clinically, they're, they're good, you know, they got all the, all the table stakes there, but you just see there's a.

Dr. Kevin Christie: A little bit [00:16:00] of a, a, a hole in that, uh, believing in what they're offering or that conviction. Um, is there a certain level where you say, you know what? I think we can really onboard this person, train them. We're gonna start with some of the, um, results, the evidence. I know you got the, with ice, that probably helps.

Is there a sort of like where you dive into like, let's just, let's just. Inch them up a little bit more on the clinical side or talk through them on why this stuff does work or anything like that. Or is there a point of no return where you's like, they got a lot of skillset, but they just don't, they don't have that belief in it.

Jeff Moore: That's a great term. You just used that, that point of no return because that, that person's not a no. Right. I mean, there's a, a lot of the things you just said, I mean, there, there's a lot of buckets that are filled there. Yep. Sometimes those people just need. The level of mentorship around them where they can hit some real home runs.

Mm-hmm. Because sometimes that clinician is either newer or you are moving into a more effective model from [00:17:00] one that maybe wasn't quite as effective. And if they have a clinician around them that can do case reviews every other week, that can come alongside and offer some insight to get a patient from saying, you know what?

I think I do feel a bit better. Two. Yeah. Doc, whatever we're doing together, I've made more progress doing this than anything I've done in the past five years. You can only hear that second one so many times until you believe it, but sometimes it requires a mentor who already has that gift to get a little bit more of a high touch environment around that therapist to get them a few reps where they hear that, and now all of a sudden the snowball's rolling down the hill.

Dr. Kevin Christie: Jeff, that was one of the best answers to one of the worst questions I've had on the show in eight years. I, I phrased that question in all kinds of weird ways and you take, tease it out perfectly. So I I thank you for saving me on that one. But, uh, yeah, you know, the, the mentorship thing is, is a big one, and I, I, as you were talking, I was like, you know what?

That's really what kind of saved me early on when I was in chiropractic [00:18:00] school. I, I don't know how familiar you're with chiropractic school, but it can be a mixed bag and, you know, I, and I, I really liked the school I went to, but that first year I was kind of. Going down, like not really finding my, my traction of the, the type of chiropractic that I wanted to practice.

I, I went to, I was an athlete growing up. Then I, I went to Florida State and, and was exercise fizz and on the strength conditioning program there, and I. I wanted to work with athletes and when I got to Kyro school, I kind of just wasn't finding that. But then I found a mentorship wi Within Motion Palpation Institute and a couple of the docs there, uh, Mark King, Brett Winchester at the time, and, and Corey Campbell, and now they're still at it 20, 20 years later, which has been cool.

But that gave me. Confidence in and some conviction. I still kind of sucked when I graduated, right? Like, like we all all do, do we? Yeah, we gotta get a lot better. Uh, but I, I knew that I had been exposed to some doctors that really knew what they were doing, and when I had them work on me, I, I [00:19:00] felt such a level of difference and, and it was great.

And, and that was a, that was a key thing to us. So I think a, I think, you know, a take home here for our audience is if you find yourself in that. Kind of, uh, that chasm of like, look, you're a good doctor and you're a good person and you got all these qualities that are good. You're just not getting across that chasm into what you're talking about with that conviction and, and really believing in what you're doing.

And maybe it is mentorship that that can help you. Maybe it's me, mentorship clinically, maybe it's mentorship leadership wise, or understanding business a little bit, because I do think that's some, that's obviously what you're. Um, onward solves for these PTs is that they don't have to worry about so much of the business side of things, which is, which is great, I'm sure.

Uh, and a lot of these doctors listening to our audience, uh, to our episode today, they are in the Miro of clinical and business and maybe they don't have any confidence around business, and it's seeping into their confidence as a. As a provider in general, and they go into that treatment room and it, again, [00:20:00] it's, it's pretty evident that this person is just not, uh, confident right now.

Right. Does that sound accurate? Maybe? Absolutely. And, and I do think the only solution there is to either get that person some wins or get them around someone who's getting regular wins so that they can look and be like, look, there's something, there's something I'm not doing, but it can be done.

Jeff Moore: Believing that right there is enough, right If, if they can just see that and be like, it's not a mystical ghost, like this can work. I just need to learn something that I don't currently know. As long as they believe that we'll get under the finish line. I love that it kind of reminds me of a, of a concept I learned, and I can never remember the book at some point.

Dr. Kevin Christie: I'm gonna actually look it up so I can reference it appropriately, but, uh, skill stacking, right? The idea of skill stacking, and I think we, that goes unnoticed as we progress, right? So I'm, I'm 20 years out of graduating, uh, chiropractic school and when I graduated, um, [00:21:00] I didn't have a lot of skills, right? I had a skill, uh, uh, of, of being a chiropractor to, to.

Pass boards and to get a job. And I had a, I had to really refine that skill and it takes time. And I was, I I, looking back on it, I feel like I was, I did the right thing. I really focused on my clinical really strongly for the first five years. And I did a lot longer after that, but I was all in, uh, then I was like, you know what, um.

I had to build a practice, you know, a couple years into it. And so I was out in the community and I was doing public speaking and, uh, doing all kinds of different things out in the community. So I built a skill of, um, communication and kind of overcoming my fears a little bit. And then I opened up my own practice and realized like things were going, really going good, and then insurance got bad and I had to figure that out.

And I, I jumped into, I'm a member of Strategic Coach, if you've heard of that. They're a entrepreneur coaching group, and I needed a. I need to really get that skill of being an entrepreneur, which is a kind of multilayer one. That kind of layer that kind of led me into, uh, marketing and learning that. Yeah.

So I kind of just was stacking these [00:22:00] skills and, yep. And is that something that you see some of the best leaders do is like, okay, maybe they're, they're coming out strong with a couple things, but then they're, they're always willing to learn and, and, and develop new skills that they can then package into, into a whole, uh, product as a person.

You know, it's funny, I think when people look at. Ultra successful people. You know, whether it's that doctor who's waiting list is just, you know, three months long, no matter where he or she goes, um, they tend to feel that person has an extraordinary talent. And I almost find that's never the case. They just have a tremendous amount of micro talents that summate I.

Jeff Moore: Into an incredible human product. Mm-hmm. That's what it is. They, they have done, like you said, interpersonal skills, manual therapy skills, business skills in even inside of those, there's so many niche, but they just keep adding one more thing. They're competent at. The summation of all of that is extraordinary, but it's not the individual things that are extraordinary.

They are basic [00:23:00] competencies. There's just more inside of that person because they've done the work to create that. And then the synergy of all of that comes together looking like quite the extraordinary product. And so I think that, I hope people hear that because if you think it's the other one, if you think like someone just has a crazy gift or whatever, that's a little bit disheartening.

'cause it's like, well, maybe I don't have that gift. But when you realize that these exceptional people are really just people that took the time and had the discipline to truly earn a long range of symbiotic talents and gain those skills, that's the outcome. Anybody can do that and anybody includes you.

Dr. Kevin Christie: Yeah. And I think that's one of the misconceptions of leadership is people just only think of the charismatic leader, right? That, you know, they wake up and, and they're, you know, dripping in charisma when they, you know, when they walk outta bed. And there's people like that. I mean, it'd be nice, right? I'd love, I ha if I had that.

But I think one of the things that I had to develop over time. As, as it pertains to [00:24:00] confidence in my own leadership, which that it, it comes in different packages. Mm-hmm. And, and it doesn't just mean that you are, you know, a charismatic leader that, yeah, that's nice, but there's a lot of quiet leaders.

There's a lot of people that are, uh, you know, like you said, it's some of the characteristics of discipline and, uh, you know, maybe grit and stuff like that will also be really good forms. Of leadership. And so I think that's been the journey I've been on is getting comfortable in my own skin on what my leadership style looks like and, and how, um, how that works.

Right. Is have you, have you noticed that with some people, like there's just, you know, different leadership styles and there's no way of like plugging into one thing? Well, I think what's so important about that discussion right there is, especially for your audience members who are looking to build like serious teams, like, and I only, I only say serious from a sense of scale.

Jeff Moore: Like it's one thing a person can be a great leader and have, you know, five or six folks that are working with them or under them. I don't like the term under them, but you know what I mean, in a hierarchy of that [00:25:00] nature. But if you're looking to expand where you're gonna have a team of. 25 or 50 or even beyond that, the one leader solves all doesn't work.

Because what you really need is a group of leaders that are different kinds of leaders. Mm-hmm. You, you do need the charismatic leader. That person's generally gonna be able to inspire. They're gonna be a visionary. There's a lot to be said for that person. But that person is not worth their weight in anything.

If they aren't supported by a leader who is more logistically oriented and maybe a bit more realistic and maybe, you know, some of the, then we need a great communicator. Like there are, as you begin to develop serious organizations, you need to have your eye out for a blend of leadership that is, you know, more a whole than the sum of its parts, if you will.

And that's what too. Somebody who's looking for leadership in that company can identify in those different people what they need right then. Mm-hmm. That can't happen if you're one person. So I really want folks, if you're thinking [00:26:00] about going big, you really need to think about architecting a team that has a variety of those leadership styles, because that really, if you're looking to create something special that is a requirement.

Dr. Kevin Christie: No, it makes sense. And I think about, we joke around, we have a mastermind group and I'll, I'll, uh, I'll talk about the East Group for right now, but, um, you know, I lead that group. But then Kurt Kippenberger, who's one of our associate coaches is, is kinda my right hand for that. And, uh, he's a lot more fun than I am.

He's, uh, he's got that charisma, he is got that magnetism to him and it, it really helps with, uh, managing that room of 25 doctors. And so it's, uh, yep, you, you need that sometimes. Yeah. And, and, and you've gotta be humble enough to seek your opposite. And that's one, that's one reason a lot of leaders sealing out is if you are a leader and you're working with a really talented person who has shared vision and shared interest, common goals.

Jeff Moore: They're [00:27:00] kind of annoying for you to work with. You should really consider working with that person more, right? 'cause the odds are they're bringing something into your, into your ecosystem that you probably need in a gap. You probably have. So I always tell leaders to seek their opposite. Right. You've got you covered.

Now you need to look at where are my gaps and how can I hire them and the allies that bring alongside me. Mm-hmm. Yeah. And I'm, I'm even noticing that a little bit with, with our doc here, me, there's two docs in our practice and we're really in a good, good phase right now. And, uh, Dr. Gage is very systems based, which is awesome.

Dr. Kevin Christie: And it's ironic 'cause I. I preach systems a lot and, and try to teach it to our, our, our clients, but I'm just not good at actual systems and, and implementing it. But having someone that is, has really helped in noticing a difference with that. So sometimes you gotta be honest with your, your weak links.

Right. I I love that. I love the humility that you say that with, because that goes so far of like. I see so many people not wanting to [00:28:00] admit they're weak in an area. Mm-hmm. And so they grind like crazy to get mediocre in an area where they're not gifted. And it's like, boy, if you would just hire out your weaknesses, this could, you could do so much more for so many people if you would stop this obsession with doing it all, you know?

Yeah. You know, that's been the, uh, you know, kind of a, you know. An honest moment in the struggle of like coaching chiropractors like I do, is that it's impossible for any chiropractor that's, let's say coaching someone on all things to have a, a, a successful practice to be good at all those things. And I would be like, God, am I really teaching on this subject or talking to this chiropractor about this subject when I'm really, actually.

Shitty at it. Um, you know, but I, I, I think you, you, but I, I think the thing is is I'm, I'm in a position where I get to interview people like yourself where I can kind of collect and catalog really good, uh, ideas and lessons from that. And I can convey that to a, a client and say, okay, I may not be the best at this, but I know this is what you need to do.

'cause [00:29:00] I've talked to people that have done this successfully and there are certain people that have that unique ability, right. Yep. Absolutely. That's it. You, what did Einstein say? You don't have to know everything if you know where to find it. That idea that that's it, right? Like there's a lot of times where I'm like, okay, you're asking me something that I know If I was in your shoes, I would not be able to execute at an awesome level.

Jeff Moore: I can get you going in the right direction and I can sure as hell find you the next person that's gonna bring you to the finish line. I can get you those resources and being a resource dealer at the end of the day. How connected you are, how many folks are talking to you? Oh, that right there. You don't need to have the skills, but you gotta know where they live.

Dr. Kevin Christie: I like that term resource deal. I'm writing that down. You got a bunch of those. Are you from the south originally? No, I'm from the opposite. I'm from upper mic, upper Peninsula of Michigan, up by Lake Superior. Really small town up by Canada. A lot of people from the south have all these great quips. And so, um, last little topic, and you can punt it if you want to, 'cause it's a little bit of a, a sidebar, but I'm sure you'd see and deal with it a lot.[00:30:00]

And that's kind of the overwhelm and, and burnout of things like where, you know, a young provider or even not a young provider just doesn't see the forest or the trees on how to. How they'll be able to develop certain skills that they will be able to overcome. That it feels really hard right now. Uh, but it doesn't mean it's always gonna be that hard.

And sometimes when you're uncomfortable, it means you're growing. It doesn't mean you're facing overwhelming burnout. And I, uh, I do believe there's a lot of people that, um, actually, you know, they, they do suffer from that ordeal that, or they're coming up against that. And I know healthcare's really hard.

It's tricky because we. We deal with people all the time that are in pain and they're struggling and we have a level of empathy towards them, and then we have to also go home to our families and our kids, and we like, there's a lot on our plates. I, I, I do get that. But um, I think like a lot of things. A lot of people, uh, get a little uncomfortable and then they're basically equating it to having a condition.

And again, I don't, I'm not saying that the discount, the people that actually are dealing with that, [00:31:00] but I just think there's, it's okay to be uncomfortable and overcoming that and learning to overcome that or solve those problems, uh, is going to get you further and you will learn how to address that to where you don't face.

Burnout because kind of going back to what we said earlier, if you had no problems and everything, every day was easy, like you're probably not doing anything right? Yeah. Um, so what are kind of your, some of your thoughts on helping people, um, you know, understand where they are, if it's getting to that point, or some strategies around it, ideas, anything around that.

Jeff Moore: The biggest thing I tell people is stop trying to do it alone. Right. We, we all, we always talk about if you wanna go fast, go alone, but if you wanna go far, go together like that. That phrase is near and dear to my heart. Mm-hmm. And especially in the burnout phase, because what you need to be in. Is a system where, 'cause at the beginning of your career, you're not supposed to be where you [00:32:00] want to be.

Right. You're, you're supposed to know where you want to go, but the beginning is never the optimal circumstance. Right. And we, and we take that on knowingly, however. Mm-hmm. You do want concrete examples and guides that you believe are going to eventually get you where you're trying to go. And so being in a system where you're working with people that.

Have the life that you are ready to earn. Right? And you're willing to go through some troughs to get there. Yeah. But you also know they're going to help you. This goes this. This is right back to the same conversation about having folks set examples of really overdelivering for patients so that you can see you're gonna be there one day.

The same is true for life in work-life balance, or however you want to use nomenclature around that. You gotta be in systems. Where the more senior folks, you're like, gosh, I want to be there one day. And they say, I want to get that person here one day. And they're making vested commitments to you so that they're bringing you along and [00:33:00] helping decrease friction on the journey.

It will not be easy, but if you know it's possible, 'cause you see it every day and that person's pulling you along, mm-hmm. It won't happen overnight. But you trust it'll happen. I think that not believing it's ever going to happen or not having a great example or someone showing you the staircase, that's when the overwhelm gets you.

It's not supposed to be easy, but to not have a map makes it feel impossible. Have a map and that's your crew. That's a big, yeah, that's a big point. I was actually having a conversation with my associate and also one of the, we have a PT group that rents me here and they're both, you know, late twenties and, and I'm 45 and I, I love being 45.

Dr. Kevin Christie: You know, it's just like, uh, it's not easy. It's a little bit AER than it 27 and stuff like that, but I feel good about, okay, you know what? Not that I'm settling by any stretch, but, uh, I got across that chasm into a certain level of, okay. Uh, this career has turned out well for me. Totally. And I said the hard part is when you are [00:34:00] 27, 28 is for the most part, you probably don't know yet if this, uh, is gonna work out.

It's, uh, it's like you're going and it's. Dark out there and you don't know where you're going and you're hoping that you find the, uh, the path. And, uh, but I, I try to explain to 'em as like, look, you know, you guys are doing a right, a lot of the right stuff, and that is the, that at, at 26, 7, 28. The, the success is the fact that you are doing the right things, in my opinion, right?

Like, yeah, we'd all like to have more money, we'd like to have more of this, that, or whatever. But at a certain age, when you're younger, the success is the process and you're sticking to it and having that belief that you're gonna get there. And I, I love how you just, you kind of phrase that if at any point if you're listening to this and you're dealing with it, maybe you just aren't seeing that path.

Or maybe you don't have the right mentors, like you said earlier, and you, and you need to find that. And a lot of times that can, uh, help you overcome it. Right. Absolutely. Absolutely. [00:35:00] Yeah. And I, I hope, I hope members hear that. 'cause the burnout thing is real. I mean, it's prevalent, it's out there, it's, it's a real challenge.

Jeff Moore: But if you're grinding, like you just said, like that 27, 28, I love that. Age is so fun to observe. Like I said, I'm mid forties too, so I, I, I feel the same way. You do. I had a great mentor one time tell me that if you work. Hard when you're 25 to 35, you'll play for the rest of your life. If you play when you're 25 to 35, you're gonna work hard for the rest of your life.

And for those that are out there, 25 to 35 and you feel like you're grinding, I think that you're setting yourself up for a really. Enjoyable. It never gets easy. We don't want it easy. We wanna keep being shaped by life, right? But it gets awfully enjoyable as you begin to crest that 35 to 40 age, and all of a sudden you're doing a lot of things that are elective and that mean a lot to you, and that phase is coming.

If you can just get through the storm. Yeah. And I think what's interesting about when you do get to our age and when you do have, [00:36:00] uh, what's unique I think also is we have two levels of schooling, right. Uh, obviously the high school stuff too, but let's just take you like your undergrad. I have a bunch of undergrad friends, and then I got a bunch of chiropractic school friends.

Dr. Kevin Christie: Right? So you probably have a lot of undergrad friends, a lot of PT school friends and Yep. And you, so you got two different dichotomies of careers, obviously. Um. But I can look back in the ones in particular, the undergrad friends. 'cause I was like, if you ended up going to PT or chiro school, you're probably a level-headed dude.

And you probably, you know, you probably kind of like work hard, but obviously not every chiro and PT are where they want to be in their mid forties. But I look at some of my undergrad friends who are now 45 and they just. Dicked around for so long, and now they're just in careers that, like it paid the bills for a while, now it's not paying the bills.

Or it's like they hate it or they're getting laid off in corporate America and they're, they're struggling. The, and that's, that's a hard place to be. So it, yeah, it's, it's much easier to struggle when you're younger and put in the hard work. And like you [00:37:00] said, you'll be able to really, um, enjoy the fruits of that work.

And again, not that it's easy, but it, it, you have a level of, um. Really satisfaction, I think, in what you're doing. Yeah. And you, your autonomy only increases. Part of the reason that early years are hard is you're in that phase where you're doing what you have to, you don't have a lot of elective with your time and, and anyway, you don't have a big enough patient following that.

Jeff Moore: You can set your ideal hours and people will fit your hours, right? Like you've gotta meet them where they're at. But just know that with every passing year. That softens every year. And so pretty soon you're like, man, I'm still working a lot. But that's great 'cause I love it and I love what I do and I love the results of it, but I'm also doing it a bit more on my terms.

And I think as you begin to feel that the energy of your life really kind of re gets more exciting, I think, in a lot of ways. And so again, if you're like, if the weight of the world's on your shoulders, it doesn't stay there. Mm-hmm. It doesn't, and it, and it does get easier, especially when [00:38:00] you keep on learning and you keep on learning from, from mentors.

Dr. Kevin Christie: And so, uh, Jeff, this has been, this has been an absolute, uh, pleasure. Uh, I'd love to give you an opportunity to, to tell, uh, where they can find you both, you know, whether they want to learn on the clinical side or if they want to see what you got going on at, at onward. How can they find you on each, um, platforms.

Jeff Moore: Yeah, you bet. So on the clinical education side, just go to PT on ice.com. We, uh, we own every domain that has the words, you know, Institute of Clinical Excellence in it, but that one tends to be the most direct route for most people. Everything's on there. You know, you can download our app, which makes it easier.

So we have an ice physio app, so you can go on Android, um, or um, I iTunes or iStore and get the iPhone app or get the Android app. That has our whole community. So like all of our online courses, all of our live courses, we have tons of free resources. We've got, you know, communities that we share things in.

We've got book clubs, marathon clubs, we've got a big community in there. So jump in there and you just kind of mix it up with us and you'll see all the options we have available. And then [00:39:00] over@onwardphysicaltherapy.com. If you want to go there and look at where all the clinics are, kind of, you know, where can you jump on board, where don't we have one?

Right? If you ever want to be involved and think about planting the flag somewhere, um, those are all really good spots to kind of connect with us. Yeah. And I want to, uh, challenge my, my audience a, you know, most of 'em are chiropractors, but um, a lot of them do a lot of rehab now. And that's great. Totally.

Dr. Kevin Christie: And so, and that's where, you know, Ashley and Brittany got so much how to go into your, uh, trainings there. And I, they've been to multiple, which has been awesome. And then also maybe you just need to find a good PT clinic to refer to. 'cause I know we refer to PT often when it's just something that, um, we don't do in-house.

Uh, obviously post-surgical, we don't do. Or if they really need a level of. You know, we could sit here and talk about an hour on who could really use great pt, especially the advanced level pt, right? Return to sport and things like that. Sure. So if there's a gap in what you offer, check out, see if there's one of your, uh, clinics there onward is, uh, where you'd look at that.

And so cool to see the, you know, hopefully we get, get you on here again and, uh, maybe have you come out to one of our masterminds one year and, and [00:40:00] we, we bring in guest presenters and. You know, we pay and do all that stuff. And so, uh, but I'd love to see the growth that you got going on here after another couple years.

Jeff Moore: Yeah, I'd love to circle back. I'd love to join you all live. Whatever makes sense on your end. Cool, Jeff. Well thanks for your time today. Yeah, thanks so much for having me.

 EPISODE 420: The Profit Share Model

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 a solo episode with you and it is on the idea of a profit sharing model. Uh, I don't think it's for everybody, but I do see a lot of value in it, and I wanna give you a little bit of background.

I. Uh, first with, you know, where the kind of the synthesis of this has come. 'cause I'm, I'm, you know, another disclaimer, I'm, I'm not a financial expert. I've been in practice for 20 years. Um, been fortunate enough to interview a lot of experts and also be taught by a lot of financial experts. And, you know, this isn't.

What I've necessarily created, um, I've applied it to my practice and I'm gonna share, you share with you that, and you can kind of work with your expert, uh, you know, your accountant, uh, maybe you have a financial coach. I. Or maybe you, you bring on someone to help you out with this. But, uh, where this came from was just a little background, was, uh, mastermind [00:01:00] 2023 in the east in Fort Lauderdale.

We had Dr. Ray Tuck, uh, the late Dr. Ray Tuck present to us, uh, his model and just a little background, 10 11 clinics for the Virginia area and they use the profit sharing model for their. Doctors that were with them for some period of time and for their, um, many of their satellite locations. And he taught us a lot about how they structure theirs.

A lot of that was derived from, and I've read, um, the Great Game of Business by Jack Stack, a really good book recommendation I have for you. And they talk a lot about the ESOP model in there, ESOP, basically kind of like a stock option aspect. And I've, um. Read that book. Uh, I've had John Williams on recently, so I recommend, uh, that was just, um, that would've been maybe in February or March of 2025, had him on and, and he is certified in that.

He is actually coming to present for our East West combo [00:02:00] Mastermind in October of 2025 and gonna be discussing the Great Game of Business and I'm excited about that. Uh, also have had Greg Crabtree on the podcast, had him. Uh, come and do a, uh, training session for our Mastermind members, and he talked a lot about different aspects of what we're gonna talk about today.

Always recommend his, his stuff and his book. Simple Numbers 2.0. Uh, and then we've applied this recently to our, uh, practice and that's where we've kind of come up with some of the things that we're doing with our profit sharing model. Now, um, you know, again, some of the disclaimers I have, I do not think this is necessarily for everyone.

I do think almost all clinics could. Make this work. Um, I don't have all the nuances of, of maybe like a 5, 6, 7 doctor practice. Um, no. Some other disclaimers is, you know, uh, not quite sure. Um. Where it would, what it would look [00:03:00] like if you have, uh, partnerships that maybe are not spousal and what that looks like.

Um, again, I'm not a financial expert. I don't have all the answers either. And, um, one of the things I actually did was, um, previous to this recording, me recording this episode, we had our, uh, Charleston Mastermind, our East Group, and we. I, I kind of presented to this and got a lot of good feedback from it as well.

And so always looking for feedback as we go along. But so far, so good as we've applied it, uh, to our, um, practice. I. Now I think some of the, the issues that we see with just overall associate compensation, which has obviously been a struggle for both employer and associate and, and it's made it hard to retain really good talent.

I think that's some of the issues we're seeing with associate compensation. Um, I think the salary only like, or what the salary demands are or [00:04:00] salary desires of associates and what owners can afford is not in line. That's just a harsh reality that a lot of us are seeing, and it's not that the associate isn't quote unquote worth.

Uh, X amount of dollars. It's how many evidence-based chiropractic employers out there can afford to do that on a pure salary for just treating patients. And the reality of it is, is typically the owner is losing money on that doctor for quite some time until they're fully integrated onboard in the practice and actually start building.

A patient base, um, you know, there's the percentage of collections, right? The, the split, and that's a tricky one. Um, you know, that's, that's the most common and still in many cases, the easiest and, and, and can be very, um, beneficial for both parties. Uh, but it's tricky because the percentage of collections, um, doesn't take in the rising cost of overhead.

So, for an example, if you. If you gave a, if you had an associate associate [00:05:00] and they were getting 45% of collections and that started seven years ago and they're still with you, your overhead has probably significantly increased since then. And it doesn't take that into consideration 'cause you're getting a, they're getting a percentage of the top line, not the bottom line.

Um, and then, you know, there's a lot of, uh, I think, you know, Greg Crabtree talks about where. It's really hard for the employer. The real reality of it is, and I know a lot of, a lot of associates may not want to hear this and uh, maybe even some employers don't, but it's really hard to make it work. Um, I. If the associate is getting, uh, above like 40, 45, 50% or more, um, if this person's a W2, you gotta also consider that when you write those checks to that employee, um, you're getting payroll taxed on that.

You're getting another 10% taxed. And so Greg Crabtree talks about really kind of like a between a 30 and 40% [00:06:00] for the treating doctor is where the sweet spot tends to be, to where it actually makes viable sense for the owner to take on that risk and. All the overhead that is part of a business that a lot of times isn't seen there.

And so there's some, you know, issues with, with that. Um, a lot of nuances around the percentage. I still think it's a very good model. Just gotta, you gotta be teased out appropriately. I think another issue with associate compensation is the lack of either. Perceived growth by the associate or actual growth.

Like they feel like they're stuck and there's no real room for growth, uh, professionally and, you know, financially. Right. And, uh, that's a, that's a, a key thing. Uh, and then lastly, I, and I'm sure there's more than this, but just wanted to kind of tease this out a little bit before we dive into some of the specifics is, you know, fitting, uh, a higher doctor income.

Just like say a straight salary, um, into the 2.0 number, the Greg Crabtree 2.0 number. So let me give a [00:07:00] quick definition of that, and if you need more, you can Google it. Uh, uh, you know, you can jet CPT it, but I. Basically what Greg Crabtree has, uh, written about and teaches about and, and, and has studied for years is that let's say you have a $500,000, uh, a year business.

So you collect $500,000. Your overall labor costs, including payroll taxes, should be about $250,000. So, you know, 2.0, you divide, um, the, the 500,000 by 250,000. Payroll, and that is 2.0. His range he gives is a 1.9 to 2.1. I'll let you do that math, but uh, think about it, right? So if you had a $500,000 revenue practice, you would need to keep your overall labor costs to about $250,000, give or take.

And, um, you know, how much of that is going to you as the, the treating owner, how much is going to your other staff? And then obviously fitting in. [00:08:00] A, you know, 75, 80, $90,000 pure salary into that payroll. To make it make sense financially as a business is really hard. Um, it's why you gotta start getting up there, um, if you're gonna, if you're gonna do that, okay.

And I think, um, you know, some of the benefits of a profit sharing model is one, is it gives the, um, associate doctor an ownership mentality. They're actually going to bear some of the fruit of this. Um, there's gonna be some room for growth for the associate financially 'cause they can grow as the practice grows and how as they help grow the practice.

Two, it's a good education of the associate. I think if you. Um, provide some clarity and training within finances around this. They, they will benefit greatly from that. And that's, I think, a lot of times unfortunate when associates maybe work somewhere for a few years and they don't get any of that type of training and they.

Open up on their own and, and they're kind of, kind of lost financially on what the realities of it are. And [00:09:00] so this, uh, really educates in that I think it lessens the burden on salary creep, right? Like the kind of salaries keep on creeping up. Creeping up. And it's maybe not based on production, but based on just, you know, the fact the person's been there for another year and another year and another year.

Um, it takes into consideration overhead. Right. So if overhead goes up, then that could eat into profits, and that could eat into, um, the profit share. And so you want to, um, make sure everybody is growing appropriately. Um, it's gonna help for ideal practice growth, and we're seeing that, um, uh, in, in our practice since we've implemented this, which has been really nice.

