EPISODE 385: The Favorable Research to Support Chiropractic with Shawn Thistle, 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] All right. I'm excited to have Dr. Sean Thistle on the episode again, not the first or the last, and we're going to have a little bit of a kind of an update on the research and some other topics, uh, this, this particular episode. So welcome to the show. Tell us a little bit about the, um, the new world of Sean Thistle and what you've got going on.

Update our audience. This might be the first time they've heard of you. I doubt it, but, uh, what do you got going on?

Shawn Thistle: All right. Thanks, Kevin. It's nice to be back again and always good to chat with you. Uh, these days, um, as always, I'm up to a combination of, uh, helping chiropractors integrate, integrate research into their patient care and creating, uh, evidence based, uh, usable continuing education courses for chiropractors.

So for our colleagues down in the States, I'm a, I'm a PACE approved, um, continuing education provider. And so, you know, I practiced for a long time and then sort of transitioned into doing this full time because, you know, staying up on the literature is a full time job. And putting a clinical lens on things is [00:01:00] sort of what I specialize in.

And we offer a subscription based service with weekly research reviews that many of your listeners are probably familiar with. And the online, uh, continuing education offerings. And then the rest of my time where you and I bump into each other at chiropractic conferences, I'm on the, on the speaking tour and, and run my own events that way and do a bit of teaching at CMCC in Toronto and, um, medical legal consulting in chiropractic cases in Canada is kind of the other thing that I do to, to round out the week, you know,

Dr. Kevin Christie: busy, busy.

And we had a good time in Vegas together there. We had a little, Salon dinner, which, uh, for the folks out there that aren't familiar with that, just a conversational type dinner around a topic. There was eight of us that we kind of cherry picked and wanted to have, uh, diverse thoughts on the, of the profession.

And I thought that was fun and it was enjoyable.

Shawn Thistle: That was honestly, I appreciate the invite to that event. And it was one of the kind of, it was a cool format, first of all. And [00:02:00] I think everybody that was there, it's a way to get. A bunch of people together in kind of a collegial environment that may not have ever sat together and you realize how much you have in common with everybody.

And when you talk about the profession as a whole, only good things happen. And I thought that was really cool. So yeah, that was a really great event.

Dr. Kevin Christie: Yeah. I'll try to do another, another one next year. I'm not sure if I'll be in Vegas, but I'll do it, do it somewhere. And

Shawn Thistle: yeah,

Dr. Kevin Christie: it was good. I think the only thing I would change is get into a quieter environment.

Um, but that's going to be challenging at restaurants, right?

Shawn Thistle: Yeah. It, yeah, I know what you mean. It wasn't that bad though. I mean, it's, I've been in louder restaurants, so it could have been worse. Yes, for sure.

Dr. Kevin Christie: It was very good. Yeah. Very good. Very good. And then the other thing I wanted to thank you for is you've been a big help for our MCM, uh, clients and you're producing the slide deck material, uh, that we post for our clients on Instagram and Facebook.

And, uh, that's been very well received and kind of distilling down the research [00:03:00] into the, to the lay person to consume.

Shawn Thistle: Nice. Yeah. I'm glad. I think I'm always looking for different formats and, you know, when you came to me with that idea, I'm like, Yeah, it's like how, how much, how quickly can you boil down a study into three or four statements and get the point across and stimulate some interest.

And really, like you and I talked about, give our colleagues something to talk about with their patients or help inform patients about what we do at the same time. So, yeah, I like doing it that way. It's cool.

Dr. Kevin Christie: Yeah, it's been neat. And we've had some good feedback as far as what even our chiropractic members have learned by just getting them and reviewing them.

It's like, Oh, okay. I didn't know that that was out there. And I think that's something that I want to kind of roll into and segue is because, you know, it's like if you If you got arrested by the cops in Vegas for doing something you shouldn't be doing, but you didn't know that was illegal, that's not an excuse, right?

The police aren't going to buy that as a, as an excuse for the crime you just committed. And it's kind of the same way with research is that, [00:04:00] uh, as a doctor, um, it's part of your responsibility to know what's out there or coming out there. And if you don't know what the research is and you can't really just say, well, I didn't know that, uh, it doesn't, uh, it doesn't really line up too well.

And so I think, Uh, what you've done is Yeoman's work to really try to educate, uh, the chiropractor on what is the research saying? What's, uh, what, what do we feel really strong about? What are we looking forward to over the next six months or the next year? Um, around that. And so what, what are some of the things you're seeing in the research that you're, um, excited about?

You still got some interpretation to figure out with that. I love the fact that you had a clinical background. In practice and you, and you've been in the trenches and so you can apply it to that. So what are some of the things you're seeing?

Shawn Thistle: Well, I think, you know, the, the, the responsibility to stay current on research is not a uniquely chiropractic problem.

If you're a physical therapist or a cardiologist or whatever your [00:05:00] specialty is. There's some obligation that comes along with being a doctor that you're, you're, you're current on what's happening and the average clinicians ability and willingness, I think, to stay current on the evidence is are both challenges now, because people are busy with their practice and, and, you know, you do a great job dealing with all the aspects of practice on your, your podcast and everything you do apart from knowledge transfer, but knowledge transfer takes time.

It takes some awareness of what the, what kinds of evidence there are. And I would suggest that there's a, there are a couple of issues. Now, there's a volume issue of science that's coming out. When I first started. Reviewing papers for a subscription based service. I was concerned that I wouldn't have enough papers to review 1 per week.

And now, literally, I can do 50 a week and not cover everything. So my job is to help. Identify a variety of different topics that clinicians might be interested in, and not like, low back pain all the time, or something that people might get a bit [00:06:00] bored with, but also help them understand the sort of 30, 000 foot view of evidence and what things are happening and where things are shifting.

So to your question. I think we've, we've made a transition as a profession, and it's, it's partly because of different sources of big data that are available to us now. Like, you have to remember evidence based medicine wasn't a thing until the mid nineties really, uh, randomized trials weren't conducted and until the 1920s or 30s, and they were conducted poorly without much ethics approval and all kinds of problems with it.

But the model that we've always been trying to fit ourselves into as a profession in the last 30 years is pretty new. And we, we've gone from trying to show people that we can conduct the randomized trials and fit into the evidence based pyramid and do what we can to having access to huge databases of real world data of how chiropractors are helping people, uh, you know, in clinical practice all across the United States and North America and in [00:07:00] Europe, for example, and how, you know, the impact that we're having on patients live.

So I think the need for good. High quality, well designed, randomized trials is still there, but I feel like that's being supplanted a little bit by our access to big data, which taken as a collective can show us the impact that chiropractic can have from a cost saving perspective from helping back pain patients avoid opioid prescriptions, benzodiazepines, gabapentin.

I have a review coming out this week on Robert Traeger's new paper about tramadol prescriptions. And how seeing a chiropractor for radicular low back pain can reduce the chances of being prescribed tramadol. And we just didn't have this stuff before. And I don't think we would have pulled this info out of a randomized trial, but when we see what's happening in the real world via insurance data, or however else you can access it in these big databases, there, there are a couple of things.

There's power at scale and the answers are so consistent. They become hard to argue with, even if there are some drawbacks to that [00:08:00] methodology. And I think That's a major shift that that we have to sort of ride the wave of, um, until it sort of shifts again. But I think the narrative around chiropractic care and the impact we can have for patients has shifted more in the last 5 years than it has in the last 30.

And I think that's a powerful thing to to embrace for us. But as you said, it's a matter of. You know, the clinicians knowing what to talk about when they meet MDs or when they meet new patients and have how we network around that and how we integrate our knowledge into actionable things that we can do with patients, referral sources, third party payers and that sort of thing.

So there's still a lot of work to do, but I think, you know, I've talked to a couple of conferences about. You know, do we need more randomized trials on chiropractic manipulation versus exercise for back pain? I don't think we do. They're both clinical guideline recommended treatments. 1 is not necessarily better than the other, but via these big databases, we might be able to pick out.

[00:09:00] when and who would respond better to manipulation or exercise at a different time based on maybe what kind of back pain they have. And the Danes are doing a lot of good work on back pain trajectories now. And I think in the next few years, they're going to help us elucidate seven or eight different types of back pain that people have.

And with. Income in combination with some bigger data there, we might be able to start algorithmically pointing a certain type of back pain to a certain type of treatment. I think that's going to be a golden road for us. If we can figure that out, because that will help the average clinician understand what to do with a patient in their office on Monday morning.

So there's sort of a lot of things happening, but I think the main shift in the last few years has been Is from, you know, randomized trials with 50 patients per group to looking at databases with 115 million people. Like, I'm not sure, you know, you can't compare the impact of 1 to the other anymore. Plus, randomized trials are super expensive to conduct.

Um, [00:10:00] there are even the best design trials are still open to criticism and look, database papers are not perfect either. But geez, they keep telling us the same answer over and over and over again at scale. So I think they're becoming harder to argue with. So that's sort of where I sit on what the shift is.

And it's, it's really exciting to see. And I think what's nice about it is that these results and the impact that they can have on patients are almost a direct reflection of what all of us have seen in practice and what all of us have been waiting for the evidence to tell us. So I think We're entering a really good time period for chiropractors in terms of how we integrate and consume evidence.

Cause it's all lining up pretty well for us at this point.

Dr. Kevin Christie: Yeah, it's pretty cool. And you mentioned big data. I was just at a Jay Greenstein's event in DC and he talks a lot about data as well. Um, based on like what you're talking about, they're looking at even from insurance carriers and competing with them.

And so you're seeing the, the, the data. Really be able to tell [00:11:00] stories in different aspects of the profession. It's excited to be able to leverage that. And, and obviously our, our ability to, um, aggregate and accumulate all that data is getting better and better, which is pretty cool. Are you seeing anything with AI that's helping with, with that, uh, currently down the

Shawn Thistle: road?

In some ways, I'm, I'm the wrong person to ask about AI. That's, that's a J, that's a J thing to talk about, um, as you know, but I think, you know, from a, from my perspective, AI presents a couple of challenges. One is that in some places. These sorts of tools are being used to like mass produce research and it's getting harder in some areas to tell what's real and what's not, but that's a knowledge transfer problem.

I think the power in the AI is going to come in the coming years anyway, in helping us crunch all this data and figure out what's what and come up with these algorithms that might be able to help us in [00:12:00] clinical practice and even identify. Some relationships and other things that we may not have even known were there.

So, you know, I, I think there's a, there's a broad, uh, positive possibility for it, but just like any other application of AI, we just have to navigate it carefully, I think.

Dr. Kevin Christie: No, it makes sense for sure. Um, one of the things I've, I've been, uh, I think a subscriber for three or four years now of your service and what I liked, there's a lot of things.

Um, it definitely helps me keep up to date on certain things, but you'll break it down because then, you know, a lot of times when you, when you're When someone says chiropractic, like, what does that mean? But you'll actually like tease out, you know, spinal manipulative therapy is showing this, and you'll even say, sometimes I see some things on dry needling sometimes and an exercise.

And, and so you, you, you don't just lump it into things and you really carve out what you're seeing. And it helps me as a provider, um, connect the dots or, you know, when something. Like we just had in the state of Florida, actually, um, dry needling. We're allowed to [00:13:00] do now as chiropractors without doing the acupuncture training, which is a big deal for us.

It's it was a big battle just got signed in last week. And I've been able to keep up with like, I mean, a lot of us know this, but I was keeping up with like, what can dry needling do? What's what's the whole. In what we're, uh, offering or in what we're seeing in our patients that we're not getting results in, uh, and what could that fill?

I'm an evidence based model. And so I've, I've always appreciated that. Yeah. And one of the things I did notice is that spinal manipulative therapy has a lot of, a lot of benefits. Um, I think it's, it's becoming pretty apparent. Uh, what are your, what are your, some of your updates on, on that?

Shawn Thistle: Yeah, 1 of the 1 of the things that I put together this year was a 5 hour seminar, like a video based course you can take on my platform with Dr Simon Wang from CMCC.

He's spoken at Parker events in the last few years. So some of your listeners may have seen [00:14:00] Simon. And we put a course together about the mechanisms of action of spinal manipulation and looked at the data and the science on physiological changes, immunology, biomechanics, um, all the way through to contextual factors and kind of the qualitative stuff that might impact treatment response.

And, you know, the, the ultimate punchline from that course is the, the, the, the effects of spinal manipulation are probably. Pretty broad in terms of where they come from. And I think ultimately down the road, maybe 1 mechanism applies more to 1 patient than another. Like, maybe it's the modulation of the pain generating system in 1 patient.

Maybe you're reducing a region of spinal stiffness that was generating some nociceptive signals in another. Uh, maybe some patients feel better over time because they're their immune system responds differently to spinal manipulation and responds well. And for some patients, maybe it's just the act of coming into your office and they love seeing Dr.

Kevin. And I think [00:15:00] we shouldn't stress too much about the mechanisms. It's kind of like geeking out on what manipulation does. And that's why we put the course together. It's been very popular course so far. Because of course, chiropractors are interested in this, but I think, you know, I think The profession has survived over over time in the absence of evidence, because we provide an intervention that patients find helpful.

I think the evidence is going to help us fine tune how we apply that intervention. And I think it's equally as important to know who to adjust. Just like it's important to know who not to adjust. And I think. Once we figure out the nuances there and start to apply it in clinical practice, I think chiropractors have a pretty good batting average overall, in terms of patient, uh, successful outcomes, patient satisfaction and that sort of thing.

But if we can make that even better, the argument for us at a system level in the health care system at large becomes a lot more compelling. And so I think that's, we have to continue to dive into the mechanisms [00:16:00] that way, but also recognize that. We can't define ourselves as one intervention. Seeing a chiropractor and seeing a chiropractor that takes time to do a lot of detailed history and communicate with you and talk to you and empathize with you and be a source of information and comfort and, you know, Support.

I think all of those things are important. And as we see that kind of qualitative literature emerge over time, it's again, just backfilling what we already knew is that, you know, it's something around the whole health care experience that chiropractors provide that's magical for patients. And I think we shouldn't.

be so eager to attribute it directly to the treatment we provide all the time and be open to the fact that it might be some other things. So I may have strayed a bit from where you're

Dr. Kevin Christie: is perfect. You know, cause there's a, it's multi layered for sure. I just think I've noticed a lot from the evidence based chiropractors and some of them are straying away [00:17:00] from spinal manipulation altogether.

And if that's their personal choice, that's fine. And they may be heavy into. Muscle work or heavy into, uh, you know, rehab, exercise, things like that. And I know all that's fine, but I think some of them might just have a void also in, in what the research is saying about the benefits of spinal manipulative therapy therapy.

And so that's not why they're doing it. Or they, frankly, I see some of them, they just, um. They never really put in the hours and efforts to get good at it. So they're not seeing the results of it because it's maybe not a great adjustment being delivered. Uh, so there's a lot of nuances to that, but I just want to make sure that whatever direction the chiropractor wants to go in the services they offer their patient, I'm fine with as long as it's an evidence based realm, but don't throw out spinal manipulative therapy because you don't think it's actually, um, We're, you know, what the, the, [00:18:00] the efficacy is not there or something.

Right. Like it's, it's there. Definitely. And I, and I think it's important for them to know,

Shawn Thistle: and it's, you know, it's maybe we're getting to the age where we're talking about the generational thing, but the fact of the matter is manual therapy is a learned skill over time. And I think what, what I've seen in the real world is that some graduates come out and they're frustrated that they're not as good as the seasoned veteran doc that they start working with, but it's not reasonable to think that you're going to be the same there.

And you've, you talk about developing young chiropractors and we talked about that at the salon dinner too. And, and it's, you know, wanting to, to achieve early in your career, there's nothing wrong with that. You still have to be realistic with yourself about your experience level, how many humans you've had your hands on.

And I think from a, from a 30, 000 foot view perspective, our ability to provide, um, empathetic, comprehensive manual therapy will be a strength of our profession going forward. As medicine [00:19:00] evolves away from touch and personal human interaction with patients as AI starts to weave its way into medicine too.

So, you know, um, there, there's, there's a lot of value clinically and a lot of power in human touch in a healthcare environment. And I think that alone is a reason to continue with manual medicine provided that it's given in. Conjunction with other evidence based treatments and you make those decisions in conjunction with the patient.

