Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
A Guilt-Free Vacation: Leave Your Practice in Good Hands
This article is for the successful chiropractor. You love chiropractic, love your patients and your busy, successful practice. You're the envy of colleagues, friends and neighbors. But I know your dirty little secret. As great as your practice is – you're chained to it. And, if you try to sneak away – even for a short time – it can cost you multiple tens of thousands of dollars. You're a prisoner.
Here's what I mean: You take your family of four to Europe, the Caribbean or Hawaii for one short week. Depending on how you fly, where you stay and what you do when you get there (don't forget the shopping) it can cost $12,000 to $15,000, right? Wrong, and you know where this is going, don't you?
The price of the trip is only half the cost. You lose another $12,000 to $15,000 in practice revenue for being out of the office. And, instead of a jammed packed schedule when you return, the practice seems to have "hurt feelings" and takes a little time and TLC to get back to its old sweet affectionate self. The total damages could exceed $30,000.
A philosophical approach would be that it all evens out, but it's expensive. And isn't this why you become the master of the three to four day weekend vacation? I've met many DC's who haven't had a full week off in a decade or more. A very few have good vacation relief help, but most lose money and patients when they're out of the office. Sound familiar? By the way, how many of you are thinking about a full two weeks off or a solid month of freedom? Didn't think so.
In short, you're a slave to your success. Don't get me wrong, you have it good. Many DC's struggle in practice their entire lives and would give their eyeteeth for your day-to-day life and income. But you're still a prisoner. The handcuffs are gold, but they're still handcuffs.
The good news is, it doesn't have to be that way. You can have more freedom, a better income and a practice that greets you with a kiss at the door when you return after an enjoyable vacation. For example: Dr. John loves his practice. He's also a big NASCAR fan and attends key races with his family in their motor home. On race week, he'll leave town Wednesday night and doesn't return to the office until Tuesday morning. John also takes several weeks off each year. Just ask him about Hawaii. And by the way, John is doing yet another best-ever year in practice.
John has learned to develop associate doctors – the right way. I can hear it already. "I've had associates before and ... (insert negative complaint here.)" I know, I know. "Associates are unmotivated, unskilled, feel that the world owes them and don't appreciate anything you do for them." The fact is, both sides of the owner-associate equation are anywhere from cautious to cynical about the arrangement. That shouldn't be a mystery since most associateships end badly. And, like a bad marriage, each side blames the other.
With so much good possible and the need so great on both sides, why aren't more successful chiropractors developing successful associates in win-win relationships? Who's to blame? In my 25-years of coaching on this subject, I'd say it's usually the owner's fault, but that's good news. Because you can't fix what isn't your fault. In the next few paragraphs I'll give you the strategies and systems that have taken me years to piece together and have allowed me to successfully develop dozens of associates and sell 10 clinics to associates in real win-win relationships.
First, know that all associates want to succeed and some have the talent and work ethic necessary to do just that – so pick a good one. The best question I ask in my interviews is, "What do you want to be doing in five years." If their goals don't match yours, walk away.
Second, frame the game correctly for maximum motivation – for both of you. I tell applicants, "This isn't just a job – it's a career opportunity. Even though I'm the boss – you aren't just working for me – you're working for your future. Whatever your dream practice looks like is what you're working for."
Third, take the time to teach your associate what they really want and are motivated to learn – how to be as successful as you are. Teach the step-by-step nuts and bolts of your success that you've worked hard to assemble over so many years. This is usually where things start to break down – the owner doesn't train and by default doesn't lead. I set aside two hours on Monday to train on every phase of practice success, starting with marketing, patient management and patient care.
If you're not sure what to teach your associate, here are two simple strategies:
- Drag out your favorite consultants notes, update them with the changes you've added and teach that.
- Go high tech and ask a CA to video you from a patient's point of view as you do through your day one, day two, returning visit, re-evaluations and re-reports. You'll capture exactly what you want your associate to replicate including scripting, inflection and facial expression.
Use a simple video-editing program like iMovie and you'll end up with a series of short videos of key patient interactions from doctor's greeting, initial history, exam and x-rays, report of findings – all broken up into short bite sized clips. Don't over think it - just shoot it. Don't like it? Shoot it again.
You can also narrate a series of short "how to" videos on taking and analyzing x-rays, how you arrive at a diagnosis, write up a care plan and interface with key CA positions. And, wouldn't it be helpful to have a number of short videos on proper use of your computerized chart note system? Store the videos in a learning library on your server or a training computer. Your associates goal is to replicate what they see on the video. Don't be afraid of hearing your associate parrot your scripts and patient interactions – pray for it.
I would teach marketing starting day one. If they can produce new patients everything works better. If you and your associate work hard, they'll start to get busy with new patients they produced. However, be careful about taking too much time off too soon. When you know your associate can handle it, have them take care of your practice and theirs on a Friday. Some time later, a Thursday and a Friday while you slip away. Gradually stretch it out as you trust the results.
It's my belief that developing and mentoring young chiropractors will be win-win for everyone.
I woke to a knock on my door at 7:05 a.m. Room service had sent my hot black coffee as my wake up. On my tray was an envelope. I sipped my coffee as I walked to the balcony. The tropical sky, palm trees and beach looked inviting. I pulled up a chair on my lanai and opened the envelope. The fax simply read 2,008. My interoffice manager back in Seattle had scrawled the number 2,008! More than 2,000 visits in one week and I was 6,000 miles away in the Palau Rock Island on a two-week scuba diving trip.