And I think it's an ideal setup for an intrapreneur. Right? So if you had to categorize three, um. Types of chiropractors, uh, associates, which we have in the past on other episodes. But like one might be just your pure clinician on one end of the spectrum. On the other end, end of the spectrum, you're have your entrepreneur type, and in the middle is that builder chiropractor.

That entrepreneur really has a, has a good [00:10:00] entrepreneur spirit to 'em, um, but functions better within the frameworks of an existing practice. And I feel like this profit sharing model has a really good. Um, uh, combination of things to that is ideal for, uh, that intrapreneur, right? So that entrepreneur now, um.

Ray Tuck, when he had, he had, um, taught us this. There's a couple levers you can pull, which is pretty cool, right? So 'cause was like, okay, what percentage of profit are they getting? And it could be arranged, nothing setting stone, but it could be his recommendation was anywhere between 20 and 30% on what that is.

And then, you know, you're gonna have two levers, okay, what's the associate salary and then what's the percentage of. Profit share. And if you go a little on the, you could decide to go a little bit lower on the, um, regular straight salary and a little higher on the percentage. Or you can go a little bit higher on the, uh, salary and a little lower on the percentage.

I [00:11:00] think you definitely need to run your numbers and you, if you do the math and you say. Wow. If I gave them 30% profit on this, that would be, doesn't make sense, right? Like, that'd be just way too much money for, for the production done. And so you gotta look at your own books. I can, you know, there's not a clear cut on this and I'm not gonna give you one on it.

Uh, we do help, uh, chiropractors work through this and figure some of that stuff out and our. Coaching side of things, but it's hard to just give you a straight, okay, you gotta do this. Um, and then the other thing is, is like you're not gonna just hire a doctor with this model, right? You're gonna say, um, okay, you're starting tomorrow and you're gonna get a profit share.

No, they're gonna earn the profit share. There's gonna be a, a doctor after at least one year. I would say give it a year. And they get a salary, and then they can be eligible for the profit share. If you, you know, set some certain metrics, right? Like if you can then answer the question, knowing what I know now, would I hire this doctor again?

And it's a, you know, it's a, a hell yes. Then they're probably [00:12:00] worth putting onto a profit sharing model. So you're not doing this for just because they got a job. Um, they are gonna work towards this and earn it. Then from there, um, you may have to tweak the salary up or down and the percentage, and you can work on those two, uh, knobs and you know, and so maybe it's a 55,000.

Again, this is completely general, but maybe it's a $55,000 salary, but it's a nice 25% profit share. Or maybe you're gonna go up a little bit on the salary and down to a 20%. Or maybe you just got a really profitable practice that brings in a million dollars. And if you just gave them. 30% profit share or even 20% profit share.

It just wouldn't make sense. And so maybe it's a 15% profit share. And when they, you run the numbers, that particular associate doctor, if they do their thing and they get 15% of profit, they're making, uh, the same or more as another doctor in a different practice with a 30% profit share. Right? Because it's all [00:13:00] relative to how much profit there is.

And so I know a lot of you are probably asking if you're on the associate side, it's like, well, can't the owner hide profit? Well, yeah, they can, but not if you do this right and not, if you provide one of the key things in this, which is, um, you, you definitely need to provide. Clarity right now, you don't necessarily, uh, you, you'll, you'll want to give a payroll number for the clinic each month, but not who's getting what, right?

So it might just say, okay, yeah, payroll for the clinic is $25,000, but doesn't tease out who's getting what. So the associate doesn't have to know who's getting paid what, but they'll need to know what the, the expenses are. And so a lot of the, you know, the devils are in the details. With this, and this is gonna be really, you gotta consider your operating expenses and not necessarily all expenses.

Okay? So for instance, if you run your car through your business, that's not gonna go into this overhead. Like that's not [00:14:00] an expense to run the business. And so that shouldn't ding the associate. On the, um, on the profits. Right? And so it's really your operating expenses. And the other one, when people ask like, what about debt payments?

Well, I think if it was a, uh, like an equipment loan that had an RI, you, you know, you would probably consider that in there as, as overhead if it's, you got an EIDL loan from five years ago when you're making a payment on that, I would not put that in there. That is, I wouldn't burden the. The overhead with that, um, that would come out of profits, right?

That would, and on your end of the profits. So, um, debt payments, I think you need to work with your advisor on like what would be included in there. Like if you have a table lease, yes. Could go in your operating expenses and, um, impact that, uh, profit sharing. The other thing, um, yet you need to do in this model typically is paying yourself a fair salary, right?

[00:15:00] And what that looks like, um, as, as a treating doctor, um, you know, and then I'm not gonna get into like the owner's salary versus set distribution, right? So let's say you, you know, I'm gonna, you're gonna pay yourself a hundred thousand dollars a year as the treating owner. Um, for treating patients, but maybe you decide, you and your account decide to pay yourself $60,000 as a W2 salary and $40,000 as a, as an owner's distribution, as a set distribution.

Now that would, um, that full hundred thousand would go into the payroll as an overhead for that profit sharing model. But you're just divvying it up separately. And that particular set distribution, I'll call it for the sake of argument, is different than a profit distribution that you take after the fact.

Because the way this really works, and this is a Greg Crabtree thing, is the. Um, you want to, you wanna maintain at least a, a 15% profit share per him. But that's, again, with you paying yourself a, like a, an industry expected [00:16:00] salary. Like a lot of times what chiropractors say, oh, like, I'm, I'm 50% profitable, but they're counting like.

The 50% overhead is not including what they pay themselves, right? And that's not reality. If you went to go sell that practice, they would want to know what it costs for that doctor to treat patients. So this is all, you know, predicated on you paying yourself a, a fair wage in this model. And then, um. A another thing here is a profit share is not ownership interest.

It doesn't, you know, like if you offer a 25% profit share, it doesn't mean that that doc, that associate owns 25% of your business. Now, that would be a separate thing. They could buy in or however you want to decide to do that. But profit sharing is not ownership interest, it's not shares and things of that nature.

And then. Really what you want to, um, consider some certain things is, um, you know, s sinking funds. So what we have a line item for sinking fund and I go in the beginning of the year because you try to wanna dis distribute [00:17:00] out some of your expenses so it doesn't kill a month because of Oh yeah.

Malpractice insurances for both doctors. Well came up in June, and so then you write all these checks and then there's no profit. So I, what I do is I take all my, you know, malpractice insurances. We have a $2,000 sponsorship that we do for a running group and then equipment repair for a couple thousand dollars.

And, um, a bunch of things like the, are big ticket items and you add it up and then that, uh, let's say, let's just say it's, uh, $16,000 a year. Um. Or lemme just make it easier. Let's say it's, uh, um, $12,000 a year. And then you would have a line item that says sinking fund $1,000 per month. So 1000 times 12 months is 12,000.

And so that's a monthly expense is 1000. Then you're gonna wanna also have a miscellaneous one on there, and that way it shows Okay, yeah, there's certain things I can't predict, you know, and if it pops up I'm gonna provide [00:18:00] you clarity with it. Um, but it's, um. It could be, uh, you know, this, it could be less, but you want to, and then I will show the miscellaneous expenses for that particular month on there, right?

Um, the other thing that I do is for each expense category, I, I, I will market as a fixed expense, right? Like my. Uh, my, my rent is a fixed expense. My phone service is a fixed expense, and then there's some that are estimated, right? So like my merchant processing fees is an estimate. So I provide clarity, but knowing that these estimates could be different.

Uh, and then we, uh, one thing we make sure we do is review each month. So when we get the collection report and I go and I, you know, do all my, my overhead and put it on a Google sheet, we review it together to provide clarity on it. Now. This. Uh, looks potentially different than your QuickBooks. Okay? So your, the Google sheet you put on there and or [00:19:00] however a spreadsheet is gonna look a little bit different than your, your QuickBooks, and I'll talk about that in a second.

Uh, and again, I'm not gonna be able to cover everything today. I want to get you the conceptual idea of this model and how it works. Okay? Uh, one other thing on there is, is you, you, you should, and this is something I learned from. Ray and also another doc that's been doing this for a multi clinic practice is a management fee.

So you would, um, you would charge a management fee in there, um, maybe $2,000 plus or minus, whatever, and that goes into the overhead as well. And that's for you to be the manager of this. Um, so you're paying yourself, um. Your salary for being a treating doctor, whatever that is, that goes into your payroll, that's an expense.

You have a management fee for managing all this stuff and managing the practice. That's an expense. And then your third way of as the owner getting paid would be obviously owners distribution on on profits. Okay. And so that's kind of, you know, the categories, the [00:20:00] different categories you have. Um, on this spreadsheet, and this comes from Ray's work, is you're gonna have a category of wages and benefits and you're gonna tease out the payroll plus the payroll employer taxes your facilities.

That's all things like rent and phones, and. Power bill and cable and all that. You're gonna have professional services such as merchant processing, bookkeeping, EHRs, all that type of stuff. You're gonna have your marketing category, you're gonna have your supplies category, and then you could have a miscellaneous, and that's where I put my syncing fund and, uh, other miscellaneous expenses.

And those would be the categories that you have teased out for, um, breaking that down for the person. And then from there I monitor two key things to make decisions. Right? And that's gonna be the 2.0 number I mentioned and also profit margin. And as Greg Crabtree talks about is he really believes in, um.

The 2.0 number for your payroll [00:21:00] and then profit margin of, of 15%. Now he says you can go down to 10%. If you're investing in something like a, you know, an associate doctor, you might, that might ding your profit for a little bit, but you want to come back up. Uh, and then there's definitely nothing wrong with being more profitable, which is, which is great.

And then the, uh, so you know, like for instance, I felt like in our Q1 we were, uh, really, we did really well with our, uh, 2.0 number, our pay. We were payroll light, but we have some interns, so we weren't, um, burning our staff out. 'cause like, one of the things that, um, Crabtree talks about is that. If you're two payroll light, it might look good for you financially, but you're burning your team out and you can run into problems.

If you're two payroll bloated, then that's obviously an issue. And so there's that sweet spot and that's why it's so important for the team members that you have to be very efficient. Right? So give you an example. Imagine if you had an associate you were paying, uh, $90,000 to, and they just weren't bringing in.

Business or that [00:22:00] you are giving them new patients and they couldn't keep 'em right? So now you've got a problem where the, there's a bad labor efficient ratio there. That person is not bringing in enough revenue to offset the cost, and that's when you know you could be payroll bloated. Whereas if that.

Doc, if she's like killing it and then it makes sense, then that math works out. And so I monitor that 2.0 number and then also the profit margin. And so we were really good on the profit margin. And if, if we say to ourselves, and I go and I talk to, uh, our team and say, okay, we're gonna hire a ca, right?

When I'm gonna hire a ca, I can show it's like, look, we've got the room in our payroll, uh, on this 2.0 scale. And then we're also, uh, you know, we were 28%. Operating profit margin in Q1. And so there's wiggle room on the operating profit margin as well. Um, now that's where I want to give you a differential of what operating profit margin [00:23:00] is.

And, and again, I'm not an expert, but just the way I'm looking at it here. Versus what you might see as actual, uh, profit, profit margin on your QuickBooks, right? So if, um, if you're paying down a bunch of like, let me see if you're, um, you know, paying down certain debts and things like that. You might not show a lot of profit per se.

And then that's where you dive into certain things like ebitda and I'll let you Google that. I'm not gonna do it. So the, I just, I'm bringing it up 'cause I don't want you to get hung up in the weeds on what your QuickBooks and your EBITDA is and this and that and the other thing versus, um, your operating.

So exa example, like let's say you and your wife go out to dinner and you guys have a legitimate talk about business and you, you have a $350 dinner in my opinion. That would not be part of your operating cost in this profit sharing model. So it would, you wouldn't show up on, on as your, uh, as an [00:24:00] expense on that.

And so in that scenario, your operating profit margin would be different, but on your QuickBooks is gonna show up as an expense, as a business expense. And so I think you get that one example and you can extrapolate out the other examples there.

Now the, so then the kind of the last topic on it that I'll, I'll discuss is that, okay, now you got profit, right? And we're doing ours quarterly. So it's quarterly profit share, not monthly. It's just too complicated to do it monthly. Uh, it. It's, um, I think a quarter spreads smooth things out if you, you know, if you have a really good month and a really bad month, it's kind of a kick in the, you know what, so it's nice to spread it out quarterly.

Um, and then from there, let's just say in a particular quarter, you, maybe you do it a month, however you wanna do it, but. If you do it, and let's just say you had 10,000, I'm gonna make it super easy with money. You had $10,000 in profit for the quarter. Um, and [00:25:00] then you did, let's say you did a 25% profit share.

Um, your, the, the associate would get $2,500 of that 10, and then you would get $7,500 of that 10,000. Now, um. That 70, $7,500 is now tr technically the true profit, right? So that's again, where I'm telling you. The QuickBooks profit in your profit based on your operating margin here is different. So obviously if you write that doctor a $2,500 payroll check for his or her profit share, that is actually overhead in your QuickBooks.

That's not gonna be profit, so you're not gonna pay tax on that profit. So even though your operating profit was 10,000, the QuickBooks is gonna. Represent $7,500. I hope that makes sense. Like right. So once you've written that check, the profit really is now $7,500, not the 10. So you wouldn't, um, pay tax on profits of 10.

You would pay tax on profits of the [00:26:00] 7,500. Okay? And so out of that, um. $7,500. Crabtree would talk about his kind of split in thirds. He has like a 40, 30, 30, uh, again, I'll let you work with your accountant on it, and he's kind of super conservative on 40% going to tax on profit. But let's just say you split it up in thirds for the sake of this conversation.

A third to taxes on profit. A third, he recommends reinvesting back into the business. And that could be paying off debt, it could be buying equipment, it could be hiring someone. It could be adding money into a sinking fund or emergency fund, whatever. It's just going back into the business for growth. And the other third would be for your personal distribution.

And so that's that third way of you getting paid. So the more profitable you are, the more money you're gonna make, the more money you're gonna be able to reinvest into the business. And the more. Um, money the associate's gonna make. And so that's the, the contextual aspect of it is that everybody's working to be profitable.

Everybody [00:27:00] cares about profit. When you have an ass own a percentage, they don't really care about profit, they just care about what they've collected. And so there's decisions that are, uh, there's a little, some blind spots on there, but when we're all working towards profit, we know Yeah. How can we do this?

How can we collect as much as we can? How can we collect as much as we can efficiently and go above and beyond to make this happen? And I think that's what we're seeing. By implementing this profit sharing model, and when it works out and you're handsomely profitable, uh, everybody's doing well. And if there's overhead, it's taken into consideration.

Right? And, uh, it's not all in the back of the, of the owner. And so, um, that is. A lot of the details of the profit sharing models, not all the details. Um, but I want you to start thinking about that. I I do. It's going very well for us. I think there's different seasons of practices where it makes sense. I think if you're thinking about, uh, satellite offices really, really think about this.

[00:28:00] 'cause one of the killers, killers, killers of satellite offices, a doctor turnover. And if you've got someone on a profit sharing model, um, that's going to reduce that. So I hope this was helpful again. Um. Our coaching clients and mastermind clients have access to stuff like this and are helping guiding them through unique situations for their practice.

And so check us out@modernchiropracticmarketing.com. We're here to help you in any way we can.

 EPISODE 422: Scaling Smart with a Fractional CFO with Tim Hawkins

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] Hey docs. Welcome to another episode of Modern Chiropractic Mastery. Today I'm excited to bring Tim Hawkins to our episode, and he is a CFO. He is a, he does some fractional CFO work, and we'll describe what that is. And he has a unique expertise in the chiropractic, uh, profession. And so we dive into a lot of things about financial forecasting.

And really the, the theme of what we dive into is, is knowing when you can scale from one location to multiple, but. It's not only about that in this particular episode, so if you're not looking to do that, you'll still get a lot out of this. And we talk about certain things like profit margins and cash flows and forecasting finances and all the things that go into it.

And a lot of you may have an accountant, um, and you have a bookkeeper. Those tend to be. Kind of after the fact professionals oftentimes, right? Like so they do your taxes or do your books. Uh, but what a CFO does is actually help you predict and project your finances and help you with growth [00:01:00] decisions and not just, um, do your taxes, right?

So we dive into many things. Uh, that a chiropractic practice should consider as far as their, the financial health of their practice. And, and we even dive into the personal life a little bit because as a small business, you and typically a pastor entity, really your business and your personal is, is all one in a, in a lot of ways, obviously not legally and not in your accounting, but if you spend too much money in your personal life, you might drain your business to support that.

Or if you spend too much money. In your, , business or you don't make enough money in your business, it's gonna impact your personal life as you know. So, um, yeah, I thought it was a really wide ranging good interview with Tim Hawkins. And so, without further ado, here is our discussion on leveraging finances and scaling to multiple offices, plus all other things CFO.

 Alright, I got Tim Hawkins on the show today and excited to dive into, um, you know, what a fractional CFO is, how that can help a [00:02:00] practice, uh, when you may, uh, you know, certain things you need to understand for your one practice and then when it might be timed if you wanted to open up a satellite office or a second location or even scaling further from there.

But before we dive into those, uh, topics, give us a little lay of the land, Tim, where, where you're located, what some of your backgrounds, some of the work you've done with chiropractors.

Tim Hawkins: Sure. Thanks Kevin. Um, I'm located just outside of DC and Virginia. Um, that's, that's our core base. But you know, we've, we work with people across the country, few, uh, foreign countries as well.

Um, been working with chiropractors for, gosh, 10, 12 years now. Nice. Nice varying sizes, you know, multiple clinics, individuals, solo clinics, um, across the board, other medical practices as well. So seeing some of the similarities there. How that transfers over to, you know, wisdom around the, uh, uh, the chiropractic world and,

Dr. Kevin Christie: yeah.

Yeah. That's awesome. And then, I guess let's set the tone. [00:03:00] Define for us what a fractional CFO is, because I know a lot of chiropractors would love to have A-A-C-F-O for various reasons, and, you know, not being the nitty gritty of all the finances and obviously hiring a full-time. CFO usually commands some well into the six figures, and there's certain things out there that we're seeing now, whether it's CFO or CMO, like marketing person, uh, you know, VAs virtual assistants that you can do kind of a fractional, um, situation now.

So what, what would you, how would you define fractional CFO and what would a chiropractor look for in that role?

Tim Hawkins: Absolutely. Um. It, it's, um, what, what happens a lot of times, and this is traditionally what happens with small businesses mm-hmm. Is, um, you, you kind of, you'll have a bookkeeper, you know, those debts and credits and those invoices need to go out and those revenues need to be collected and counted.

And then you'll oftentimes have a tax accountant and you lull yourself to sleep saying, okay, I've got the financial accounting world [00:04:00] taken care of because I have these two things. What you're missing there is, is the next level of reading what the business is saying to you. One of the core ways that, that your business and your operation, your organization will talk to you is through, um, through its numbers.

And it's really hard to connect the dots if you have the training of a bookkeeper or mm-hmm. And, and again, a tax accountant who maybe traditionally used to do some of that work, they're so focused on code and they're so busy as. Any, if you have a good tax provider, you know how busy they are that this, this stuff gets lost and so things will sneak up on you because you're not listening to what the business is saying.

So when you bring in a fractional CFO, we don't have to be there every day, but if your operation's not that big, you can certainly have us there even once, twice a month. Kinda look at what these numbers are, make sure you set financial disciplines around your processes on accounting and finance, and then get you accustomed to looking at.

Key [00:05:00] ratios, um, either specific to your, to the industry and like what's happening with your patients and your provider utilization, but also then pulling it back. What does gross margin mean? What's EBITDA mean? Why is that important to me? And that you as a chiropractor, you can totally understand that, that that's well within your realm.

It just takes consistent conversation around it, and then you will start to use those tools. Um, to make better decisions. So having a CFO and doing that kind of a, a fractional thing really makes a lot of sense today, and it really helps people have an, you know, impact on health of the business.

Dr. Kevin Christie: Yeah. You know, I think, uh, I've been practicing for 20 years.

I've been owning my own outright for 15 years, and I just now feel like I'm getting the beat of it. Uh, I'm not, not an expert by any stretch, but I, I do have 15 years experience in my practice, and I've made plenty of mistakes. And, you know, I've done a, a lot of, uh, fortunate, a lot of interviewing of experts like yourself and, and things of that nature.

And I start, I, I would say, I finally [00:06:00] understand. What a healthy practice is financially. And, and one of the, um, one of the sayings that I often reference from Westgate is, uh, volume is vanity. Um, profit is sanity and cash is reality, right? Because a lot of people get concerned, you know, they might read their p and ls at the end of the year and it says, uh.

You know, profit of $75,000 and you're like, well, where's that $75,000? Right. Um, and so that's, uh, that's different than actual $75,000 cash profit on a p and l looks differently. And so people get very confused with that. Um, what are, what would you say in that regard? I just want to, it's kind of a sidebar topic, but, um, on that profit and loss at the end of the year when, when someone sees that.

A number and they say themselves, wow, I actually was profitable, but I don't feel like I have any money anywhere where to go. Uh, what, what's the reality behind that?

Tim Hawkins: Absolutely. Um, so the first thing I'll say on that [00:07:00] is, is the way the hair stands up on the back of my neck. When you say, I. At the end of the year when you look at this number, so one of the big things that I bring into this is

Dr. Kevin Christie: mm-hmm.

Tim Hawkins: By that point, it's kind of too late, right? Yeah. Mm-hmm. So, um, and that's the difference between, I'll say, accounting and where bookkeepers typically lie and, and accounting controller type things lie, they look backwards to make sure that data's accurate, the finance and the CFO is gonna be looking forward.

So, um, where, where that goes. So I would wanna be looking at this monthly, at least quarterly, but monthly we should be driving home what we're seeing. And, you know, what your end of year is gonna look like. Probably by September, if it's calendar year. Um, you know, we we're, we have a good handle on that. And so where that goes is, there's a lot of other things happening.

There's ar that's maybe not being collected. Mm-hmm. Um, you know, there could be equipment purchases that end up. Capitalize on the balance sheet that don't flow through to your profit. Um, and then, [00:08:00] um, things like paying down debt. Mm-hmm. Um, owner distributions. Things that are happening on the balance sheet will absolutely affect cash, but won't necessarily show up on a, you know, on a, a good accrual p and l in your profit.

And

Dr. Kevin Christie: I, I'm glad you broke that down. And, and I wanted to just start with that for people 'cause it does get confusing and then I think it helps us set the tone for where A CFO um, really stay. Uh, really just plays a key role because one of the other things I've, I've said a lot of times is often. Your accountant is kind of the postmortem of the situation, right?

Like, right, okay. It's February, I'm getting to your, uh, 20, 24, uh, numbers and we're gonna file your taxes. And it, it is what it is, right? Like they're, they're kind of doing the postmortem and then obviously submitting things to IRS. Uh, and, and that's, uh, a huge thing that needs to be done. And there's not discounting that.

Uh, but very rarely is the accountant, unless they are designed as a. As A-A-C-F-O, I would, I, I guess, um, [00:09:00] would be really helping you project to say, you know what, yeah, your parameters are are pretty good. Like we just wrapped up Q1 of 2025, obviously as we record this. And so Q1 can, can tell you a lot of things.

And I know for me, I looked at, okay, what was our operating profit margin? We have some goals there and we hit that, uh, was our payroll, uh, within certain parameters that we like and we didn't feel like we were overstaffed or understaffed. Um, you know, cer certain variables there. Obviously we look at revenue and we look at certain things there and we can, uh, start to monitor if we're on the, on the right track.

Um, do you find that Q1, like kind of looking at Q1 can really help set the tone for the rest of the year for, for a practice?

Tim Hawkins: Absolutely. I, I think, um. Was key word there is around budgeting, right? Mm-hmm. And looking at those quarters, so I, I think you use whatever quarter just ended via Q1, Q3, and you're rolling forward, [00:10:00] what's this gonna tell me over the next two to three quarters?

So, um, every quarter matters. They're all very similar. If you have seasonality, understanding that by knowing your quarters is gonna be huge. Mm-hmm. Um. Don't see that as much here, but sometimes, sometimes we do.

Dr. Kevin Christie: Can I, can I say, can I say something to that? 'cause I was, I'm really glad you brought it up 'cause I was gonna mention it.

I'm down in south Florida in Boca Raton, which is, would be kind of like the, the Disney world of, uh, snowbirds. Right, right. And it's, uh, I mean we're just way busier Q1 than we will be any other quarter. QQ four is, is good as well, but I. I looked at Q1 profit margin and revenues and things and said it needs to be like, let's just make an example.

Let's say we wanted a 15% operate, you know, profit margin by the end of the year. If I would've been at 15% or 16% for Q1, I'm gonna probably be behind the eight ball for the year, um, because of what you mentioned around seasonality. So [00:11:00] I think that's the other huge thing of having an expert. Um, in your corner is to understand those seasonalities and where it's like, look, you were 17% profit, but that's not like you needed to be at 26% for this quarter.

'cause this is your, your haymaker here. Um, so I'm glad you brought that up.

Tim Hawkins: Yeah. And your, and your, your business has been telling you that for years, right? So. Um, as, as we use our data points to inform the future mm-hmm. Very specifically to your clinic, geographic region makes a huge impact on this type of thing, and the seasonality piece as well as you mentioned, which is great.

Um, but if I look at what your first quarter in the last three years look like compared to your, your following three quarters of a calendar year. We can, we can make really good projections about that now. And you're right. It, I mean, that could mean you need to make some, some belt tightening on the cost side to make sure we stay safe for the next three quarters.

Better to make that decision in April [00:12:00] than October when you realize that, you know, we're not quite there. The, the ability to have impact on these decisions is so much less the longer you wait. So. Yeah, every quarter matters. Yep.

Dr. Kevin Christie: It, it does. And like a couple things that we did, um, is we, we hit, we hit our parameter.

So I was really happy about that in Q1. But one of the things we learned last year from a, a guest presenter, which was really good, was that we're just slower in the summer. But I kept on, I always waited until the summer to, to start, I. Increasing marketing, um, because I had time, uh, to, to do that. But we realized we needed to hit that more like in April, like right now is to start to look at ways to increase our, uh, marketing presence in the summer.

It's gonna be slower just the way it is, but can we make it better than previous summers? And, and, and that's one of the things we will do is, uh, so I'll. I'll compare quarter over quarter, which is obviously, um, that's what everybody should do. Uh, you, you want to see your trend lines as well, but I, I'm gonna look at my Q3.

So Q3 is our [00:13:00] worst quarter. Uh, 'cause that's gonna hit, um, basically, you know, September, August and July, which is just not, not our bread and butter here. And I'll look at the previous summer and, and then I was like, okay, what if we doubled up our marketing here? What if I took a little bit of the money that was extra from Q1?

And use it into marketing. And so I'm not impacting cash flow on marketing things in the summer. Uh, I'm using reserve money from when it was nice. Right. And so this is some of the things that we've gotten better at over the years is because one of the things I would do a few years ago, or last year even maybe, was like, well, I gotta cut back on the, on the marketing a little bit in the summer, the marketing spend, because our, uh, cash flow's gonna be a little bit tighter, tighter in the summer.

But what I should have been just doing is taking five or $10,000 from the wintertime and putting into a marketing sinking fund there, or whatever you wanna call it, and then utilize that money, but it doesn't impact your summer cash flow.

Tim Hawkins: Absolutely. And you know what else it does? Is it, it increase those kind of actions?[00:14:00]

Those kind of insights and then executing on them increases the value of your clinic compared to other clinics in the, even your immediate area. Um, you know, people are coming in there and you're, you're looking to exit the business. Mm-hmm. You have more value because you're showing much better performance during, say, the slow summer months because the actions you're taking now, which can really pay off at the end as well.

Dr. Kevin Christie: Love it. Love it. So I want to, I wanna segue a little bit, but I'll, I'll prep us for it. And, um, we kind of, you know, there's parameters of having a healthy, uh, one practice location and, and really feeling like, you know what, we're, we're doing pretty good. Um, and I know that it's always, it's always harder with small businesses because a small business could.

Essentially, um, overspending their personal life and drain their business accounts. And so theoretically the business would be healthy if they weren't draining it from their personal life. Um, but let's say that's not the case. Uh, what, what are some of the things you look for in like a healthy one?

Practice setup? Some of the key performance indicators. It doesn't have [00:15:00] to necessarily be exact numbers, but just what are the things you're looking at?

Tim Hawkins: Yeah, absolutely. So, um, and, and, and this is the core tenant. If, if anyone comes to me and says, I'm, I'm looking at. Expanding. I want to open a clinic, or I wanna purchase or acquire a, an existing clinic.

Mm-hmm. Um, you know, there's some very specific questions I ask first before we even get to talking about that, you know? Yeah. First of all, what's the motivation and what, why are you doing this? A lot of times the motivation's wrong, and then where I get indications on that is by looking at the current operation.

And you have to really know your current operation and see where it's operating at full strength, where you might have some soft spots, things that you need to improve on, be it, you know, marketing or, uh, recruiting staff retention, you know, down the road, down the line. Um, yeah. And you need to know those things.

You need to know your KPIs. I I need to be able to wake you up in the middle of the night and ask [00:16:00] you. What your goal, you know, provider capacity utilization is, and you just mm-hmm. Blurt it out and fall back asleep. Okay. You need, you need to build that out so that you're operating as best as possible so that you're moving in a position of strength into this new expansion.