I mean, there are so many ways to integrate it. Well, I think abandoning it. And I know what you're saying. I've seen it online too is, you know, there's, there's some frustration with, I think, skill level, so they don't necessarily see the results that they want. But. Again, they've come out of chiropractic school thinking they're going to know everything they ever want to know, and there are lots of avenues.

Like, I'm not a technique guru, but if someone wants to get better at their manual skills, they could go to MPI, for [00:20:00] example, in the United States. Those guys do amazing work and help people fine tune, uh, what they do. And so I think. We have to impart on our new grads the idea that you're at the beginning of your journey, not at the end of it.

And that includes financially, skill wise, uh, cultural authority wise and confidence wise. And it's up to the rest of us who are in practice that work with the younger docs to help bring them along. And I think that's something you focus on a lot through the work that you do. So it's, it's really important to do that.

Dr. Kevin Christie: It's, I'm so glad

Shawn Thistle: you

Dr. Kevin Christie: brought that up. It's really pure gold there. And it's, you know, you have that, you have to have that growth mindset and try to work towards mastery. Cause it's not going to happen overnight. And I think what's happening is certain things, the learning curve is not as steep, right? Like no offense to these things I'm going to say, but Exercise and doing exercise with patients is great and phenomenal.

The learning curve is not as steep as say manipulation, palpation, manipulation, dry [00:21:00] needling. You can, you can get that in a weekend and do dry needling on Monday. The learning curve is not as steep. Uh, kinesio taping, laser therapy, right? Like you name it, a lot of those things don't have a deep, steep learning curve.

Whereas palpation manipulation does, and I'm afraid that too many of the newer DCs coming out are, are, you know, not overcoming that obstacle as Ryan Holly was holiday would say, and they're kind of going to the path of least resistance. And then almost in defense of it. Is saying, well, manipulation doesn't work and it's overrated like all those things to feel better about it.

I'm not saying everybody does it, but I do see that happening a little bit. I do think I do think they need to hit it head on and just say, you know what? Yeah, I'm 26 years old graduating. I'm probably not going to be a skilled hands on palpation manipulation. chiropractor until I'm 30 or 31, or maybe it's 27, whatever it is, but it's going to take some time and you got [00:22:00] to embrace the suck a little bit sometimes.

Shawn Thistle: Yeah. Yeah.

Dr. Kevin Christie: Because on the other end of that is another 30 years of phenomenal practice and benefiting patients. And I think, yeah, I'm so glad you, you brought that up because it wasn't a direction I was necessarily thinking and it's just really spot on.

Shawn Thistle: Well, there are two, two simple facts there and one simple fact is you remember being a chiropractic student.

Who do you primarily work on when you're learning

Dr. Kevin Christie: classmates

Shawn Thistle: who are all young fit people, right? Walk around any chiropractic campus. It's a bunch of young fit people. And then when you get into practice, who are your patients? Like old stiff people, I'm generalizing, but, you know, and all of a sudden, you've got a body type on your table that you don't have much experience with.

And so give yourself some grace to learn. And then the 2nd thing I tell young practitioners is if you move to a small town in Ohio or Ontario or wherever you are, call the oldest chiropractor. In the in the town and go and get [00:23:00] adjusted by that chiropractor and you'll see how amazing they are and and then you'll know what your delta is from where you are to where you need to be.

And so, you know, I don't think we leverage that natural mentorship stream that kind of. You know, our chiropractic colleagues have a history of eating their young instead of supporting them. And I know you help people try and navigate that. And it's an important thing to focus on because the, the younger generation, I know there's some data out there showing that the attrition rate in chiropractic is going up, which is astonishing to me.

You're going to pay all that money, go to school for all that time, come out into practice, and you don't make 200 grand in your first three years. And then you quit. Like, no, it takes time. And there's, like you said, there's, there's, there's good stuff on the other side of hard work and looking at it as a journey, not a destination.

So,

Dr. Kevin Christie: yeah, it's so true. You're not going to make the 200 usually at age 30, um, but maybe at age 40, 50, 60, you know, you could have 20, [00:24:00] 25 years of making that money. It'll put a big dent in your retirement, but it's not going to happen overnight.

Shawn Thistle: Yeah, and there are very few professions where you, you know, if you're a corporate lawyer, you don't start out making 300 grand a year either.

So, that's funny. Sometimes I don't know what people expect. And so maybe it's a, it's a matter of being a bit more, uh, forthright with them when they apply to chiropractic school.

Dr. Kevin Christie: Yeah,

Shawn Thistle: because when I, when I applied, I don't remember ever thinking I was entitled to make X number of dollars when I graduated.

I knew I'd have to go out and build a practice. That was just part of it. And I don't know if that's changed or the expectations have changed. I'm not sure.

Dr. Kevin Christie: Yeah, it's tricky. Um, but I got one more question for you and I'm going to put you on the spot here. Um, yes, sir. Evidence based versus evidence informed.

What are your thoughts?

Shawn Thistle: So I've used both over, over time. I think when I started doing this, I was a staunch evidence based guy. And then I thought that seemed to put people off sometimes, like it made people sensitive. I'm [00:25:00] still not sure why, to be honest. So I shifted into evidence informed for a while.

And then I had a couple of our highest level scientists in the chiropractic profession ask me why I used it. And one of them said to me, well, you're either evidence based or you're not. And I'm not sure what evidence informed means. And it seems like evidence informed is turned into this partial excuse to ignore the evidence.

So, and I think that, you know, the, the language that medicine around the world uses and the World Health Organization uses, for example, is evidence based. So why don't we just use that? And it still means combining what the evidence says, what your patient preferences are, what your experiences as a clinician is.

But that model itself makes a huge assumption. And that assumption is that the clinician knows what the best evidence says. And that's where the, you know, the three legged stool just literally falls over most of the time. So that's what I try to help people with. And I think, you know, we have enough clinical guidelines now for back [00:26:00] pain, neck pain, and the things that we deal with on a frequent basis that I don't think there's any excuse for the average clinician not to have some idea, uh, what the evidence says.

And then the nuances of how the new bigger studies are, are tweaking our messaging and, and helping us, uh, inform patients and medical doctors better about what we do. For example. Is something that has to be done, uh, on an ongoing basis. So I don't really, I'm not offended by either term, to be honest, I kind of get it.

As long as the evidence informed term is not used as an excuse to say, yeah, yeah, I know the evidence says this. I'm just going to do this anyway. Does that

Dr. Kevin Christie: make sense? It makes perfect sense. And you sold me on it because I was drifting away from evidence based and evidence informed and I, that's why I brought it up to you before recorded.

I was like, you know, where does, where does Sean stand on this? Cause I'm getting confused by it now.

Shawn Thistle: It's. Well, you know, I think it also boils down to this 20 years ago to be purely evidence based, there wasn't much you could do in practice as a [00:27:00] chiropractor, because we didn't have a solid evidence based behind really anything we do.

But I think we have some answers now. And so I think it's okay to say your evidence based recognizing that health care comes with a lot of inherent gray areas. And that's okay. But to just turn away from the evidence and say it was too complicated. There's too much of it. I don't know what it says anyway, that's unacceptable.

So I think whatever term you use, you have to make some commitment to understanding what the evidence says. So,

Dr. Kevin Christie: yeah, well, there it is. There it is. We're going to go evidence based moving forward on the MCM podcast.

Shawn Thistle: We'll make T-shirts and stuff. It'll be good . Don't be, don't be scared of it. I guess that's the evidence informed is kind of, I don't know, to me it kind of implies like you're kind of nervous about it.

We have nothing to be nervous about anymore.

Dr. Kevin Christie: No, I agree. That's what's exciting about it and I think we have a great future ahead of us as chiropractors, as long as we stay on that path of mastery and keep on getting better, uh, clinically communication, all this stuff. Right.

Shawn Thistle: [00:28:00] Absolutely.

Dr. Kevin Christie: And you're playing a big role in that.

And before I let you go, how can our audience find out more about what you have going on?

Shawn Thistle: All right. So they can head over to seanthistle. com. That's where all of my courses and research reviews are. Um, if you'd like to on the newest, the new platform, when I, when I created it last summer, uh, we made all of the.

weekly research reviews available individually. So if people want to test out one or two and see what it's like, you don't have to subscribe to the whole bunch. Um, your listeners here can use a coupon code MCM 30 to save 30 percent on anything I do. And, um, if anyone has any questions about it, they can reach me at Sean at seanthistle.

com. And, uh, yeah, I'm always happy to help with, with knowledge integration or seminar speaking or helping people get their Con Ed hours. And. Looking forward to connecting with some more colleagues down in the U. S.

Dr. Kevin Christie: Yeah, definitely. And, uh, I'll put that in the show notes. That is S H a W in. [00:29:00] And so, uh, check that out.

Uh, one of the things I believe wholeheartedly in is delegating and I've delegated that I've been a subscriber of, of yours for a few years now. And it's my way of delegating to get the information sent to me. And so I can keep up with it consistently. I haven't delegated the reading of it. I'm still doing that.

AI is not doing that yet. for me, but I'm reading it, but at least it, it gives, it gets in my inbox. And I know it's like, okay, here's updates. And then it has helped to read through the slide deck material you create for our MCM members. And it's a good way of learning. And it's kind of like Blinkist, your, those little slide decks, like, Oh, I got to read up more on that.

So I can go into log into your portal and read more into it. Uh, that really has helped me clinically. And I appreciate that.

Shawn Thistle: Well, thanks. And, you know, I've got, I think we've, uh, we've done about 1200 reviews, uh, since I started, uh, doing this, we post about, uh, 50 of them a [00:30:00] year. And it's a variety of different topics.

Uh, if you subscribe to the whole bunch, as you know, you can search by topic and they're organized by topic. Um, so you can answer more specific questions and. As always, if anyone has something they'd like me to review that I haven't reviewed before, just let me know. Sounds good, Doc. I really appreciate your time.

All right. Thanks a lot, Kev. Great to catch up with you. Keep doing

 EPISODE 386: Marketing to the Active Care Patient

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 for you. And this is marketing to the active care patient. And I want you to kind of think about it more as communicating with the active care patient. Patient, and that's typically what marketing is, especially when you're doing ethical, elegant marketing, content marketing, education based marketing.

It's going to be all about communication and you know, there's three phases, uh, to a patient life cycle. There's the new patient. Right? That's part one. Two is the active care patient. And three is the inactive care patient. You should be doing marketing for all three phases of that patient life cycle. Uh, but today we're going to dive into, uh, the active patient, right?

That active care patient and give you some ideas to communicate well with them. And the reason why you want to do this, [00:01:00] honestly, is is it all comes down to patient outcomes. Everything is about patient outcomes, especially for the evidence based chiropractors. You know, we, we want to be patient centered, but the reality of it is, is, You know, we can be patient centered.

We can be outcomes driven and do it in a way that, yeah, it helps our practice. It helps it grow. It helps it thrive. It helps it, um, you know, have profit margins that you can reinvest in yourself and in your team and in your patients and ultimately provide a great experience. It's okay to make decisions that are both patient centered and.

good business decisions and good strategy, uh, to have a healthy practice. And I think this phase of the patient life cycle, uh, goes unnoticed. Sometimes, you know, we think a lot about new patient marketing and we think about reactivations and that's kind of that phase one and three that I mentioned.

Right? So new [00:02:00] patient and inactive patient, we, you know, we hear a lot of people talk about reactivations and those are all. great. But this active care patient, this, uh, this stretch of time with your patient goes on notice from a, um, let's just call it, you know, communication and marketing standpoint. And, uh, you know, the active care patient is obviously from when they come into your office for the initial exam, uh, all the way until they are discharged from care.

Even if you put them on a performance or a maintenance care, um, that's fine. That's going to be after the They're the active care. And so we're going to define it as from first visit to discharge from care as the active, uh, care patient. And what's going to happen is if you do effective content, education, marketing, whatever you want to call it for that patient, three things are going to happen.

You're going to increase the adherence. The patient adherence to that treatment plan, which is frankly going to, [00:03:00] uh, optimize their patient outcomes, right? A lot of times patient outcomes suffer because you have a leak in the bucket and patients are not adhering to a, uh, a standard of care, uh, that is, that is good for them.

And so you're having outcome issues there. The second thing it's going to do is they will potentially utilize more services that you believe in, right? Services that are going to help. them. It might be services, it might be products, right? And that's fine. You shouldn't be shy about having add on services.

Uh, that are going to help your patients. And then third, it's going to actually help you get more referrals. The way it gets more referrals is the fact that a patient refers people to you at the most opportune time for them to do that is during their active care plan with you, right? Like if they're with you for a month, that is the most likely.

referral time period that they're going to send friends, family and colleague [00:04:00] members, uh, to your practice. And so if you do a great job of educating your patient during that period of time, there's going to be a higher chance that they refer more, you know, if they get an email from you and they're like, Oh, I didn't know you treated.

TMD, TMJ, they probably don't know what TMD is, right? But, uh, or plantar fasciitis, if you're giving them like information on some of the things that you treat, they're going to know how to refer to you. So those are the three things that really good, uh, communication and marketing to the active care patient does.

One is increase patient adherence. Two is increase, Utilization of services and you're going to get more referrals, right? And, and that's a, that's just a key aspect of building a sustainable and thriving practice that has different, um, you know, different peaks and valleys. And we want to really, um, get the peaks higher in the valleys higher as well.

not lower. Uh, so we, we want to [00:05:00] make sure we smooth out that a little. And the patient adherence, I think, is, is one of the biggest things chiropractors struggle with. And it really impacts your, um, your outcomes, like I mentioned, and it just impacts your business too. And there's a handful of things of, of why a patient prematurely falls off.

It could be financial, right? Um, Um, if you have higher prices, if you're at a network, um, probably going to happen more often to you than if you are in network with all the insurances or, um, you know, your, your particular state has lower co pays and lower deductibles. So, you know, finance is definitely a part of that.

Um, maybe, uh, they, there's a time issue, uh, maybe you're too busy and there's not enough availability for them. Uh, there's a lot of things you got to look at from that perspective as well. Um, maybe they're not getting better after, [00:06:00] you know, they gave you three or four visits and they're not better and they weren't, uh, properly, um, educated on what their low back condition was going to be like.

And so maybe that happens, or sometimes. They actually feel better. Um, they get better pain wise, but maybe they're not better function wise. And you got to be able to explain that to them. Maybe they're not just, they're just not bought into what the experience is or the guidance you're giving them. And those are the things that you really have to make sure your communication is on point to, to really improve this.

Okay. So I want to, dive into seven things that you could improve on or do, um, to communicate with that patient. And this is more about really educating them. There's other ways of communicating, obviously, like a, you know, an appointment reminder text is a way of communicating, but that's not necessarily marketing.

That's a good thing to [00:07:00] do, but I'm not going to dive into that type of stuff as procedural. Okay. So the first thing is, is your report of findings. Um, you gotta have a great report of findings. And, um, I think a lot of chiropractors struggle with that. We actually just did our, one of our big coaching calls here, uh, this week on report of findings and, you know, how we story branded asking the dance, all that are factor question at the history, uh, having confidence in what you're Uh, providing them, we go over the clinical compass evidence based guidelines for treatment frequency and duration, a lot of things that we have a very nice step by step approach for a report of findings that isn't.

Um, brow beating anybody. We're not having this big dog and pony show. You don't have to bring the entire family to report a findings. It's actually just being a really good doctor and having great communication with them and having an effective way of talking to them and giving them the particular information they need to feel good about the guidance that you're giving them and [00:08:00] the leadership that you're providing for them.

And so, uh, you gotta get really good on your report of findings and do it. I mean, it takes us like three to five minutes. And it's a nice dialogue. It's not drinking water out of a fire hydrant. It's not 25 minutes, and it's not a sales job. And so, um, report of findings is a big one. So that's number one.

We, we, we work with our clients a lot on the findings and especially if you have associates that need to, you know, Improve on that. We do a lot with that as well. Uh, number two is consider a really nice new patient packet for your, for your new patients, right? Um, have information on there. Some of the other services you do.

Uh, if you have something like Cairo up, I recommend putting the condition report in there. It doesn't have to be this huge, big thing, but it could be a nice little. Packet or folder with pertinent information. If you offer things, things like shockwave or laser, whatever, have information about there. Um, we also give out, we have those healthy info cards, which actually you can get for [00:09:00] free on our website, go to modern chiropractic marketing.

com. Um, there's a resources tab and you'll see healthy info cards. We have micro break cards, desk ergonomics, cards, carpal tunnel stretching. So basically it's for the desk worker. We also have certain things on there, like the. Core exercise card and you can actually download that it's PSD files and send it to your graphic designer.

and you can rebrand it and put your clinic information on it. And we print it out on these really nice card stock. And so we give that to our new patients, the pertinent ones. I think we have five on there. And so we pick whatever ones that, um, make sense for that patient and give that to them. So consider a nice little new patient packet.