So, um, I wanna see cashflow healthy, not just for the last year. I, I like to see that consistent over a couple years. How you flow through slow points like the summer you mentioned. Um, I wanna see how your staff retention is. Are, are your providers happy and, and your admin staff happy and they stay for a while if you've introduced any new services products?

Have they had enough time to settle down so that we can really see the profitability of them and the, and the value they're adding to the practice? Um, and then what kind of war chest you built up to actually fund and finance and expansion.

Dr. Kevin Christie: Mm-hmm.

Tim Hawkins: Things like that. I'll, I'll add one more, which I think is, is huge around two every [00:17:00] day is technology and, um, you know, we, we have some softwares I that, that everyone uses, some, some key ones in the, uh, in the industry.

And I think a lot of the focus happens on the front end and, and the patient engagement, um, and all that type of stuff that rolls into the billing. But the back end of that software also, there's a lot of data in there that should be informing. More macro things about how the business runs, you know, uh, average patient value or patient lifetime value.

Um, revenue per patient, revenue per visit collections. Um, a lot of times we bill really well, we don't collect nearly as well, those kind of things. So really under seeing how the team. Understands that software.

Dr. Kevin Christie: Mm-hmm.

Tim Hawkins: All these things gimme a comfort level to start talking about, Hey, let's expand, let's open a new clinic.

Let's go make an acquisition.

Dr. Kevin Christie: Yeah. I, I, I like that. And there's a lot of things that we could, um, [00:18:00] kind of chat about from there. And one of the things I wanted to, I. Kind of touch on, 'cause it's tricky. You mentioned collections and you know, you, you could have, um, you know, two clinics and, and one could have a 30% profit margin, right?

I'll say, oh, that's really good and, and everything. And you have another clinic that's got, uh, 15 or let, is call it this, go even lower. It's go like 10% profit margin and you're like, oh, okay, that's, that clinic's probably not as healthy, but. Like if, if clinic a 'cause what I see a lot with chiropractors is they, um, their revenue is so low, right?

Like their, their 200,000 a year revenue, they keep their overhead very low. And so their profit margin is, is pretty good. But what they're absolutely paying themselves and what they're absolutely. Collecting and hoarding away is not a lot. Whereas a other clinic that's at 10%, maybe they're a million dollar or they're a $1.5 million or a $2 million clinic, and so the absolute amount of money that person's able to pay [00:19:00] themselves and support their family.

The absolute amount of money that's coming into the. Business that can be utilized for reinvestment is, is a lot more substantial and can do that. And so I just see a lot of chiropractors, they, they make the mistake. It's almost like they have a badge of honor that their overhead is really low. And I get that.

You don't want to be overhead, you don't want your overhead outpace you and all that. But there is the concept of like, you have to invest and spend money to make money, right. And right. I think that's a key thing that you, someone with your skillset is allow, is able to talk to 'em about, um, do you, do you try to have that conversation with 'em?

Like, look, you, you do have to spend some more money. Or if you got, if you went from this, uh, 900 square foot office to 2000 square foot, you'd be able to double your, um, uh, revenue each week or, you know, have another provider or two and things of that nature. Is that some of the stuff that you look at as well?

Tim Hawkins: Absolutely. I, I think the way I would approach it, so the simple way to approach it for me is to, to set a mindset, [00:20:00] um, about what the expectations are on the, on the business, and

Dr. Kevin Christie: mm-hmm.

Tim Hawkins: I'll break it down into a few pieces. So when you look at a pro profit and loss, you got your top line revenue, your gross revenue, you got your cost of providing the services as in the center, and then you have your support costs underneath.

The final piece at the bottom is, um. Net income, E, we we're gonna say EBITDA because mm-hmm. I like to focus on ebitda. Yep. Which is earnings before interest, taxes, depreciation, amortization, just for the proper noun there. So I look at those four pieces and what, where I start with somebody is I say, okay, for every dollar of that top line revenue.

Mm-hmm. Let's just start with the idea of 50 cents. Of cost is going in to provide that service. So I have a dollar, I use 50 cents for for providing the service. Mm-hmm. And then my goal is to use 30 cents to support the providing of that service. Mm-hmm. And then 20 cents on ebitda, which is basically the profit take home.

And you know, those fluctuate. [00:21:00] I wouldn't necessarily say that's every clinic, I think. Mm-hmm. Probably get down a little bit more, like 25% on that support services and 25% then on ebitda. And, and then we start tweaking those bells, right? But, um, and then if and why, and so why I'm answering your question that way is mm-hmm.

Once I set that parameter, I come in and say, you're, you're spinning 10 cents on support cost for the revenue you have at the top. Instead of 20 cents or 25 cents or 30 cents, what are we missing? And, and what is causing us to squeeze our business that tightly to not, um, spend what would be a traditional breakdown of a business's p and l.

And by coming in from that angle, I'll start to see little hints. A lot of times it's around collections. A lot of times it's billing efficiency, things that are happening. Um, you know, client feedback marketing is a huge one, right? Yes. So people aren't spending [00:22:00] on marketing because. They're afraid that that next dollar won't come in, and then there'll be the, the, those little breakdowns will, will fall.

But if you're not spending that little, that piece of the dollar on that support, it will affect your top line revenue. It will affect your profit.

Dr. Kevin Christie: Absolutely. And it's, we have a big issue in our pra in our, uh, profession, where a lot of people are very weary of spending money on marketing. And it's really hard to scale when you don't do that.

Right? Like, it, you, you know, there's a lot of people, again, will, will, will have a, you know, hang their hat on the fact that they built a referral-based practice and they don't do any marketing. And it's fine if you just want to be one provider, um, and do all that. But typically to add a doctors or to really grow revenue with profits, and, and again, if you want to.

Have a second location or more, you're going to have to have a marketing spend that is, is obviously strategic and, and has a return on it. And, uh, chiropractors have to get outta that mindset of just not spending money on marketing. [00:23:00]

Tim Hawkins: It's, it's a, you know, diversification is huge in, in lowering your risks.

Right? And you have risk all across being a business owner and, uh, marketing is really about creating brand. Mm-hmm. One of the things you can do with that marketing is, you know, building different patient channels. Say you are heavy on the referral marketing market part. Mm-hmm. Right. Or, and you do a lot with insurance or Medicare or, you know, personal injury stuff.

Um, building out those others, starting to invest now mm-hmm. Could be one thing that really keeps you afloat and ahead of the game when there's a downturn for some reason or a change, you know, five years from now. So I, I completely agree. And, and building that brand takes time. It's consistent marketing over years.

And that, that adds a huge value to your, to your business when you do wanna exit. Well,

Dr. Kevin Christie: it, and it does. And I think the other misconception, and I won't spend too much more time on the marketing, but is that, uh, it's just ad spend only. [00:24:00] And they're thinking of that, uh, that's obviously part of it, but it could be things, you know, like if you wanted to get more personal injury patients.

If you spent 500 to a thousand a month on, um, lunches with attorneys and dinners, you would probably generate more business. If, uh, you wanted more MD referrals and you, if you spent 500 to a thousand a month or even more on md uh, meetings and lunches and things like that, you would probably get more MD referrals, and that would have a much better return on investment because if you know what your new patient is worth, let's say it's worth $1,500 on average, and you spent 500 a month on md.

Lunches and you start getting a few MD referrals a month. I mean, that's a direct ROI and that's how you would scale your marketing to, to grow. And so, um, highly, highly recommend that. Um, the other thing I, I want to just bring up real quick, and one of the things we did is, is, um, we recently, a year ago invested in, in technology.

We did shockwave and you know, those aren't cheap. Um, but we're, we're gonna generate. Probably close to a hundred thousand this year. [00:25:00] Uh, we're on pace for that in new revenue. And it wasn't that, it just took it, I mean, maybe some patients would've gotten our regular care and not shockly, but a lot of 'em iss just new money and for a pretty reasonable investment in doing that.

And we're getting better outcomes with certain conditions. So it helps drive referrals. Uh, do you also help chiropractors with knowing when to get equipment? Does it make sense to buy it outright? Does it make sense to finance it? Uh, things like that.

Tim Hawkins: Absolutely, because that's all part of the decision, make, uh, process around the numbers.

And so that immediately to have that conversation be informed, we need to be confident in what. Mm-hmm. The last few months have told us what our balance sheet really looks like. All lot of times it's about cash. Or how easily we could finance equipment like that. So, um, that's, that's a key component of, you know, any kind of expansion, be it equipment services or a new clinic expansion, you know, in other locations they're all very similar and [00:26:00] they're all finance based.

Dr. Kevin Christie: Do you also in a, in a. Smaller, uh, business type of setting, like most chiropractic offices are. Do you also work with the doctor on also kind of tying in their personal findings and making sure they're not bleeding the business from that side of things? Do you, do you have those discussions?

Tim Hawkins: Yeah. You know, more and more every day I've, I've, we're almost starting to market ourselves as holistic.

Yeah. Um. Uh, advisors because there's so much that happens on the personal side, and there's so much need over there that the current structure of the business is never gonna support that. Eventually you're gonna squeeze one to bankruptcy, right? Yeah. Either the business or you, or both. So it has to be part of the conversation, and I think it also has to be part of the conversation as to where you are mentally, right?

It's not just how you're spending money. Sometimes that's a symptom of. Where you're on your personal life art, if you're, if you're needing to double down on retirement savings for [00:27:00] some reason, or mm-hmm. You know, you have young kids at home, or you're putting kids through college, those are all questions that need to be part of the discussion before you do any kind of big investment and expansion or something like that.

Dr. Kevin Christie: Yeah, because it's, you know, uh, I'm, I'm, I'm in my mid forties and it's one of those things like if I were to, um, decide to open up a second location, I would have to have that conversation with my wife and say, you know, look, um, uh, we're gonna have to maybe not. To utilize money in our personal life for this, and let's go a little lean this year on the personal side, uh, and let's reinvest money into the business side for some delayed gratification and then ultimate growth because, yeah, I mean, as a small business owner, if you, like you mentioned award chest, if you developed award chest of a hundred thousand dollars.

Uh, you could easily take that money and get a whole new, like, uh, roof for your house, right? Or upgrade, upgrade the kitchen. I mean, it's your money. You don't have a, a board to answer to or stockholders. Like, you could [00:28:00] take that money and buy a second, put a down payment on a second home and, uh, the Carolinas, right?

And so you gotta get clear on what your family goals are, uh, what on what you're gonna use that war chest for. And you obviously, you would probably want to do that prior to accumulating the money. Um, but, uh, I, I, I'm glad to hear that, that some of the conversations we're having people 'cause this, it seems like it's such a massive component of this whole thing.

Tim Hawkins: It is. And, and that war chest, that, that the term I use, which I love, I, I think a lot of times that is on the personal side, so immediately have to swing back there and say, okay, you've been able to take this much money out of the business. Is it going somewhere where it's sitting or has it all been spent because that's, mm-hmm.

A big part of the protection on the downside risk of, you know, opening a new location. Um, and you know, a key part of that too, I'll say, and this is where a personal financial planner working with a business CFO or in a communication, you know, between folks like that is the opportunity cost. Because one of the things I was gonna look at is I can certainly help walk [00:29:00] through all this strategy to expand the business, but you, you gotta ask yourself, is that the best use of.

My, my reserve funds, is that the best opportunity for me to make money? You know, based on the conversation, we may say, you know what? Stock market's actually gonna be better than this, so why take this risk? And, and those, you have to have those clear-eyed conversations before you dive into something like this.

Versus just push button saying, I'm doing well, let's, let's open another one and do, well double.

Dr. Kevin Christie: Yeah, and it's a, it's a good point. And you mentioned it like you, one of the first questions you asked 'em is like what their vision is and what their reasoning for wanting to open up another location or more.

Uh, because again, yeah, it, it may not be the best use of your, of your investment to, to do that. You may be more wise to just expand and grow your one location, um, depending on what, again, what the goals are. Um, and so that's, uh, definitely fascinating. Or like you said, just investing, you know, maybe buying that, uh.

Second home that's gonna appreciate and you're gonna enjoy it on [00:30:00] weekends with family. Uh, maybe you're at that stage of your life where grandkids are coming and you want a place where the whole family goes to. Right. It just all goes into uh Right one, one's vision. Um, that's cool. And then, uh, just I guess the other last kind of question I have, and we can chat about this a few minutes.

Do you also start to try, do you do anything? Let me re kind of rephrase the question. To try to get a beat on or gauge a person's risk tolerance in this. And it's like, look, you've got this money here, but let's keep that on tap for emergency, and then let's maybe see if we can get a bank loan to do a second location.

Uh, or you know, just what are some of your thoughts around the risk tolerance of it? Because obviously everybody's different and some people can be, uh, Elon Musk and some people, uh, cannot. Uh, yeah. And we don't have to be that to, to obviously open up a second location. But what, what are some of the things you do to try to gauge that?

Tim Hawkins: So, uh, that's a great question and that is absolutely underpinning the vision, motivation why questions that I asked in the front end because, um, if, if I haven't been [00:31:00] working with you to date, I really don't know how you're coming into this and mm-hmm. There are so many facets to the risk part, um, how you get the money.

So you don't necessarily need a war chest sitting in your personal bank account. Mm-hmm. I mean, you can get a loan from a bank, you can get financing from whoever. The acquiree is a lot of times is cell phone business. There's a lot of these options on ways to get money to, to finance an expansion. But y if I don't real, I need to understand on the front end if you're gonna be losing sleep for the next four years because you have banked it, like there are people who just can't deal with the concept of having bank debt, knowing other people money.

Um, I would never, I, if, if I don't know that ahead time, that's gonna be a headache and a torture for both of us over the next few years. Yeah. Um, and so yeah, understanding that risk tolerance is huge and I, I, and that's imputed in all of my conversations with clients. I, I will guide them to specific [00:32:00] tax providers based on their risk tolerance.

Your risk tolerance should match the risk tolerance of, of the person giving you tax advice. Otherwise, there's gonna be. Sleepless nights, there's gonna be anxiety involved in that. And as if you're gonna expand to another clinic, you know, we talk about risk and, and that kind of thing. And your tolerance for it.

Your role's gotta change. I mean, you're maturing into a CEO from a, from a practitioner a lot of times, and that's a huge change. It's, it's really a different dynamic. And what happens a lot of times if you don't approach that clear-eyed you, your, your risk tolerance is. Or, or your, you know, the, the ability for you to handle the risk.

If, if revenues are a little bit low, suddenly you end up at the new location, you know, seeing patients when really what we need is you to be doubly focused on the overall macros about how we're getting this up to speed and, and how, you know, just, and also not putting the old practice or the old location on cruise [00:33:00] control.

All this all buys into your ability to how you react to risk. Mm-hmm. Which is one of the reasons I love to work with. Um, business owners for a little bit before they make a big decision like this, because that's all kind of then inherent in our conversations.

Dr. Kevin Christie: Yeah, you know, it's, uh, I've seen situations, I'm sure you have too, where they open up that second location and then the first location starts to suffer 'cause their bandwidth is spread thin.

And that's that opportunity cost that's there. Um, and that happens. And yeah, I think everybody's, uh, relationship to risk is, is a reality that you have to take on. Um, I. I think I do see a lot of people, and maybe you're seeing it as well, obviously private equity is getting into the chiropractic space and, um, they, they tend to like multi-unit businesses.

Uh, I don't know if there's a magic number, but I've heard like having 10, uh, locations would be really good to have a private of equity equity person come in and, and, and swoop them all up and have your big payday. Uh, is that some of the stuff that you see certain chiropractors working [00:34:00] towards?

Tim Hawkins: Yeah, I don't, I don't think you need to be quite as big as 10 to be seeing that.

Once you're, once you're above three or four, I think you start to see those conversations start. And, you know, when, when we get into that conversation of, of a bigger business and, and more locations, um, you, your, one of the key factors to always talk about is that your buyers are changing.

Dr. Kevin Christie: Mm-hmm.

Tim Hawkins: Your acquisition pool, your eventual exit.

Now you are dealing in the private equity world, venture capital world a lot more clearly. Mm-hmm. And, and the pool is much smaller, right? Mm-hmm. And those guys are much more influenced by the macroeconomics of, of, you know, where we are, you know, economics countrywide internationally. So, you know, you could suddenly, when your exit exit point hits, that could dry up and you're not gonna get a single clinic oftentimes buying a a five clinic.

Practice, especially not at the premium, right? So, mm-hmm. So, you know, that goes back to, so we do see that, to answer your [00:35:00] question, and I think that goes back also to the transformation of the chiropractor, business owner to, to have those conversations. Um, you're, you're, you're building yourself as a CEO.

You're developing yourself as a CEO and not a technical practitioner anymore. It takes a little time. And you need advisors alongside. You need good legal advice. You need good finance advice too. You need those wing people to help help you make those decisions, but it's

Dr. Kevin Christie: a key

Tim Hawkins: point.

Dr. Kevin Christie: It's been great, Tim, I I'm gonna, uh, leave everybody with one little thing.

You know, I, it's okay to be good at business and be a doctor. I think there's a misconception that, um, they, a lot of chiropractors just want to be doctors only, and if they try to dive into learning about business, uh, then it's gonna take away from them as a doctor. And it's just not the case. Your, your career is gonna evolve.

Uh, I think being good at business means providing the best patient experience, hiring grade, developing a team culture, understanding marketing, understanding growth. Um, because if you don't have that growth, it's gonna be [00:36:00] hard to have, um, a thriving practice that you feel great about. I. And, and it ultimately are the best version of yourself as a, as a chiropractor.

Uh, and so I think stuff like this is where you need to start learning it. And, uh, as strategic coach would say the concept of who, not how, which means find a who to do it for you and not how to do it yourself is also important. And, and on that note, um, if someone wants to reach out to you, uh, how can they find you?

Tim Hawkins: Yeah, absolutely. Um. It's probably best to my direct contact t Hawkins, HA wk i s@lbd.com. Is is a good way to reach me and, and just gimme a call 5 7 1 2 6 3 13 44. Uh, we're revamping the website so probably can find it there as well. www.ltd.com Larry time boy dog.

Dr. Kevin Christie: Perfect. We'll, uh, we'll put that in the show notes.

Well, thank you for this, uh, great, uh, wisdom in the chiropractic profession, and it should just be the kind of tip of the iceberg for our audience to [00:37:00] realize they need to understand this stuff.

Tim Hawkins: Thanks, Kevin. Glad to be here. I.

 EPISODE 423: The Integrated Practice with Jonathan Saigh 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. 

[00:00:00] Alright, Jonathan, really appreciate you, uh, hopping on this podcast today. I'm excited to, to dive into it. We, uh, got to know each other last year in the Mastermind and it was a, it was a pleasure. And then it was cool to see, uh, your team share with us the integrative clinic that you have. But before we dive into that, uh, just tell us a little bit about yourself personally and professionally.

Yeah, thanks for having me on, Kevin. Uh. Like you said, the Mastermind last year was a great time. We really enjoyed it and took a lot away from the group. Um, not a true plug for the Mastermind, but if anyone's on the fence, they can always call me and I will definitely be a, a reference for it. It was a great time, but, uh, yeah.

Jonathan say outta Wisconsin, uh, originally from Michigan. I grew up in a small town with actually one of your other podcast guests that we were texting about Jeff Moore. Uh, he was a little bit older than me, but he's a physical therapist that he just had on a few weeks ago. Uh, so small world, but uh, yeah, that was funny.

Yeah, it was a little crazy. I listened to that one. He's, he's still has much energy as I remember. [00:01:00] Uh, you know, I looked up to him. I was in middle school, he was in high school. He and his brother were good athletes and my brother and I were younger and than, than they were. And, uh, so just kind of small, but I remember he was full of energy all the time.

Jeff was so glad to see he still got it. Definitely. Um, but yeah, went from Michigan, went to University of Michigan, played football. Um, uh, offensive line. So, you know, really learned a lot there, had some challenges, uh, as far as some medical injuries that sidelined me for years. Um, you know, careers never go the way you want, always end before you're ready for them to end.

And that really taught me some life lessons early on when I wasn't ready for life lessons. Yeah. Um, and still use those today, but that's kind of where we are. And then went to Logan University and, uh, met, uh. Good group of people that I'm still, you know, in business with, one being my wife. So she went to school with us.

And then, uh, my other two, uh, best friends, uh, Nick and Emma. So we've got a group of us that you have stayed together for. Coming up on, you know, over a [00:02:00] decade now, which is quite amazing. Yeah. So you don't see that, that's, that's, yeah. That's cool. And, uh, I guess they didn't have a lot of NIL money back when you were playing, so you couldn't retire outta college?

No, it was all illegal. You know, if you were taking a, a free burger or, um, you know, a dinner somewhere, um, it, you know, it happened. I have no. Well, I'm saying it now, but yeah, we would go to pay our check occasionally. This happened to you once or twice in my career, but your check would be paid for and nobody would even be there to like think.

But uh, that was technically illegal. We're supposed to report that to the ncaa and yeah, it's a lot different now. A lot different now, a chuckle, but I would've, uh, I think I a different college experience and would've leveraged. Um, my NIL, you know, like everybody does now. Um, yeah, leverage it for, for long-term gain, but, uh, it's, it's interesting how it's changed.

It is, it's fascinating. So let's, um, let's fast forward a little or rewind a little bit, but graduated from, uh, [00:03:00] chiropractic school. Did you work for anyone before or did you just dive right into practice ownership? You know, it's funny you bring that up. We have a, a joke here. Uh. Nick, uh, he's, he's funny, but, uh, I worked with Nick and, uh, he made a comment one time that, that my GPA was so bad I could only employ myself.

Uh, kind of true with my undergrad GPA, but not my chi. My chiro school was much better, but no, never worked for anybody, knew I couldn't because I had a vision from, uh, before I went to Kyra school. Mm-hmm. Um, my dad, uh, was a primary care physician, family physician, small town, so I always knew that. My practice was gonna be different than a traditional chiropractic office.

It was never gonna be siloed into one service line. And I went into chiro school with that mentality of being open to working with other disciplines. And, um, therefore, I knew I was gonna struggle working with anybody else. I couldn't, you know, couldn't work for somebody with the vision that I had. And because I think mainly a lot of 'em don't [00:04:00] have the vision I had from the beginning.

Um, so yeah, nothing against it, but I just was not right to work for anybody else. So I, I waited, took us a while, we bought our own practice. Mm-hmm. Um, but I think it was nine months after graduation or maybe like 10. And then we purchased a, a practice that kind of did our model, which is similar to, you know, how you practice chiro rehab.

Mm-hmm. And we knew it was gonna be a little easier fit to integrate. Um, and then quickly learned that there's nothing easy. Yes. Uh, so that, you know, if it was easy, everyone would do it. And there's a reason why not many people do it 'cause it is challenging. Mm-hmm. But it was what, what we wanted. And I had envisioned for years, and thankfully my wife and my friends were on board for the ride, so, mm-hmm.

That's cool. And then the practice you bought, what, what did it look like, uh, as far as a service? It did offer, obviously, you know, chiropractic, you mentioned some rehab. Was there, uh, some other entities in that or, you know, what did that look like? Yeah, so it was Cairo Rehab. Um, [00:05:00] I. And it was, it was pretty decent model that it was set up on, but it was all work comp, personal injury, that was it.

Um, okay. No Medicare, no commercial carriers. Um, 70% Spanish speaking, and we're south of Milwaukee, Wisconsin. So that was a little challenging to get into. Uh, the other portion of it, it was, I went in pretty eyes wide open, but. We don't know how, uh, but the revenue was about one third our first year from what we expected it to be based off of the, the previous three years tax returns to back it up.

So we did all our due diligence correctly. Uh, but still, it, it didn't make money. And, uh, you know, we went in and my wife and I didn't take, um, any paychecks outta the practice for 34 months. So lived with her parents and commuted 80 miles a day for three and a half years. Um, but really put the grind on and.

Uh, so that's kinda what it looked like originally and we had to revamp it because it, you know, wasn't profitable. It, you know, broke even that first year. Um, and another thing I did is [00:06:00] two months after we purchased the practice, I brought, um, my good friend Nick over and, and paid him. So he, he got paid his second year, 25%, raise his third year, 25% raise from that new salary.

So really committed to him and to, to building something bigger than just. You know, a one or two person operation. You know, my wife and I, so from day one, I took a lot of heat from a lot of people on paying somebody else without taking a salary myself. But I committed to the growth and the vision that we had and committing to that.

I wish more people had the delayed gratification. Right. Where you really put the work in. And, um, and then ultimately you're gonna, you're gonna see that, and that sometimes as an owner, uh, yeah, you may not be the one making the most money in the clinic mm-hmm. But you're building something that ultimately down the road, uh, will, and then you, you mentioned your vision early on, what's, you know, and, and I just, I wanna frame it as well, uh, Emma, who is also in our.

Mastermind that year. She was, uh, she was kind [00:07:00] enough to share a video that you guys had put together, uh, which was really cool to watch it and see your vision and why, uh, really come to light. But before we dive into where you guys are at now, uh, you know, what was the why of, of building a clinic that was integrated even from when you knew the vision in chiropractic school?

Uh, what was the why behind that? The, the why for me was in chiropractic school, they drilled into our heads, you know, roughly 10% of of people in the United States see a chiropractor and then it's 90 plus percent allopath medicine. And I looked at that stat early on, you know, with my, my, uh, family background that, well, why would I limit myself to that small percentage of, of people, you know, there's so many more people that we can reach.

So my vision was always. Go, go after that additional portion of the population with the conservative mindset and, and really like there's a way to do allopathic medicine that is not just drugs and surgery. [00:08:00] And that's how I went into it and knew that we could reach more people, um, with an expanded model, expanded service lines, offering that allopathic model, but differently.

And, and what really happened when we first got in, we weren't big enough to, we didn't have the finances to do that yet. Um mm-hmm. But you've come, you've come across this. Every, every physician you know has, you refer somebody out and their patient experience is horrible. It may be a good provider, but the patient experience is really bad.

And then the patient comes back to you slightly upset that, well, you sent me here and it was horrible. I didn't get in for two months. I got in. They didn't review my case, they just gave me this. They didn't even talk to me in the room. Why did you send me there? So we realized. We wanted to control that, and then we just had to figure out, work backwards.

Okay, how do we get to this point? How do we get there? How do we control that patient experience? But really put the twist on it of the conservative chiropractic mindset, and not necessarily dictating care of the medical providers, but just, Hey, here's the research. Here's what we can do. We don't [00:09:00] really wanna push this, this, you know, uh, sector of what you legally can do as a, uh, position, mid-level.

Whichever you go with, but you know, really, here's what the services we wanna offer is, that's something you're interested in. And, and once we got into it and our reputation got out there, I mean, people started outta the woodwork, mid-levels, physicians loved it. You know, they wanted to refer to us, they wanted to work for us.

And it just, you gotta get through that delayed gratification period, like you said, and build the reputation and then people will seek you out for it. Yeah. I, I love that. It, it, it really stood out to me where you said kind of allopathic model, but without the drugs and surgery, in a sense, you're kind of putting a twist on it.

And then it is something that we sometimes fail to realize is how bad it is out there in a sense of mm-hmm. The experience that most patients are getting in the medical model. It's just, it's a really bad situation and we can do it from a different angle. 'cause I think we as chiropractors come at it from an angle where we [00:10:00] have to have.

Patient first. We have to have a good experience, uh, because if we don't, we're just gonna die on the vine. And so we, we have to have that and be able to, to marry the two and, and control that patient experience. Uh, yeah. And another thing that with that was I, you know, I knew that there's, there's other services that benefit patients that chiropractors just can't do, right?

Mm-hmm. Physical therapy, uh, sure we had a kind, a rehab model, but then we were limited on, we, you can't do physical therapy to Medicare patients. Okay, well, how do we, how do we. Do this properly. Okay, well, we have to bring on a physical therapy team. Mm-hmm. You know, physical therapists and you hear a lot of, well, PTs and dcs, they don't like each other.

And it, it's really an individual basis if you're running the right operation with the right vision and you can get people on board to buy into it. It's never an issue on the credentialing of the individual provider. Either they're onboard for your, your vision of what you're trying to do to your community, serve your community, or they're not, and.[00:11:00]

We've been in this for nine years now and we've had people who aren't on board and we have people who, who are. So really going through that process, that hiring process, and explaining your vision. Patience first. I think I brought this up in the mastermind to you. You know, my two rules. Number one, is it good for the patient?

Number two, is it good for the business? If it's not, if it doesn't pass, number one, we don't care about number two. Mm-hmm. And you get this all the time, you know, uh, down in Florida that you get a vendor walking in and telling you how much money you can make on this. And we do not care. Like you ju you build a business around how much money and revenue you can make in profit margins.

Patients will sniff that out. Employees will sniff that out. You will not be successful. Uh, so that's really what we built it on is rule number one. Is it good for the patient? Mm-hmm. And that's what I'm always about is going back to my athletic past is, you know, tell me I can't do something or I'm not good at it, and I'll just smile.

I'll walk away and then we'll come back and prove to you that we can in the proper way. And that's what we've done. You know, said, [00:12:00] well, you can't, uh. You can't do this as a chiropractor. Okay, watch, you know, I remember all the instructors back at Logan and, uh, well, you can't do that. Okay, well, let's see how, if we can't do it in 10 years, so.