With some good educational materials in there,

the next one we do is I use an app called Bonjoro and it's, uh, it's 25 a month. It's free at first, and you get to a certain point, then it's 25 a month. And, uh, basically it's a video [00:10:00] app. It does other things, but what I do is, uh, we get a new patient and then that next morning, I will, uh, shoot a quick video.

It's just me holding my cell phone up, kind of like selfie style. And for like 30 seconds, like, Hey, John, this is Dr. Christy. It was a pleasure meeting you yesterday. Um, we're looking forward to get you back to playing some golf. Uh, don't worry if you're a little sore, that can happen sometimes. Uh, not, not a big deal, uh, to be glad it'll go away.

Make sure you do the. The stretches we gave you and we look forward to seeing on your next visit. Right? So it's a personalized little video. And then what happens is from the app, you actually, it emails to them, but when they open up the email, it's, it's a nice video that's embedded into the body of the email, like a thumbnail and they can click it and watch it right in the email, right in the email.

So it's not like an attachment and it's just a nice thing. It's kind of in lieu of calling your new patients and seeing how they're doing. That's fine too. That's really good. A lot of people obviously just go right to voicemail, but you can leave a voicemail. Uh, but this is my way [00:11:00] of doing it to where, honestly, I just don't want to necessarily get on the phone and have phone conversations with all the new patients, uh, but there's nothing wrong with that.

Uh, but the bonjour has been a really nice touch and we get a lot of great feedback from there. And that's one of those touch points. That's, um, I think it's important. I wouldn't necessarily call it. Uh, you know, it's not a ton of content education, but I do try to put something in there where I want to reiterate, like, don't worry if you're sore or don't worry if the pain doesn't go away or whatever it is like to something that might cement for them, like, okay, I'm, I'm in the right place.

And so that is spelled B O N J O R. So bonjoro.

Next is an email onboarding sequence. My first caveat to this is if you get a new patient that signs up your practice and they get a slew of emails with paperwork, and then they're getting email reminders for the appointment and they're getting text messages, [00:12:00] you may want to avoid this. You want to audit how much communication they're getting before they even come in or that first, um, you know, few weeks of care, but you could do a nice email onboarding sequence.

We have one. And it's, uh, four emails and it drips after like they, they've come in the practice, they've, they've been in one time, their email gets sent in. And then from there, uh, they will get a welcome email. And then the second email will be about, um, a lot of the low back conditions we treat. Then the third email will be a lot about the neck conditions we treat, even though we treat a lot of stuff.

Those are main things. And then the fourth email is actually an email of some of the other services we have. So we're educating them on some of the main conditions we have and then obviously some of the services and so you could do an email onboarding sequence with MailChimp. Uh, if you're a member of our Chiropractic Success Academy, we have a lesson in there on that.

Uh, but MailChimp, if you have or whatever you use, we'll walk you through and help you out.[00:13:00]

Fifth, I think is a nice new patient tour. All right. Again, if you have cool services, maybe you have a clinic gym hybrid or you have shockwave or laser or dry kneeling or a stretching person, whatever, there's a lot of things you may have. Um. Yeah. Yeah. Um. Give a nice tour, especially if you're proud of your office, do a new patient tour, make sure you show them the different opportunities they have in your practice as far as health, maybe a functional medicine doctor or some integrated medicine, whatever it may be, heck, even if you ran out, you know, to like, we ran out to a physical therapy group and we have a massage therapist.

And so we will mention them in our tour. And so consider a new patient tour that is not overly done, but nice and gives them a little walkthrough of what to expect and then some of the services, uh, you have. And so consider a, a new patient tour. Um, the next thing that I really, I like doing is we send a welcome letter to our new patients and we have kind of a template through there.[00:14:00]

Again, we coach our clients on this, how to have a tailored but templated welcome letter. And so we are, yeah, I'm sending them a Bonjoro video. And then they're getting a letter a few days later in a mail. We're, we're really welcoming to our practice and we're communicating with them and we want them to feel like, you know, they're in the right place and they're getting a, a remarkable experience.

So consider that. That, um, welcome matter letter in the physical mail. So mail it to them. And then lastly is there's a lot of opportunities to send your patients videos or blogs that you've done as content, right? And so some of the examples I give for this is if a patient asked me about mattresses, we have a whole mattress buying guide on our blog.

So I'll go over to my computer. I'll snag that from our website and I'll email it right to them through our EHR system directly. Um, or, you know, you get a runner and they, I asked them if they do a pre run warmup and they don't. So I walk over to our YouTube channel, get the link to [00:15:00] a pre run warmup we did and email it to them right through the EHR system.

Another one is, um, is, uh, People with low back pain and they got an air travel coming up. We wrote a blog on how to travel via plane. When you have back pain, I'll go over and I'll email it to them. So you can use the content you have to educate them during their active care patient, uh, experience. And that way it helps educate them.

And it's a great opportunity to improve their outcomes. And so just to, you know, Reiterate, you got seven and I'm sure there's more, but I'm just going to start with these seven. Make sure your report of findings is on point. Consider a new patient packet. Look into Bonjoro. Email onboarding sequence could be done by your email platform, not your EHR.

New patient tours can be really nice. Welcome letter in the physical mail, in the mailbox. I know it's hard for you to believe that sometimes you can send mail in a mailbox and then lastly educating your [00:16:00] patient through your videos and blogs that you have done and that will be a really good, um, you know, it's just a comprehensive strategy to get education and communication to your patient during that active care period.

Phase, which again is from new patient to doctor discharge. I hope that helps. Um, we'll probably do some other solo episodes where we tackle a little bit of new patient cycle and then also inactive patients have a great rest of the week. Talk to you soon.

 EPISODE 387: 5 Weekly Touch Points with Ashley Jordan, 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. Today I have Dr. Ashley Jordan, who's going to join me for a conversation. She is actually one of our associate coaches here at Modern Chiropractic Mastery. And we, um, have had a great year. She started in January, 2024. New coach, um, has been one of our coaching clients for five years.

She shares a little bit of that story, but we're going to dive in today about community outreach and what they've done in their practice to do that. What she's doing to help our clients and some of her one on one coaching clients. But then also, uh, she does a monthly creative call. Um, the first Thursday of every month and the, uh, great thing about that call amongst many is that, uh, we have owner doctors on there.

We have associates on there. A lot of the owner doctors have their associates on there. Uh, sometimes there are team members because that call is all centered around create creative and so creative around community outreach, what to do, you know, [00:01:00] credibility, enhancing things, how to organize it and structure it.

For maximum benefits, campaign ideas for marketing office initiatives internally to drum up some energy and excitement with your patient base. And that call has been great and well attended since we launched that five or six months ago. And so we're going to dive into today a few things. Uh, we're going to dive into her idea of the five weekly touches in the community.

Uh, we're also going to dive into even some burnout prevention and things of that nature. And just some of the things, uh, she's seen over the last five or six years with the exponential growth of their practice. And we outlined that and, uh, you know, you're, you're going to hear the growth that the practice that her and Brittany have had, and it's pretty substantial in a shorter period of time.

And I just want you to know that you can do that if you have the right guidance, the right coaching and you, and, and you put in the work, um, You can definitely do that. And I've seen it firsthand, obviously many times, uh, with some of our clients that do put in the work and it's, uh, it's pretty [00:02:00] cool to see it's, it was, it's been a fun, um, exponential ride for Ashley and Brittany, and now they're part of our mastermind group as well.

And they're just really putting in the work and getting all the, the results that we all dream of. And so we, uh, we dive a little bit into that today and talk about things you can do in your practice to increase, uh, your community outreach and bring in more. A new patient. So without further ado, here is my conversation with Dr.

Ashley Jordan.

Dr. Kevin Christie: All right, Ashley, thanks for, for joining. Uh, it's the first time you've been on the podcast since you are now a official MCM coach, you and Brittany were on it, uh, uh, before that, but you in January, uh, joined forces with us here at MCM and it's been, it's been awesome. So, uh, welcome back to the show. Yeah.

Ashley Jordan, DC: Great to be on. Yeah. So, uh, we're going to dive in, you know, we're going to kind of talk about something I think that's important, you know, in the last, I would say 10 years. I think it was 2014 where I really [00:03:00] dove into, um, content marketing, digital marketing, social media. Uh, I vividly remember that because I joined strategic coach in 2013.

Dr. Kevin Christie: And then it was in 2014, I got a letter from strategic coach, uh, Uh, and it was, uh, promoting Joe Polish's Genius Network. And, uh, Joe Polish is a world class marketer for, since the nineties. And I was like, who's this Joe Polish guy? And I looked it up and he had a podcast, uh, with Dean Jackson. And that's when I was diving into it.

And, uh, and then ultimately. We here we are 10 years later, and I think it's been interesting to see the progression in the landscape of the, uh, online marketing we'll call it, or the digital marketing. And, you know, when I talk about that, we're talking everything from, uh, Google to Facebook, to Instagram, Tik TOK, I mean, YouTube videos, like the whole nine yards and having that, uh, total web presence.

And I don't think it's, it's, [00:04:00] we. Highly, highly, highly recommend doing all that stuff. And I mean, that's, what's just been amazing, uh, for my practice, but it's, it's changed. Uh, what have you seen change a little bit over, over the last five or six years in the online world? Um, we started out with just doing the super basic videos and, um, definitely not just doing the online world and more or less doing a little bit of online, but definitely getting out.

Ashley Jordan, DC: Into the community and also just being consistent with online, right? Like you just get your videos out no matter what.

Dr. Kevin Christie: Yeah, absolutely. And you guys have been really good at that. Um, and I, the way I, we talk about it, obviously when we're coaching clients is to have a really thriving influx of patients.

Um, you know, you want to, you want to market for new patients. You want to market to the. active patient. So when they're, [00:05:00] um, you know, basically a new patient all the way until you discharge them. So that active care and then they're inactive patient base, you want to be marketing to them. And, and there's a lot of creative ways of, of doing that.

And so we talk about that. I'm going to put that aside for now. And then the other thing we talk about is having a. A really well rounded approach in your community. And when I say community, I'm going to, that's going to be, you know, people you don't know, that's going to be your patients, right? And there's three things I look at for that is, is one is, uh, definitely want to optimize the patient experience and get.

Patient referrals. We all know that the patient referral is, is kind of your best bet for getting new patients. And, and then the second thing we talk about is that total web presence and all the online and digital content you're, you're getting out there. And then the third thing, and what we're going to really kind of dive into today Is is building that network of people that are referring to you.

And these aren't necessarily your patients, right? [00:06:00] These are kind of gatekeepers. These are the personal trainers, the yoga instructor, the doctors, the attorneys, uh, people in the community. Maybe it's your church. Maybe it's a B and I group. It's just, it's just this almost army of people. It's the bike shop guy who does bike fittings.

It's the running shoe store. It's like, I mean, it's just all these folks that know you as the expert and, and doing that. And that's kind of that community outreach that we, we talk a lot about. And so that's why I want to, I want to dive into that, um, today and get some of your, your thoughts on it. Because I think what's happening is too many of the.

of the younger DCs, and I would say the younger DC now is probably 25 to 40, um, who's grown up with this digital marketing, is only relying on that. Are you, are you seeing some of that? And what are your thoughts on the chiropractor that's building, trying to build his or her practice, and it's just online only?

Ashley Jordan, DC: Yeah, it's definitely, Uh, with COVID, I think a lot of people switch so [00:07:00] much to just the online and now we have to start getting back out in into the communities and start building back these practices again.

Dr. Kevin Christie: Yeah, that's a good point. I didn't think about that with the, with COVID, obviously that was the elephant in the room for that.

Um, and you know, we're, we're here, we're, we're big proponents of online marketing and content and getting creative and we teach chiropractors how to obviously get even better at that and, and kind of cut through the, through the noise. Um, but, but something I think that we've been doing really well, uh, with, uh, with our members is a community outreach plan and, You've been kind enough to you're doing a monthly creative call to our members and it's all around this.

Can you just uh, first dive into um, kind of the Framework of what the the monthly creative call is that you're doing.

Ashley Jordan, DC: Yeah, so we break it into three different parts The first thing we do is talk about all the monthly campaigns, which again, that's all the online stuff And then we go into [00:08:00] different community outreach ideas And then we always end with a few different in office initiatives that people can do in their office.

So, it's been super good to just get our clients all rolling on like this full framework instead of just the online.

Dr. Kevin Christie: Yeah, and that was your idea when you You came on board to coaching is like, cause I think you, I think you noticed it when we were doing our regular traditional coaching calls or our group calls and stuff.

And there was a lot of need for that and clarification on it. And even, and even like planning of it, right? It's like, if you go, you know, for instance, we go to this tennis academy every Saturday and we work on some of the tennis players and it's, uh, you helped you and Brittany helped develop a. You know, a whole QR code process that goes to a Google form that goes to zaps over to your email list and like a whole, whole kind of backstage of it.

And I think that's something between certain ideas like that. And also our CSA digital dashboard, where we have all the planning tools for community outreach and, and [00:09:00] really. Working on that backstage of it too, and getting, make sure you organize it and cultivate those leads. And so that's been a nice to, to really work with our members.

And we've gotten a lot of good feedback on that.

Ashley Jordan, DC: Yeah, for sure. I would definitely say it's more like an and not an or to make sure you're doing all the things and not just community outreach or just social media. The best, the best bang for your buck is to get that whole, that whole, whole model.

Dr. Kevin Christie: Yeah.

And let's, I want to dive into the community outreach side of things. Um, what do you think is some of the limiting thoughts on it from a chiropractor or some of the things that kind of roadblock them in actually getting out there and doing it?

Ashley Jordan, DC: I think setting aside the time, like when you're first starting out, people think they need to be in their clinic close to 40 hours a week, right?

Sometimes you've got to carve out these times and sometimes you've got to work weekends when you're first starting out. Heck, we're still [00:10:00] doing one a quarter at least of getting out to a 5k. So I think those are the big ones is you have to set aside the time. And then even walking into a place cold can be tough for people.

So I think those are, those are big, big couple of different ones.

Dr. Kevin Christie: Yeah, definitely. And, and, and don't be too good for it. Right. I think that's something I noticed is people think it's like, ah, you know, I, um, you know, I got in this to be a doctor, not to, to be, go out and promoting myself, but you can't be above that.

I mean, heck I'm 20 years into it. And actually tonight, the day we record this, not, not release it. I'm going to a, um, a running store at seven o'clock tonight. I'm going to go home after work, have dinner with the family, come go back to a running store because they, they, They do a big, uh, Saturday running group in tonight.

They do the kind of kickoff, uh, introduction and they let me come and speak for, for like seven minutes, you know, and, um, and so, but it's an opportunity and I'm going to do it. You know, uh, my, my [00:11:00] associate is, uh, in Colorado Springs actually for, uh, active release technique training. So I'm going to dive in and do that.

And this Saturday I'm actually, uh, once a month I do that tennis academy. So, uh, you know, I'm not, I'm not above it. And I don't think anybody should, should think that. Do you, do you see that sometimes where they think that's, yeah, I don't really want to be going out there and doing that type of stuff.

Ashley Jordan, DC: Yeah, for sure. And like us personally, even though we have our associate getting out there, we make sure that we're doing our same five community touch points each and every week. So definitely make sure that everyone's, everyone's contributing.

Dr. Kevin Christie: So let's, let's dive into that. Uh, five weekly touches. Cause that's something that you've really been, um, talking a lot about with our, with our members, uh, what does, what does that look like?

Is that five touches per clinic or per doctor?

Ashley Jordan, DC: I think it all depends on your situation. Someone actually in the mastermind is who brought it up to me is we were trying to figure out like what's reasonable for a [00:12:00] reasonable amount to have our associate get out in the community. And she actually started the five touch points.

So for our clinic alone, uh, me and Brit do five together. And then our associate does his own five. I think you've got to figure out what's realistic for your clinic. But the next biggest thing is you've got to hold yourself accountable. A plug to the CSA is, um, once you do these five, you've got to put them into your CSA.

So then you can follow up. If you don't track it, you can't change it, right? So if you're not following up with these five touch points, then some of them can be a waste of your time. So we've been loving not only the five touch points, but also plugging them into the CSA and making sure that like, if someone is already referring, we'll probably hit them up once a quarter, but if they're not referring yet.

I'm trying to follow up at least once a month to turn them into a referring, just a great referral. So that's been [00:13:00] awesome over the last six months.

Dr. Kevin Christie: Yeah, no, definitely. That was kind of something that I thought about. Again, I want to give credit to a strategic coach. They, they have something called the top 20 and farm club, which is, it's just like, okay, write out what your network is.

Right. And so I felt like the top 20, uh, didn't really. Translate too much of the chiropractic. I think at a certain point, you need a lot more than top 20, you know, 20 people referring to you. And so we built out a tool that allowed for this and on the dashboard and, uh, we call it the my network tool. And essentially if you meet with somebody, And you have a connection with them.

I don't care if it's a cup of coffee or if it's at a running shoe event, like I will tonight or whatever, um, you're going to put them on the potential referring category on that dashboard. And then it's got things on there where you can track like when was your last touch point? And the goal is, is to cultivate that relationship.

So then, then you can actually drag and drop it over into the [00:14:00] referring partner. Section and so you're really tracking people that are in that category of okay. I've connected with them. I've met with them. We've established a relationship there of some sort. How do I cultivate cultivate this into a referring relationship?

And so that's the tool you're referencing in there. And that's just 1 of the things we, we also built out the. Um, allied health network tool, which I stole the idea from, from Kurt, who's one of our coaches, and I'm sure he stole from somebody else, but that's where you develop, um, you know, a referring system to other healthcare providers.

So if your patient comes in and needs a massage therapist, you have one. If you're. Patient comes in and they need a baseball training coach. You have one. If they need an orthopedic surgeon, you have one and it's all on this database. And then it gives you an idea of, okay, what holes do you have in your network that you need to go out and connect with?

And so we coach our clients on how to [00:15:00] do that. Um, are you guys doing some of the allied health network stuff in your community?

Ashley Jordan, DC: Yeah, definitely a little bit of that as well as starting to get back into shadowing some of these doctor's offices. So then I think it's, it's easy for them to become part of your allied network.

Dr. Kevin Christie: Yeah, talk about that. You know, I love the idea. In the past I've, um, when I was younger, I shadowed actually a few surgeries and that's something I recommend as well, but are you shadowing in their office?

Ashley Jordan, DC: Yeah, we do a pain clinic at least once a year and we refer a ton back and forth with him. And then we're starting to try to get into a few different primary cares that we work really well with.

We did shadow one at the end of last summer, and it was actually eye opening. He went into diet and exercise and just things that I wouldn't expect a primary care. And, and within that next week, we got a handful of referrals from the office. So I would definitely try to get into some of these clinics.[00:16:00]

And we actually just hired a community outreach to try to help us start setting these up just because we don't have the exact time. So

Dr. Kevin Christie: you hired an actual person to help with the community outreach?

Ashley Jordan, DC: Just super part time, but it's been good so far.

Dr. Kevin Christie: That's great. That's really cool. And then, um, one of the things I remember you two did that I liked was when we were talking about the allied health network and, you know, plugging the holes.

If you don't have a neurologist, you know, basically on this tool we have on the CSA dashboard is it'll actually let you pick a specialty under health. So that'd be in your health care providers and then under performance. So I think tennis coach, um, and it gives you a list of ones and you can click it and it, you know, And then it helps you to say, okay, yeah, that's something I don't have.

And one of the things I remember you did was you have that relationship with that primary care doctor. And so theoretically, if you're, if you need a neurologist, you could ask the other doctor that you do have a relationship with, like, Hey, who's the top [00:17:00] neurologist and then. They get you that information like, Oh, you know, Dr.

Smith is the top neurologist. And then you call them and you, you know, you're probably going to speak to the front desk person at Dr. Smith's office, but say, Hey, this is Dr. Christie. I'm, uh, you know, a chiropractor in the area. Uh, Dr. Jones, a primary care doctor said that Dr. Smith is, is the neurologist. I need to know I'm trying to build out a world class referral system.

They're like, so I can send my patients to, is there a chance I could stop by the office? I'd love to be Dr. Smith and connect with them. Right. Um, is that something that you, you, you did that, right? It was a primary care doctor, if I recall.

Ashley Jordan, DC: Um, no, it was actually the pain clinic doctor that he had a whole, a whole sheet and he, and he gave us all, everyone who he refers to.

And it's kind of cool because we were the only chiropractor that he refers to on the sheet. So it's cool. Yeah. So it's kind of cool to be able to ask and just see. See who, see who they're referring to. I mean, we have a couple of really good doctors that [00:18:00] we super trust and he's one of them, so I knew that everyone that was on his list would be super trustworthy.

Dr. Kevin Christie: Yeah, that's great. Um, and so you just leverage a, uh, another expert to get some of those contacts and, and go from there. And I think, you know, the first order of business on that is to have a great referral system for your patients, because that's part of being a great doctor. But then the second part is, is, yeah, you're building a network of, of like minded, uh, referral partners.

So, um, can, can be very, very beneficial for, for that. Um, now, With your, with your five weekly touches, I think one of the things that we talk a lot about as well, and I think psychologically, evidence based chiropractors have struggled with the idea of getting out in the community a lot is because they think about the old school cheesy shit that chiropractors have done for years, right?

The, uh, what we call like kind of the credibility subtracting things out in the community and the things that we try to coach our clients on are like, Are the, are the credibility enhancing things, um, you know, public speaking, meeting with [00:19:00] doctors, working, uh, running event, things like that, where you're being helpful.

Um, what are some of the things that you try to do in your clinic with the weekly, uh, the five weekly touches? What are some of the ideas there?

Ashley Jordan, DC: Well, I think one of the biggest things that it's easiest to try to be your ideal patient. So we really want to treat runners. Guess what? This summer, we really dove in and have showed up to run club each and every week.

A lot of those runners are also taking or even teaching Pilates class. So we're hitting up a Pilates class. We let one video a week be one of our five. Um, then this week alone, we met up with another one of the local PPs. Uh, that we refer to a lot and let just had a good conversation with her on how we could help people that aren't responding to her, but they don't want surgery or medication, we would be a great option.

Yeah, so that's been good. [00:20:00] Other than that the community videos have been awesome So we try to do at least one community video a month This week alone. We actually went to the local bike shop and then you're just talking all about How you can help them or what they have to offer and then getting the community video out to your network The bike shop guy was so thankful.

No one's ever done anything like that So if you can get in with that Uh, we've also done them with different running coaches. Uh, golf pros is a really good one. One way that we talked about getting in with, with some of the golf pros in, in one of our MCM calls was go and take a lesson. Like a lot of people are struggling getting past that first front door of the golf shops.

Go take a lesson. So that was good. Running shoe store, we did one at, um, and then last week we actually did one with one of the local strength coaches. So it's just. starting to get out in the [00:21:00] community. And it's definitely, we hold the line and, and hold it, hold each other accountable. On our Wednesday meetings with all three of us doctors, the first thing we're doing is, what were your five touches?

How did they go? And, and talking through it and seeing if we can build a relationship.

Dr. Kevin Christie: That's great. You know, you, you two have a, um, a saying and it's be about it. And you've talked about that and you've really lived those core values of what your practice is. And it means more than just marketing. And it's also the health and fitness and your team members and health and fitness.

But, um, You and Brittany are really busy, you know, you, you guys, um, have a very busy practice and you provide great care and now you're coaching and you are both in our mastermind and you, and you both like to be out in the lake in the summertime and, but you are able to get stuff done. And I think that's something that a lot of chiropractors have to sometimes look in the mirror and say, frankly.

Um, my [00:22:00] practice is not where I thought it would be. I envisioned to be or frankly, where it should be. And I've been doing this for too long for it not to be there. Um, and this could be one of those big hurdles that you, you may need some help with on, on, on getting across from that. And just saying, you know what, we just got to get this done.

Ashley Jordan, DC: Yes, I mean, our run club and Pilates are both at 530 in the morning. Like, we don't want to be there, but we know that if we don't get our five touches in, I can't make my associate and hold him accountable if I'm not doing it myself. So we try, we always try to be about it, but we make sure that we're leading from the front and doing all the things that we expect everyone else in our clinic to be doing.

Dr. Kevin Christie: I love it. And I want to kind of transition to that because you, you, you both do push the envelope, uh, which, which is cool. And there's always seasons of life for sure around that. And, you know, maybe when one is 55 and the practice is booming, you don't necessarily need to do it yourself, [00:23:00] uh, but you got team members doing it, uh, you know, and obviously in Chicago back in July and our mastermind, the whole topic of the weekend was kind of pushing the envelope, but, but not burning out.

Um, What are, what are some of your thoughts on the, on the burnout thing? What are you doing to mitigate that and keep on being energized?

Ashley Jordan, DC: I definitely think scheduling everything out has helped us a ton. Um, we make sure we're getting some form of exercise six days a week. Uh, we both gratitude journal.

That's been huge. I know we talk a ton about the gap and the gain on on everything mcm and I think that the gratitude journal Has helped me a ton stay out of that gap so much Uh, definitely like we have we try to have our our not necessarily a full free day But we cut our saturday and sunday to noon and after is free time Right.

So we know that we're going to work hard, um, but then we definitely [00:24:00] play super hard if we're not working and the sun's out in the summer, we're on the lake, we're surfing, we're enjoying all those things. A couple other things I think that you've talked about is like outsourcing as much as you can. I used to enjoy cleaning the house.

I do not have the time to do it anymore. Right? Even cooking, like our lunches every single day for the last two and a half years have been delivered to the office. Those types of things can free you up to be able to make yourself have the time to work on your practice and avoid burnout.

Dr. Kevin Christie: I love that, you know, reinvesting some of the money into that.

And I do the same thing in a sense of delegating in my professional life, but also in my, in my personal life, I feel like I've got a whole team of people in my personal life. Uh, fortunately my, my wife takes care of a lot of things. She's home with the kids and doing that work. Uh, but then, you know, like I'm not mowing the lawn, I'm not.

We got a cleaner coming in. We do all that type of stuff as well, [00:25:00] because it's like, we want to, uh, I think two things it's, it's focused on the things that really matter in our personal life and focus on the things for me that matter in the professional life, uh, to, to do that. And it definitely helps clear my head of all the.

All the crap there. And I want to also, um, give a goal of clarity. The, the book is the gap in the game and gain, sorry, the gap and the gain. It's a, it's a concept again from strategic coach. And I think I'll define that. I highly recommend if you're listening to buy the book by the big book, it's on Amazon.

And it's a great easy read, but, uh, the gap in the game essentially is that, um, you know, where you are at currently right now, um, you will measure yourself against the ideal and that is the gap. And you're saying yourself, even though everything is great, you wish you had X, Y, and Z, or you wish your practice was this and you're measuring yourself against the ideal.

But what you should be doing is measuring back to where you have progressed from. And that's the gain you've gained from [00:26:00] X. Right. And so we all get in the gap. Um, but if you can start to consider, it's like, okay, well, look where I was three years ago or six years ago or whatever, um, you're going to feel better about the progress that you've made.

And cause if you compare against the ideal constantly, The ideal is like the horizon. It's always moving forward. And, and so that you gotta be careful of that. Now it's, you want to have a vision, uh, and that's going to guide you, but you want to always have gratitude of what the progress that you have made.

And so, uh, read that book. I know a lot of people that I've recommended that to, um, read it like once a year,

Ashley Jordan, DC: for sure. And one of my favorite things that you talk about, I think Dan Sullivan says it, um, how many times he gets in the gap every single day, but how quickly he gets out now. So I think that's, that's an awesome way to look at it as well.

Dr. Kevin Christie: Yeah. It's the refractory period, you know, it's like, okay, we're all going to get in the gap, but, uh, is it, is it lasting for, you know, a day and a week or a month, or is it lasting for 25 seconds? Right. And that's the, that's the key [00:27:00] for sure. So Cool. Yeah. I just think, you know, chiropractors need to find a good integration.

I don't like, you know, I kind of moved on from the work life balance thing. It's work life integration. But know that You know, you, you're, you're building something. If you're, if you're the owner, um, you know, you're, you're building something and you got to take pride in that. It's going to take hard work.

Once you decided to be a chiropractor, that was hard. And then once you decided to be a chiropractor who's treating patients and owning a business, that's like doubly hard, if not triply hard. Uh, if you're an associate right now, you're building a book of business. You're building a practice. You're building a patient base.

That's not easy. That's hard. But what is hard? is worth doing. And when you do it for long enough, you're going to see the fruits of your labor. Just not going to happen overnight. And I think that's something that chiropractors don't understand is that when you start doing some of this community outreach, um, it's not going to, it's not going to bear fruit right away, but when you do it consistently, then all of a sudden it starts to happen.

And [00:28:00] it's a, it's a summation effect. And it is just one of the best ways to. To, to build a practice. And if you, if you layer on a great patient experience and you get all your content out there and you become a force in the content marketing world and your community and get all that out there, and you get out in the community, your practice is going to grow exponentially a lot quicker than, than your colleagues.

Ashley Jordan, DC: For

Dr. Kevin Christie: sure. So what's, uh, what's, what are you excited about? This is August, the end of August that we're recording this. What are you excited about this next, uh, kind of rest of this year, uh, to, to cap off a great year.

Ashley Jordan, DC: So it's been a super busy work year for us. We actually are completely adding in 1500 square feet of a gym.

So that's been huge. And in the next three weeks. The gym is going to be rolling. So that's a super big one. And then we got another MCM mastermind coming up here in the next couple of months, but another pretty big work year for us.

Dr. Kevin Christie: Yeah. And I just want to, you know, [00:29:00] for our audience that didn't listen to the episode where I had you and Brit on, and, you know, I think it's been about five years since we've been working together and.

Um, you guys, you bought a practice, you know, fledgling when you bought it, it wasn't in a great space to get a front desk person and you, you both were working hard. Uh, but now you, um, five years later, you have over a thousand Google reviews, probably. Probably at 11 under now. Um, you, you, you too bought your own real estate.

That's a pretty good size to where you got a big clinic in there and now going to be a full clinic gym hybrid in there. Um, you've got associate doctor. How many team members total now, including you two?

Ashley Jordan, DC: Between nine and 10.

Dr. Kevin Christie: Yeah, between 9 and 10, uh, great profit margins, you dominate the sinking funds, and it's, and it's because obviously you both are great providers and do great with that, but it's been because you just put in [00:30:00] the, in the work and it's cool to see that when someone follows up, uh, uh, you know, a framework and inputs into work, uh, how it, how it actually bears fruit.

Ashley Jordan, DC: Yeah, coaching has 100 percent completely changed our life. One of our favorite sayings is you don't know what you don't know. And in school, they don't teach you how to how to actually run a business. They teach you how to pass boards. And MCM has 100 percent done that for us. Like I do not miss any meetings.

I don't think I've missed one in four years. One that when we and the ones that we do one a week. So coaching can 100 percent change your life if you put Put the work in for it.

Dr. Kevin Christie: One of my favorite

Ashley Jordan, DC: sayings on it is, if you want to go fast, go alone, but if you want to go far, go together, get the people around you that are where you want to be, ask as many questions as you can.

Dr. Kevin Christie: That's awesome. I love that. And yeah, it's just, um, I think the big thing is if you, if you [00:31:00] really do dedicate yourself to coaching and you got a good framework in there and you put in the work, you'll, you'll be, um, a very good. business person in addition to a very good doctor and you can be both. And when we really talk about being a good business person, it's, it's about doing all the fundamentals, right.

And having a good vision and all that. And, and, and that's a really good place to be in. And it was cool. We'll kind of leave it at this, um, in Chicago, we, We have two members that, uh, one is 61 and one is 71. And we did a wisdom session with them, uh, where they are an hour. We kind of Q and a them on different things and just to hear their insights of, uh, again, they both have phenomenal, awesome practices.

Um, but to, to hear, you know, there's ups and downs, there's buildings that burn down and there's, you know, there's like a lot of stuff that can happen, um, but they've, um, put in the work over time. And they've done the things that have given them energy, and it's been cool to see [00:32:00] that. And I think the sooner you start, the quicker it will happen for you.

But you can be very good at business like these two gentlemen, and have phenomenal clinical practices.

Ashley Jordan, DC: For sure.