Quick question. Well, it's been tougher, uh, blocking a player that ended up playing in the NFL for a long time, which I'm sure you did. 'cause you played at Michigan, uh, or some of your business challenges. Oh, business challenges because you get your ass kicked in football, you can, you know, you rub it off, you get back up, then you go back to line to do it again.

Business, it, it can affect not you, but the rest of your people. I mean, we have 45 families now that we. Provide for, for, we're, we're not, uh, you know, three, four employees anymore. So yeah, football. There's a couple. Brandon Graham was a teammate of mine. He just retired from the Eagles, just won his second Super Bowl.

Yeah. Um, some other big names, you know, Lamar Woodley was another defensive player I used to go against all the time. Just, uh, I'll never forget, I one play, you know, in [00:13:00] practice did well against Lamar and he got mad and he said, okay, I got you in the next one. And sure enough, he threw me like a little rag doll and I was 296 pounds.

He threw me in the air like I didn't exist. And he said, I told you I got you. And that was it. He walked back to the huddle and you do it again and. Um, but no, I think business is the more challenging one because there's more on the line, you know, in, in athletics originally it's your ego, um, you know, all the hard work you put in.

But then business, it comes down to there's more riding outta your family, your employees, families, uh, team members. Uh, so there's just more, I think, on the line in business, especially when you get to kind of a level where you're, it's not just you and a and a receptionist, it's you and a full rehab department.

Medical department, uh, you know, billing department, you end up having departments no longer just a few employees. And that's, I think what I, uh, I lose sleep over that, you know, I want to do right by them. Mm-hmm. And not just, just me anymore. And that was a big [00:14:00] shift and I had to shift, make that shift early on, probably a year, two or three where I, okay, we're at 10 plus employees now it's, you're no longer.

Yeah. You can call yourself head honcho, but. No one else cares. It's really can you provide opportunity for them? Can you put a roof over their head? That's what I really strive for. And, and day to day, that's, that's really what keeps me coming to work, uh, nowadays. Yeah. I love it. So let's, uh, let's fast forward.

You mentioned nine years, uh, the business, uh, since you bought it, I assume, and we got kind of the picture of it early on. Now give us the, the, the picture now of what the, the clinic looks like, the, the space and the team. I know it'll be hard to go through all of, but just kind of a, a nice overview of where we've gotten in nine years.

Yeah, the clinic shifted. We were in about 4,900 square feet. It was a great setup for a Cairo rehab office. Um, and we made the medical model work there and we just, we knew we needed more, so we actually just shifted [00:15:00] down about half a mile down the same street, and now we are 11,000 square feet. Uh, 45 employees.

Not everyone's based here. We have mobile teams that kind of travel the state for some of our medical services. So we have a fleet of vehicles. Um, I think on day to day we're probably 35 in office, and then 10 are either remote workers or, uh, medical teams that are traveling. Um, so yeah, it's, it's a juggernaut now.

It used to be 36 people in a week was a busy week. 'cause we were three days a week when we first started. And now, you know, if we don't have 36 by noon, something's wrong. Somebody has, something's gone haywire. So it's completely shifted. You know, it's, we are not a high volume clinic. We just have so many employees that we can handle.

 More volume. So we are not a two minute appointment type. You are doing rehab or physical therapy plus an adjustment, potentially medical visit, depending on what your treatment plan is. patients are here for a while. 45 minutes to an [00:16:00] hour and a half depending on what they're getting.

Mm-hmm. Uh, and we'd really pride ourselves on our waiting room was really small, and when I designed the space, I built it that way. Mm-hmm. We only have maybe 10 chairs, and if there's more than three people in those chairs that are existing patients, not a new patient, something's wrong. We get people in and out, everyone's on time.

We'd run a pretty tight ship. Patients know the expectation, you're on time and they show up and everyone's pretty good within a few minutes. Um, but yeah, we're, we kind of funnel 'em in and lack of better terms. You've heard them like cattle in and out. Mm-hmm. Uh, we have kind of stations, right? They, they go through and we, we've laid out the clinic while that it flows from one end to the other.

They're not backtracking too much when they're here. Um, but. We're kind of unfortunately, or unfortunately, I don't know, with quickly two years now, we're out of space a little bit. We're getting there. So, you know, what do you do? And uh, my head is on the chopping block physically, so yeah, [00:17:00] they're trying to tell me you need to start mentally preparing to move out.

So, uh, did you buy the space? I, I recall. I did. Yep. So we did an SBA 5 0 4 loan, so the building's 33,000 square feet. We have 11 of the physical space, but for the 5 0 4, you get the common area as well to meet the 51% requirement. Uh, pretty cool program if anyone's interested in that. Mm-hmm. A lot of red tape.

So yeah, that's what I, that's what I did. Yep. Yep. Yeah, so you're familiar with, I think we talked about it at one of our events. Um, it, it can be a good program, but the bank does own you afterwards. You just have to be comfortable with that. Mm-hmm. You know, they put a lot of requirements on you. So, um, and, and I will say commercial real estate is not for everybody, especially, you know, I've eight tenants in this building, multiple tenants across other buildings, and it's, it's a different job.

But, um, if you're into it, it can be rewarding. It's just you go in with eyes wide open. It's, it's, uh. It's a different business model, you know? So yeah. Now, [00:18:00] now, um, can you move into some of the other space you have or is it all occupied and it would be hard to, to take over more space within your own building?

Yeah, we're, we're fully occupied, but we do have one that is coming up that we might take over, but yep. We have other locations that I can go to. Mm-hmm. So we do, we do have another office space that we could jump over to, and that's where I was going to go. And, uh, probably we will see what happens through the summer, but that's where I'll end up.

I already have the space, so I prefer to rent this. This is a prime location, a new, uh, supermarket just went in across the street. So it makes sense to rent this one, um, that other space that's coming up, but we'll see what happens. Yeah. Nice. You never know, right? You forecast out and then everything changes and that's the fun part of the Yeah.

You just gotta keep options open.

Yeah.

Um, so tell me, okay, you got, obviously you got some dcs. Uh, do you have medical directory, have, um, any mid-levels? Like what are some of the different types of positions you have within the clinic now? Yeah, so I think we have three, three MD supervisors, [00:19:00] uh mm-hmm. We have five or six mid-levels, um, two PTs, uh, PTAs, athletic trainers, um, we call 'em techs.

So, uh, chiro tech, uh, physical therapy techs. We have both reception care managers, billing liaisons, uh, that these are all onsite people still. Mm-hmm. Um, then from there we have virtual assistants that run some of the backend items. That's, that's awesome. Um, now, you know, I, I think one of the things I wanted to get from this too was that, um, other than just like some of the logistics of having a, a medically integrated clinic, but it's just the idea of, you know, thinking bigger.

You know, like any advice to doctors on, on thinking bigger and strategies of having a, a growth mindset around it. And it doesn't necessarily need to be. An integrated model, but just some of the stuff, uh, you know, whether it's good or bad, but just some advice on, on thinking bigger. 'cause I do think we, uh, maybe [00:20:00] our profession suffers from thinking bigger.

I agree with that. And, and full disclosure, you know, I'm not a chiropractor. I never have been. I. And I went into Cairo school knowing that I knew I was not gonna be a chiropractor. And that's no offense to the pr, to the profession. I love the profession. It's, it's obviously given me everything I have in life, uh, saved me from, we didn't go into that, but my athletic past, that's what saved me.

My roommate's dad was a chiropractor. Mm-hmm. Um, with my injuries, you know, he, he enabled me to stay at, at the university and continue to play. And without him, I, I would've. Given up my career after my freshman year. But, um, with that, you know, I, I don't look at myself as a chiropractor, never have. Um, and I officially stopped practicing, I think about five years ago now.

Um mm-hmm. So I'm a real estate professional. Mm-hmm. Technically, and it, it's bonafide. I mean, I have a dozen properties now and that's what I manage on a day, day-to-day basis. Uh, still involved with the practice, but I manage the managers essentially here. So I'm not adjusting people anymore. Uh, but I think the biggest [00:21:00] thing on the growth mindset is you have to be willing to evolve, right?

We ran into some roadblocks early on, um, and it was about Medicare specifically with pt. We, we knew our patients needed physical therapy, rehab. We can't give away the service for free and we can't bill for it. So what do we do? Do we just refer them out to somebody else, back to the hospital or back to another A TI Athletico where we know they're gonna complain about the service.

They're, the providers aren't gonna listen to our orders, they're gonna disagree with us. There's no collaboration. So they're gonna treat the patient and then we're not gonna find out about it until we request the note three weeks later and it's gonna take them three to four weeks to get us the notes.

So now we're two months into their treatment over there, and we don't know what the heck is going on. So like having that growth mindset of when a problem arises. Not giving up on it, realizing there has to be a way around this. Let's think about it. It might be hard, but what are we gonna do about it?

Mm-hmm. Rule number one, is it good for the patient? We disagreed with it being good for the patient to refer [00:22:00] them out for that. So then we brought it in, okay, how do we do that? Physical therapy specifically? They opened it up with Covid that it could be a telemed position. So we took advantage of that in 2020.

And then when they shut it down, uh, I'm blanking if it was 21, 22, whenever they shut down the telemed, then we offered our physical therapist full time, and she moved from Virginia. Her and her husband relocated from the military. He was getting out, so they came here. And that's just, that's just how we look at it as, as.

That willingness to evolve and, and just not take a, a, a change or a problem, you know, at face value and stop looking into it and stop pushing, pushing the envelope. Um, so that was kind of one of it. And then the other part with that, you know, evolving is you as an individual have to evolve. You are not the same provider.

We've talked about this with Brett, uh, Winchester, Mark King. You know, I've known those two for 15 years now. Both mentors of mine, of mentors of yours, you know? Right. They were at the Mastermind. It's, [00:23:00] you're not that same provider that, that you were when you graduated, when you started practice those same, that you were five years into practice and realizing businesses is like that as well.

You're not the same business owner. That you were when you started. I, I know for a fact you weren't. Right? Like we've had conversations. It's, you, you, it's never a, a, never a linear path. There's going to be ups and downs, and with that experience, that scar tissue, you learn, you evolve, you become better. And that goes back to my original introduction of the athletics.

Mm-hmm. Right. Getting, getting your butt whooped by people who are better than you, pushes you. Mm-hmm. And we really just have that mindset on the business side. And that's what's always been my growth mindset, is I wanted to help more people than were willing to be helped by chiropractic alone. Mm-hmm.

And some people disagree with that, and that's okay. I respect their, their opinion on that. And, uh, we just have that mindset of we want to help as many [00:24:00] people as possible. Um, and, and we, you know, we do other services here. We mm-hmm. We almost give providers the same opportunity that we give patients. We give providers the opportunity to collaborate with other specialties.

Um, you know, we have an anesthesiologist who does pain management and a surgery center here for us, with us, I should say. It's never for us, it's always a team member or with us. Um, you know, we just, Nick just got off the call with a podiatrist today that wants to come in and start collaborating. Mm-hmm.

And, you know, utilizing our hyperbaric oxygen chambers, we have two of those and our surgery center. Oh, great. That's wonderful. You know, just that, that willingness to be open to change. Um, is, is is tough for some people 'cause change is uncomfortable. But we've really leaned into being comfortable when you're uncomfortable.

Lloyd Carr was my college coach, and mm-hmm. He taught us that. Yeah. Um, control what you can control, number one, and then be comfortable with being uncomfortable, number two. So, [00:25:00] uh, that's just kind of where we are in the growth mindset. We're, we're never satisfied with where we are. We do celebrate the wins.

Um. We just know we have more as a team and as, as a company than, than just being satisfied with, with doing what we're currently doing. Um, so not everyone can get on board with that vision. Let me be clear about that. Mm-hmm. We talked in the mastermind quite a bit about, uh, how hard it is to, to find employees that are aligned with your vision and um, you know, it's a constant challenge there, but.

Once you can get people to buy into the growth mindset and what they can actually do and they're capable of, it's amazing when I take a lot of pride in seeing potential in employees that they don't see in themselves. Some people can't handle that and they will quit. But that is probably my biggest, um, um, I think attribute is I push people because I know they're capable of it and they don't think they are.

Yeah, I'm really bad at a lot of [00:26:00] things, but that's one thing I'm pretty good at. Mm-hmm. Um, so yeah, it's, uh, the growth mindset's a topic I think that you see a lot on Instagram and TikTok. Yeah. Right. And, and every guru's got a CA, a course for it. But it really, there's a lot of cliche things that are, are actual true, actually true if you implement them.

And, um, it starts with delayed gratification. I cannot emphasize that enough. Yeah. Nick and I drove the, the two biggest piece of junk cars in our parking lot when we had hourly employees. They had nicer cars than us, but we were dedicated to like what we were doing, not taking the money and mm-hmm. Now people look back or look at us and go, oh, it must be nice.

Must be nice. And I, you and I have talked about that. Yeah. It wasn't nice when I was, you know, getting married and couldn't afford a honeymoon, and I had friends that were golfing every Friday in the summer and I was working 60, 70 hours was a standard week, not even, not even extra time for me. Mm-hmm. You need to take a break.

My mother-in-law love her to death. Right. [00:27:00] But she's like, I think you're working too hard. But that's what you have to do in the beginning. So, um, yeah. And I want to touch on the phrase you said, be comfortable with the uncomfortable. And I do think that's kind of a, a problem we're seeing with a lot of people is once they hit up against that uncomfortableness or discomfort, they um, they back off and say up, I don't want, I don't wanna do that.

Um. You know, I don't wanna get burned out. Like they, there's almost this unhealthy relationship with discomfort now, and that's really hard to grow when you aren't willing to, to do that. And, uh, I think that's, that really sums up what growth mindset is, or just even being in business and, and when you open up a practice, even if you're a full-time treating physician.

You are now a business owner and you're going to, if, if, if you're gonna actually do this thing and make it worthwhile, uh, there's gonna be some discomfort. There always is. And I think, uh, you know, it goes back to kind of a cultural [00:28:00] shift. I, I reference athletics a lot because I think it, it really shapes character.

And I'm a little older for this, it was, it was starting to come on when I was in high school. The younger kids were getting participation trophies and I think there that really set up the expectation that it's just okay existing. Mm-hmm. It's okay to be on the team, but not contributing. It's okay to. To to go out there and perform.

But did you give it your best? No. Well, it's still okay. And that's where being comfortable when things get uncomfortable is very difficult for a lot of people nowadays. And I think that that has. Partly, you know, to do with the cultural shift, but I'm, I agree with you that if it was easy, everyone would do it.

So you have to be prepared as a business owner that it will not be easy. There's a few people that I follow and you do as well. Uh, Hermo is one of 'em and, uh, it, it expect it to take longer and cost more money and mm-hmm. Expect to fail. And, and I. You know, he talks [00:29:00] about all the time he put up a post today actually about how many failures he's had.

Partnerships failed, corporations failed. Um, and I go back and look and, and Nick and I together, uh, 'cause Emma wasn't with us yet in the early stages. Mm-hmm. Um, 'cause she's a stud and she was out doing her thing with the Chicago Bears second female chiropractor and f fell. We'll give her little shout out outs when she listens.

But before her time, you know, Nick and I, we, we can go back to one decision that costs us a million dollars over about three year period. Mm-hmm. Back when we weren't making any money, I wasn't taking a salary. You start talking about, holy cow, that 300,000 in one year when I wasn't taking a salary living in the basement, that could have changed my life at that point.

That wasn't life changing money back then. Um, so it's just you, you gotta be comfortable when, when things aren't going right and you cannot give up. You have to realize, um, that that first. Hurdle is when most people are going to give up. You know, the average, I'd probably call it, 80% of people would [00:30:00] give up that first one.

Then the second one hits, that's gonna be another 10 to 15% are gonna give up. So can you keep pushing through all of that? That's what's gonna separate you as a business owner, as a provider on your skillset as a better husband. A better spouse, anything. I mean, you can relate it to anything. Really when things get tough, what do you do?

 Fight or flight. But the third one is freeze and a lot of people freeze and, and really, uh, you can't, you gotta keep moving, even if it's one foot in front of the other when you think that there is no end in sight. Mm-hmm. Uh, that's what really separates people. So, um. Yeah, it's, it's challenging, but you know, you've been punched in the mouth enough times in your life, you realize it's going to continue to happen.

Yeah. We have a joke, Emma and I have a joke. Uh, we say that all we need is this to happen and then it'll be smooth sailing and we laugh about it now because it's, uh, it's never that way. And there's always going to be another hurdle that you didn't plan for. [00:31:00] Um. Something happens and you lose a provider unexpectedly or, or somebody quits without honoring their, their, uh, you know, six week, uh, termination notice.

They just leave you abruptly and now you're, what do you do?

I had a, a patient, he is a ex Navy seal. He is a very successful business guy now he is in his sixties and uh, he was on the SEAL teams and all that. And he said they had three, like to have the, just the ultimate in leadership.

And when you're in a Navy seal, obviously you gotta have that, that's like the upper echelon. And he had three key things. I'm not gonna say the third one 'cause it was pretty derogatory and funny. It's, but, but, uh, uh, the first two is, it was just communication. And he, and he said it in a way that's just like your communication ashes.

Just to be precise. And it can't be, you can't be just like beating around a bush a little bit. You gotta really communicate. I mean, there's just no way. Uh, you gotta, you really gotta do that. And then he said you have to have a system of problem solving. You have to be able to take every problem [00:32:00] and handle it and have a system around it because, uh, there's gonna be endless amount of problems and you cannot predict what problems they are.

But if you have a system to handle problems, then you can address most of them. Obviously there's gonna be certain things. Has a Navy seal that, uh, maybe it doesn't get solved and that's fatal. Uh, but yes, that, that was like two of the three. And again, I'll leave the third one out and I just, to your point is you gotta get comfortable and have a system around solving problems because they're gonna arise and your problems are gonna always be there, but it's gonna look different.

Like if you don't do shit and you don't try to grow and you go you know, mediocrity and you're 50 years old, like you're gonna have problems. Mm-hmm. Um, if you head, if you take 'em head on and you overcome them. And you're 50 years old, you're gonna have problems still, but you, maybe you're a lot better off in life and you got some comfort and you could provide for your family and other people like that.

And so you gotta get a, uh, comfortable with, with the problem solving. So it, well, you're, you're hating on some stuff too that Yeah. That we didn't really touch on that I, I feel need to touch on is, is I have a team, you know, that's the good thing [00:33:00] is I have two high level people. On a team. And then I have a second tier of people that, I mean, they're, they're committed for life.

Mm-hmm. You know, so I have two tiers of people who are committed. And you go back to that team mentality of, of, back in the beginning, I didn't wanna do this alone. I want, I'm, I'm a PAC individual, I like people around me. And I've said this when I had no money, no title, no staff. I said, I don't want to go to the top alone.

I want people to come with me. I want my friends with me. So. I created this, this business that allowed me to do that to, to bring people with me, uh, in this military athletics business. I think it's the same where, where around people. You have to have those systems. You have to have other people that compliment your failures, what you're not good at.

Everyone within our office knows I'm a visionary. Don't, do not look at me to be a how, well, how do we do that? You know, an operator, COO is not my position. I'm the vision. I can see where we're gonna go. I can kind of navigate how we're gonna get there, but the actual details, that's [00:34:00] Emma. And then to actually hold the line, that's where then Nick comes in and mm-hmm.

That's where the three of us are so different, but we work so well together. Because we leverage the other person's strength. Um, and then it comes down to I'm not selfish and I didn't just take myself to the top. You know, they come with, uh, they're rewarded the same as I am. Uh, but then the other thing is, is we're touching on there or you were with the seals, but you get to choose your hard.

You know, being poor is hard, being rich is hard. Which one do you want? Uh, being happy with your job is hard. Being upset with your job is hard. Mm-hmm. So which one you get to choose. And that's the great thing that we have today, is you get to pick which hard you want to go after. And that's what I think we did here early on was we chose our hard, we knew it was gonna be difficult.

We knew the cards were gonna be stacked against us in every single group at the hospital. It was against us. That was our biggest competitor when we were this little baby of a clinic. Mm-hmm. I never said it was another chiro office or a [00:35:00] PT clinic. And by the way, PT clinics came after us, turned us into the PT board because we had physical therapy on our website instead of physical therapy modality.

So like we had a target on our back from day one, but it was the hospitals I was going after them. Um, and so we picked our heart, you know, they, they have endless resources. We don't, so we have to run the ship better, tighter. Better patient experience. We don't have the ability to mess up and it doesn't matter because we have, you know, 30 orthopedic surgeons behind us to pick up the slack that we missed.

Mm-hmm. One screwed up, one patient experience. Yeah. Um, so I, I really live by that, that no matter what you're gonna do in life, it's going to be hard. So why not pick something that, number one, fill your cup, and number two, you know, is rewarding to, to your family, to other people. And that's how we look at it.

Mm-hmm. So we're. We're excited every day when, when, even when things are going bad, it's, it's not fun to come into work. But what's our other option? We're gonna sit there and choose the hard, uh, that is fighting so. [00:36:00] Love it.

And I'm gonna just one last little quick topic and uh, you know, you could obviously have 10 episodes on this, on an integrated clinic, but if someone wanted to get started with it and right now they don't have anything going on there, uh, what would be your recommendation as a first hire?

Not as like consulting or an attorney, I all that You definitely gotta be doing some of that stuff, but, uh, would it be getting, finding a medical director? Would it be maybe thinking about PT or, uh, what would you say if you're gonna get going with that? Yeah, the first one, obviously you nailed it, right?

You, you gotta get the legal stuff out of the way. Um, so, so after that, you have to replace yourself. You cannot be an owner operator if you're gonna get into the medical integrated space. You have to be able to, I. Separate out from that. You cannot be a key man practice anymore. You have to realize that the company you're building is going to be bigger than you.

Um, you may be the best chiropractor in the world, right? We've had these conversations. We all think we're the [00:37:00] best at what we do, and we may be. On our micro level, and then you meet Brett Winchester and Mark King. I'm lacking a little bit, but, uh, you have to replace yourself. 'cause number one, it's gonna, if you can replace yourself, it shows you have the, the finances to afford it.

You have to, that kind of proves two steps here that you can financially afford to replace yourself. And two, operationally, you're not the key man anymore, and you can step back into that true operational role because again, everything is gonna be harder, longer, more expensive than you think. So. I look at it like that, that that's the first step.

And so, replacing yourself, so what do you do? You may be like, I was, I, we did everything. Mm-hmm. Um, we were the cleaning crew for I think the first three or four years. So we, uh, one of our first steps, believe it or not, was hiring a cleaning crew. Mm-hmm. Um, once a week, back in the day. And, and people may laugh at that, like, oh, that's.

Small, but it, it really was a first mental hurdle for us to, you can't control everything. You can't do everything. You have to get better [00:38:00] at what you do to become more profitable, to be able to spend the money elsewhere. And in the beginning though, you have to do the opposite. You have to not spend money anywhere.

Mm-hmm. So it's really replacing yourself and looking at what roles are you currently doing, and then what do the company finances look like of the roles in that you can replace. And it's, this is a grant card owned thing. You know, I'm gonna pay somebody to mow my lawn because I can make more money by doing something else.

You can't just pay them to mow the lawn and then you sit and watch them mow the lawn. You, you know, you're not there yet. So, uh, I think that's what it was, is replacing, and for me it was. I had to replace so many jobs. I think four or five jobs roughly. Bookkeeping, accounting, cleaning, chiro, uh, rehab tech.

So call it a pt, really? 'cause we, I just wasn't billing Medicare. Um, so, so paying some high level jobs. Um, and that was a big one early on when I still wasn't taking a large salary. I still don't take large salaries. I, we put it back into the, the clinic, but, um. [00:39:00] That was a big step because it's a mental hurdle too.

Mm-hmm. It's hard to let go of the, the business that you've built your baby for X amount of years. So wherever point you are and you're thinking about getting into, uh, integrated practice. You now have to let it go and realize that somebody's not gonna do it a hundred percent the way that you've done it or you want it to be done.

And that goes back to your comment with the Navy Seals. You have to have systems already in place and you have to have, you know, operating handbooks of how you're going to do things. Because if you don't, then you get into it and it is overwhelming. And the other part of integrated is it's expensive.

Mm-hmm. Be ready. The cash, uh, the cash flow out doesn't stop because you are now paying mid-level providers or an MD do surgeons pain management. Um, the, the, the amount of finances that you have to have once you, you're fully running right in the beginning. You can go part-time. We know that you can get strategic about it.[00:40:00]

Uh, but, but you have to be ready that a, a medical practice operates financially at a different level than a sole. Uh, ownership chiropractic office. It, it just becomes a juggernaut and once you turn it on, it's really hard to turn it off. So you have to be, then change your financial safety nets and things like that and just be prepared for that sort of thing.

Um, that I think we've talked. It, it, it comes hard and fast. And then next thing you know, you look back and our expenses right now, uh, per month are just about two times what we made our entire first year. Mm-hmm. So every month it's no matter if we make money or not, that money is going out the door. So what is your six month safety net?

Whatever you determine, six, 12 months, what does that cash flow look like? That cash reserve that you need to have, and it becomes a big number, pretty, pretty quickly. And, um. You just have to be prepared for it. And you get numb to it. You get numb to the numbers. When you know money in, you're like, yeah, but here's all the money [00:41:00] going out, you know?

Yeah, for sure. It changes completely so. Uh, just be prepared for a, a fun ride though. Yeah, well, it's a great answer 'cause it's, um, you know, you gotta start with the, the essentials. And I have another colleague that's, uh, got a few locations that are integrated and he doesn't treat patients anymore. And he's like, I don't know how anybody, like, I just like the stuff I have to deal with all, you know, just create division to make sure it goes out.

He is like meetings and, and doing all that. He is like, we wouldn't be able to do it. And, uh, it's, it's definitely that clinical duplication you're gonna need to start out with. And then, and then kind of go from there. Yeah. And that, and you know, to kind of really answer your question outside of hiring yourself, you know, then you gotta just vet the, the, uh, medical providers really making sure they're on with your vision.

In realizing this as a collaboration, what do it doesn't have to be, you know, you can build your practice the way you want, but our practice is built on collaboration. Um, people have a say in things, not a say in things, but we have meetings and. Medical providers, they [00:42:00] make their own decisions, but we are going to educate them on the information that we have.

And, and with that is conservative care of chiropractic, physical therapy, uh, imaging. You know, a lot of medical providers, um, don't really review imaging and really haven't seen it. They just see the reports all the time. Mm-hmm. So really teaching them, here's, here's the actual x-ray, throw it up in the meeting.

Um, so once you replace yourself, it's I think getting a really good, uh, provider that understands the vision. And, and it's not as hard as you would think because so many people have been in the hospital system for years and they know that that is not the right system. They, they know that it is patient last, everyone's a number.

Uh, it's just not personalized. So it, it is easier to find people than you think, but then getting them to. Operate within your systems and your vision becomes a difficult part. And that's where the training, the systems that you're talking about really come into play. Um, and, and no matter how often you have 'em, you can always have it more often.

We were [00:43:00] doing once a month, and now I think it's every day. So when we have meetings, so team meetings, uh, but it's all about, uh, improving the process so that it's smoother. Well, Jonathan, this has been amazing and, uh, got into some growth mindset stuff that I, uh, really, really appreciate. And I know sometimes it can be cliche, but I thought you brought a lot of great information on that.

And again, however, the person wants to, uh, direct that they, they have to get that vision down and then they have to have a strategy to overcome the obstacles and get there and, and build a practice that's gonna serve you. And it can happen a lot quicker than you expect. And sometimes it can happen a little bit slower, but as long as you're making.

The right decisions are on the right path. You're gonna, you're gonna see through that vision for sure. Absolutely. Yeah. Yeah. Well, I appreciate it, man, and hopefully we, uh, run into each other soon. Yeah, thanks Kevin. Always a pleasure catching up with you.

 EPISODE 424: The Margin Expander

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 year host Dr. Kevin Christie. And today I'm gonna do a solo episode and we're gonna talk about creating margin in your life. And, uh, we've, we've talked about this before in the podcast, but. Had a little bit more different take on a little more expanded version of it, building out a, um, a margin expander tool for our coaching clients.

And it's something that we're really trying to focus on here at MCM is, I think sometimes with professional development, call it, coaching, whatever you want to, , it can be just more and more, more or, uh, just all motivation, you know, and, and gets things done and, and you gotta work hard. There's just no doubt about that.

But I think what we. Or trying to do for our clients. And in a lot of ways, um, succeeding in that in some ways getting better at it, but it's more about improving margin in our chiropractor's lives. And we're gonna kind of dive into what that looks like in its multifaceted and be, but before I do that, uh, you have to know what stage of [00:01:00] life you're in, right?

Um, my life now at 45, uh, married with two kids. In 20 years into practice looks a lot different than it did at 30 or even 33 or 35. Um, you know, and so you, you, you know, you, you have to understand that there is a, a really hardworking period of time of your life, and you have to be okay with that. And I, I do believe too many.

Um, and I, I, I'm not generalizing any type of, um. Uh, age grow. I think this happens, uh, in multiple generations, not just the current one, but it could have been 25 years ago, 30 years ago. But I think you see it more now just because social media is so brutal and people see the, the 45-year-old being able to do X, Y, and Z.

And so then the 28-year-old, um, the 30-year-old, the 30 5-year-old, uh, wants that as well, that kind of work life balance. But they didn't see that the person that's 55 years old just, you know. [00:02:00] Knuckles, bleeding work for 20 years, 15 years, 30 years to, to get there and then started to chip away at these margins.