Dr. Kevin Christie: All right. Cool. Well, this was nice. I appreciate you coming on and I appreciate your, your work that you're doing with not only coaching some of our members and being on the group calls and doing the, the creative call, but also the ideas, uh, that you keep on bringing to the table and we're getting better over here at, at MCM.

So I thank you for that.

Ashley Jordan, DC: Okay. It's been awesome.

 EPISODE 388: Overcoming Inflation in Your Life with Christine Odle

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, I'm excited to bring you a interview with Christine Odell. As many of you know, if you've listened to this podcast over the years, uh, Christine was instrumental in getting me back on track financially in my personal and professional life back in 2016, 2017, probably rounded out into early 2018.

We really got things rolling and got back on track, you know, just like anything. Uh, you make mistakes. Um, we're not experts in finances or at least, um, many of us are not. And I had a great. Start to my career. Great start to my practice 2010 when we opened up all the way to 2015, things got rocky with insurance as I dropped insurances, things got rocky in the personal life, but Christine was there to really help me understand personal and business finances.

And she's just a really, really good at what she does. And she's been on this show a handful of times and has been a, quite a resource for other chiropractors. And, uh, we dive into personal. finances, you know, and kind of [00:01:00] overcoming inflation. It's obviously a real thing and some things you can do you and your significant others to, to work around that.

And she's got real life experience, real life strategies that you can implement. And she dives into that today and provides you with a ton of information. And at the end, she's got an opportunity for you to learn more and how you can help your, or of your finances. And it's been something that we, we really work with chiropractors a lot and talk about in our coaching programs, because it's, um, you know, as much as we don't want to make it about money all the times, you know, those that have financial peace or, you know, Cashflow confidence are functioning at a very high level and feeling good about their progression throughout, uh, their career in, in, in their personal lives.

And so, uh, we dive into some of those topics today. And so without further ado, here's my interview with Christine Odell.

 All right. I'm excited to have Christine Odell on the podcast. It's been a [00:02:00] little while since you've been on. And, um, you know, I, I always reference you and what you did to help me, uh, through different financial times, whether it was my own personal struggles in 2017 or our world struggles in 2020 with, with COVID and navigating all of that.

But, uh, welcome to the show. What's new in your world.

Christine Odle: Thanks, Dr. Christie. I'm so happy to be back. Um, Well, the world is doing crazy things and we had no idea five years from today what we were going to experience. And so I think today might be a similar situation. We have no idea what's coming. Um, but this is a great time for us to get ready for ourselves.

Dr. Kevin Christie: Yeah, I agree with that. It's it was funny. Um, Uh, my wife and I, we just celebrated our five year anniversary a couple of weeks ago, or I should, I don't know when this episode comes out, but it was in July. We celebrated and we went back, uh, to Sonoma where we got married and we kind of talked about the last five years, uh, together, uh, as far as our [00:03:00] marriage and it would have been 2019, July, 2019, we got married and it was kind of comical how much went on in the last five years.

Christine Odle: That's a good statement to say. Yes. Comical is good.

Dr. Kevin Christie: Many positives into my personal world and all that, but obviously the world's been tricky and I want to, we're going to dive into the topic of inflation today and I know that's hitting a lot of people. It's hitting us, uh, personally, it's, uh, it's hitting us as business owners and, and trying to, you know, Navigate that.

Obviously, if you're a chiropractor that, um, works for someone, it's hard to navigate your own personal inflation costs and kind of your fixed pay. If you're a chiropractor that owns your practice, you're kind of getting hit, uh, from both ends there, as far as your, your cost of living has gone way up. And then your cost of running a practice has gone way up.

And I can guarantee you your insurance reimbursement has not gone up. And if [00:04:00] anything, it's. Probably gone down, but I'd like to start out with the history of inflation and some of the, uh, some of the history of that, that you've really, uh, doven into.

Christine Odle: So, okay, first it's important to define what inflation means, because the idea is everything goes up in that in price.

And so the actual definition is it's the change in your purchasing power. So if you're buying something, then you might have bought gas at 65 cents a gallon back in the 80s, but now it's, um, depending on where you are in the country, somewhere between 3 and 7 a gallon, right? And so part of that is the economy on where you are.

Part of that is taxes. Part of that is 100 different things. Things that go on. Um, part of that's also politics. So this is not a politics discussion, but it kind of is. Um, so one of the things I did is, uh, when Dr Christie asked me to do this is I went [00:05:00] back and I studied a little bit of, uh, What politics has to do with how inflation functions.

Now, I don't care if you're Republican or Democrat, that doesn't matter in this, but it's good to understand the, the way it goes. So I went back to 1901 enlisted all the presidents in order and how many years they were in office. And then I went back and said, are they Republican or Democrat? And then I went to the inflation rate tables and was kind of shocked at what I found.

I kind of had an idea that years with Republican presidents, the inflation rates were historically lower. The only place that that was different was Nixon and Ford. We have a resignation of a president, vice president takes over, but those, um, eight years of time is where in the Republican party was the only time inflation was really high over the 4%.

And the national average for inflation is 3%. So if you go back over time, you say 3 [00:06:00] percent is the national average. But when a Democrat president is in place, the inflation rate usually is well over 5%.

Dr. Kevin Christie: Interesting.

Christine Odle: In some years. Yes, very interesting. Um, in some years, and if you look at the overall term of a president, like if we go back to 45 to 53 with president Truman, he started with a 2.

3 percent inflation rate, but by the end of his term it was 14. 4 percent. If you go back to Hoover, he started at a negative 2. 3 percent, so your purchasing power was getting better, so it's opposite of Inflation is increasing your purchasing power is less if inflation is decreasing your purchasing power is better so in Hoover, it went from negative 2.

3 percent to a negative 9%. So if you think back to the fifties of our parents and grandparents, they had lots of purchasing power. Then we see, we [00:07:00] saw that in, you know, you could buy a house on Sears from Sears, right? Cause there's lots of purchasing power back then. Um, so, but then if you bounce forward to 1995 from 1990, about 93.

The inflation rate got down to 3%, and if you go all the way up to when Trump got out of office, it stayed at 3 percent or lower that entire time. So we're looking at 25 years, an entire generation, where this country experienced virtually no inflation rate. Biden comes into office, you can blame it on Biden, you can blame it on Democrats, you can blame it on, uh, COVID, you can blame it on a hundred million different things, um, suddenly we're at 8%, and we haven't seen 8 percent inflation rate since the Carter years.

Dr. Kevin Christie: Yeah, I remember growing up as a kid, I was born in 1980 and growing up as a kid, my parents talking about the seventies and how hard that was. And, you know, it was interesting to your point in the eighties, [00:08:00] uh, when I was raised, I wasn't only child, so it's a little cheaper, but we were able to live off of my dad's income only.

My mom was able to stay home with me and my dad had a very middle class income. Um, if you adjusted for, Whatever, inflation and cost of living now. Uh, there's no way my dad would have been able to support without my mom working in, in today's environment. So it's definitely, definitely fascinating for sure to, to hear the history of that.

And I, you know, like, what are your thoughts on the, cause I, A lot of, um, young chiropractors feel pretty down about the situation and I get it. I think we all feel down about the situation. And I try to also reference, um, 2008, obviously I was a different animal. I joke around, I would have been 28 then and I was just getting started, but, um, things were cheap, but nobody had any money.

So it was a, it was a whole, it was a whole other level of frustration. And I remember, uh, having that where [00:09:00] just like so many patients, like none of them had jobs and money and you could lower your prices and buying a house was cheap, but just no one could afford to, to do anything. Cause they had, they had no money.

Um, whereas you fast forward now, there's like people actually, Making good incomes, uh, theoretically, uh, but then they can't afford anything. And it always seems like inflation has such a, a psychological impact on people. Uh, what are some of your thoughts on that?

Christine Odle: Um, I think money has psychological impacts on people.

Um, money is very emotional. So. Kind of that same thing. If we go back to the nineties, your average household income in the nineties was in the high 30, 000. So let's just say 40, 000. So that was the average in the nineties was you're making 20 bucks an hour. And that's your average income bump to now your average income.

And this is, this is all [00:10:00] data I get off of government websites, by the way. Um, average income is 102, 000, which is 50 an hour. So in 25 years, we bumped. 30 an hour. And this is kind of interesting. Like our wages went way up, but inflation was stagnant. And what I've been able to find from being financial coach for so many years is our wants take over our needs is that we want so much.

So when I was growing up, we had one television and it was black and white. Yes. I just dated myself, but we also didn't have cable TV or cell phones. Um, I remember a long distance phone bill back then being over a hundred dollars at times and. So just what our needs are now. Now you walk into the average household and we have bought a house in St.

George, Utah, and we drive up the road in suburban America, and you can't park your car in your garage because there's so much stuff in the garage. You see this every [00:11:00] single day. And we walk into a house and there's a television. Every single bedroom, every child has a cell phone. I mean, so a lot of our wants in life have over superseded our needs.

So in an. If we're battling inflation, one of the things I think is the most useful is to figure out how to do a budget for your family. There's a hundred million theories on budgets, and here's the easiest one. Figure out what you absolutely have to have to survive. You need food, you need housing, you need transportation, and reasonable clothing, right?

So, if we're in crunch mode, we're not going to Neiman Marcus to buy a tank top, we're going to Walmart to buy a tank top, right? So, we really need to focus on what our needs are, what we absolutely have to have to survive, and then gradually add in the wants.

Dr. Kevin Christie: I

Christine Odle: think if we do that in a budgeting mode, then we can start seeing, oh my goodness, eating [00:12:00] out twice a day.

Every single day of the week is probably not cost effective because that's what we want every time we need to eat, right?

Dr. Kevin Christie: Yeah. And I want to touch on that. Cause I'm, I had it down as one of my notes, there was a funny meme going and passing around. It wasn't fun. I mean, it was actually like a. Supposedly a poll or a study and it said like, what is the household income needed to live comfortably?

And it had a different states and it had different numbers. And some of the states were like 225, 000 and this and that. And people were commenting, it's like, oh, you're going to, you need to make 250, 000 to, to live with a family of four. And, and I actually remember commenting on it and I was like, I think a big problem is not necessarily what the number is to quote unquote, live comfortably.

I think. As a society, we've changed what comfort is to us. And we almost like think of comfort as like you said, is, um, you [00:13:00] know, sending the kids to private school, it's having, uh, the kids having 10 different pairs of shoes and, uh, yeah, Uber eats two to three times a week. Starbucks every day. Like, it's just, you start to think about, again, growing up in the eighties.

I remember how fewer things I had. Or my family had or our house had, uh, than, than my current house hold, you know, and, and just the, the lifestyle creep that has happened to people. And I think it's because of social media. I think it's because of invention of things. Yeah. It's like nice to for everybody to have a cell phone, but when we were growing up, you had one wall.

And you had one phone on one wall in the kitchen usually, and maybe you had one in a, in another office bedroom or something. Right. Uh, now you've got death by a thousand cuts because people have Netflix subscription and Hulu and, uh, Amazon, like they got 14 different things to watch TV on. Plus they have their cable bill of 250 right?

Like it's gotten the [00:14:00] same, the amount of things you need or you think you need. Right. And I, and I, and I think that's a big, big issue here for sure. Yeah.

Christine Odle: I do believe that that's a big thing. I was actually recently talking with a client. Um, and I was just, you know, running through his bank statements with him and like, what is this?

And what is this? And what is this? And he's like, am I still paying 1500 a month to them? And I'm like, okay, you make too much money if you're not noticing a 1, 500 a month payment going to somebody you're not using right Um, but it's that creep too, right? So it's apple apple tunes, itunes, spotify, netflix, hulu Once you add it all up, it's over a hundred dollars a month and then that's twelve hundred dollars a year and you're like Oh dang, if I had twelve hundred bucks right now, I'd do something different Right.

The cell phones are the same thing. And so that's why I always say you could take yourself back to your vital needs What is what exactly do you need to just live on? And [00:15:00] my husband and I did this recently too. We we were headed to town and he likes to shop and i'm like, okay We'll go shopping. How much money do we need for shopping?

And he's like, I don't know throw a thousand bucks in your purse I'm like, okay We use paper money not credit cards or debit cards But through the thousand dollars in my purse and off we went and we went in and out of stores You And he's like, you're not buying anything. I said, you said we're shopping.

You didn't say we were buying. And there's a difference. People go in and out of stores and they buy a trinket at every one. Um, and I just kind of walked in and looked around and there's nothing I wanted. There's nothing I needed. So I just turned around and walked out and he's like, he goes, we could get a new frying pan.

I'm like, yeah, but the frying pan we have works just fine. So. That's kind of the things that you have to do when you're shopping. And I actually stopped going to Walmart four years ago and had nothing to do with the pandemic. I just realized one day, every single time I walked into Walmart, I spent a hundred dollars and I was like, I walked through the store and I said, there's nothing I want to buy here.

I don't want to buy food here. I don't want to buy [00:16:00] anything else here. It's cheap plastic stuff. So we just don't shop at Walmart anymore.

Dr. Kevin Christie: Yeah. And on the, on the flip side of that, and I'm going to, you know, talk about it even from my, my perspective of my family is, um, and you know, we're in a, A very nice position financially and we're lucky for that.

Um, but our grocery bills, you know, we, yeah, my wife shops at, at Whole Foods and I like to go to Fresh Market, which is here. And um, we do try to eat healthy and organic and things of that nature. And it's just astronomically expensive. And so if you find yourself where inflation is impacting you, um, you know, you may have to consider going from, if you've been shopping at Whole Foods, you might want to go back to Publix or whatever one is in your region.

That's like your regular grocery store here. Not that it's cheap, but it's definitely cheaper than Whole Foods and Fresh Market. So it's sometimes you, you gotta kind of go back on that. You still order a good food or, [00:17:00] you know, buy good food, but maybe not at, uh, at the, at the Whole Foods there.

Christine Odle: So, funny enough that you say that because it's something that I've hacked to death.

Um, if you stick on the outside of the grocery store and never go on to the inside of the grocery store, you can save money on food because your body actually likes whole foods better than it likes plastic foods. So, you can save a ton of money on that because you're not always hungry. That's one thing.

Most of us live within 20 miles of a farm. And if you're in New York City, you don't count. Sorry, can't help you there. But most of us, there's actually farmers markets everywhere and food at farmers markets, almost always cheaper than the grocery store if you're trying to cut and stay healthy. But I agree, sometimes you do have to find the lesser expensive store for some things.

But groceries is typically the last place I cut. Because our bodies do not function well if we don't feed them right.

Dr. Kevin Christie: I agree with that. I'd rather see you

Christine Odle: cut with, [00:18:00] you know, let's, here's the things I don't cut. I do not cut my chiropractor and that's not because I'm on this call.

Dr. Kevin Christie: It's a

Christine Odle: necessity in my life.

Um, I feel the healthiest when I'm seeing my chiropractor. Um, the other thing I feel the healthiest is when I'm eating whole foods and taking really good supplements. Um, I don't feel healthiest when I sit down and watch TV all day. Which by the way, never happens. But when, even when we have like a TV day, because there's a blizzard going on in Colorado, um, at the end of the day, I'm like, gosh, what a waste of time.

So we have cut all of those subscription accounts because it doesn't make us feel good. So when you're looking at needs, I think the other thing is what makes you feel good. So if you're part of a sports team and it makes you feel good, keep that, get rid of Netflix. Um, and I think that really helps people with the budgeting.

Same thing with cell phones. I mean, I've, I've done this one for years. I have a track phone that I got years ago because my client said [00:19:00] this was back when long distance wasn't free for everybody. Um, some of my clients said, I can't call you long distance. So I got a track phone. Track phones cost 20 bucks for the phone and about a hundred dollars a year for plenty of minutes.

You just can't do everything on your phone on that little mini computer. So there's a place there though. If you're looking at a 3, 000 a year cell phone bill, you can cut that very, very quickly. So there's lots of things you can do, but the key is Not to crush your budget so much that you don't feel good because if you don't feel good or you're not having at least some of life in this country, then you will, by definition, bust your budget 100 percent of the time

Dr. Kevin Christie: you have to feel a

Christine Odle: little bit normal.

Dr. Kevin Christie: And then Starbucks

Christine Odle: once a week instead of every day. Yeah.

Dr. Kevin Christie: No, I mean, there's a lot of things you can do. And I guess one of the things I wanted to make sure we talk about, cause I know you specialize this pretty well, but, and I've had [00:20:00] conversation with a lot of chiropractors and then it's the, it's the communication with a significant other and, and getting on the same page.

And sometimes people don't like to talk about money and, uh, What are your, what are your thoughts and strategies around that and making sure that the, the, the partnership there is on the same page and everybody's working towards the same goal?

Christine Odle: I look at two sides of it. One of it, one side, um, Zig Ziglar says two people in a marriage, just to like one of you is unnecessary.

So in most cases, one of you is a little bit better wired to manage the money than the other one. And so. Rather than making a fight out of it, like you didn't do this, or you didn't do that, pick the person in the marriage who is better at managing the finances to handle the bulk of it. So, making sure things get paid on time, making sure the bank account is reconciled, that we've looked through the credit card statements to make sure that Just say, what, what's on there.

We actually planned [00:21:00] a, we planned on spending and we did spend. The other thing is, never use finances as a weapon because 78 percent of. Marriages in this country fail on finance fights. Don't make it a weapon, use some other weapon. but instead make it a communication point because our finances in this country are Our value system to make it a communication point if you're not married yet, and you're getting married get somebody to help you before you get married and commingle everything.

I do recommend that you commingle everything I don't recommend that it's his money and her money and you have this job and I have that job I actually do recommend you put it together, because again it's your value system it's the, it can be the glue. Or it can be the weapon. So make it the glue that you're saying this is all of the money that we earn together and this is where we should spend it each month.

And then do a budget each month. And then don't just do the budget and throw it in a corner. Keep it handy so you can look at it and say how much [00:22:00] did we budget for groceries and where are we in that plan? How much did we budget for household stuff and where are we in that plan? But use it as a tool. Um, I think that that's probably the most important, but understand that one of you mean the same thing.

One of us is a night owl. One of us is a morning person, right? If you're ever lucky enough to have somebody on the same page on both of those, that's awesome. Just make it so it's a point of communication. Too many times if we separate it, uh, our value systems go with that. And that's a part of what the divorce is.

It's like, well, you have more money than me, so you get to spend more money than me. No, that doesn't work. You have less money, you get to spend less money. That doesn't work. If we put it all in the same pot and work on it together, that works really well. And then

Dr. Kevin Christie: how often do you recommend a couple get together and talk about the budget or the finances and get on the same page with that?

Christine Odle: Honestly, everybody's going to cringe when I say this, you probably ought to do it [00:23:00] weekly. But once you get used to it, weekly is a 10 minute conversation, not a three hour dissertation. Right. It's where are we? Um, was there a cut in pay this week? Was there a bonus this week? Um, do we need to cut back somewhere?

Did we overspend somewhere? Just a touch base on it. Monthly, we should probably say, um, like this is, if this is the end of the month, we're going to say, okay, next month, we're going to sit down and say, we expect this much money to come in. Where do we want it to go next month? So you want to plan next month in the previous month.

What I see happen most of the time is we try to plan this month. At the end of this month, and you can't do that because. You can look back, but you can't fix anything along the way if you do that, then you're going to be scrambling. And this is how we wander into debt in this country, is that we're trying to plan the money after the money has already been spent.

So if you want a guide, a little [00:24:00] bit, um, depending on, so depending on where you live, let's just say Dr. Christie's in Florida. So some months of the year, the air conditioning is on 24 7, we don't go outside because it's so hot. It's steamy out there. And so our electric bill is probably going to be higher in those months, but in the winter months when the weather is really pleasant, we're going to be outside more, AC doesn't have to be as high, so we don't have to pay as much electricity in those months.

And so if we're looking back, we want to say something like that. We probably need to average it over time. Same thing with kids sports. A lot of times those are in the school year. Um, sometimes summer camps in the summer. So we just kind of want to, if we want to look back at the history, that's helpful, but going forward.

What do we need for the next month?

Dr. Kevin Christie: Makes sense. And then, um, something I wanted to touch base on that because I feel like with, with [00:25:00] this whole situation, you know, we got inflation, it's, things are getting more expensive. We can obviously budget and get some good frameworks there. Um, try to cut some expenses. So, you know, if, you know, if inflation was 8%, Can you last year, can you find 8 percent to cut some of the coffees and this and that?

And you can kind of get back to where you are. Um, I think some of our chiropractors work, they get some bonuses. Obviously, I think you need a budget to where the bonuses are extra money and you put that away. Um, and then I think you got to avoid the lifestyle creep and try to make sure you're saving for retirement.

And when you make, start to make more money. It doesn't mean that you go from the 20 bottle of wine, uh, three times a week to the 50 bottle of wine three times a week. So we want to avoid some of that. And, and it's, it's also the idea of delayed gratification, you know, depending on the age that you are, you gotta be willing to delay some of the gratification and reinvest some of that money into your future, into your business.

Um, Because too [00:26:00] often I see the, the personal budget gets out of hand. And so once they are over and they take money from their business to pay for that personal overage, and so now they're draining their business of money that could impact our cashflow or at worst or at best, it's impacting their ability to reinvest that money into the business that could then, um, you know, obviously pay them dividends down the road for that and having a level of delayed gratification.

What are your thoughts on that? On delayed gratification and some ideas around that.

Christine Odle: Well, if you're talking about being a business owner, then the delayed gratification, um, Is actually a tax strategy as well. So we have the choices, business owners, everything we earn minus everything we have to run our business.

And then we have our profit and we can just give the rest of it, give a big portion of it to the government. That's one strategy. And most people are afraid of the government. So that's what they do. They end up paying [00:27:00] overpaying the government. But if we're really sitting there and getting intentional about our money, which is a lot of what this call is about, then what if, you know, The end of the day, you look down and you say, Oh, I have a profit.

What if we take some of that profit and start investing in our retirement? We can use, you know, 401k, simple IRAs, SEP IRAs, all of those, or even traditional after tax, um, traditional, I take it back, traditional on the personal side, but in the business, um, you can invest quite a bit in yourself. And I use the tagline in my, in my book.

And oftentimes is how to make more by making less. And so as business owners, especially if you've had a wage job before that business owners, we try to replace that wage. And I always encourage people as a business owner, don't try to replace that wage, try to put as much expenses as you can that benefit you in your business.

So things like creating benefits for [00:28:00] yourself or your team. Um, Retirement accounts. Everybody thinks that they can't afford benefits for themselves or their team and I can tell you that Employees would prefer to have benefits because they don't want to be able to have to go out outside with their take home pay and try to create these benefits for themselves.

That's a very expensive place for them to do it, but in house, you almost can get away with paying a little less in wages to your team and create those benefits. They benefit you as a business owner, and it benefits the team. And it creates a loyalty within the team as well. They're not going to run off to just a higher paying job unless they can run off to a higher paying job plus higher paying benefits.

So benefits is a great place to kind of delay that gratification on the take home pay if you're a business owner.

Dr. Kevin Christie: I'm glad you brought that up because that is a great way if you're a business owner you do have Some strategies that the non business owner has to obviously stave off the inflation and some of your tax strategy aspects can be.

So I'm glad you [00:29:00] brought that up. That's a, a great way of, of doing that. Um, I want to transition a little bit to the next thing because what's interesting about the inflation number, I know there's some other things that aren't in the CPI and all that, but something that's definitely not in the inflation number, uh, which really skews the whole thing.

Is what I keep on hearing is the cost of money, which is, uh, if that car was 50, 000 five years ago and that, and that same car is 50, 000 now, and you have to take a loan on that car to get it, the cost of that car. Is actually way more now because the interest rate is so much higher. Your monthly payment is higher.

The cost of that vehicle over the terms of that, say 72 months is way higher. Same thing you're seeing with buying a house, you know, like people's purchasing power is down on buying a house. Not only because the house is more expensive, but the interest rate isn't 3 percent anymore. It's it's 7%, right?

Like. If I took my same house and let's say I [00:30:00] bought, I bought mine in 2020 and I have, I do have an interest rate of 3%. If I tried buying my same house at the same amount that I bought it for, it wouldn't be, but if I did, but it was at 7%, my monthly payment would be way more. Um, and so, you know, people's credit card, uh, interest rates are higher.

I mean, it's all just the cost of money. Is is higher. And so some folks are not only running into their cost of living and costly running a business has gone up, but the cost of the debt that they have or that they want to take on is a lot more. And so that's causing an impact there. Um, you're, you're, you've always been my debt specialist.

What are your, some of your thoughts on that cost of money? And then what What it would look like for them if they actually started paying down some debt so that they're not running into payments that are, that are bleeding into their budgets.

Christine Odle: That's actually part of this whole conversation too. Um, well, as you know, I'm not a big fan of debt.[00:31:00]

Um, although in the past, well, just to go backwards. And, um, 2001, my husband and I were over half a million dollars in debt and it wasn't a house. Um, by 2009 we paid it all off. So, getting out of debt and staying out of debt was a big thing for us. Well then in 2018 we decided to buy another house in another city and I actually did take on a mortgage for that.

And so I had to kind of backpedal and say, wait a minute. I'm going against what I'm telling people not to do, but you're exactly right. The cost of money. So for us to buy that house would have wiped out most of our savings. So taking out a mortgage, a reasonable mortgage made sense. And so when you're going to buy a house, um, you definitely want what's a reasonable mortgage.

Um, Ownership of a house is a great hedge on inflation, by the way. So it kind of hand in hand. So if you're buying a house today at the 7%, understand that alone is 30 [00:32:00] years. And we just talked about the history and depending on who's in office, depends on inflation, which would also have a direct impact on interest rates.

So if your interest rate 7%, it's very unlikely for the next 30 years, it's going to stay 7%. There's going to be a window in there where the rates are going to dip again. And that's a great time to be ready to refinance and potentially lower the payment and lower the amount of interest that you're paying out to the bank.

So, I would say don't, if you're thinking about buying a house now and you're thinking interest rates such a big problem, I would say go a smaller home. And be ready, you know, get the rest of your ducks in a row over time, because you still have to pay to someplace to live, right? Unless you're in a tiny house in a trailer park, you're still going to pay rent somewhere for something.

And, oh, by the way, trailer houses, or tiny houses in a trailer park is not a bad thing. But it's a lesser thing, right? [00:33:00] It's a very, it's almost like living in a tent. So we're, we're saying we, we still have to pay rent somewhere, which means we still have to pay something to live. So, if you take that same amount, possibly that you're paying in rent and say, okay, can I buy a home for that same dollar amount?

It might be a smaller home to start. Nobody likes moving, but if we could buy maybe a 300, 000 home or condo or something for now, right out this interest rate thing for a while and be ready by getting rid of other debt in the meantime, that we could buy a bigger house later. The average people stay in their homes is only eight to 13 years anyway.

Okay, so we're just going to look at that window a little bit. We get stuck on now, today. This is where we, this is where it's always going to be. But if we're looking to the future, there's going to be inflation, but there's also going to be fluctuations.

Dr. Kevin Christie: Plus, if you buy that house at the 7%, you know, it's going to go, it's going to, the house is going to [00:34:00] cost more money the longer you wait.

And then if it somehow dips down, let's just make up, it dips down to five and a half, guess what's going to happen. Everybody's going to look to buy the house and then it's going to cost the house. The cost of the house is going to go up. If you've already bought the house, you can just refinance down to the 5.

you don't have to fight everybody else trying to buy the house.

Christine Odle: Correct. So the refinancing is always an option, which historically wasn't a big option, but I go back to when I started in banking in the early nineties and my boss had a house loan with a 15 percent interest rate. So the 7 percent is still not as scary as that 15 percent was right.

And I think my mom's house was somewhere in the 17 to 18 percent rate when she bought her house in the seventies. So we've, we're still not way up there. I would be surprised if. In our current situation, we would get that close in the next 10 years. I've been surprised before as Dr. Christy knows, but I've been surprised many, many [00:35:00] times before.

But so the other thing about buying a home now is if you're buying it, what you can afford now. Yeah, 30 years of that payment. So if it's 2, 000 a month now, just for example, then it's 2, 000 a month, 30 years from now, if you stay in the same house and pay it over the time, most people don't, most people get increases in salaries, change in jobs, increases in their businesses, and most people pay off their houses early anyway.

So.

Dr. Kevin Christie: Well, it's interesting because I live in a neighborhood that's about 40 years old, and I actually have some neighbors that have lived in the house since the late 80s and early 90s. And I always laugh about because you can always look up the historical records and it's like, or I've even talked to them about it.

And it's funny with like, how little they paid for the house. Some of them, their mortgage is so low, or it's Paid off their property in Florida. We're lucky. We have a homestead exemption. So, you know, property taxes don't really increase. So they're paying next to nothing. And then their neighbor [00:36:00] next to them bought the house two years ago.

And it's comical how much they paid for the house, what the interest rate is, uh, what the property taxes are. It's, it's, it's quite stunning. The difference. Yeah.

Christine Odle: Yeah, you can definitely see that. So, so there's a lot of benefit to just saying, Hey, I need to buy a house today. Go ahead. And you know, with the 7%, there's a lot of benefit because you hear the, I always hear this.

I'm on a fixed income. Great. I'm on a fixed rent. How many people can say that they're on a fixed rent? Because that's what your house payment is for 30 years. It's fixed at this price for 30 years. And with that idea, it's also assuming if you have it fixed at that point that you're never going to get a raise.

And we all know that's not true.

Dr. Kevin Christie: That's true. Well, Christine, this has been, this has been great. I know we could probably do this for a few hours and we might need a part two to it, but I think you, you provide us with a lot of good historical context and some strategies to start working towards that. Um, I, you know, it's, it can be frustrating, but just like I always talk about on the [00:37:00] other end of 2008 and how frustrating that was for me trying to get out of the gates personally and professionally, uh, there was a lot of positives on the other side of that.

And we may not know what the positives are. On the other side of this inflation. Um, but just do all the right things, uh, keep, you know, working hard, try to do things that also increase your, uh, your pay or your strategies within your business, and then maybe make some cuts that aren't going to harm your family or your business and see where you can save 10 percent here and there in your, in your personal and business budget.

And you'll, you'll do good things. How can our audience. Reach out to you if they want to chat more about these or if they're looking to take another level on their financial knowledge.

Christine Odle: You can find me on my website, christineodl. com and I have a couple of options there for, I've got a book that I wrote called Rocking Your Business Finances.

Um, I have an online community and uh, just if you just want to [00:38:00] ask me a question, just shoot me an email, um, christine at christineodl. com and I'll see if I can answer that question for you.

Dr. Kevin Christie: Perfect. And I'd highly recommend the book as well. Um, and I again, want to always thank you for your instrumental work and, and my, uh, financial knowledge and development.

I can never thank you enough.

Christine Odle: Well, thank you. I learned a lot from you as well.

EPISODE 389: Strategically Delegating Rehab in Your Practice with Taylor Premer 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 my interview with Dr. Taylor Priemer. And we're going to dive into a topic that, um, I, you know, it's, it's important to me. And that is the delegation of rehab. And I think a lot of chiropractors feel like they have to do the rehab. And you may, if you're listening to this and you decide you want to do all the rehab, and that is, uh, that fills your cup and you feel like that is where you're, unique ability is, um, I'm not here to, to try to change your mind completely, but there's a lot of chiropractors out there that are currently doing all the rehab and would, um, we either like to, to delegate it, know they want to delegate it, or they're kind of on the fence of it.

And I wanted to bring Taylor on here to chat about that because he's, uh, kind of run the gamut with that. Um, at Winchester spine and sports, we dive into what it has looked like in the progression of his early career, um, to be doing the rehab and then to be delegating the rehab and some of his [00:01:00] insights, uh, on that.

And, uh, I thought he'd be a great guest for that because he's, uh, lived it and breathed it and has some really good insights on, um, delegating the rehab and what the patient experience has actually been. when they do delegate it. So we will dive into that topic. Something I want to mention too, as we, towards the end of the conversation, discuss shortly after this release of the MPI Adjustathon will be going on in Kansas City, Overland Park.

And I'll be there. I'm excited to be there. First Adjustathon, uh, surprising. I've been to all the MPI seminars. I've been to a bunch of them, but I have not been to an Adjustathon yet, but excited to be there. So hopefully you will join us there. So just go to motionpalpation. org to check it out. There's going to be a.

just great amount of chiropractors. There's going to be a student track at DC only track. So if you are a licensed DC, um, you will have a, your own separate track to learn some advanced palpations and manipulations. And so check that out. All right. Without further ado, here's my interview with [00:02:00] Dr.

Taylor Premer.