And so you do have to work hard and you have to get there and, and know that if you continue to do the right things, you will. I. Be able to increase the margins in, in life and work towards it. And it's always a fluid situation, right? Like, we're gonna go over eight different aspects of improving margin in your life in this episode.

And, and it is a fluid situation, so you need to kind of audit yourself every so often to see where you're at and where you can improve that. And that's, uh, part of the, the tool we're putting together for our. Our clients to, to work through that. But I'm just gonna cover, uh, the eight, uh, kind of briefly in certain things that you can start considering yourself, how you're doing in these, um, do a little bit of a mini self-audit, um, but, you know, ultimately creating ideal margins in life.

And you've heard that word margin, maybe with profit margin, but it just meet, you know, it's, it's building a buffer, um, [00:03:00] or extra capacity to handle, you know, unexpected challenges. Reduce stress and enhance wellbeing, you know, and I think that's ultimately what we're looking for, where you have some kind of peace of mind a around, um, these aspects.

And when you don't have margin in these, and some folks as I read this off, you might have no margin in any of 'em or o only margin in one. And that's where, you know, burnout happens and frustration and, and you just become. Disenchanted, uh, with the profession or sometimes even, uh, with life. So, let's, let's dive in.

Uh, margin, you know, the first one is finances. You know, that's a big one. We, we know that. I'm just gonna dive into that one. Uh, you know, financial margin provides security and freedom to handle emergencies or invest in growth and feeling good about. How are you doing that? You know, an example would be having a, a really solid emergency fund, um, and, and have that liquidity behind you that you feel good about.

It also means you have good profit [00:04:00] margin. We've heard, again mentioned that, uh, your, your business has good profit margin. It means it has good cash flow. You know, again, example of difference between profit margin and cash flow could be, you could have confidence. In your profit margin at the end of the year, but you didn't have confidence throughout the year in your cashflow.

You could have had a couple snags throughout that year, but ultimately had, you know, more really good months and it had made up for it and things like that. But that's something that we try to work a lot with our clients is, is understanding what financial. Um, health is, and, and ultimately margin in your finances.

So that's a big one. I think we all know about that. Um, but you want to create margin. And you know when that air conditioning breaks at your house and it's $7,000, you have $7,000. That's nice. That's a good feeling. It's not fun to spend the $7,000. On the air conditioning, but it's also a lot better than, uh, putting on a credit card that you can't pay off, right?

So financial margin would be number one. Number two that a lot of people think about is [00:05:00] time, right? Extra time reduces stress and allows flexibility for unexpected needs or opportunities. Now, I think we are a little bit handcuffed here as doctors where we do have to have a schedule of treating patients.

Now, if, uh, but I'm gonna talk about time for a little bit. A lot of you. Have half days throughout the week. A couple of those that gives you some time margin to schedule things with your kids or your doctor's appointments or your errands or your health, you know, like working out. Um, so I think on the, on the overall, most chiropractors have good.

Schedules, right. Um, a lot, some half days throughout the week where a lot of people, a lot of professionals are, are busting it from like eight to six Monday through Friday, and they got no wiggle room, uh, until the weekend. And so we've got some good margin error typically as a chiropractor. Um, we get a little bit, we get a little bit, um, bogged down with the fact that we have to, you know, have a patient schedule.

So if you have patients from, you know. Nine to [00:06:00] 12 and, and two to six on a Monday, and then something happens with the kids at 10:00 AM It's a little tricky there for sure. But obviously if, if something's an emergency, you can't always reschedule patients. So you do have some margin there. But you know, as you progress in your career and you build a business that's thriving, you, you hire team and have other doctors and, and so if something were to happen or, uh, you know, most recently for me, we had our, um, our kids.

Parent teacher meetings and I want to be to there. So it, it was right in a smack dab of my Wednesday treatment schedule, but I blocked it off in advance and all was good. So there's a little margin there as far as time, and so it's important, you know, leave gaps in your schedule. Um, say no to low priority commitments.

Um, try to, try to get ahead of your schedule a few weeks in advance. Um, this is a big thing we talk about. I'm not gonna dive too much into, uh, time blocking and calendar, but that's something that we, uh, work with our clients a lot on getting ahead of their calendar and putting things on there. So time margin is important.

Uh, the [00:07:00] next one I talk about is. Is energy, um, physical, mental, right? So energy reserves help you stay productive and resilient under pressure. A lot of times when someone is not resilient under pressure, it's because of fatigue. And it's even like the difference between on a, in a football game, the, the, the players in the first quarter versus the fourth quarter, right?

Like a lot, a lot of games you'll see just completely switch in the fourth quarter. 'cause one team. Uh, it's just exhaust, like, just physically, mentally not there. And some teams thrive at the end of games. And why is that? But, um, you know, physical, some of that is mental, right? As we can imagine. So, uh, it's really important to keep that physical and mental energy margin.

You have, uh, make sure you're sleeping well, eating well, exercise, you know, take breaks, recharge, things like that. And you, you gotta make sure that you're doing enough to have energy margin. Again, that's physical and mental, and you want to have those energy reserves. To help you stay productive and resilient under pressure.

'cause you, if you're not there, if you don't have any margin of energy. Um, [00:08:00] you're, you're going to not be as resilient, um, throughout your days, weeks, and months and years. Okay. Um, the next one, uh, number four is gonna be relationships. So relationships, uh, margin and your relationships allows for deeper connections and time to nurture key relationships.

I think that's very important with your team, with your family. Uh, and even with your, your connections in the community, right? So, um, forming deep relationships in your community is going to be very beneficial. Um, you know, and so just, uh, you know, consider limiting shallow commitments and, um, dedicate regular quality time to, to loved ones.

I think the relationship side of things is very, very important, and frankly, that's one of the reasons. Our Mastermind has done so well in, in the sense of, uh, the results people have gotten within the Mastermind. And the fact that's such a high, I mean, kind of a crazy high percentage of our members, uh, recommit each year and the [00:09:00] relationship building that goes on, and they're not in a kind of woowoo way, but just in the fact that.

We know we've got good connections with a handful of members within a mastermind that are going through similar things, uh, helps you go get through certain struggles. And so I think that's been very beneficial. I know it has been for me. And then be able to facilitate two groups and, uh, do that seven, uh, weekends.

Uh, um, a year has just been amazing for my relationship margin as it pertains to the, uh, to the, uh, professional side. Okay, uh, next is gonna be work. So margin of work, uh, work margin prevents overwork and boost efficiency, right? You don't want to be overworked. You want to feel like you are not in that constant overwhelm.

And I know that's hard when you get a busy practice, but that's why you need to design it. And that's one thing we, we try to do for our clients again, is design a practice that's got healthy profit margins and is growing and then you're able, you understand when you need to reinvest. So that. [00:10:00] You and your other, your other team members are not getting overworked.

Um, you want to feel like, yeah, I have time to get my notes done. I have time to treat patients. I, I don't feel like at the end of the day, I just got, you know, run through the wringer. That's gonna happen. There's no doubt about it. But you want to path out of that, right? And so definitely want some margin.

Uh, of work. Um, next is emotional capacity, and again, I just, uh, I put together eight. You might find some other ones. Um, but as I kind of went through this, I real and kind of did some research around it, I really felt like these are, um, very good and very, um, comprehensive. So emotional capacity, emotional margin, supports re resilience.

And balanced reactions to stress, right? So I think we all can relate to that. So emotional margin supports resilience and balance. The reactions to stress as a leader, whether you're leading the whole team, family or your [00:11:00] patients, um, you need to have that, um, balance reaction. You know, you want to, you know, it's kind of keeping.

That, um, stability within all of it, right? And so you gotta have, uh, you know, maybe it's meditation, maybe it's self care, maybe it's, um, you know, uh, setting certain boundaries. But I think we all can, can relate to that emotional margin. And in times of life where maybe you didn't have any emotional margin.

And sometimes that's gonna be hard, right? There's tragedies. Um, or super challenging times. We all kinda relate to that to where you probably didn't have much margin of, of emotional capacity. And that's, you know, normal when you're going through something crazy hard like that. Um, but we at some point want to get out of that.

Yeah. Maybe going through divorce, some things like that. There's, there's gonna be a, a struggle on that emotional capacity, but you will get through that at a certain point. But then sometimes people don't have [00:12:00] anything super. Challenging in a sense, going on, and they're still struggling with the emotional capacity, so we need to work on that.

Okay. Uh, next is gonna be health. Health margin, prevents illness and supports recovery. As a chiropractor, you probably don't need me, uh, to talk about health margin and know what that is. You know what that is. You see it with your patients all the time when they don't have margin of health physically or mentally.

Um, let's not even put it in the mental side. That's kinda in the emotional capacity pot potentially there, but, um, let's just put it in physical health, you know, and then it's, uh, chronic pain. I mean, when you don't have margin of health, it's, it's a real struggle. So I'm not gonna dive too much into that, but if you feel like you need to improve that, I highly recommend it.

And then the last one, you know, I, I kind of. Was kind of, um, back and forth on adding this one, but actually more I thought about it. I thought it was great. And that is, this is gonna be my eighth one here. This is kind of the cherry on top, and that is the margin of leisure. Uh, margin in leisure [00:13:00] ensures you have.

You know, time for hobbies, relaxation, activities that bring joy, uh, you know, which kind of recharge you and prevent burnout. It's gonna help, uh, you know, with your creativity and mental health and, and just ul ultimately your sense of fulfillment outside of work and obligations. And I don't think we're doing enough of that in our life.

And I, I harken back to something like when I, I read a lot of history and you know how you read back on some of the. People from a hundred, 200 years ago on maybe the more affluent side of things or in positions of power and stuff like that. They spent a lot of time with leisure, even during crazy times.

And, uh, they would be outside and they, you know, would play croquet or they would go on these long hikes or they would, I mean, they just had a lot of leisure time built into their days. And, um, I don't think enough of us are doing that, even when we're in the grind of it. I see it a lot in my being in Bo Raton, Florida, which is a highly re retire.

There's a lot of different types of folks here, and it's [00:14:00] very well-rounded, but we have a high retirement or snowbirds. And so, especially during the wintertime, I got a lot of people down here. I mean, they, they're living the life of leisure now. They might be 70 years old. Um, but why aren't we doing some leisure activities when we're.

40 years old or 35 years old, and things that you enjoy doing, whether it's running rock climbing, golfing, exercising, uh, just going for walks or maybe it's playing with the kids, you know, I mean, it's just a, a, a million things you can do, but you should schedule that in and have some leisure into your life and that will help, um, prevent.

Burnout. So, um, just to kind of recap eight leisure time, finances, energy, relationships, work, emotional capacity and health. And this is gonna be something that we are consistently working with our clients and making sure that they are doing as best as they can as it pertains to this. But at the same time.

[00:15:00] Um, you know, very productive. You can do, you can work on all these and get better at this and still. Kill it in business and do well. And that's the thing that you have to do it, you can be highly, like Gino Wickman says, you can, um, you know, you can be very ambitious but have inner peace. And I think that's where this is, is finding that, um, the margin in life and, um, being very productive, but strategically so I hope that was helpful to get you some insights and, uh, do a little bit of an audit on where you can improve on those eight.

 EPISODE 425: Grit, Grace, and Gratitude with Corey Campbell 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, and excited to have Dr. Corey Campbell of Motion Palpation Institute and also in private practice. And I love having him on. This is, uh, not his first time on, but we, uh, I like having him on 'cause he, he gets a real good pulse of the profession. He teaches throughout the year, many times to many chiropractors of all, um, experienced levels, students all the way up to experienced doctors.

And he's, you know, kind of. Got the beat on the profession in a lot of ways over the last 20 plus years of, of doing that. And so we dive in today on something that he coined and it's become kind of a motto for MPI and that is, uh, grit, grace, and gratitude and what that means in practice and how that is applicable to your everyday life as a chiropractor, because it's not easy.

It's not easy. Clinically, and it's definitely not easy dealing with, um, the ups and downs of business or the ups and downs of a potential patient's emotional state on what they're dealing [00:01:00] with, right? And so we have a lot on our plate and you can navigate this. And there are many chiropractors that have, and.

You can get even better at it. And so we dive into what that means to him, what that means as a chiropractor, and then we, we dive into some sidebar conversations about things in the profession. Uh, always enjoyable to have Corey on the podcast and look forward to seeing him, uh, this year at some of the seminars that he teaches at and that I try to attend each year.

So, without further ado, here's my interview. With Dr. Corey Campbell.

 All right. Got Cory Campbell on the episode today, our second time, I believe, being on the show. And, uh, look back on the last time you were on and what we talked about and talked a lot about the adjustment and manual therapy and things of that, that sense of like really using your hands. Uh, today we're gonna talk about something that you've, uh, discussed quite a bit within the NPI circles, and that is.

Grit, grace and gratitude and what that means. But [00:02:00] before we dive into it, Corey, what's new in your world? Tell us a little bit about yourself and, and let's get into it.

Corey Campbell, DC: Well, I have a private practice in Omaha. I've been, um, in practice for 22 years now. . , I teach, and then I, I do, uh, some consulting work for, uh, the University of Nebraska.

Dr. Kevin Christie: Nice. Then tell me how long have you, uh, been teaching for MPI?

Corey Campbell, DC: So I've been with MPI since, uh, 2003 and on the board since 2004 or five, I believe.

Dr. Kevin Christie: Nice. And then, uh, when, when did you come up with this, uh, grit, grace and gratitude idea and some of the impetus behind that? And let's dive into it a little bit and why you think it applies to us as chiropractors.

Corey Campbell, DC: You know, I, I, I'm not even sure when I started using it. I did it in, um. A class in San Jose once I was, I was big into listening to Brendan Burchard and he was always putting, like, [00:03:00] always putting words together and was always in groups of three.

And it always had the same starting consonants and that kind of thing and that, , I was writing, um, I was just writing some stuff for my, my intro and for my, my exit talk. Um, and I came up with that because it kind of, you know, I was thinking about, you know, what it takes to get through a day. And a week and a month and a year as a chiropractor.

And those were kind of the three words that just kind of come, coming up, you know, as, as far as like in my head. And so, um, it is kind of taken on a life of its own. And I, I say it every time. I, I do something now, um, when I finish up my classes and it's kind of stuck and it's something that, uh, you know, I've, I've, I've broken it down a few times, um, so that people kind of understand where it comes from and.

It's just, it's got, it's catchy and I, I think it kind of encapsulates, you know, a typical day for a chiropractor if you're trying to be, like you say, like a thriving chiropractor. So think it just kind of [00:04:00] encapsulates a lot of stuff that you need.

Dr. Kevin Christie: I mean, typical day in a typical career for a chiropractor, I, I love it.

'cause you know, you do need those things. And, um, the thing that I think about with the Grace as well, I'm gonna kind of pick that one for a second, is that, um. You know, I think you need grace as it pertains to dealing with patients and understanding that yeah, it can be hard, you know, if you see 20 people in a day, some of 'em are in their worst state, you know, pain wise.

And we have to, to deal with that and we have to give them some grace and we can't let that impact us. Um, negatively. Uh, I think we have to give ourselves some grace that we're gonna have some, some tough days and bad days or challenges. And, uh, I, I love that word 'cause I think it applies to a lot of different.

Facets of what we do. Would, would you agree to that?

Corey Campbell, DC: Absolutely. I think so. When I, I broke it down in a video one time, and you know, I've, I've dissected this a few times, but I think Grace is the, [00:05:00] of the three is the hardest to do. I think Grace is the hardest one to show, and it's the hardest one to give, and it's the hardest one to receive.

And so I think that's the one that takes the most work. Like that's a daily habit that you have to create. To not only show grace, 'cause we all get frustrated with patients who, you know, they, they try to suck the energy outta the room. You have to give 'em grace. And, you know, I think it comes down to simply just to get, you have to love 'em all for their imperfections and for, you know, the, the, the easy ones.

You know, your Medicare patients that are just fantastic people that have seen more than you'll ever, ever hope to see, uh, that are just fun to be around. Those people are easy, but it's the ones that are, you don't know what they're going through. You know, empathy's almost impossible. 'cause you've never really walked in their shoes.

And so you have to show them grace. 'cause even sometimes sympathy is hard to get to, but if you show 'em grace, then I think those other things are easier to access. Um, and I just, you have to love your patients and you have to, you know, even if, even if they [00:06:00] frustrate you, you have to give us some grace and you, 'cause you don't know where exactly they're coming from, um, in a given day or in a year or even a, a lifetime.

And so. I think grace is the hardest one. And I definitely agree with you. Like giving ourselves grace is even hard, like showing grace to ourselves and, and you know, giving ourselves a little bit of grace at the end of the day after tough day or frustrating day or day, that just doesn't, seems like everything's crashing down on you and you're overwhelmed.

Like you have to give yourself some grace and that's the hardest thing to do because, you know, we're pretty hard on ourselves. We strive and we, we work really hard to do the best we can. To do the best that, you know, we can for our patients to do our best. And, uh, sometimes we fall short. Unfortunately, we fall down and we fail.

And, uh, it's, it's the hardest thing to do is to give yourself some grace and to show yourself some grace. So I think that's the hardest of the three to, to practice on a daily, on a daily basis, but I think it's the most important one to practice on a daily basis. [00:07:00]

Dr. Kevin Christie: Yeah, it makes sense. 'cause you know, if you think about it, if you took the whole, all three of 'em together, I, you know, the, the thing that I think about, and it's something I might have shared on an episode, but I don't wanna assume someone heard it, but I saw a reel, an Instagram reel, I think it was a couple months ago, and it talked about, you know, in, in life or in practice, you, you need to be.

Uh, the thermo, you know, you need to be the thermostat, not the thermometer. And in a way I talked about it was like you need to set that temperature of the room, uh, not be the, the basically reading the temperature and, and, and acting accordingly. And I think in life or in practice, those that, um, can go in and, and set the temperature of that room, you go, you go into that patient encounter and, and you have that grit, grace, and gratitude.

Or that day, that week, that, that month, uh, it's gonna serve you and, and it, your patient base is gonna then reflect that your team members are gonna reflect that your, your family's gonna reflect that. And I think just too many [00:08:00] people are letting, uh, life or the, or the profession kind of, kind of beat them down with that a little bit.

And, uh, that's something that sticks out to me when I think of the grit, grace, and gratitude

Corey Campbell, DC: for sure. I mean. And I always, I always have random quotes and things like that running through my head. But with Grace is, you know, for me, mercy is when, you know, when we, when we don't get something that we deserve.

And grace is when we get something we don't deserve. And I just keep kind of running that through my head all the time, you know? And, uh, I try to, I try to practice that, you know, with my patients and I try to practice that with my kids and I try to practice that with the kids I coach. And, and that's just the people I meet and interact with.

And. And then, uh, like I said, the hardest thing is, uh, you know, giving yourself a break and giving yourself some grace. That's the hardest one, and that's the one that takes the most work.

Dr. Kevin Christie: It, it really does. Um, now one of the things that I've always appreciated about MPI, and I know you kind of have this [00:09:00] become a mantra, uh, for MPI and that's where I first heard it, and you share it during different, uh, courses.

Uh, I had recently interviewed. A physical therapist, Jeff Moore, and we, it was kind of a topic of leadership we were diving into and, and one of the things that he said, uh, to help prevent burnout to be a good leader was to find mentors. And, and, and I think that's a big thing. And one of the things I always, and I actually referenced MBI in that episode, but the thing that I, it always stood out to me was the culture that MPI is built, uh, of chiropractors and the, and then those particular chiropractors going out in the field and their own practice and, and bringing that culture to their own practice and their own town and their own family.

Uh, would you say that this, uh, has become kind of a mantra that has helped. You know, obviously NPIs had that culture before that, but has this helped kind of solidify that and, and give people some perspective, [00:10:00] uh, when building their, their culture for their own practice?

Corey Campbell, DC: Yeah, I mean, I, I think it's just, it's something that, the three things that, you know, the grit, the grace, the gratitude part is just part of the overwhelm.

Just the part of the overall kind of humble. And yet driven group of people that MPI seems to attract and that we try to foster. And we really honestly wanna make a community a tribe of high achievers that are, they don't necessarily have to be high achievers, but they have to strive to be high achievers.

And it just seems like that's the group that we have. And so, mm-hmm. I think that's kind of the overall mantra of just the MPI. These three words maybe just kind of help keep it grounded and kind of give us a home base whenever we think we're smarter or better or whatever than anybody else. But honestly, we are trying to create a tribe of, and a community of really good, um, really good [00:11:00] chiropractors that are clinically good, but are also good people and good characters and, you know, have this, this competitive edge to them, but do it in a way that's ultimately.

As a servant and as a, a servant leader and you know that you're, you're never gonna be perfect and that you have a group of people, um, that you can lean on and you can go back to. And so I think, I think it's just kind of keeps us grounded and kind of keeps us humble. It keeps us knowing, you know, that we're here to serve and we're here to help people as much as possible, including the, the young docs and the, the older docs that are out there that are constantly learning and constantly growing and constantly getting better.

You know, leaving the profession hopefully in a little better place than where they found it.

Dr. Kevin Christie: Yeah. And you kind of brought up a couple things there. I want to, I want to expound on a little bit. You know, the, the new doc. The old doc, I think both of 'em, I. Find themselves, and even, let's call it the middle age doc, like myself, um, that's me.

[00:12:00] Uh, maybe it's, maybe I just kidding. No, I showed no grace right there. I showed no grace. If you can't laugh at

Corey Campbell, DC: yourself, who can you laugh at?

Dr. Kevin Christie: Uh, but I think they find themselves on an island and a lot of people always, you know, it's nice to have ideas and thoughts and, and mantras, but I. They, you know, people want strategies.

And I think that comes back to what you mentioned about having that, that group of people, and that goes back to what Jeff Moore was talking about with the mentorship and, and group of mentors. You have to have that. And, and that is one of the key strategies. I'm sure there's other ones, right? Like, uh, you could, you could, uh, put this on your wall, you could meditate, you could exercise, eat healthy.

There's a lot of things that can help you. Maintain that level of grit. 'cause if you get burned out and just exhausted and you have no strategies around that, you're not gonna have grit and you're probably not gonna have grace [00:13:00] and you're probably not gonna have gratitude. So you like you. It's one thing to to say it, but I think one of the things that is a key cog in this whole thing.

Is finding those mentors, finding that group that can help you go through this together. So it's not, you know, you don't feel like it's just you. 'cause a lot of your family members, they don't get it. It's not, you know, no fault of their own. They just don't get it. They're not, maybe they're not entrepreneurs, maybe they're not practice owners, maybe they're definitely, you know, a lot of aren't chiropractors and so it's hard to relate to that.

And so you gotta have that tribe that you mentioned to, to, to do that. Has that been, has that been one of the key strategies for you to maintain this and if, and maybe any other strategies you've had to try to, to, to really live by this?

Corey Campbell, DC: Well, no, I, I think, you know, obviously I have a, I think we all have a routine.

You know, I have a set of routines that I go through, um, you know, every day, every morning have a set things that I do. But, you know, I think it's, I don't remember who I was [00:14:00] listening to. It might even been. Like an infomercial in between a podcast I was listening to. And Tony Robbins even says it, you know, if you really wanna level up and everybody says it, if you really wanna level up and hold yourself accountable, you have to have a mentor.

You have to have somebody that you can, that one's gonna hold you accountable. And two, you can learn from. And he talks about mentorship and bottling and, you know, you model yourself after somebody, but you don't become them. They, you have to be your own person. You have to find your own way. But it does have.

In order for you to, to level up to go to that next level, you have to have some mentorship. Like you can't do it on your own. You can read books. Yes. And you can listen to things and you can put those practices into work, but you also have to have somebody that probably came up with those practices that you can lean on, or somebody that's gone through it that's done it.

And so, you know, for me, you know, Mark King has always been one of my biggest mentors. He's a life coach, he's a clinical. Mentor, he's, uh, you know, just [00:15:00] everything. He kind of understands it because he's been through it. He's mm-hmm. He's done, you know, everything in the profession and, you know, you have to have people like that.

I'm not saying you have to have Mark King as a mentor or you, or, but you have to have somebody that has gone through things that you haven't gone through or maybe have gone through, but they've handled it in a different way. And so that you can, for you to take the next step up for you to level up in anything, whether it's.

Clinical practice, whether it's knowledge, whether it's uh, clinical skill, whether it's being a better person, you have to have some sort of mentor. And, uh, I think the MPI community prides itself on once you take a class, you're kind of in that group, you're part of the tribe until you've proven otherwise to not be in that tribe where you fall out and you do your own thing, which is fine.

Just wish each other luck and, and, and go on, you know, not everybody's course is your course, but you have to have mentors that. That have gone down the path and have walked some of the journey and can [00:16:00] help you get to where you want to go.

Dr. Kevin Christie: Yeah. You guys surprisingly haven't kicked me out of the tribe yet.

No, no, no, not yet. Um. But no, it's, uh, it's true. And I think, you know, you wanna look at it from maybe a few different perspectives too. You, you, you really want to have that clinical, uh, I think a lot of people get disenfranchised clinically, uh, early on, and, and that's not good. And, and I think it, it's, it's natural.

It's hard early on. It's hard. 20 years in, but it's real hard early on and you almost doubt yourself because, or am I getting the clinical results? Do I know? And, and, and you gotta stick with that. And so you, you gotta have that clinical tribe. Uh, and then, you know, ultimately if you're gonna go down the, the path of ownership or partnership in a practice, uh, you, you probably need some people to rely on, on a practice growth standpoint or, or just business and marketing and all the different things that it takes.

'cause that's the hard part of what we do is. We, we wear many [00:17:00] hats, you know, and it, and it's tricky to do that. And so you gotta, you gotta find those people that are gonna help you out and, and sometimes just be a shoulder to, to, to cry on as well, right?

Corey Campbell, DC: Absolutely, absolutely. I mean, sometimes you just gotta call Vince, you know, and, and get it off your chest so that you can, you know, give yourself some grace or, or maybe think, be thankful for the stuff you do have and the fact that you are in a place where.

You've grown to the point where you have some frustration and some growing pains, and so then give thanks. Just the fact that you're in, in those places, but you can't do it alone. Anybody that says they're, you know, other than Stoop dog, when he accepted his, you know, his Grammy and thanked only himself, uh, that's awesome.

You know, we all, we all stand, none of us are self-made men. None of us are self-made people. We all stand on. On the shoulders of people that have gone before us and that have, you know, shown us that they're, that, you know, there, there is a, there is a way to get to [00:18:00] the levels that you want to get to and this is how you do it.

And, you know, they've been through the tough times too. And so that's part of the community. That's why MPI is so, um, I think such an important piece of, you know, obviously it's a huge part of what I do and. I just try to bring some of that back and hopefully give back to the kids, the people that, that take my classes and take our classes and hope we keep, keep building that tribe.

'cause honestly, we do believe that, you know, this isn't being arrogant, but we do believe that we have some of the highest level achievers, some of the higher achievers in the profession. And we want to foster that. We want to, we want that culture to stay strong and to stay healthy. And, um, you know, that's what we try to do with NPI.

Dr. Kevin Christie: Yeah. And that's the, that's been like the secret sauce is the culture you guys have built to where it's, it's just remarkable. When I go to different seminars, I try to do at least one MPIA year, and you go and, and you got, uh, students, you got dcs and, and everybody's. [00:19:00] Pretty function at a pretty high level, which is, which is pretty cool.

And I think, you know, I recently had Gino Wickman on my podcast and we were talking about the 10 principles out of his book Shine. And, and one of the, the key overlying concepts is that you can have maximum impact. Um. And have inner peace, right? So a lot of people think that's a, uh, you know, inverse relationship, but he's there to kind of say you can.

And I, and I always looked at you as someone that has done a lot to, to maximize impact and, and, and has a, a level of inner peace as much as, as someone can. Um, but what are some of the things you've done to do that? I, I, I, I'll kind of, I don't want to pigeonhole you here, but one of the things I've always appreciated about you is your.

You're kind of, you're a family man and you haven't let business beat you down to where you've put, uh, priorities in places they shouldn't have been. And you've, and you've put priorities on, on family. Is, [00:20:00] has that been kind of where like your, your gratitude, uh, with, with your family and all that is, has that helped with inner peace as it relates to practice vice versa?

Is there a, is there even a connection there? What are, what are some of your thoughts on that?

Corey Campbell, DC: Um, that's a great question. So again, like success without fulfillment's, kind of the ultimate failure. I, I think that's, that might be a Tony Robbins quote as well. And, um, you know, I've always, I don't know, I, I guess it's just, I came to a point in my life where I had to make some choices about, you know.

Do I keep grinding like this? Do I, do I teach as much as I do? Do I, you know, do I put in the hours that I'm putting in and all these other places and, and, or do I do, I start pouring into some other buckets that I really like, that I enjoy, that aren't gonna give me financial dividends. They're not gonna gimme any of that, but that, [00:21:00] you know, at the end of the day, um, am I happy with who I see in the mirror?

And can I rest well? And so I made that decision to, uh, I love coaching, like youth kids. It's my passion and, um, my own kids. And I just, I, it just, it's something that just lights me up and, um, and to be able to find a balance to be able to do that and still strive clinically, um, and this profession can afford you to do that.

And as long as you. Understands scheduling and you understand, you know, how to recharge here and there, and how to also have some grit and have to grind certain things out. You know, you have to get up early in the morning. I have to, I have to get these things done before I start my day. I just have to do those.