All right. Welcome to the show, Taylor. I really appreciate you coming on and hopping on a topic that I'm excited to dive further into. And actually here's someone that's definitely run the gamut of delegation as it pertains to rehab and clinical care. But before we dive into that topic, tell us a little bit about yourself personally, professionally, and some updates.

Taylor Premer, DC: Yeah, man. So thanks for having me on. Obviously, Kevin, I've been a long time listener, so it's exciting to be on for sure. But my name is Taylor Premer. So I'm a, I'm a chiropractor here at Winchester spine and sport in Troy, Missouri. Um, and so I have a specialty in sports medicine. And so that's kind of my, my, uh, my love.

We'll put it that way. I love seeing high school patients and high school athletes. And, uh, I, Volunteer some time at two local high schools. And so, uh, that's really what gets me up in the morning is, is getting kids back on the field and, uh, you know, I've been lucky enough to treat a bunch of professional athletes, but, uh, high school athletes are really the, what really brings me joy and gets, gets me going so, uh, that, and then, uh, [00:03:00] along with Brett Winchester, uh, we own Gestalt Education, which is a continued education company, and we also have a podcast called the Gestalt Education Show.

And so, uh, if I'm not in here treating patients, uh, we're out usually traveling to teach or to host podcasts. And then, uh, I have a wife. Her name is also Taylor, ironically.

So, uh, anyway, uh, yeah, that's, that's kind of my life. I, I'm, uh, from Nebraska originally, a little tiny town. And Somehow found my way to train Missouri and the rest is history. So, uh, I absolutely love what I do. And I know that you echo it to Kevin, that there is no better time to be a chiropractor. And, uh, I think the topic today is an exciting one because, uh, you know, early on in my career, I really didn't know what the hell chiropractic was to be completely honest with you and, and kind of having my eyes opened up to the possibilities and how you can.

Um, kind of be in two places at once is, is something that kind of excites me as, as someone that almost thrives on chaos. I love the idea of a little bit more chaos in my life. And so, uh, anyway, I'm, I'm excited to kind of dive into this topic.

Dr. Kevin Christie: Yeah, no, absolutely. Um, you know, it's been kind of something [00:04:00] that, you know, we're seeing, I think a little bit more and more is chiropractors that, um, do, you know, multimodal approach of care, which is great.

And, you know, I'm, I'm at the age now, you Where, uh, when I talk about when I used to be young, you know, um, I actually used to do a lot of rehab exercises. You know, I'm, I'm, I'm certified in the TPI stuff. I certified in the, uh, the SFMA back from the beginning part. And I was learning from great cook and read up all on the Craig Liebman's and stuff.

So I, I was, I was in the thick of it on doing the rehab and, and, and actually physically doing it with the patients and showing them how to do it. So I, I did live that life a little bit. Um, and now that I'm in my mid forties and have built up a practice built and sold another practice, I realized, you know, um, at some point there is a, uh, a growth strategy you need to have for your, for your clinical delegation so that you could have [00:05:00] longevity in, in this career we call chiropractic and also.

Build a thriving practice around it. So I wanted to bring you on to kind of talk about the process that you went through, and then also the current process that the clinic has of, of really starting to understand how to effectively delegate the, the rehab component of that. So, um, my, my first question after that long preamble there is, um, tell us about, you, you got to, to Winchester's place there as a, as a preceptor, correct?

Yeah. And then what was it like to be on the end of it to where you were learning that and learning how to delegate from another doctor, the doctors prescribing and you have to obviously, um, you know, render those services on the rehab side of things.

Taylor Premer, DC: Yeah, so I have kind of a unique, uh, start to it on honestly.

So when I first got here, uh, the, the internship program wasn't what [00:06:00] it is now. We'll put it that way. And so I honestly didn't do a ton of personalized rehab for Brad. It's some passive stuff and some rehab here and there, but it wasn't structured by any means. And so. Yeah, the majority of time I was just shadowing him, taking notes, um, helping patients get them out of rooms, maybe taking them out of decompression, doing laser, pulling needles, uh, doing some rehab here and there, but it wasn't really structured.

And so, you know, early on, I, I loved it. I mean, what an amazing experience. I spent basically six months in a room with Brett Winchester all day, every day. I mean, I am literally the luckiest human being alive for that. And so, you Um, however, I could start to see that there were some holes in the growth opportunities like we talked about kind of in the intro, you know, uh, Brett is an absolute savant when it comes to treating patients.

I mean, uh, I don't think anybody would, I would put them up against anybody in the world and don't tell him I said that. I hope he doesn't listen to this, but, um, with that being said, uh, Brett. You know, he would be an hour and a half behind at certain points. And, you know, there [00:07:00] was just some, some interesting things.

And so as I started to transition into more of a position, uh, that's when him and I started to have more conversations about what we're talking about today, uh, you know, we had a, we had a rehab tech, Danielle, that's been with Brett for a long time. And, and she would do a lot of this stuff for him, meaning.

You know, uh, we're, I'm a DNS geek. And so nobody in the world can teach respiration and internal pressure probably better than Danielle, because she's done it every year for the last almost 10 years. And so that was really the only delegation, uh, we had three doctors at the time and they were all using Danielle and it was just like, it was a lot for her to handle.

And at the time, you know, it was, we, we would basically, he would have one, maybe two interns at a time. And it wasn't very, uh, structured, like I said. And so, uh, throughout the first year and a half of my, of actually being in practice here, we started to have conversations about creating more of an intern program and creating more of that longevity conversation on what it actually looks like to delegate and what it actually looks like to.

like fully immerse students [00:08:00] into this world that we live in, you know, uh, Brett being an educator himself, he's used to having people with them. And, you know, there's not a day goes by that we don't have some sort of shadow or intern in with us, but again, there was no structure. And so, you know, within the first year, we started to have conversations about actually structuring them.

Number one. And then number two, actually like starting to reach out to more schools and get more people into our web. And That actually wanted to be here. And so, you know, early on it was just kinda like a, well, they, you know, people from, from Palmer or from Florida or from Western states, they're not gonna come to Troy because I don't know where are they gonna stay?

What are they gonna do? Like our people really wanting to do that. And, uh, we kind of jumped right into the deep end and found out that people were actually like craving to be here. Mm-Hmm. . And so that kind of evolved and it forced us really quickly to be able to kind of build a structural, uh, program and, and to where it's evolved now.

Uh, now. You know, interns are integrated into the care every single day. So today I have a new patient, uh, I think at three 30, so at three 30, an intern, whoever's turn it is just in the [00:09:00] rotation, we'll get assigned to that patient with, so they will be with me every step of the way through the entire care plan, through that patient's lifespan, whether they're here longer or the interns are longer.

And so, uh, what it forces us to do is number one, us as physicians, we have to have. You know, very pointed reasons for what we're doing, meaning every single time that I am doing something in the treatment room, whether that's an assessment, whether that's sending for imaging for lab work, a rehab exercise, I have someone that's going to be asking me why we're doing that, number one.

And then number two. It forces us to kind of think about the lifespan of that patient. I mean, what does this case look like in two weeks? What does that look like in three weeks? And so that's kind of where it's evolved to now where interns are extremely valuable to our practice. Uh, not only to, to kind of delegate the rehab process off to you, but also it kind of forces us to get.

Kind of pull back the curtains and, you know, full holes barred, like discuss cases that aren't working well, discuss cases that are going really well and kind of decide [00:10:00] on what, what needs to happen from there. And so that's kind of been the evolution, honestly. And there were some hard times, but I had some hard, hard discussions.

And, uh, if you know, Brett and I, we liked, did you have each other a little bit, there was some, there was some. I don't know some, a little bit of back and forth on what that actually looked like. And now I think it's probably, uh, it is an invaluable experience to be here for the interns and seeing them progress from students to doctors has been really cool.

I mean, the, the amount of growth that we can get kids to, to feel in the first, uh, you know, couple of months is pretty extraordinary. And I think that, uh, you know, similar to in med school where you're integrated into the hospital or into this, you know, network, we're doing the same thing here with, with our internships.

And so that's really how it's evolved. And we're, we're super proud of it.

Dr. Kevin Christie: That's great. Yeah. And I want to, I want a couple of questions on that. I'm going to go back to your rehab tech. Um, what are her credentials before I was saying when she started working for you

Taylor Premer, DC: guys? Ironically, Brett knew her family and she was working checkout at Walmart.[00:11:00]

And so Brett, yeah. And so Brett fell in love with her, uh, Her personality and her ability to connect with people and said, I will teach you everything you need. You need to know. And I think it's a good point to bring up to Kevin, because I think we get so caught up in people having training credentials, personal training credentials and all these different things, because we feel like.

It's so difficult to learn these things. You need to have some sort of background. And the reality is you really don't. It just takes effort and it takes time, uh, to, to really teach them how you want things to be conceived or how you want it to, the patient to view this or how you want it to be kind of, uh, settled out.

So yeah, she was just check out at Walmart.

Dr. Kevin Christie: Yeah. You want to find the person that has a good personality and has a high capacity to learn, obviously eager to learn. It doesn't have to have the alphabet behind their name to get that for this rehab tech position, which is, which is really awesome. So that's why I wanted to ask that.

Cause I kind of knew the answer. Um, and also

Taylor Premer, DC: too, Kevin, I mean, like talking about overhead, like nobody knows more about overhead than you. Uh, being able to. [00:12:00] Maybe not pay them quite as much as that athletic trainer or, you know, the, the personal training background. It just allows you to do more things in the practice.

You have more to the community, bring in more people, uh, have more marketing and do more things in the community. And it doesn't devalue her at all. I mean, she makes a great living doing this, but it just opens up many more doors in your practice to be able to do things. Yeah.

Dr. Kevin Christie: And what's cool about it. And we've talked about this on a previous episode is we're, we're through MCM and we're working with our clients.

We're, we're talking a lot about this idea of a Swiss army CA where, you know, maybe you hire for that rehab tech, but they also can back up the front desk or even be part of the front. They can also help out with other things when the clinic, and it's just really having that right hand person to, to help the doctor out, kind of like how you mentioned the interns shadow you for the case.

And, uh, and that's really good. And that leads me to my second question is. You talked about, about structure, and I think one of the things I'd love to hear you talk about, because this is, in my [00:13:00] opinion, a key ingredient to this whole thing, whether you have a rehab tech or you have an influx of interns is, is a training program to, to learn this stuff.

What is, what does that look like in your clinic? And then, uh, some things that you'd recommend as far as training consistently for that person.

Taylor Premer, DC: Yeah, so every Wednesday we have a meeting. So the first hour of our schedule is blocked off every single Wednesday. The first Wednesday of every month is a full staff meeting.

And that's where Brett usually will either bring someone into the community that's, you know, doing really exceptional things to kind of talk about. Uh, how they grow their business and, and, uh, things like that, or if it's just us as a staff talking about ways that we can improve the practice or, you know, uh, we do a one on one reports.

And so each one of us has our own little, um, thing that we're responsible, responsible for in the practice. For me, it's the high schools and external marketing. And so every, every first Wednesday of the month, I know that I'm going to be called on to basically give a report on. Hey, this is what the status of the high schools is.

This is the sports we have coming up. This is what to [00:14:00] expect with injuries. Uh, this is what we need to have sports, physicals, and then also like, Hey, this is where the community golf tournaments are and things like that. Uh, but then all the other Wednesdays are doctors meetings and interns meetings and, and it's, uh, per topic.

And so usually how we do it is we just kind of work our way through the body, whether that's foot and ankle, knee, hip, uh, or like an MDT day or a DNS day and things like that. And so it's very, you Um, you know, one of each of us doctors is usually giving input or we have like a responsibility on, okay, we're talking about DNS today.

Okay, you're going to talk about respiration. You're going to talk about three months prone and then Brett will maybe interject into like a couple of cases that he's had lately on what that actually looks like. Uh, so that's, that's part of it. And then I have Tuesday mornings off and so Tuesday mornings are my day off at the practice.

And so usually, if not every Tuesday, every other Tuesday, we'll do it just a quick in service with the patient or with the interns where it's just me and them. Uh, you know, whatever they're struggling with, or if us doctors notice that, hey, this isn't quite right as far as the rehab or the laser needling or whatever it might be taping, then I'll, I'll just take them through [00:15:00] those, those little things.

And, um, so that's kind of how it's structured. And then, honestly, it's just like, uh, every single day at the end of the day, we usually. We have seltzers, we drink a little tequila, do something like that. And then it opens up the floor for the interns to actually ask questions about cases. Hey, when you were doing this, can you show me what exactly that looked like?

And so it's just kind of like an ongoing conversation. We have structured days, Tuesday mornings and Wednesdays that are kind of like for education, for teaching, but then every single day it usually culminates into conversations about other things or, Hey, I noticed, uh, I've been having a hard time doing this.

I noticed you did it really well. Do you mind if next Tuesday we talk about that? And then that just gets kind of added into the education. So I say structured, it's pretty structured. We're getting better at actually getting like a curriculum set out. Uh, but honestly it's, it's, it, what makes it fun is that each intern has just a different set of skills, a different set of challenges, a different set of, uh, you know, ideas on what they want to learn.

And so that just kind of helps evolve the curriculum as we go through their internship. And that's, that's kind [00:16:00] of how we evolve it.

Dr. Kevin Christie: Yeah. And I think, you know, the, the training is a huge part of it. And, and, uh, you know, we have that. And I, what's good about it is when you put it together, um, and you get, if you start getting interns, obviously if you have a rehab tech, it might take a little bit longer.

You get a good chiropractic intern. They're going to have a, probably a higher capacity, probably, uh, obviously a lot more education, uh, than someone that doesn't have gone through four years of chiropractic school plus four years of undergrad. Uh, but. Either your onboarding for your interns still needs to happen.

It might just be quicker, which is cool. Cause I think I want to dispel the myth because I hear sometimes from chiropractors that, you know, I don't want to really deal with the internship program schools because it's like, I might get one for four months. I might get one for eight. I might have a gap.

They're worried about the consistency of it because obviously it's a little easier for your clinic and probably my clinic to get a steady influx of interns than maybe, uh, other clinics. So that's just a reality. And, um, my, my argument of that is, is, [00:17:00] is, is. Is just put together a really good training program on board the preceptor.

Try to get as many as you can, when you can like get, you know, get proactive with that, uh, but any just insights on onboarding more of a chiropractic intern versus say a rehab tech.

Taylor Premer, DC: Yeah, I think you're, you bring up some good points. I mean, it's something that we've struggled with too. I mean, you just never know, you know, we're pretty picky on our interns.

We want them to have certain skills and certain, uh, You know, seminars they've taken and things like that, just because one, it helps her onboarding process feel a bit quicker, but also to, uh, we're, we're trusting them with a lot of things. And so we want them to be proactive, but honestly, like personality trumps all like that literally trumps everything.

And so I think if you have a good personality and you have someone that's willing to learn, like we talked about earlier, then, you know, the onboarding is pretty damn quick, but I think, uh, Having just time set away, I think that is the most difficult thing. It's very easy to just cram as many patients into a week as you can, but You know, then now you haven't taken the time aside to [00:18:00] try to educate.

Then you're, you're forced to try to educate while you're treating and you're trying to educate between patients and things like that. And that is just, that's a recipe for disaster. Uh, one, it's going to just overwhelm you to the patient experience. It goes out the door because now you're, you're not connecting with them.

You're connecting with the person that's in the room with you. And so I think that is my biggest tip is just literally have time set aside where it's, Hey, this is the time. It doesn't matter how many patients, how, if I'm leaving for the weekend, Uh, this is the time. We can't add more patients to this time.

This is it. Like this time is set aside. The staff knows it. The interns knows it. The docs know it. Time is set aside and stick to it and just be very diligent in that time set aside and don't, don't, uh, you know, come off of that time.

Dr. Kevin Christie: Okay. And then I want to just switch gears a little bit. Cause I get it.

There's, you know, some of the docs listening here that are, are rehab heavy. You know, rehab can get very complicated, like I get it, you know, if you're some chiropractors are doing post surgical rehab, uh, you start adding things like DNS and neurodynamics and the Liebenson stuff [00:19:00] and all they get, I, I get it, like some of these chiropractors are Spending 30 to 60 minutes with patients doing rehab and it gets very intricate and understanding the, the patient's bodies and progressions and regressions.