And if I do those, then I, I have the sense of clarity about what I can do [00:22:00] with the rest of my day, with the rest of my week. I can, I can go teach. On a weekend, and then the next weekend I can go coach a Nebraska National Girls Wrestling team and just mm-hmm. Both things give me joy. Mm-hmm. Um, but I have to say no to something in order to say yes to another.

And once I realized that there are certain things that, that allow me to look at myself in the mirror and to allow me to rest my head at night and be okay with myself, that I just have to do it otherwise. I am not pouring into any buckets, but I'm taking water out of them. You know, I'm, I'm, I'm basically withdrawing things instead of putting things in.

And I'm not doing any deposits. I'm just chewing withdrawals. And once I realized that I have to, you know, deposit into different buckets and prioritize my ti time and the power of, no, you know, we've all heard that being able to say no to some things, being able to back off [00:23:00] like. It's amazing because it doesn't really, like, your patient numbers don't change.

They actually get better because people are somewhere like you have an energy about you that people are drawn to, or opportunities show up that you would've never thought would show up, you know, like the working with the university. Um, you know, and that just the other things that I've been asked to do because I realized that I needed to pour into other buckets, things that weren't going to give me.

Financial, um, they weren't going to produce financially, they weren't gonna gimme a huge return on investment, but the return on investment is something that you can't measure.

Dr. Kevin Christie: Mm-hmm. And once

Corey Campbell, DC: I realized that and made that switch, um, things have been so much, you know, I'm just, I just have more fulfillment I feel, I feel more fulfilled than I did when I was just chasing certain, you know, bars of success, you know, certain levels of success, whatever that definition is.

Dr. Kevin Christie: So I know [00:24:00] that, like you mentioned, teaching, I know MPI gives you a private jet to fly around and all the Yeah. Luxuries. Yeah. All that. So aside from, from all the, the money, um, what, uh, what, what do you get out of, uh, teaching? Like what, what is that for you that you get, 'cause you obviously teach a lot and it's been a big part of your career.

Uh, what has that done for you?

Corey Campbell, DC: Uh, a lot. I mean. You know, I'm, I'm a farm and ranch kid from western Nebraska. I was raised around cattle and wheat and, and dirt and alfalfa and things like that. And, um, it's given me, I've gotten cheap parts of the world. I never thought I'd ever go to, you know, Sweden and the Czech Republic and the UK and Switzerland and Sweden to Chile and, you know, all these cool places.

Um, it gives me that, but it also, like, I get to meet so many cool people, so many people that are. They're hungry, they're, maybe they've been misin [00:25:00] misinformed by some things. And just to be able to see the lights go on and, and to see that switch clip in people like that gives me tremendous satisfaction.

Like, I just love it when people get it. Like all of a sudden they're like, oh, this makes sense. Uh, or, you know, those are the things that I like and. It forces me to take really complicated stuff and to make it as simple as possible so that I could coach it and teach it to people who have never heard it before, and that, you know, selfishly, that makes me a better doctor because I can now explain things to Mary who's never, you know, been to a chiropractor before that she can understand because I've had to break it down into pieces and parts and I've had to reverse engineer things and I've had to go back through.

I. And be like, okay, it's great that we have all this information, but what can I do it? How do I apply it? And then how can I teach it to somebody? You know, I always kind of go back to, I teach, I coach, um, youth wrestling and, and youth football here [00:26:00] in Gretna where I live. And, um, to take something that's actually very fundamental, but to break it down so that an 8-year-old can understand it is very difficult.

Once you understand it, you can break it down into pieces and parts that they can digest and they can pick up on quickly. That to me, like once that light switch goes on and once that, that switch is flipped and you can see it in their eyes, um, that's just tremendously satisfying and that's what I, that's what I get outta teaching.

I just, I love being able to break things down so that people can understand it, they can use it, they can apply it, and then they can realize that, you know, this is just the foundation that. You put the trampoline on and if you keep working on the foundation, you keep learning the basic fundamental things you'll be doing back flips before you know it.

And uh, that's to me is just, that's the challenge. But that's what I love the most is, is the challenge of being able to explain things to people and to, and to have them get it and to have that light switch go on. To me, that's extremely satisfying. [00:27:00]

Dr. Kevin Christie: That's awesome. And I'm looking at the schedule, it looks like you're gonna be out in the UK in July.

Huh? That's exciting.

Corey Campbell, DC: I am, I'm going to Chile this week. I'm actually being in Chile this weekend.

Dr. Kevin Christie: Oh, nice. So Chile, you got uk and then, and then we got the, uh, super Bowl of chiropractic. That's gonna be the adjust athon.

Corey Campbell, DC: Yes. Yep. It's, uh, it is, it is the Super Bowl of, of a far as the adjusting seminars go.

And, and for us, for the, in the MPI world. It's always at Cleveland and Kansas City and Overland Park. It's at the school. It's in that gorgeous cafeterias ballroom thing that they have with the Yeah, the windows and everything all the way around. Um, it gets bigger and bigger every year and we have added a, a, a DC tracks.

We have a doctor track that's just specifically geared for doctors who've been out in practice, um, to give them some more like clinical case management type stuff. How you deal with this versus just the peer hands on palp [00:28:00] and adjust that the students get, but all the instructors are there. We always bring in people with, you know, that are, have been in the NPI world that don't necessarily teach full-time to help the assistants or to even help with like the DC track because they become very good at some, some specific niche or, or something that they're really good at.

And so, um, yeah, it's just, it, it's a lot of people. It's a lot of docs. It's a great chance to, to meet and to, to find mentors. Maybe you need a mentor in your area. Um, 'cause there's docs from all over the world there. Docs from all over the, every state is kind of rep, almost represented, I think maybe except for Alaska.

Who knows? Maybe we even have some there from there. But there's so many people in such a wide range of first timers to guys that have been practice for 45 years. Like we have kinda that whole mix. They're all really good people and they're really good docs and it's just a tremendous experience. Like, and it's, it's [00:29:00] one instructor after another teaching different things.

We all teach, you know, various different things and then we get to go teach to the docs in a separate settings so that they're not around all 250 students. They get to be in a smaller, more intimate settings so they can really get their hands on and learn some things. It's just like, you know, Brett and I have said for years, it's a Super Bowl of.

Our, for our class, for our, our group. It's the Super Bowl of adjusting. And, um, we're, we're very proud of what it's become.

Dr. Kevin Christie: Yeah, it's amazing. Uh, and in my 20 years of doing NPI seminars, last year was the first, uh, justit thought I had been to shockingly. And it was, it was awesome. And yeah, I like how the, you know, you got the student track, the DC track and rotate and, uh, it was, I got a lot of good feedback from the dcs.

Obviously the students love it and you get a, a lot of the nm PI folks there. Obviously Brett is there. You got Lindsay Muma there, Erica Merick there, you, Terry Elder and, and, and obviously Mark King [00:30:00] will be there. So you get the, almost the whole slate there of, of instructors to, to help out and then you enroll some other experienced docs to help out as well, which is pretty cool.

Corey Campbell, DC: Yeah, I mean you get everybody type possible. You got. People that have been in practice as long as Mark, you have people that's somewhere in the middle. You have, you know, people that are newer, you know, that are younger in practice and they all have all are very good instructors. Obviously, you know, Brett's one of the best instructors in the, in the world.

Um, and you got Sarah and Mark and Brett and, and Lindsay and Erica and Terry Elder will be there. And like we just have so many people, so much knowledge in the room and so much. So much experience, especially in instructing and teaching, which I think is very valuable. It's one thing to have knowledge and and experience.

It's another thing to be able to, to teach it, you know, to be able to use it in a way that people can use, you [00:31:00] know, for themselves. And so there's a lot of that, just some really good instructors, really good people. And it's obviously, it's a, it's social. There's a big social thing at the end of this of Saturday.

Um, there's, there's opportunities for students to. Meet doctors and, and lineup associates or preceptors. So there's all kinds of cool, you know, additions that we've made to the, to the adjust on. Um, and all of it has value and it's all done in a, in a super positive, fun, um, high energy environment. So it's just, it's a cool, it's a, it's just a cool class.

It's, it's my favorite, uh, of the year and it is for most of the instructors.

Dr. Kevin Christie: It's awesome. Are you guys gonna do the, uh, job fair aspect

Corey Campbell, DC: again this year? I think so, yeah. I think we're gonna tweak it a little bit because we had so many people last year that it's kind of bogged down, so I think we're gonna tweak it a little.

Um, but I think we are gonna do it. Um, uh, again, seems, seems to be a big, a big hit at least. Mm-hmm. [00:32:00] And, and from what I've gotten into feedback anyway.

Dr. Kevin Christie: No, I enjoyed it. It was good. And, uh, yeah, that is September 27th, 28th in, in Kansas City, like you mentioned. And so, uh, those listening, you can go to motion palpation.org and check out the seminars and do that.

I, I just highly, I. Highly recommend it. I think, um, you know, the more and more that I work with chiropractors from different aspects of things and see the ones that are thriving, uh, it's really this combination of being just great with your hands. Um, you know, be it palpation, adjusting, maybe it's soft tissue, but you got, that's like the core product.

You gotta be good at that. Uh, yeah. And then you can layer on. You can layer on the rehab, you can layer on the modalities and the shockwaves. Those are all, all great, no doubt about it. Yeah. Uh, but if all you have is rehab, or all you have is a modality and you're not good with your hands, uh, there's just too many people in your community that can do rehab and can do modalities.[00:33:00]

It's the ones that can just be just killer with their hands and add those other things. Those are the ones we're seeing seem, seem to be thriving the most.

Corey Campbell, DC: I'm so glad you said that. 'cause that's something that, you know, I think sometimes I just take for granted because I'm around those people so much.

Mm-hmm. Um, you know, the Brets and the, the Mark Kings of the world that it, it, it is amazing to me. Um, there, like you said, there's so many people out there that just wanna be great at, you know, this technique or this. You know, whatever seminar they went to that cost thousands of dollars, they're just gonna focus on that then not be good with your hands.

It's just, to me, it's, I, it just baffles me like how the people, people come to you because you are unique and because you provide a service that nobody else in your community can provide. And maybe in the world that can provide that kind of service. And it's not about. The letters and all the fancy things that [00:34:00] you know, and all this knowledge that you have floating around your head.

And you, you can do this exercise better than somebody, it's how you deliver with your hands. Like that's mm-hmm. Being good with your hands and being skilled with your hands, and then having the clinical decision making in your head, uh, to be able to get that, you know, across the patients. And then have the heart and some compassion and some grit to get through a day like that's.

You know, that's what makes great clinicians great, but you have to be good with your hands. It's a skill that is unlike any other, it's one that, you know, I can constantly sharpen the sword on. 'cause I'm never going to, never gonna be perfect, but I'm always gonna work to get better. It's just, it's such a cool skill that, that nobody else can provide.

It makes you indispensable, it makes you unique, it makes you sought after. And then, like you said, you can add all those other things on as you go. And you can be an absolute force to be reckoned with clinically, and you can be marketable and you don't have to spend a lot of marketing dollars because nobody else is doing what you're doing.

It just builds on itself. But [00:35:00] you're right, you have to be good with your hands. It's just, I, it just baffles me that people think they can take a class and think they know it and, and they're good. You know, like, or they take this, you know, one, one technique and that that's all you need. Like, that's, it's not it, it's.

But you, I'm so glad you brought that up. 'cause you do, you have to be good with your hands.

Dr. Kevin Christie: Well, you, uh, demoed a CT junction move on me last year at just Ahan and, and I wouldn't go to Nebraska for many reasons, but I would fly to get that adjustment and, uh, it the College

Corey Campbell, DC: World Series, huh?

Dr. Kevin Christie: Yeah. I'll go there for the College World Series.

A stake in your adjustment. Um. But yeah, it just makes a difference. And when you, yeah, when, when you, when you experience that, you then realize why someone would, uh, obviously come to come to your practice. So it's good stuff. Well, CC, this has been great, man. Uh, looking forward to seeing you somewhere this year.

I'm sure we will. And, uh, thanks for, for sharing your, your [00:36:00] grit, grace, and gratitude to our profession. It's, uh, it doesn't go unnoticed and it's, uh, something that I've always. Uh, admired and you've been a mentor to me, so I appreciate that.

Corey Campbell, DC: Well, likewise, I've learned a ton from you too, Kevin, so I appreciate it and thanks for having me here, man.

It's been, it's been fun.

 EPISODE 426: AI and It's Role in Search with Darcy Sullivan

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 this interview with Darcy Sullivan. We try to have her on every so often to discuss, search, Google, all the SEO type of stuff. And you know, today, today's day and age is fascinating with ai and so we're gonna dive into the topic of how AI is impacting, uh, Google search. And we will probably have a handful of these conversations over the next six to 12 months as things do change.

Dr. Kevin Christie: Uh, I do think a lot of it. Will benefit us as chiropractors. I think you just need to understand what you need to do to compete in a world where people are using ai, uh, like a chat, CPT, AROC, a Claude, any of those, um, to search for their answers or their solutions to their problems. And you need to be able to be the answer to that.

Dr. Kevin Christie: I've shared on previous podcasts how patients are now finding chiropractors using the AI versus going into Google and typing in. A chiropractor or whatever. They are still doing that. Uh, but it's starting to change a [00:01:00] little bit. I do think being a physical location will benefit us, but in this, uh, conversation that Darcy and I have today, we really dive into some of the things you need to be considering to do, get ahead of it and plan for the future.

Dr. Kevin Christie: It is here and it's coming fast, and it's okay. You're gonna be all right. You just gotta make sure you keep up with it, just like. You know, if you've been in practice for 5, 10, 20, 25 years, I'm in my 20th year of practice now. It looks a whole lot different now than it did in uh, 20, let's see, 2005 when I graduated.

Dr. Kevin Christie: So 20 years. Uh, but, you know, 2010 looked different than 2005 and so on and so forth. So you just gotta keep up with it, and we are here to help you out as much as you need. So, without further ado, here is my conversation with Darcy Sullivan.

Dr. Kevin Christie: Okay. As I do once, twice, or three times a year, have Darcy Sullivan on our podcast to give us updates on, uh, all things SEO, uh, search Google. [00:02:00] And, and then now we're gonna tie in a little bit of, uh, ai. So, uh, what's new in your world, Darcy?

Darcy Sullivan: Well, hi, and thanks for having me back. Um, we were chatting a couple minutes before you hit record and I was talking to you about how.

Darcy Sullivan: Google just had an event, Google io. Um, it was mid-May, end of May, and they were talking about what's new and where they're headed, what's going on with ai, which led to the conversation of AI mode, which is a new feature on Google that I, I don't think many people are talking about, or a lot of people have really.

Darcy Sullivan: Dived into and tried, which now, right? With Google, we've got general Google, we've got Google business profile listings, we've got Google AI mode, we've got Google AI overviews. We have all of these things on top of all the other ways people [00:03:00] are searching these days.

Dr. Kevin Christie: Yeah, there's a lot going on and I listen to a lot of podcasts on it.

Dr. Kevin Christie: We're trying to, here at MCM, uh, you know, I'm, I wouldn't consider myself an AI expert, but I'm definitely plugged into a lot of different resources and, uh, learnings to keep our company up to speed with that, and then ultimately help chiropractors navigate this and implement certain things like we are with our, our clients.

Dr. Kevin Christie: But one of the things I keep on hearing, I actually listened to an interview of the CEO of Google. And, and funny enough, I know that the, the, at least one, but maybe both founders are back at it big time helping out because it's such a big thing. But they were talking about the idea of the innovator's dilemma, uh, which is when you sometimes have to, uh, burn your money, cash cow producing things to uh, keep up with the.

Dr. Kevin Christie: The trend. And that's a hard thing right now. 'cause Google has obviously done made so much money [00:04:00] off search and, and ads. Uh, but things are changing and they're trying to figure that out. So it's interesting.

Darcy Sullivan: Yes, yes. It's definitely evolving. We'll put it that way. Yeah.

Dr. Kevin Christie: What's the, just give us a kind of overview of what the AI mode is.

Darcy Sullivan: Okay, so AI mode, which. I would suggest to everybody listening is that, you know, after sometime this week, just take five minutes. Mm-hmm. Play with it. Play with regular Google. Play with chat, GPT to ask it. Chiropractors in your area and specific questions. AI mode is more of that conversational search and.

Darcy Sullivan: The way it's delivering information looks different. So for example, before our call, I went to Google and I just typed in Booker Con sports chiropractor. Mm-hmm. And I typed in the same [00:05:00] thing in AI mode just to see how it displays information mm-hmm. And what information it displays. And obviously your, your business is.

Darcy Sullivan: One of the top ones that that's showcased, but yeah. Always nice, right? But it, it, it pulls information differently and it leaves you ready to ask questions. So it could be about approaches. It could be more for that educated user or searcher. So we have to realize everybody's searching differently. Mm-hmm.

Darcy Sullivan: You had the episode on recently about how somebody found you because they were searching for. A doctor who was similar to another doctor.

Dr. Kevin Christie: Yep.

Darcy Sullivan: And that's a very different mindset and of somebody searching versus somebody that's just clicking, clicking on every ad they see for a chiropractor near me. So one thing that we really wanna do [00:06:00] is get into the the mindset and understand.

Darcy Sullivan: The process that people go through when they're looking for your services. And it's really great when you do have that dialect with them. 'cause you do have the data points from Google Analytics and other, other options. But having that conversation with 'em with, how did you find out about us? How you get into their mindset of what keywords are they using, what terminology were they using?

Darcy Sullivan: What sources did they use to, to look up the information? Mm-hmm.

Dr. Kevin Christie: It's, it's fascinating to see the psychology changing and you know, we've seen this in the past where, uh, you know, Facebook dominated, uh, and then Instagram popped up and you saw a difference in the psychology around that, or even who is using it, uh, age groups and stuff like that.

Dr. Kevin Christie: And so you saw a big swing to, to Instagram content. And so now, um, you know, we're in a situation where. AI is changing search. It's higher intent search. [00:07:00] Um, and I think, um, we just have to be pre prepared for that. Right. Um, and I think. One of the things that I had talked about also in that podcast, which kind of just give everybody a little bit of context, was that, um, you know, content is still gonna matter a lot and it probably e even more than than before.

Dr. Kevin Christie: And I want to go, I want to go down that route a little bit and then we'll circle back. I. To some more of the details of AI in search, but, uh, again, not everybody listens to every episode, but Gary V was at, uh, Parker Vegas, uh, the big chiropractic conference and he was one of the keynote speakers and he was talking about AI in search and he talked about just creating a lot of content.

Dr. Kevin Christie: Um, and then I think ultimately why I'm doing pretty well on the AI search is because we've consistently created a, a ton of content over time. And, and that's where the AI is. Is piecing it together as far as what type of chiropractor we are, the types of, um, audience persona that we target and, and things like [00:08:00] that.

Dr. Kevin Christie: Uh, what are some of your thoughts on the content side of things as it relates to where the AI search is going?

Darcy Sullivan: So. When you're describing that you're pushing out a lot of content, it's not that you're pushing out a lot of content, you're pushing out valuable content. There's a huge difference between just pushing out general basic content versus content that relates.

Darcy Sullivan: To your target audience that relates to search terms, that relates to your brand identity. So, you know, sometimes people are like, Ooh, let's go try AI and I'll just have it write all this content for me and I'll have it do all this and I'll have it do all that. And it does, but it also does that for every single other person that asks it the same basic questions.

Darcy Sullivan: Mm-hmm. So content is absolutely. Important. More important now probably than, than before, but it's when it's done the right [00:09:00] way, which you guys are absolutely doing. And I know that's one of the things that you really push through here, but there really is a difference between doing content versus valuable content.

Dr. Kevin Christie: Yeah. And that's why, you know, as you obviously help out with our, uh, media side of our offering with chiropractors is that we, um, you know, it's not canned. Uh, content on video and things like that. We're, we're coaching our clients to shoot for videos and, you know, the idea of turning them into influencers isn't our goal.

Dr. Kevin Christie: Uh, we're not trying to turn them into, uh, you know, YouTube paid a, or getting like a million dollars a year on YouTube ads. Uh, but. With our chiropractors that are consistently creating content, which we're getting them to shoot for videos, and we do all the production, production and editing and, and producing, and then we do all the distribution for them.

Dr. Kevin Christie: So it's going on YouTube, it's, it's going on Google Business profile. It's, we're posting on their Instagram and Facebook, uh, email going out once a week. You're, you're doing a robust blog for our, our members every other month [00:10:00] that goes on their website. We're, we're doing a lot of that so that they. Are creating consistent content that's educational based, like to your point, and it's their information.

Dr. Kevin Christie: It's not just canned, uh, content. It's, it's their info, their expertise. And so when that consistently happens, I think chiropractors need to rewire their brain a little bit on, say, creating content. It's not, I'm gonna shoot this video. I'm gonna get a million views and I'm gonna get 10 new patients from that.

Dr. Kevin Christie: Maybe. Maybe that happens, that's great. But if it doesn't, which is not gonna happen for everybody, uh, you still doing that every month is going to be beneficial. And, and I think high buyers need to start understanding that they're gonna really gain from that, especially against their competitors locally.

Dr. Kevin Christie: Did I, did I, uh, was I accurate in that? Did I miss anything?

Darcy Sullivan: No, you, you did. And when we do talk about content, you know, not just. Video content, blog content, content for the website. We also wanna [00:11:00] make sure that we're you, you're creating content that either fits people specifically at certain stages of them deciding whether or not they're gonna do business with you.

Darcy Sullivan: Or that, and that you also include content that hits everybody at every stage. Mm-hmm. Um, and that you're, you're tying it together because the web is just that. It's a web. And so on your website, when you've got this great content, like it's, it's great to have videos, but if you're gonna put a video on your website.

Darcy Sullivan: You know, you're not just gonna put a blog and drop a video in and be like, we dropped a blog. Um, you need that text for people to gather and read and for Google to grab onto and understand then how does it relate to other pieces of content on your website? Because as we look at these. AI solutions, you know, they're going through and they're crawling all these data points and all this information on your website to provide the best result.

Darcy Sullivan: And the way [00:12:00] that they're able to do that is to crawl and to understand the way that your website works and what your clear offering is. So that's when we do see issues, which we have been for years, of people who had like generic content on their website. Or website that doesn't match what they're offering or they have a chiropractic care page, but it has all of a paragraph on it where it's not giving that robust information that helps AI sort through the information on your website to deliver you as the solution, and not only ai, but also Google and other search results.

Dr. Kevin Christie: Yeah. And that's why it's gonna be so important. And obviously a big part of what we've done over the years, um, with you and on our end is we, we have robust services pages, uh, written content on there, video on there, uh, conditioned pages, uh, of all those built out. That was a project. Uh, and then also the blogs we do consistently.

Dr. Kevin Christie: And, uh, one of the things that we have talked to our clients about on the condition page side of things is like, [00:13:00] look, shoot videos. On a particular, like, make this a project. 'cause sometimes they get overwhelmed. They might have 30 conditions they treat and they want to have 30 condition pages. And I was like, make it a project.

Dr. Kevin Christie: Maybe it takes a year. I think it took us over a year to do, but this was five or six years ago and it's been, and it's been worthwhile. And when we created, you know, we did like three or four per month, and then we would distribute those out as our content through other platforms. So it was killing two birds of one stone.

Dr. Kevin Christie: And so that's something that we, um, we, we talk a lot with our, um. With our members. And I think the other thing that I keep on learning, uh, as I, as I attend some of these virtual summits and certain things like that around ai. Is that it's really gonna be human plus AI is where the magic's gonna be. Not just ai, like to your point, you wouldn't want to go into chat GPT and say, write me a headache blog.

Dr. Kevin Christie: Uh, and then you just do that, and then you take it, and then you put that on your website. Uh, that's just gonna be not, not great. Uh, but [00:14:00] if you had, let's just say you shot a great video, a four minute video on headaches and it's your information, um, you could take that video and up. You know, upload it to something like the script and get a transcript from it and upload it and say, write me a, uh, you know, a page, like an email or something, something written or a social media post or something to help you out to get that video.

Dr. Kevin Christie: Like maybe you're gonna post that video on Facebook and now you have a catchy title and something like that. That's your information and it's you plus the AI helping you out a bit. Um, so I think that's something that people need to understand.

Darcy Sullivan: Yeah, absolutely. And if you are using these AI tools to help you, you know, you shouldn't rely solely on them, but giving them directive about your writing style, showing them examples of things you've written before, um, you know, like you said, with headaches, having them.

Darcy Sullivan: Create a blog, you know, leverage content that you've put together to create [00:15:00] something. Mm-hmm. And then you go back and forth with it. Like, I never, never take it for what it spits out as the first result. And same goes for like, if you're coming up with like a catchy title for your email blasts or your blogs, I always tell it like.

Darcy Sullivan: You know or suggest to people if you're gonna take a blog post and tell it to write an email for you, give it the blog post, but then tell it to give you four variations of what the email should be and why, why it selected them, which one's the best. And then it gives you room to take elements from those.

Darcy Sullivan: And then maybe you like a paragraph from one and a paragraph from other, merge it together, and then you go back to it and say. This is what I have. How do we get this to the next level? That's, that's a very different way than going to chat GPT and just saying, write me an email about, yeah, fill in the blank.

Dr. Kevin Christie: No. Exactly. And that's why I wanna make sure people know, because I do have a feeling many, uh, I'll just talk [00:16:00] about chiropractors, but people in, uh, businesses in general and markers in general are gonna take the easy route and just have AI try to create all its content. And I don't think it's gonna have the same traction, uh, because, you know, AI is gonna know and, and the go, Google's gonna know.

Dr. Kevin Christie: Uh, but let's, let's switch gears a a little bit, um, on the. Physical location. Like if, you know, obviously our audience has physical chiropractic locations for the most part, uh, I psychologically people are probably going to still use Google maybe for that. Like, uh, fi you know, Bo find me a chiropractor near me, or chiropractor Boca Ratone.

Dr. Kevin Christie: Uh, do you think people will do that and have less of a problem than say if you were a, um. You know, maybe you are a news site and you're trying to get people to your, uh, news site to get ads and all that, whereas people might not be looking at that. They might just search, uh, AI for that. Is there any difference there?

Darcy Sullivan: So I would say a couple things. One, I. As a physical [00:17:00] location, you know, you are gonna have people that are searching from their phone. They could be using Apple Maps, um, to find your location. They could be searching online, so you do wanna make sure. That all of your listings online are congruent, that they have the correct name, address, phone number, that, that helps in general because when that information matches, first of all, you want people to show up to the right location.

Darcy Sullivan: Mm-hmm. Um, but that's gonna help you no matter where somebody is searching, the fact that you've got these con, this congruent information that showcases your business.

Dr. Kevin Christie: Perfect. So that could help out a little bit. Um, now on the psych psychology of things are, do you think you're starting to see a lot more people going directly to, uh, ai?

Dr. Kevin Christie: I mean, I know for myself, I've actually, I. Put on my homepage, you can, you know how like on your, on your iPhone at least you can [00:18:00] put a, the app as like a big app on there? Yeah. And you can, what's that called? I forget that. Uh,

Darcy Sullivan: I, I can't remember what.

Dr. Kevin Christie: Yeah. Yeah. But I finally did, did, I finally did that and I've almost like, retrained myself to just ask the AI stuff versus logging on, like going on my Google app that I used to do.

Darcy Sullivan: I, I mean, I, I, I think it's gonna come up to. The way people search and the mentality. Mm-hmm. And the fact that younger people. Are gonna be more adaptive to this. I, I absolutely think that, so one, it, it directly depends on your audience, right? Mm-hmm. I mean, if you are in down, you know, New York City, your audience is gonna be different then if you're in the middle of nowhere and there's one stop sign.

Darcy Sullivan: Um, but I, I think that when you go about SEO from a place. Where you're focusing on amazing content on your [00:19:00] website that truly highlights. Your offerings when you have it properly optimized, when you have your Google Business profile listing properly optimized, when you've given a little love to Yelp, even though I know some people don't love Yelp.

Darcy Sullivan: Mm-hmm. But that you've got quality reviews there, and a couple reviews on Facebook and a couple other reviews sprinkled throughout that showcase that you are a legitimate business no matter the way people search. No matter how people search, where they search is using some form of aggregated data that it's collecting from all these various locations.

Darcy Sullivan: Mm-hmm. Yeah. So even though search is changing, and we saw this before, like it re I back in the day when you, before voice search, you would type in Facebook, CEO. Now you would type in who is the Facebook, the CEO of Facebook, or you would ask it [00:20:00] so. When you get back to basics, when it comes to SEO, everything that we've been saying for a long time is still relevant, if not, mm-hmm.

Darcy Sullivan: More relevant now, it's just that you're casting a wider net, and sometimes when you cast this wider net. Of those data points might not show up on Google Analytics. So you've got to be sure that you're, you're tracking your conversions, how people are actually coming to find you and noticing that there's probably more than one touch point before they make the decision.

Dr. Kevin Christie: Yeah, absolutely. Uh, people are, are doing their, their due diligence now, which is, which is good. Um. That's why I think, you know, that that total web presence that I've referenced before is continuing to do that and trusting that process. Um, you're gonna gain a lot more new patients per year and whatever the effort you put into it and, and return, you're gonna get as long as you do it.

Dr. Kevin Christie: And again, you don't have to be a, [00:21:00] um. You know, a world class content creator on video or an A-list celebrity or, you know, um, Hemingway when you're writing, but it's gotta be authentic. It's gotta be you, it's gotta be educational. I think we have a leg up on that with other businesses that we have a lot of great education, uh, and great information to give out to our community, um, that will be useful.

Dr. Kevin Christie: So that'll be good. But what would be a handful of your recommendations for chiropractors? Uh, just kind of in a little bit of a, a summary of things that. They should be doing, they should be considering doing. I'm not, we're not gonna touch base. One of the things that I kind of thought about touching base on would be AI's impact on Google ads.

Dr. Kevin Christie: I'm gonna do a little more due diligence on that before I, I navigate the, that topic. Uh, but what would be some of your things you would recommend, uh, chiropractors do to try to stay ahead of the curve as it relates to AI and search?

Darcy Sullivan: Yeah, so I would say a couple things. If you're, if you're just getting started.

Darcy Sullivan: Focus on the foundation of [00:22:00] making sure that you have a website, and even though it might take you a year or so, to build out a full robust mm-hmm. Website and be ready to really dive into content that your listings online are congruent, that you've optimized your Google business profile listing that you name, address, and phone number are listed correctly throughout all online listings that you're collecting, those reviews that you're, you're.

Darcy Sullivan: Starting to dip your toes into the world of content. Mm-hmm. And that your website is mobile friendly, that it's SEO optimized, which we don't have time today to go into all of those details of what's required with that. But then once you do have that, then go on that content journey to making sure that your content is in alignment with what people are searching for and that.

Darcy Sullivan: Usually surrounds the services that you offer and the conditions that you treat, which really, like if you're, if you're just getting started, start with the basics, which are, what are [00:23:00] most of the problems and what are most of the solutions.

Dr. Kevin Christie: Yeah, you mentioned like a year to, to do some things and I, I always find it funny because, uh, sometimes people don't get into really making their website, uh, a content rich platform or shooting content consistently because they know it's a, a long game and they feel a little overwhelmed with that project.

Dr. Kevin Christie: But, you know, it's just like, but then, you know, they'll, they'll buy a house and remodel it for a year and it, it, it take that time. But it's like sometimes when you own a business, you. Uh, every business, like if, you know, some of the successful ones, they're, they're making decisions and doing things that they know may not bear fruit in five to 10 years.

Dr. Kevin Christie: Right? Amazon was like famous for that. And as a, as a business owner, you have to start doing things and, and working on, you know, step-by-step and getting going and know that it might not bear fruit for, uh, 6, 12, 18 months, but it will, and you gotta just trust that process. So if you need to completely revamp a website, you gotta start working on it.

Dr. Kevin Christie: If you, if you know, uh, having. 30 condition pages on your website would be amazing, [00:24:00] but it sounds daunting. Start by having two to four of 'em done a month or whatever, and just keep on plugging away. And as you're creating that content, get it distributed out to your audience. So just, uh, take it step by step.

Dr. Kevin Christie: Know that it's gonna be important, especially as we continue to progress through this ai.

Darcy Sullivan: Yeah. And I think that you pointed out a good point there. It's, it's a layered approach. Mm-hmm. And so in your, when you're doing SEO and when you're doing content, right, you're, you're using it also on social media, on your email list and you know.

Darcy Sullivan: I don't wanna jump ahead too far, but I could see in two years, depending on how, how Google sorts things out with how they wanna go with ai. Mm-hmm. You know, are they gonna be looking at the fact that somebody was on your email list? Mm-hmm. Because they're using Gmail and they take that information to also put into the, the factor when they're delivering results in search.

Darcy Sullivan: Mm-hmm. Again, I don't wanna get ahead of ourselves, but you do have this, [00:25:00] again, all online presence that you do wanna make sure that you're providing value, but you're doing it in a way that that's gonna help you now and in the future. Yeah.

Dr. Kevin Christie: I envision, uh, my practice in five years will have a ton of new patients just because AI is sending people to our practice.

Dr. Kevin Christie: Uh, AI is doing my notes and I've got humanoid robots doing things in the practice except for the adjustment. It's gonna be a wild ride the next five to 10 years, and I'm, I'm, I'm here for it. So, uh, Darcy, thanks again for, for bringing your expertise. How can our, uh, audience reach out to you if they need, uh, all things, uh, SEO website and, and everything you offer for chiropractors?

Darcy Sullivan: Sure. They can always visit the website, propel your company.com or they can book a call, um, or find additional resources. And I'll give you an AI guide that we have that you can drop in the show notes. Along with some other stuff if you want it.

Dr. Kevin Christie: Perfect. Thank you so [00:26:00] much. I appreciate it.

Darcy Sullivan: You're welcome.

 EPISODE 427: Your Network is Your Net Worth

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. 

Speaker: [00:00:00] Hey doc. Welcome to another episode of Modern Chiropractic Mastery. Today I'm going to discuss an opportunity, an opportunity to growth, uh, for your practice, for yourself, and, and that is the West Mastermind. We've got an exciting year. In 2025, this is the second year of the West, and we're gonna go right into 2026.

Speaker: Uh, the East Group has been going since 2022, and that one is, is filled, but the west has got a, a few spaces and we've got a great, exciting lineup coming up and I wanted to share that with you and why, you know, why it could benefit you. Um, you know, the Mastermind was developed for practices that are already doing well, already thriving.

Speaker: Uh, and that's why we put a, a minimum revenue on there of 350,000 a year in clinic collections. I'd say many are above that, but we felt like that number was good. We have a lot of, you know, docs out there that are single provider doctors, and that number is a, a very healthy number for a, a single doctor and lower [00:01:00] lowish overhead.

Speaker: But maybe a couple tweaks here, a couple, you know, being exposed to some other people in clinics. Uh, could get you into that 5, 6, 7 and up to a million. We got quite a few clinics that are in those ranges and even surpassing a million, and it's actually been good to have a room filled of some practices that are one, two, $3 million practice and some that are, uh, 400, 500, 3 5700.

Speaker: Uh, a lot of great ideas on both, just, uh, different stages of the career. And we've had doctors that are in there that are in their fifties learning from docs in their thirties and, uh, applying some of those principles to make their seasoned practice even better. So it's been a great, um, both groups have been, been a great array of doctors, different experience levels, different types of practices, uh, all evidence, uh, based.

Speaker: Um, but it's been really cool to see the growth there and I, I have no doubt that you would benefit from it if you are in that kind of stage of your, uh, career. And so we're gonna be in, uh, four [00:02:00] locations next year, kind of run. Give you a little rundown of that. We're gonna be in Tucson, Arizona of every sixth and seventh of 2026.

Speaker: That's gonna be myself, and we're gonna dive into all things in marketing. We will. Uh, work together our group. And that's the thing with the Mastermind. It's not just a didactic lecture, it's facilitating information. And then we work, we set up the tables in a u shape and, and, and discuss things. And when this particular marketing weekend, we'll, um, get everybody's best marketing strategy they've done and work through it and build out a plan for the year.

Speaker: Uh, so that'll be Tucson, Arizona, February 6th and seventh. And the way these are designed is Friday. All day from nine to five in the meeting space. We serve lunch and have lunch together. Uh, then we do kind of a cocktail reception dinner after that as a group covered by MCM as well. Uh, then we have Saturday mornings from nine to one where we dive into material again, and then we typically do something fun that is, uh, unique to that area.

Speaker: Um, and so we will be in, uh, Tucson in February. Then we're gonna move on [00:03:00] to Santa Fe, New Mexico, and that's May 15th and 16th 2026. Uh, that'll be be with Dr. Lindsay Muma and we're gonna be, uh, diving into aligning niche and culture in chiropractic practice. Lindsay has a unique, um, presentation. She gave some of this information to the East Group where you really get clear on your niche and she's someone that has developed a, a unique niche.

Speaker: Uh, that has not only separated herself in her pr, in her community, but also frankly, she's become a, an expert in that, uh, nationwide and even outside of the country. She goes to Europe and and teaches. And so she's gonna, and she's developed a really cool culture in her practice and how that aligns with the niche that you're looking for.

Speaker: And so she will be our guest presenter hanging out with us all weekend. Uh, and that is gonna be Santa Fe, New Mexico. May 15th and 16th. Then we're gonna be moving on to. Sonoma California with, uh, Dr. Brandon Steele, and that will be August 7th [00:04:00] through eighth in 2026. He spoke to our, uh, EASE group this particular year, and that went amazing.

Speaker: That is creating more engaged patients and satisfaction. We really dive into the patient experience and he did a really good job of doing that. So inviting him to come speak to the West Group, and that's gonna be in Sonoma, California at a really cool. A Sonoma type resort that, uh, actually my wife and I got married in and it's, uh, got a lot of meaning there and it's just a phenomenal resort.

Speaker: Um, and we try to, you know, we try to do nice places. We try to bring great presenters and we all work together. I think one of the things that, um, why we've had such a high retention since 2022 in each group is that it becomes that every 90 days where you can go to a cool place. With good people and actually learn and, and really bring it home with you.

Speaker: It's not just kind of theoretical stuff, it's actual business principles, anything business related, and you learn from the group and you learn from the presenters, and then you have consistent [00:05:00] accountability throughout the year, uh, which has, which has been really good. But we, we definitely try to go to cool places, uh, to do that.

Speaker: We're actually, uh, coming up here in August for the West Group this year in 2025. We're on our way to. Uh, Whitefish, Montana. So that'll, that'll be nice. So, but I'm looking forward to getting to Sonoma. Uh, then we'll wrap up the year in an East west combo meeting. So each, the last meeting each year now, uh, the east and the west group meets together and we set that up a little bit different.

Speaker: Nice little end of the year party. Uh, and that one in 2026 is gonna be in Dallas slash Fort Worth, Texas. That'll be October 23rd and 24th. And that's gonna be with Rob Dubay. He's the co-author with Gino Wickman of the book Shine, and he's gonna really dive into. Um, to, you know, disciplined and free 10 steps to peaceful entrepreneurship.

Speaker: If you haven't read the book Shine, I highly recommend it. I had Gina Wickman on earlier this year on the podcast and he did a good, a great job of talking about that and it's a really good [00:06:00] book and so we're excited to facilitate that. 'cause that's ultimately what we're trying to build is really good chiropractors that are also thriving financially, but also thriving.

Speaker: Uh, as a person and as a family per, you know, family or leader, whatever it may be, uh, we want you to really thrive. And the whole concepts around the book Shine and their 10 principles is what helps, uh, develop it. And so that is gonna be, uh, the Mastermind in 2026, if you are around that, uh, 350 k revenue number or, or or damn near close to it.

Speaker: Um, check us out again. A lot of the clinics are above that, so if you're listening and you're a $1 million practice, we have those practices in there. You're gonna help, you're gonna learn from them, but you're also gonna learn from maybe some of the, the younger docs that have some really good ideas. Uh, one of the things that we've been tackling every week and throughout is, is kind of the technology of things and the AI and, um, amongst other things to try to keep everybody up to speed with that.

Speaker: Um, and what [00:07:00] I think what's been great about the the Masterminds is. Um, people keep on coming back. I know it's an investment of, of money. Uh, I know it's an investment of time, there's no doubt about that. But the people that have joined since 2022, it's been pretty remarkable. Um, the, it's like in the 80, 90% range of people that have returned the following year.

Speaker: And then like, you know, we're gonna be going into, we already locked in the, the members for East 2026. And out of the members that started in 2022, almost all of them except for a few, are still with us into 2026. And in the West group, we, we, uh, our first year was 2024. We only had, we only lost one person into 2025 going into 26.

Speaker: I think we're only losing, uh, one or two. One is just due to, um, family commitments. And so you could, you know, if you're interested too, I can even set you up with one of the members to chat about it. Because, um, the proof is in the pudding and a lot of these West [00:08:00] members joined a couple years ago, you know, and had had faith in the idea and the process, and ultimately have been getting great results.

Speaker: And it's that the west group is growing, which is, uh, which is nice to see. And uh, again, we, we try to really give you a, uh, great experience when you come out, but you know, to get away and get off that island of your own clinic, but to actually. Bring home some tangible work into your practice and, uh, we've, uh, got some amazing stories about that.

Speaker: One I'm gonna share here and in a second from Dr. Ryan Wigness who has, uh, a great locations in the Whitefish, Montana area and what the mastermind's done for him.

Speaker 2: My name is Ryan Wigness. I'm the owner of Whitefish Chiropractic at Whitefish Montana. We run a motion palpation based, uh, office. Uh, we also incorporate, uh, DNS, dry needling, laser shockwave, and various other, uh, treatment modalities, uh, to our practice. [00:09:00] Whenever I go to these, uh, uh, weekend masterminds, I come back with a ton of great ideas.

Speaker 2: Um, I'm energized. Uh, my staff is energized by some of the new things that we can do to our office to help our office grow. Uh, that growth has resulted in, uh, over 75%, uh, growth in our, the three years that I've been at the Mastermind, and we're on track for over 20% growth again this year.

Speaker 2: Some of the reasons I joined the Mastermind, uh, three years ago were I had been in practice for 20 years and I was starting to deal with the issues of burnout and lack of time. Uh, I also wanted to implement some marketing strategies, uh, but without having an ability to measure the success of these marketing strategies and not having a good playbook or framework in place to be able to add these, uh, systematically.

Speaker 2: I was kinda stuck in a, in a place where we were doing good, uh, but I wanted to do great and I really wanted to free up more of my time and really get excited about practice. Again,

Speaker 2: I recommend the [00:10:00] Mastermind to my colleagues because it's been a great opportunity to meet other successful chiropractors and bounce ideas off them and kind of get a feel for what everybody else is doing in our profession. We as a group, we've created a really cool community. It allows us to help each other out when things aren't going so well, uh, celebrate our successes, and I've developed some really great friendships from the Mastermind.

Speaker 2: We've been able to grow as a group and as we grow as a group. Uh, it's because of the growth of the individual members and the community that is created in the Mastermind itself.

Speaker: All right. And that's Dr. Ryan Ness again. He already had a really good practice. He had a, actually joined the East Group in 2022. He's one of our founding members in the east and was coming all the way from Montana.

Speaker: And then once we started the 2024 West, he moved into there. And so he's one of our west members. Um, we also, I'm not gonna share the audio of this one, because they were, they were [00:11:00] recently on the podcast. And that is, uh, Dr. Laura and Tyler Wright. Uh, you can look back, uh, maybe six or seven ago episodes ago, they shared their story of, uh, moving to Anchorage, Alaska, and they're in the Mastermind as well.

Speaker: And so sometimes it's growing exponentially financially, and then sometimes it's taking on something that's really hard, you know, the rights would've done that. Anyway. Um, but as they have said, like being part of Mastermind helped them really tackle something very big in their life. And so that was fun to, to watch that happen.

Speaker: And they, uh, now are doing great and it's, uh, you know, got bought a building there and building a practice and we all know what the, the struggles are of that, but they are, uh, tackling it well and they've got us to help them out. And so, um, in addition to when you join the mastermind. Um, we have a Signal App group, which is like a WhatsApp group, and that actually started a couple years ago, and that's been one of the best things [00:12:00] we've added and is very engaged and helps each other out, uh, very consistently.

Speaker: And so you don't, it's not just meeting four times a year and you forget about each other. We actually really keep up. We also do three group Zoom calls with guest presenters on particular business topics. And then you have access to me as you need. To go from there. And so, um, check it out. This is the West Mastermind.

Speaker: Again. The east is filled. Um, but the West has some spots and we would love to have you, uh, join us and help grow your practice. Check us out@modernchiropracticmarketing.com. You can go there. There's a, um, a mastermind tab. You can click on 2026 West and see all the details and you can reach out to us if you want to chat or if you wanna chat with one of our members.

Speaker: Uh, we are here to help you out.

 EPISODE 429: A Special Rebroadcast: How To Become The CEO of Your Practice with Ray Tuck, 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. 

[00:00:00] Today is gonna be a special episode. It is a rebroadcast. Uh, I've never done really a rebroadcast 'cause I always wanna bring you, uh, new content and, but this is with Dr. Ray Tuck. Um, had a lot of people reference this episode, uh, one of the better episodes we had. One of the more dynamic chiropractors, um, sadly we did lose Dr.

Ray Tuck, uh, over about a year or so ago, um, to cancer. Um, he was just quite a human being and obviously quite a chiropractor. And we had him on the podcast, the, the one you're gonna listen to here. And following that, we, I got to know him a little bit more. Uh, we had him come speak to our mastermind group in Fort Lauderdale, Florida in.

2023. And it was, um, quite an overwhelmingly great response. And we referenced that weekend quite a bit in what he taught us. And then he had done a, a subsequent zoom call, [00:01:00] uh, to our mastermind group as well. And just a, a wealth of knowledge and the passion that he brought, uh, to life and to into the profession is unequal.

And so I thought it was, um, a, a, a good idea to, to rebroadcast this episode with Dr. Ray Tuck so you can still gain some insights from a, a legend in our profession. And, um, it's, it, it was just an honor to, to get to work with him, get to know him, and get, and to get to interview him. And so I hope you enjoy this interview from a few years ago.

Without further ado, here is my rebroadcast interview with Dr. Ray Tuck.

Dr. Kevin Christie: Welcome to the show, Dr. Ray Tuck. I really appreciate your time today. I'm excited to dive into this topic of, uh, you know, progressing through this career that we are, uh, blessed to have and going from potentially a treating doctor to more of a CEO role. And we're gonna dive into that. But before we do, tell us a little bit about [00:02:00] yourself personally and professionally, and we'll go from there.

Dr, Ray Tuck: Sure. Yeah. Well, first of all, thank you for having me on your show. I'm really excited to, to, to dig into this conversation with you a little bit. Uh, my name is Rayak. Uh, I am a second generation chiropractor. Uh, been very blessed to, uh, wanted to be a chiropractor since I was a little kid. Um, and, uh, worked in my dad's offices.

Dr, Ray Tuck: Uh, he had multiple offices. Um, so when I graduated in 1997 from national, um, I came back and opened up an office under his, you know, uh, group or umbrella, uh, if you will, of, of clinics. Um, practiced with him for a few years, uh, added up, uh, separating, uh, him from him. Uh, my partner, uh, and I, uh, we. Uh, business partner and I, we, we pulled away and we, we, um, ran two of those clinics for a while.

Dr, Ray Tuck: Uh, unfortunately in, in, uh, uh, 2005, my father had a, uh, [00:03:00] stroke, uh, which was very unexpected. Uh, he was a very young man of 53. And, uh, kind of put me in a unique spot where, uh, I went from, uh, having two clinics and about six employees to about. Uh, nine clinics and about 36 employees, uh, you know, give or take.

Dr, Ray Tuck: And, uh, at that point, that's when I realized I needed to, uh, probably, uh, look at my role in the company a little different. Um, at the time we had probably about, uh, eight, nine doctors. Uh, we were running those offices, uh, brought in some business, uh, consultants to help us kind of build a framework and a 10 year plan on how we would turn it into.

Dr, Ray Tuck: Fruition. So on a personal note, I'm married, uh, with, uh, uh, two children. I've been married for 27 years now. Uh, my wife still talks to me, which we're real excited about, uh, but, and I'm about ready to be a grandfather, so I'm excited about that in September. So,

Dr. Kevin Christie: oh, that's great. That's [00:04:00] great. Um, and, and where, where do you live and where are some of your practices located?

Dr. Kevin Christie: What region? I know you have multiple

Dr, Ray Tuck: Yeah, yeah, yeah. We're in, uh, uh, Virginia. Southwest part in the mountains. Uh, the more rural part of Virginia, Virginia Tech is where, uh, Blacksburg is located, and Blacksburg is our, uh, where our headquarters are.

Dr. Kevin Christie: Perfect. All right. Did you go to Virginia Tech?

Dr, Ray Tuck: My wife did and I went to, uh, Rafford University right next door.

Dr, Ray Tuck: So you have to be a Virginia Tech fan if you live in Blacksburg or people throw toilet paper at your house.

Dr. Kevin Christie: That's right. I went to Florida State, so there was a little rivalry there when Yeah.

Dr, Ray Tuck: We've experienced some of that. Yeah. I was actually,

Dr. Kevin Christie: I was at Florida State when we, uh, we did actually win a, uh, national championship.

Dr, Ray Tuck: Yeah, that Well, that's awesome because something about Florida State used to whip us every time. I don't know what it, that Bowden had it down on

Dr. Kevin Christie: Bemer. Yeah. And then you guys had Michael Vick and that was a little scary, but we were able to, uh, handle that for, for a game. So that was good. But, uh, [00:05:00] I, I appreciate the, the kind of the, the onboarding of, of how you got to, to where you are now.

Dr. Kevin Christie: Um, I, I actually made it public a few weeks ago in my Facebook group, uh, where I'm going to go down this journey as well of. Uh, I've been practicing for 16 years and been fortunate enough to, to do a lot of cool things with, uh, treating, uh, patients in different scenarios. And, and, uh, I'm gonna next year, um, at some point, probably ju, June 30th is the date I've put down to, to step out of, uh, patient care and take on more of A-A-C-E-O role.

Dr. Kevin Christie: Uh, when, when you decided to, to do that, um. Tell me a little bit about your, your, your head space during that time. Was it stressful, exciting? Uh, where were you at on that?

Dr, Ray Tuck: Well, actually Kevin, I'd say it's both. Uh, I was scared to death, um, because, uh, uh, on multiple fronts, number one, you know, I absolutely love treating patients.

Dr, Ray Tuck: Mm-hmm. Um, I had [00:06:00] such a ball, um, and I still probably could say I miss it to this day. Mm-hmm. Um, the interaction, watching patients go from a state where they're not able to live life to the fullest, to, to really helping them achieve whatever their goal was. Uh, however. I will tell you one of the cool things, and the exciting part is, is how can you expand that impact, right?

Dr, Ray Tuck: Mm-hmm. Uh, you know, in southwest Virginia, we really wanted to, to make an impact on our community. So I grew up here, so watching people, you know, in improve people's health and really changing the way they experience healthcare mm-hmm. Was important to us. So putting those energies and experience as a clinician.

Dr, Ray Tuck: Into building a, uh, organization around that I think has, has been very exciting. But it's, it's, it's scary as as hell to be honest with you, Kevin. 'cause you know, if you're producing income as a provider as you are, and you're gonna have to replace that income, right? So that you can continue to, to grow and thrive.

Dr, Ray Tuck: And so [00:07:00] it's, it's a little, uh, it's a little scary at times.

Dr. Kevin Christie: Yeah, no, no doubt about it. I, I would say. Um, I've had this in my mind for a few years. I, I didn't know when it would be. Uh, I've kind of accelerated it a little bit. Uh, I went from part or full-time to part-time after the pandemic, and that's, uh, that was a big jump.

Dr. Kevin Christie: So I'm, I'm treating patients Mondays and Thursdays only and we're doing well. Um, got a great doctor here, it's full-time. And then bringing on another doctor in January to onboard for about six months before I do, uh, step out. Mm-hmm. And yeah, for me, I kind of just, um. You know, I've, I've been fortunate to really grow the modern Chiropractic marketing group.

Dr. Kevin Christie: Mm-hmm. Uh, the Chiropractic Success Academy and, and also the, the practice. And between those three things, I feel like I can make a, a big impact. And it's taking a lot of my time to develop that even further. And, and, and I think the more, uh, hopefully the chiropractors I can impact, uh, that'll, that'll offset some of the.

Dr. Kevin Christie: Maybe purpose [00:08:00] that I'll lose out on treating patients. 'cause it is a big sense of purpose and, and, and you just, I mean, there's so many great things about treating patients, so I, I can appreciate what you're saying on that.

Dr, Ray Tuck: Yeah. Well, and it's funny you bring up about your, you know, bringing on, uh, new doctors because, you know, I think there's a lot of great young doctors out there, uh, that are just graduating and they just want a great home to see patients and mm-hmm.

Dr, Ray Tuck: Be able to focus and give a great patient-centered care, uh, delivery. But trying to find those homes sometimes is a little frustrating for them too, you know?

Dr. Kevin Christie: Yeah,

Dr, Ray Tuck: yeah. Absolutely. So you providing that not only is impacting your patient base mm-hmm. But also, you know, a real positive impact on the profession.

Dr, Ray Tuck: I.

Dr. Kevin Christie: Definitely. And so, um, how, how long would you say you, um, went from the decision you're gonna step out of patient care to the actual, the day? Did you do it, was it a year, six months, four years? What was that process like?

Dr, Ray Tuck: Well, I'm gonna have to dust off the memory plan. Um. I, you know, I, I did go, uh, to a part-time practice.

Dr, Ray Tuck: [00:09:00] Uh, some of that was just, as I mentioned about the, the income reality. You know, when you're Kevin in your practice, you're, you know, you're, you're bringing in cash flow. Mm-hmm. You know, and, and it's, you know, it's the dirty secret, unfortunately, that we are running businesses. I mean, you know, and, uh, now I have to say, in, in thinking about us, hopping on, the one thing that always pops in my mind, healthcare is a, is a fickle business, right?

Dr, Ray Tuck: Because. If you were running a manufacturing company or another group, you know, it's, you know, pro it, it's, it's not bad that profits are your, your main, you know. Kind of, uh, net, you know, KPI, if you will care, but the reality is, is we, we got people's laws at stake here. Mm-hmm. And sometimes the best decision for a patient isn't always the best financial decision.

Dr, Ray Tuck: So you've gotta buffer that in or budget that in, in by. Pulling out part-time and then slowly kind of replacing that with a younger doctor kind of can help make sure that you don't compromise the patient [00:10:00] experience or patient outcomes except make sure that, that you can, um, you know, live a, a, a, a good, good life with a strong business.

Dr, Ray Tuck: You know, a healthy business is part of having, being able to provide great care.

Dr. Kevin Christie: No, absolutely. And I'm gonna give you an example what one of the things I'm doing and, and then I'll let you think on something maybe that you did to help with the, the transition. But I'm going to, uh, I've been in talking with a few different other groups that teach educational workshops and we're gonna have anywhere from four to six, um.

Dr. Kevin Christie: Educational workshops hosted at our office each year and try to turn our, our practice into kind of like a, a learning environment, uh, to where we make sure that my providers also attend those and, you know, really dive into it. Obviously we'll have a lot of other outside providers coming in, but I want to, I really want to make sure.

Dr. Kevin Christie: We kind of attach a clinical training aspect to the practice so [00:11:00] that the doctors that do work here have that continual growth, uh, clinically. And that's something that I'm, uh, going to invest in to obviously make sure that the level of care is what it needs to be in this, in this practice, uh, was there anything in particular that you did to make sure that your doctors really were able to, uh.

Dr. Kevin Christie: Convey the same type of care that you were when you were treating patients.

Dr, Ray Tuck: Yeah. Yeah. No, that's a great question. And, um, you know, and not, I hope I don't dig too deep on, on, on the answer here, but you know, so, you know, I. You use the term evidence-based, it always kind of creates all kinds of emotions and

Dr. Kevin Christie: mm-hmm.

Dr, Ray Tuck: Um, and of course, as clinicians, we always think about evidence-based care delivery, but in truth, whether it's running a business or whatever, it's just taking data, uh, objectively looking at the data and making the best decision. And so kind of along that same line, we created some, [00:12:00] some what I would call.

Dr, Ray Tuck: KPIs or, or key performance indicators. And we had three. Uh, the first one, uh, is patient experience or patient perception of their experience. Mm-hmm. Number two was quality metrics. Uh, we actually sat down and we, uh, asked ourselves literally. What, you know, what does an appropriate, uh, evidence-based care delivery look like?

Dr, Ray Tuck: Um, and we define that to create a quality review. And then our last one is a financial sustainability. Um, and so we felt like, you know, not to overuse an analogy of the three-legged stool, but if you have great profits and a great quality, but you give a crappy experience to your patients, then all of a sudden.

Dr, Ray Tuck: You know, you're not gonna make it. You can have great quality and, and, and great patient experience, but if you're not managing your financials appropriately, again, you know, you, you're not gonna be sustainable for your patients in the future. Mm-hmm. So we leveraged that. And so we trained our doctors on what quality care looks [00:13:00] like, and then we bought, you know, so we defined it, we taught it.

Dr, Ray Tuck: Mm-hmm. And then we, we held 'em accountable to it, and we did that on all three of those areas. Perfect. That your question.

Dr. Kevin Christie: No, it does, and it also kind of touches on something that I've thought a lot about and, and this was one of the things I was excited about talking to you with because, uh, Jay Greenstein had connected us and he had mentioned this, uh, component, but I feel like I need to improve my, and, and kind of doubled down on my leadership.

Dr. Kevin Christie: Uh, and, and I think that's what you, uh, essentially summarized was you took a leadership role in making sure that this was, you know, obviously that the level of care was really high. The communication was good, the trainings were good. And I think sometimes as chiropractors and this, I think I. Is important for our audience to hear, even if you're not, uh, looking to stop treating patients.

Dr. Kevin Christie: But let's say you own a practice and you have team members of any right level, uh, the leadership side of things, uh, would you say that's been one of the [00:14:00] biggest components for you? And then what are some of the things. Uh, I'm gonna kind of do, do a couple questions here at one time. Yeah, go ahead. So, what are some of the things you see in the profession that, uh, say owner chiropractors struggle with from a leadership standpoint?

Dr, Ray Tuck: Sure. Um, you know, I, I, so just, just as a side note mm-hmm. Um, you know, I, I've been blessed to be on a medical board in Virginia. It's a regulatory board, and so I, I had an opportunity to hang out with a lot of non chiropractors that are mm-hmm. Um, that's probably one of the most educational experiences I, I had.

Dr. Kevin Christie: Mm-hmm.

Dr, Ray Tuck: Um, and so when you start benchmarking our patient experience and really our patient outcomes, yeah, we're, we're awesome, man. I mean, we are the tops. Uh, I've, I, I've had a lot of, uh, medical doctors say, man, I wish I could have patients that love me the way your patients love you guys. Um, but where we [00:15:00] sometimes lack is the financials.

Dr, Ray Tuck: Side, you know, and I hate to over overshoot that too much. But, uh, when we dig in and work with other, um, uh, when we dig in and work with other, uh, practices mm-hmm. Uh, we find that their financial reporting, uh, and the feedback that they give their, their, their team, whether it be staff or doctors, is either not consistent, is, is, is skewed in some manner.

Dr, Ray Tuck: Mm-hmm. Uh, and as a result of that, their team doesn't have. For clarity on where the problems are and what they can do to improve. So for me, you know, you bring up leadership. For me, I feel like as a leader, my job is to say, okay, these are what we need to hit to. Mm-hmm. To, you know, this is where we're going.

Dr, Ray Tuck: This is our ultimate goal. But this is the day-to-day information. This is the month to month information, and here are quarterly. Quarterly. We look at things quarterly. As well as daily. And, um, that allows us to align compensation for our doctors. Yeah. With the, the outcomes we want, uh, our [00:16:00] staff the same way.

Dr, Ray Tuck: And by doing that efficiently and effectively, then doctors can spend more time seeing patients, you know, and not spend as much time putting fires out, which we often feel when we're business owners and providers.

Dr. Kevin Christie: Mm-hmm. So you provide the clarity, which is great. Mm-hmm. You give them a platform to, to grow as providers and then they don't have to worry about necessarily all of that stuff.

Dr. Kevin Christie: Right.

Dr, Ray Tuck: Right. Yeah, exactly. Well, and, and it's, it's scary, but the numbers are the numbers. Mm-hmm. Sometimes, you know, and, and I say sometimes, 'cause remember I earlier I said, you know, sometimes the best decision. For the patient isn't always the best financial decision, so they can kind of be at odds. But, but yeah.

Dr, Ray Tuck: I mean, and by doing that, I will tell you, um, as, uh, uh, our engagement with our employees and our doctors is, is better than it's ever been in our group.

Dr. Kevin Christie: Yep.

Dr, Ray Tuck: Um, patients are happier than they've ever been. Mm-hmm. Um, and quite honestly, our profits have been, been better. And, uh, um, and so as a result of that over the last several year journey, uh, which by the way even [00:17:00] predates COVID.

Dr, Ray Tuck: Uh, we, you know, we were seeing these results and that's very exciting to us 'cause we feel like we can just kind of continue to grow and, and expand our impact from there.

Dr. Kevin Christie: Perfect. And what are you, what is your, uh, team meetings or communication look like? Is it, uh, weekly? Do you have gr group meetings?

Dr. Kevin Christie: Sometimes, sometimes one-on-one? Like how does all that look like in your business?

Dr, Ray Tuck: Well, so remember we have, you know, 10 locations. Mm-hmm. Uh, we have, uh, about 18 doctors. Um, we also have a couple other small divisions of our company, uh, which I won't bore you with today. Mm-hmm. Um, and so with that being said, we have.

Dr, Ray Tuck: A leadership team huddle, uh, so every, uh, kind of ahead of each of those departments. Mm-hmm. Uh, and then we have a doctor huddle, and then each clinic has a huddle. Uh, all of those huddles are done weekly. Um, we identify what's called a critical number. Mm-hmm. Um, and the critical number doesn't always have to be a money number.

Dr, Ray Tuck: Mm-hmm. It can be anything that's gonna drive [00:18:00] success, uh, of the practices or the company. Um, and then, uh, we have uh, we actually create a monthly report. Uh, we call it our practice Vital Signs. Mm-hmm. And it's all based on those three KPIs I mentioned. Mm-hmm. Um, and what drives those KPI numbers. And then once a month we meet with every clinical team.

Dr, Ray Tuck: We review that and we're our opportunities to improve on any of those three KPIs. Um, and then I'll, I'll kind of finish with this one. Mm-hmm. And then quarterly, we, we, we base our, uh, we have the review again, but that's where we also base our performance, uh, metrics on it that can in impact their compensation.

Dr, Ray Tuck: Um, so that usually I. Uh, gets, gets their, uh, attention as well. So, yeah,

Dr. Kevin Christie: absolutely. Perfect. Thank you. Um, speaking of, of financials, um, one of the questions I wanted to make sure I ask for anybody that's, and I have some thoughts on this, but I, I definitely, um, haven't ironed it out completely yet, but anybody that's looking to do something like.

Dr. Kevin Christie: This, [00:19:00] uh, what do you recommend? How much of a runway, say after like, you know, they stopped treating patients, is there gonna be a period of time where the revenue could dip, but then come back as long as you're doing the right things? How much, uh, financial backing should they prepare to have, um, to offset any of that?

Dr. Kevin Christie: What are your, what are some of your thoughts on that?

Dr, Ray Tuck: Well, that, that could probably be a pretty I, the answer is yes. Right? Mm-hmm. You know, you need to probably expect a dip. Mm-hmm. Uh, you know, if patients love you, Kevin, the chances of a hundred percent of them just transitioning. To another doctor or probably slim.

Dr, Ray Tuck: Yeah. However, you might be able to capture 70% of them depending on who the doctor is and how well they do, 80% of them. So I think you should definitely create scenarios or contingency plans. Mm-hmm. Um, um, I, I can't say, you know, I would have two months of savings or, or any of that, that. That probably is gonna depend on how much of the pieces you, you [00:20:00] have in place before you make that big, big step.

Dr. Kevin Christie: Mm-hmm. Um,

Dr, Ray Tuck: I would say sometimes you have to double down on your sweat equity probably before you double down on your, on your cash, just so that you can, as much as you can have, if you gotta work a, a little bit on the evenings or weekends or you know, that hustle on the front end's gonna pay dividends.

Dr, Ray Tuck: You know, down the road when you do take that step away.

Dr. Kevin Christie: Yeah. It's funny you mentioned the sweat equity part, and that's been, I've kind of have a, a multi-layered approach here. One is, um, aside from my emergency savings fund, I did not want that money to be tied into this at all. I. That's in case, uh, you know, hurricanes or, uh, right.

Dr. Kevin Christie: Pandemics, right? Uh, but then I put together a, a nice oppor, I call it an opportunity fund, where it's, uh, for me, this is an opportunity to, to buy my time, uh, a bit. And so I've got that there to weather the storm, uh, you know, once that, once I do stop treating patients. So there's, [00:21:00] there's that. But also now that I'm kind of about a year away from that.

Dr. Kevin Christie: And now that COVID, at least down here in Florida, has been, we're pretty good as far as, uh, not necessarily our, our numbers or anything in this, you know, the cases, but, uh, we've gone about our life down here, so there's really no lockdowns and, and stuff like that. So we're, I. I'm getting out there, you know, just getting almost like, uh, I've been practicing since oh five, but I owe my own practice in 2010 and it's almost like I'm doing that again for this next year.

Dr. Kevin Christie: Right? Where, where I'm like getting out there. I'm meeting with a lot of different types of people, getting that community outreach going 'cause we've always been pretty strong at it. And then COVID definitely harmed that for everybody. But, uh, I'm getting really back on the saddle. So that's the second part of my plan.

Dr, Ray Tuck: That, that sounds very sound. And, and I think, you know, you hit a couple interesting points there, and one is, you know, every situation's a little different.

Dr, Ray Tuck: Mm-hmm. . Uh, I will tell you, you know, when we look for doctors that want to join our group, we look for a couple different [00:22:00] things. Um, you know, and coachable is certainly one of them. In fact, you know the joke, uh, we have another partner in our group who, uh, he's in charge of doctor performance and he's really.

Dr, Ray Tuck: The technical term in the healthcare community, they call it a CMO, you know? Yeah. That kind is how he, he, he, uh, his role with our, our chiropractic clinics

Dr. Kevin Christie: mm-hmm.

Dr, Ray Tuck: He says there's one main technique that our doc, all our doctors have to make sure they're, you know, really great at. And that's the f and h technique.

Dr, Ray Tuck: And that is, they gotta be flexible and humble. Mm-hmm. And, and, and that means they're coachable and that means they're willing to take feedback and they're willing to, to not. Necessarily get so wrapped up about being right, but about doing the right thing. So that's

Dr. Kevin Christie: cool. Yeah, that's that's good. That's important, you know, and obviously that can be a.

Dr. Kevin Christie: A problem sometimes. Uh, yeah. I've had associates before, um, and one I, you know, I just had some that were good at what they did, but didn't really bring a lot of coachability [00:23:00] or even, you know, bedside manner to the, to the table. You know, I always liken them to like the Terrell Owens of the NFL, where they're, they're great at what they do, but they're the locker room cancer, and that's not gonna, that's not gonna last too long.

Dr. Kevin Christie: Right.

Dr, Ray Tuck: No. Well, and, and I'm gonna kind of turn that. Table upside down a little bit too. But you know, also I think it's our responsibility as the one hiring doctors to set up a good work environment. You know? Um, you know, 'cause sometimes we and ourselves can take a potentially great doctor but not have the right work environment and we could turn them into that, you know, locker room cancer.

Dr, Ray Tuck: Mm-hmm. Ourselves inadvertently, just 'cause we don't have the right systems in place or not. What, what have you, you know, if we weren't human beings, it would be a lot easier, you know? Yeah. We all act like humans and it really screws things up some days.

Dr. Kevin Christie: It really does, doesn't it? Yeah. I wanted to ask a, a question.

Dr. Kevin Christie: This one's more of a, a selfish one here. We, we are out of network with insurances. Um, [00:24:00] we got a, get a fairly um. Uh, you know, high cash rate, not, not outta this world. We're in an affluent city of Bo Raton. Uh, is is one, is, is your practice in network with insurances? Two, have you worked with other chiropractors outside of your business that you've consulted with that did this transition to kind of a CEO that was more of a cash based practice?

Dr, Ray Tuck: So the answer's, uh, uh, no on the, the last one. Mm-hmm. Um, I really haven't, um, uh, I will tell you, you know, this sounds, I mean, you'll notice I said three KPIs, right? Yeah.

Dr. Kevin Christie: Um,

Dr, Ray Tuck: uh, and none of those three had anything to do with insurance networks.

Dr. Kevin Christie: Mm-hmm.

Dr, Ray Tuck: Um, you know, I, I, this is a personal philosophy here, but our point of entry is a lot less than the average.

Dr, Ray Tuck: Caregiver. Um, so I really think whether you're in network or out in network, if you're given a great experience mm-hmm. And, and, and you're given great outcomes, um, you can set the financial [00:25:00] side up so that, you know, obviously you could price yourself out of, out of business. You know, you don't wanna get too high.

Dr, Ray Tuck: But being out of network sure does, uh, uh, allow you more flexibility to balance, you know, uh, income and expenses, if you will. Um, I will tell you, in our market it's more rural, so we really haven't had an opportunity to, to take that step across the board. Um, but we have taken it with certain insurance companies mm-hmm.

Dr, Ray Tuck: That, uh. Quite bluntly, the cost of doing business with that insurance costs more than we can provide the care. Uh, we're not gonna, we're not gonna compromise quality care just so that we can have that, that, that influx of patients that we're working harder, but we're, we're actually losing ground. And, and I think the term we use for that is it sucks.

Dr, Ray Tuck: Uh, you know, uh, we'd rather focus on doing a good job and, and, you know, we're blessed. We have a great society. We have, you know, our economy is, is great. You know, folks don't giving great product, and [00:26:00] I think people will. So I don't think it matters, uh, from my perspective. Um, we also work with a lot of people that they have, uh, uh, uh, nutritional stuff.

Dr, Ray Tuck: Mm-hmm. Or they have acupuncture or massage income is income expenses or expenses when you get to that level, right? Mm-hmm. Um, I'm not taking a, a stance on what I think is better, or if you should or shouldn't. If you can balance that out, I don't think it really matters. And of course you in your world, you're the marketer, right?

Dr, Ray Tuck: So you know, more new patients in is going to, you know, so the bigger your outreach in terms of patient acquisition, I. The better your bottom line's gonna look if you, if you manage it correctly.

Dr. Kevin Christie: Yeah. And that's essentially, we, we built the practice early on in network, but everything in Florida kind of went ash or, you know, basically 40 to $45 a visit across the board.

Dr. Kevin Christie: And, and it's just too, uh, expensive to run a business here and cost of living. So, yeah. Uh, like you said, we, we had to make that decision. I don't think, like, I never say everybody should be [00:27:00] cash, you know, I think it's all. State based, uh, rural versus urban. You know, like affluence. There's all kinds of factors you, you gotta take into consideration.

Dr. Kevin Christie: I just know that, um, you know, I, I slowly increased our rates over time as my credibility in the community increased. And then it's gonna be interesting to see when I step out if we're able to maintain that. And so that's something I'll have to, to monitor obviously.

Dr, Ray Tuck: Yeah. Yeah. Well, and that's the cool thing about it.

Dr, Ray Tuck: I had a, a consultant once I worked with, he said, the problem, without having that information that you're just talking about, it's like driving down the road with your windshield, you know, blackened out. I mean, you don't have that information. You can't make the right decision or mm-hmm. Am I, you know, should I drop outta network?

Dr, Ray Tuck: Mm-hmm. Just license that. Right. For. You know, um, and unfortunately, as much as we'd love to think the whole system supports that, I think reality is, is third party payers are in the profit game and they wanna make sure that they, they're making their pro their, [00:28:00] their, their, you know, stakeholders happy. And we're not a necessarily one of those stakeholders when it comes to reimbursements and such.

Dr, Ray Tuck: Yeah.

Dr. Kevin Christie: That's for sure. So, um, how many years have you been in the CEO role?

Dr, Ray Tuck: Uh, I have been doing this full-time for, gosh, probably eight, 10 years. Okay. Uh, prior to that I was seeing patients part-time. Mm-hmm. Um, I, I would go back and see patients, uh, uh, part-time here and there, and of course we all have those patients that, that we, you know, we, we we come off the bench for and yeah.

Dr, Ray Tuck: See, but, but I've been in, in this leadership role for that time and, and. I'm not necessarily saying that if you would've, if I would've been in your shoes, I would've had. The clarity to do it. Mm-hmm. But when I went, you know, I mean, we grew up to about 13 s and about 75 employees. Mm-hmm. You only have so much time.

Dr, Ray Tuck: And then I took on some volunteer roles that sucked up a lot of my week [00:29:00] as well. So between those, uh, you know, I, I, it was, I was kind of forced into to it a little bit. Um, but, but I now realize that, that I made the right decision in terms of for me, you know? Mm-hmm.

Dr. Kevin Christie: And our, mm-hmm. And what have been some of the, the positives of, of getting out of patient care for you and your life?

Dr, Ray Tuck: Right. Well, I mean, you know, that's a great question. Um, you know, and I, I can't emphasize enough. I, I still sometimes are very tortured whether that was the right decision, you know, I am a chiropractor. Mm-hmm. Uh, but, uh, but I'll tell you that the positive thing is, is you know, and I now I'm a center it back on the patients.

Dr, Ray Tuck: I tell you, when you've got a lot of responsibility where you've got, you know, even 10 employees and you're. And, and you're having a hard time focusing on a patient because you're thinking about payroll or you're thinking about, you know, you gotta deal with this employee situation, or you're thinking about, you gotta set up the marketing plans and you're building the financials [00:30:00] and you know, you throw all that in there.

Dr, Ray Tuck: If you can't be a hundred percent. Uh, engaged and, and present for your patients. I think you're letting them down. And that was kind of where I felt that my biggest benefit is, is now when I'm working on certain aspects of the company, I can be a hundred percent engaged and I'm not feeling this tortured moment.

Dr, Ray Tuck: Uh, I joke about that chiropractors live their lives in, in five minute increments. You know, um, you know, okay, I'm doing this now I'm doing this and I'm doing this. And, but if you can't see it through sometimes. You, you, you're putting the little fires out, but you're really missing the, the, the big picture, I think sometimes, and.

Dr, Ray Tuck: Me being in this role has allowed me to step up above it a little bit. Mm-hmm. I still can get in the weeds occasionally and make sure it's working right, but I can look at it from a 10,000 foot view better. So, does that answer your question?

Dr. Kevin Christie: No, it's perfect because that's something I've struggled with over the last few years as, as I've grown the, the modern chiropractic marketing group and I travel more with speaking and.

Dr. Kevin Christie: Really creating a lot of content for, for [00:31:00] chiropractors. I've, I've found myself getting distracted during patient care. And I think sometimes the best thing you can do is just be honest with yourself. Right, right. And, and that's where I started to finally be honest with myself and say, you know, I, I can't be distracted.

Dr. Kevin Christie: With patients and give the best care. And I don't see how I can get away from being distracted. Right. And so I think, I do think the answer for my, for my patients is, is to have great providers in here that, uh, will have a less likelihood of being distracted. Right. And so that's kind of the way I've looked at it.

Dr. Kevin Christie: And I've, I've had an intimate knowledge of a couple big orthopedic groups. 'cause I actually, uh, before I bought my own office real estate, I. I just subleted space in a couple different orthopedic groups and they were big ones and they were fortunate enough to have the type of revenue and profits to where the surgeons did, did all the, the doctor work and they were able to afford having kind of [00:32:00] like a CFO or CEO type of role that was a business person, not a doctor.

Dr. Kevin Christie: Obviously it's very hard to do that in in most chiropractic clinics 'cause there's just not enough meat on the bone to hire a $300,000 a year CFO or something like that. Right. And so a struggle. So like you said, we live in five minute increments and we're wearing many hats, and that can be difficult, right?

Dr. Kevin Christie: Mm-hmm.

Dr, Ray Tuck: Well, and the one thing that is probably better now than ever before, and it's something that I would encourage all your listeners to kind of process, I. Man, there's a lot of fractional options now, you know, and, and, you know, bringing in a CFO for five hours a week or 20 hours a month, let's say, uh, that can kind of help you on a strategic level and help you look at your financials.

Dr, Ray Tuck: Mm-hmm. You know, um, you can do the same thing with a CEO, uh, you know, and those kind of things. And so you get the benefit of one CEO working with multiple mm-hmm. Practices, let's say, but it allows you to, uh, [00:33:00] uh, still get the quality of that $300,000. You know, executive, but you don't have to pay 300,000 for it.

Dr. Kevin Christie: Yeah.

Dr, Ray Tuck: Um, and you're right. That's a big thing. 'cause I mean, I realize like we have a CFO, right?

Dr. Kevin Christie: Mm-hmm. Um,

Dr, Ray Tuck: and he has been a, you know, invaluable to us to go to the next level. Without him, we couldn't do what we're doing. Mm-hmm. You know? Uh, on the other hand, if we weren't the size we were, I couldn't afford 'em.

Dr, Ray Tuck: Yeah. So here we are, you know? Yeah.

Dr. Kevin Christie: And there's not a ton of chiropractors out there with, with 10 clinics or so, and, and the type of revenue model. Uh, I, I'm always, I love talking to docs that are doing it because, uh, it could be great to do it that way if you, if you do it the right way, you know? And that's, uh, what's cool about it.

Dr. Kevin Christie: Um, but you're right. I, I did do a podcast, uh. About the idea of having a scaffolding around your business. Mm-hmm. And I have a lot of different types of people that help me. And I do have, uh, Christine Odel, who's kind of my defacto CFO, right? She handles my finances in a [00:34:00] way that's both business and personal, helps me make these decisions and all that.

Dr. Kevin Christie: Uh, she's not an accountant. She's not, you know, a financial advisor. I have my own. Advisor planner, I've got the accountant, I've got the bookkeeper. They keep in communication as well. Uh, so I do have a team around me, uh, that doesn't cost me 300,000. So You're right. Yeah. Right. It, it can be done. It can be done.

Dr, Ray Tuck: Well, and you know, it's funny you bring that up. 'cause you know, one of the things I often run into when I'm working with folks is mm-hmm. Uh, so there's a difference between a tax accountant. A finance accountant. Mm-hmm. A bookkeeper, you know, so you don't wanna go to your bookkeeper for tax advice and you don't wanna go to your tax accountant for how to manage the finances of your company.

Dr, Ray Tuck: I mean, now I got a lot of tax accountantss that may wanna punch me in the gut, but I mean, you know, their, their primary goal is to save you taxes. Well, sometimes that's not the best decision for the company is. It certainly will save you taxes. So there, there, you gotta balance that out. And that's your role as a leader of your business to, to, to, to make sure [00:35:00] you make the right decisions long term and short term.

Dr. Kevin Christie: Definitely. Definitely. And it is great to have the communication with those folks as well. And then ultimately it's your decision. You gotta take all the information in and make the decision. And that's what I've been, uh, trying to do. And as I grow, um. The, the three businesses that I, that I, that I'm part of.

Dr. Kevin Christie: So it's definitely, uh, you know, I, I only have one location, but, uh, obviously three businesses, so there's a lot of moving parts and they all kind of intermingle, you know, it's right. It's pretty cool. 'cause I'll take some marketing strategies and ideas and use my practice as like an incubator for it.

Dr. Kevin Christie: Right. See if it works, and if not, then I'll report back to chiropractors on the podcast and stuff. Right. And, and ba, you know, and vice versa. So it works out pretty well. I've gotten some great ideas from, uh, interviewing people and applied it to my practice and it's been great. So it's, uh, these are like little Trojan horses here.

Dr. Kevin Christie: My, my podcast interview.

Dr, Ray Tuck: Well, it, Kevin, I, next time I go to Parker, I hope I don't get beat up in the alley for saying this, but you know, one of my pet peeves [00:36:00] all the time and kudos for you is. I'm listening to somebody give me advice that hasn't been in practice for 20 years. Yeah. You know? Mm-hmm. Lemme tell you, healthcare is changing quick, so you've got your own laboratory, if you will.

Dr, Ray Tuck: Mm-hmm. So when you give advice, you know, I trust you, uh, because you're, you're living it every day too. Um, and without that, you kind of become detached from the realities of mm-hmm. How hard it is some days to make these business decisions, you know?

Dr. Kevin Christie: Oh, yeah, absolutely. And, and I just wanna wrap up with one topic and, and get your input on it a little bit, and then we'll, we'll go from there.

Dr. Kevin Christie: But, um, you know, a lot of chiropractors will be listening to this and, and they want to, and I actually asked. This que I asked the question in my Facebook group and some people gave the answer. Mm-hmm. And it was like, what's your, your say your exit strategy. And, and a lot of them, their exit strategy was dying on the chiropractic table.

Dr. Kevin Christie: Right. So, good thought,

Dr, Ray Tuck: bad

Dr. Kevin Christie: plan. I know. Yeah. So, so let's talk to the chi, to the chiropractor right now. That's going to die on the, [00:37:00] on the table. Um, I. Even if that's your plan I is that you should at least still gear your practice to run without you or run without you treating patients, because then you're going to have a more successful practice in general anyway.

Dr. Kevin Christie: And there's no reason why you can't still, uh, treat patients. So the, a lot of the people listening to this, uh, aren't. In the mindset of stopping treating, but what would you say to them anyway about, um, setting up their practice accordingly to where it's a thriving practice with or without them?

Dr, Ray Tuck: Right.

Dr, Ray Tuck: Well, at, you know, that's a great question and I'm gonna, I'm gonna answer it with a personal experience. Okay,

Dr. Kevin Christie: perfect.

Dr, Ray Tuck: You know, I'm 34 years old. My father was 53. Mm-hmm. Uh, he had his own, he had five practices. I had two. Um, one day wakes up, he starts having a, he starts having a stroke. Mm-hmm. Six months [00:38:00] later, he passed away from complications in that stroke.

Dr, Ray Tuck: Okay. Yet his business was ill-equipped to handle being ran without him there. Mm-hmm. Yeah. And I realized if I was going to merge the two groups together mm-hmm. It was my responsibility to fix it. So God forbid I get knocked out of a saddle, uh, that. You know, I didn't wanna put that kind of pressure on my son who is actually starting chiropractic school in the fall, as well as the other employees in the group, or the patients and other employees.

Dr, Ray Tuck: I mean, so I have been on this journey for, mm-hmm. Since then to say, how can we set it up so that if I check out tomorrow. Or I wanna go back and see patients, or I wanna, you know, run my little farm full time. Mm-hmm. Uh, the company continue to thrive and grow without me. And I think that, that, that is our responsibility.

Dr, Ray Tuck: Um, and it can be done, uh, as, as in a very effective manner. The way that you want it to be. It's your legacy in a [00:39:00] sense, you know, and, and, uh, so doing that in, in setting up what, you know, an organizational chart so everybody knows who's supposed to be doing what job descriptions, what success looks like in those building financials around those, uh, building clarity on what quality care looks like and what a quality experience looks like.

Dr, Ray Tuck: Then if I check out or I disappear for six months. Uh, you know, 'cause I get some kind of strange illness, I have confidence that the company can continue to run, uh, the way we want it to. So if you don't have those metrics in place, then you start th drifting quick and, and then all hell breaks loose. I hate to say it that way.

Dr, Ray Tuck: And there's a lot of doctors that I. Do die young, and I've talked to them and, and, and you know, it's a sad case sometimes. So Yeah. It's bad for the employees. It's sad for the patients and, and, and certainly it's awful for the families, but, uh,

Dr. Kevin Christie: yeah, definitely. And, uh, you know, that's something that I actually took care of this year.

Dr. Kevin Christie: Uh, I, I had my first son, um, last year right after the pandemic. And so [00:40:00] one of the things I wanted to do. You know, because actually, before I even dive into that, um, just to touch on what you said, it doesn't have to be something that's, uh, where you, um, something as tragic as passing away even. Mm-hmm. It can be, you know, hurting yourself physically.

Dr. Kevin Christie: I mean, think about how many chiropractors hurt themselves. Right. And they have surgery on something, and so you're not practicing now. And so if you don't set up your practice like that, uh, it's, it's gonna be, you know, really difficult When that happens. Um, it happens. So, on, on what I did once I started, you know, we had the.

Dr. Kevin Christie: We had our son and, and all that. I started to realize like I really need to, uh, tie things up from a financial protection standpoint. And so, uh, I won't go through the whole long drawn out process, but I have a pretty good, you know, thought out document of like, if I kick the bucket tomorrow, you know, this is who's going to, um, you know.

Dr. Kevin Christie: Uh, make payroll and manage all the finances of it. I've, I got a, uh, a key person policy of a million [00:41:00] dollars. So a million dollars are being injected into the business account. Uh, who's, you know, should we, who's gonna make the decision if we should sell the practice and who to sell it to the office? Real estate, uh, all those things.

Dr. Kevin Christie: We got a, a will and a trust laid out. Uh, I've got plenty of money in a, uh, from a, not money, but, uh. Mal, uh, not malpractice. Uh, life insurance, like personal life insurance got plenty of money there in case that happens. And so, uh, if, if I did kick the bucket tomorrow, um, my family, uh, will not have to worry about the money side of things, which I think, um, too many people do not take care of.

Dr, Ray Tuck: Yeah. No, it's, it's too true and good for you for doing that. 'cause I think, you know, we innately think we'll live forever, you know? Um, but we, we know consciously we won't. So good for you for doing that. 'cause I think that's the most loving thing you can do for not just your family, but for your people that depend on you.

Dr, Ray Tuck: Uh, both patients as well as, as, as the people that work for you. [00:42:00] So, good for you. Thank you, thank you. It's, uh, it's not easy to have those conversations.

Dr. Kevin Christie: It's hard. Yeah, it's hard. Like, you know, even, even to the point where it's like, what if my wife and I both kick the bucket at the same time? Like, you know, who's gonna raise the child?

Dr. Kevin Christie: Those are hard to, difficult conversations to have, but, uh, you know, it just happens too often, so. Mm-hmm.

Dr, Ray Tuck: Well, and, and worst case scenario is you've set the business up. It's now a stress-free business that produces regular revenue for everyone. Uh, patients are getting great care and you live to a hundred.

Dr, Ray Tuck: So worst case scenario is you prepared all for nothing. Uh, I can live in that world too, but.

Dr. Kevin Christie: Exactly. Well,

Dr, Ray Tuck: so,

Dr. Kevin Christie: well, I, I really want to thank you for your, your time today. You brought a lot of great insights and again, you know, for the audience that's listening, um, I, if you have that desire to get into a more of a CEO role, start planning it out, see what it looks like and, and, uh, hopefully today's episode was really helpful for that.[00:43:00]

Dr. Kevin Christie: Uh, if any of our audience has a question to reach out to you, doc, how can they do that?

Dr, Ray Tuck: Sure. You know, the easiest way is just to email me. Mm-hmm. I'm pretty easy to find. Um, you know, my email is Ray Tuck, seven letters@tuckclinic.com. Uh, we do have a website that, you know, tuck clinic.com or, you know, uh, uh, and that type of thing.

Dr, Ray Tuck: We have a little consultant business that, that we do take a limited number of clients and, and that has a website. I think it's. Consulting services.com. I'm so bad at that part. I can't even remember the exact, uh, uh, domain. But, uh, uh, the easiest way is just to email me. Um, and happy to, to answer any questions and, and be helpful any way I can.

Dr. Kevin Christie: Perfect. Thank you so much for your time today.

Dr, Ray Tuck: Oh, my pleasure. And thank you, Kevin. I appreciate you. Invite me on your shift.