Like I, I get the, how, how in depth they can get. So I don't want to, uh, discount that. So I do understand it. And then when, before we hit record, you were kind of talking about how even you were reluctant at one point to, um, delegate. The, the rehab side of things. Can you talk about that, uh, kind of progression for yourself?

Taylor Premer, DC: Yeah, I mean, honestly, like the hard truth and the thing that I kind of had to reconcile is early on, this was really crappy at assessment, to be completely honest with you. And so I think that that was a little bit difficult because I was just trying so many things because my assessment wasn't very good.

I was having to do so many things just to try. get anything to change. And so, um, it took me kind of looking in the mirror [00:20:00] and, and really getting a little bit more specific on my assessments in order to feel comfortable delegating because I didn't want to pull back the curtain all the way, you know, and I didn't want to show that maybe I didn't have everything figured out.

And so once I kind of let down my guard on those times, it was, it became a lot easier and I mean, honestly, like, you know, I was the, I was the fifth chiropractor at the time, brought it in. And so my patient wasn't very busy. I had the time. And so I said, screw it. I'm just going to go all in. I'm going to, I'm just going to, you know, ramrod this, and I will spend those 30 and 45 minutes with these patients.

But then when I started to realize really quickly is one, uh, you can't make very much money when you see people for 45 minutes and take insurance, that's just the reality. And then two, my results really weren't that much better than people that were seeing patients for 15 minutes. You know, just because you see people for an hour doesn't mean that your results are that much better.

And so, uh, I came to those realizations and then I just started getting better at my assessment and actually taking the time to get good with assessing, paying attention, uh, having a little bit [00:21:00] more of like a playbook or a strategy that, uh, kind of strategically look through the body. And that way I can be more specific in my assessment.

I would still have time to then manipulate, do my manual therapy, maybe do a couple of rehab, but then have more of like a specific, Hey, I need you to work on this thing specifically. This is what I would suggest for the rehab. But then, you know, as you start to trust the interns more in the CA, then. You can kind of give them more of a, Hey, this is what I need to work on.

I don't care how you do it, but this is what I need to change. And this is why, you know, this is the assessment that I found it in. This is why it's affecting their case. And so, you know, you can kind of have a little bit of gray areas there as far as, uh, progressing, regressing, uh, because I knew that it was, you know, anything in that area is going to be really good.

And so that was kind of my experience in the first year. It was just a lot of me. Like I, I spent a lot of time trying to figure out myself, trying to figure out what it looked like in these four walls in the treatment room and, and. You know, I learned so much, but I also learned that it was okay to [00:22:00] delegate number one, as long as you're paying attention, as long as your assessments are very clean.

Uh, and then, you know, whatever, if you send it back to an intern or CA and it doesn't go perfectly, you still got time for them to come back. But, you know, that kind of brings us in, hopefully Mark will appreciate, Mark King will talk about this, but having a plan together for the patient. That's integrated together.

You know, if you have a plan that looks like twice a week for 3 weeks or whatever that looks like, then, you know, you do your assessment. You make a clinical leap of faith. You go down that route. You have the intern go down that route. They come back and things are not going well. Well, okay, no problem.

Then go back to my assessment, reassess, re look at things. Maybe I missed this little piece here, or maybe we do need to change things up on the rehab side. Then it's a point of education for myself. It's a point of education for the intern. And then things go really well. And honestly, the patients feel very taken care of, you know, in a world of medicine where, uh, you know, doors are closed and, and there's not much of a plan and, you know, nobody talks to each other to actually have a place that [00:23:00] everybody's talking together and everybody really understands them.

They feel the experience with the patient is so much better and the results are so much better along with that.

Dr. Kevin Christie: Yeah, you know, I want to touch on it because you kind of got me thinking there when you mentioned about the assessment, uh, if you were to kind of categorize three things here, one would be your assessment, two would be manual therapy, and let's just put under manual, anything like soft tissue, manipulation, palpation, and then you throw in the third thing, which would be rehab.

It's almost like early on in this process as a chiropractor, I think some chiropractors get heavy on the rehab because maybe the assessment. Isn't where it needs to be. And so they're almost like spending the time and doing the rehab to try to cover that up a bit.

Taylor Premer, DC: Yeah.

Dr. Kevin Christie: And I'm not saying everybody's like that, but I think that it happens.

Cause I, I mentioned the book a lot and I've done it recently on the podcast, but thinking slow and fast by Daniel Kahneman, he talks about system one thinking and system two thinking system. One thinking is. [00:24:00] Two plus two, it's just an easy reactionary thinking. No, no sweat doesn't burn any calories.

System two thinking is where you really have to grind your gears to think through something. And I, I try to talk to younger chiropractors with that first five years, six years, seven years. Um, you're going to be burning through system two a lot because you don't have the clinical experience yet. Even if you're really good in year three, you're just burning through that.

Uh, my, my, my words of wisdom now that I've been doing it for almost 20 years is that You will get better. Most of your day will be system one thinking and you'll have the occasional system too. So keep getting better. But I think what happens is, you know, to get really good at the manual component of what we do again, palpation, manipulation, soft tissue to get really good at the assessment that takes a level of mastery.

Um, and a lot of people. Don't dive into that mastery and realize, like, I'm just going to dive headfirst in [00:25:00] this and it's going to take me five years or whatever. But once I break through that and I'm 32 years old or whatever, I'm going to be a master for that age at palpation manipulation, at soft tissue, at assessment, and then, like, Brett talks about all the time as being a sniper and really now cherry picking a handful of things that the rehab will take care of and give them some things at home and not like overwhelming him with two things.

And so I can see that those three variables being kind of manipulated by chiropractors like, well, I'm weak on assessment. Let me overload the rehab. And is that what you kind of went through as well as your development as a chiropractor?

Taylor Premer, DC: Absolutely. Absolutely. I think that so many people discount the manual stuff that we do just because honestly, they're not good at it yet.

And so, like you said, it's an overcompensation, you know, I hate to say it, but there are millions of people that can teach a kettlebell swing or to teach a, you know, a side bridge or I mean, [00:26:00] no offense to Danielle, but she was a checkout girl at Walmart and she is a master at doing these things. But, you know, I think, uh, there's a certain level of people coming in to see a chiropractor that there was a preconceived notion of what needs to happen and that has to involve these.

And that's just my personal opinion. I'm a chiropractor's chiropractor. I love manipulation and I love manual therapy. And I find myself trending more towards the manual things. Now that I have that kind of escape net of the intern to be able to do those things. And so to your point, exactly. I think what, what has evolved maybe in the last two years with me is conscious of kind of that system to thinking of, okay, well, here is this, whatever it might be, a trigger point, fascial adhesion, whatever it might be.

I think that this is probably going to get better with rehab. So I'm going to leave this alone. That's going to be like my auto. Okay. So then that's going to come back versus I feel this. This needs to be ART. This needs to be needle. This needs to be, you know, more of a sniper approach. Like you were [00:27:00] talking about this, this needs manual therapy and it's going to clear up really quick.

This other stuff is going to clear up with rehab. And so kind of like almost delegating my own, uh, techniques in my head, which is clinical decision making and, and, uh, the functional triage that we talk a lot about is being able to make those decisions just through feel through, through that, and honestly, to your point, it just Takes time to develop that.

And so I think, uh, if I, if I could change a couple of things just from my first couple of years of practice, it would be that spending a little bit more time on the manual side and, and being okay with failing a little bit more versus just, oh crap, I really don't know what's going on. So I'm just going to pick 14 DNS exercises and hope to God something happens, you know, and, or, you know, I'm just going to keep rubbing on this thing until they feel better, whether they like it or not, you know?

And so, yeah, I, I think it's a hundred percent, you know, in this, in this Uh, unfortunately, the climate now is, is trending more away from the manual side, which is, uh, I think, uh, it's, I think it's a big mistake by chiropractors, PTs, athletic, whoever you are, if you're a [00:28:00] bodyworker period of getting more away from the manual therapy, because maybe the research is a little bit unclear of the mechanisms.

Uh, but again, like all you can do is just continue to pay attention to your patients, continue getting better at assessing, I think having a systematic approach of assessing assessment. Is what gets you there. Meaning my assessment, your assessment, Kevin, my assessment, breath assessment, they're going to look differently.

There's going to be some overlap for sure, but you know, you may, you may value things a little bit differently than I value things in my patient experience, but at the end of the day, if there's a reason why you're going down that track and you're paying attention and you're learning from your mistakes, you're learning from your failures.

Your, you know, successes, then you're going to be so much better at the end of every single day, let alone week, month, year, several years. And, and I think that that is a, that's an art that maybe, uh, people aren't willing to go through the sacrifices and the struggles of getting really good at this stuff.

And I think it's a shame because. There is nothing better than these tools that we have with us. And that is really, [00:29:00] to me, what classifies being a good chiropractor, a good healer in general. So yeah, I, I,

Dr. Kevin Christie: I had a patient actually talked to me about this. So he was pretty, very successful, uh, tech entrepreneur.

And he's like, you know, I come to you just like some people come to my businesses is for a core competency and every business has a core. Product or core competency. And he was like, for you, I come because the manual therapy is like, yeah, you give me the rehab or I do the laser or whatever that that's, that's fine and all that.

But I, I come to you because of what you're able to do with your hands and do it in an efficient manner. And, and that's where I think a lot of chiropractors are losing that. And I, and again, I want to reassure the younger chiropractors is that if you, if you work really hard to master the palpation, the soft tissue palpation, the joint palpation.

The, the manual, the manipulation and all that again, whether you use ART, dry needling grassed, and if you get really fricking good at that and you become just a killer at that, [00:30:00] then people are going to come in for that. And then you're going to also give them the rehab, cause that's going to help them get results as well.

If, if all you are really good at is exercise and frankly, not good. With the palpation assessments and the, and the manual, um, they, they can get that in a lot of places. So it becomes harder to differentiate yourself in the marketplace on a scale that will grow a practice that will then provide freedom.

Now, yeah, like I could open up a. A rehab only practice and get some people in there that value that and don't care about the manual. There's definitely that, but to build that thriving practice where your clinic is able to see 100, 125, 150, 200 people in a week, you can put a team around you so that you can do this for 30 years.

Um, that's where the, the sweet spots going to be, um, because we're seeing too many people burning out, I think, cause they're doing too many things and it, and they're not seeing a light at the end of the tunnel.

Taylor Premer, DC: Right. Or, I mean, they're [00:31:00] just not making a professional income, you know, like that is, that is a major thing.

You know, I, I completely understand, you know, if you're a cash practice and you want to see people for an hour, that's great because you can charge your hour hourly rate, but we're in small town, Missouri. And so like, we have got to see patients. Like I have got to see a little over a hundred patients a week for me to make what I want and for me to affect the change that I want to train in the community.

And so, um, I, again, like, but you can't devalue You know what we do every single day. And I think it goes back to having a plan for your patient having a plan for yourself. I mean, like, just, you know, figure out what you want in this life in this career, because it may be different than that. You know, you may want to spend an hour with your patient.

So you may want to, you know, go into the gym and do these other things, do programming for them, do all that kind of stuff, which is great. That's not what, you know, You know, gets me going in the morning, specifically, but if you don't have a plan for developing that and creating that, then I mean, now you're going to burn out and now you're up fifth grade.

Dr. Kevin Christie: Yeah. And I think, you [00:32:00] know, on the topic of say the, the cash based rehab, um, Cairo, that's doing 30, 60 minutes, getting more power to you, you know, I talk a lot about the hourly capacity. Like you have to be able to earn a certain amount of money of revenue per hour, per doctor. And so there's a lot of, um, Cairo's that aren't doing.

Well, with that, and then there are some that are charging a lot, you know, three, 400 an hour. The tricky part about that is, um, too many are trying to do that right out of the gates. They haven't done enough to position themselves as an expert to command that amount. So it's, it's kind of putting a cart before the horse, which is a little tricky.

And, and that's, that's definitely got its flaws and, and, But hopefully you get to the point where you are just, like you said earlier, a savant, if you can get to the savant level, then you can charge more. And so typically it's progression to get there. Um, but what makes you so unique that you can command four or 500 an hour again, at scale to do it to where you're [00:33:00] having not only a good hourly capacity, because that's one thing you got to do that.

But. If you're only seeing 10 people in a, in a week, or you can only see seven people in a day, that's going to have its own capacity limitations to be able to put a team or hire, and then free yourself up to be able to take vacations or travel like you guys do, or frankly, just, um, be able to cut down your shifts to four days a week down the road if you want.

And so it, it becomes a come pigeonholed a little bit. And that's what I'm worried about for a lot of the younger chiropractors.

Taylor Premer, DC: Well, and it kind of brings up the whole point of this discussion to Kevin is, you know, if you, let's say you do value, you think patients need 30 minutes of care. Well, if you can build a team around you, they can take 15 minutes away from you.

You can spend 15 really, really good minutes with a patient, give them a really good manual therapy, give them the rehab that you think. And then you can just add on that 15 minutes, even more, you know, What are that looks like in your practice for us? It's it's, you know, our intern program, you know, like [00:34:00] our goal is for patients to be here about 20 minutes.

So however that looks like that day, you're with the doc for 15 minutes and you're with an intern for five, or maybe it's five minutes with the doc and 15 with the intern or the CA. Uh, but I think, you know, if you, if you, you don't have a plan, if you don't have an idea of where that case is going early on, then it's really hard to just make audibles and kind of make that all fit.

And then the next thing you know, you're way behind and your capacity issues and patients are unhappy because they're with you for, you know, whatever, an hour and they're got to go back to work or, you know, whatever that, or they don't feel like they had enough time with the doc or it's just a, it's a delicate little balance.

And so making sure the product is really good is, I think what it's all about, you know, that's what makes Apple, Apple or whoever company it is, their product is so good. But then everything around surrounding it is also amazing.

Dr. Kevin Christie: Yeah. Our patients are in here usually 20, 30 minutes, unless they're just like a maintenance care.

And, uh, yeah, they get doctor time, they get, uh, intern time, or if we have a rehab [00:35:00] tech and they're getting all the things that they want, they like the team atmosphere. And I, you know, not everybody's going to be able to afford a team early on. And I get that. Well, our point is here is to start building the process to where you have certain revenue.

Numbers where he's like, if I get here, here's my profit, this is when I can bring someone on. Or if you've been out of practice for three to five years, the schools are different, but you have to be out a certain amount to take on interns, you know, like start planning for that ahead of time and have a vision and be open minded to delegate.

I think that was something that you had to overcome. Like you mentioned was, was the psychology of, of delegating and it's a different level of leadership. That I think some people are afraid of as well, because yeah, you, you have to train and you have to mentor a person to be able to do that, but it really frees you up in many ways.

Taylor Premer, DC: Very true. I think you just got to be a little bit okay with maybe the results not being perfect. You know, I'm Brett's kind of perfectionist. I'm a little bit myself. And so, [00:36:00] you know, just being okay with maybe things not going perfect right away, but building towards that perfection, you know, but you can't get to that point if you don't have conversations with them about what they did good, what they did bad, what they need to improve on, what you need to improve I think that, you know, if you are just You know, quickly out of practice, just maybe even starting to put a break in your schedule where that hour a day, you know, down the road and three, four years, that's going to be your intern time to educate, or maybe your new, uh, new doctor education time, or maybe your new CA education time and, and just like starting to just build that in your brain and start, you know, You know, take that hour to educate yourself, build a curriculum, like start putting PowerPoint slides together of like, Hey, when we talk about the foot and ankle, here's what I really, uh, here's what I'm valuing right now and what I'm seeing, and then this is what I'm really want my new associate, my new CA, my new intern to know when it comes to this specific condition, this specific case, uh, even just body parts and things like that.

And so I think that would be a really good use of your time. Because then you can double down with that information. And if you want to use it for marketing [00:37:00] events, uh, you already have those PowerPoint slides done. That way, if you get asked on a Tuesday to do a marketing talk on a Wednesday, you don't have to scramble around that night and put a bunch of stuff together to build it.

And so I think, uh, that would be a very good use of your time. I was lucky. We teach a course at Maryville, which is a small school here in St. Louis of the pre PT program. And so. That's what I did. I just started using the Maryville PowerPoint slides of biomechanics and anatomy to then just build my intern slides to then use for education, which then I'm going to use to teach if I teach seminars down the route or if I, you know, I'm having a, I have a talk with the football team in Troy here in a couple weeks and so like, I already have just a bank of things that I I'm built upon in the last five, six years that now I can pull from to, to start doing it.

And it forces yourself to get better, you know, like, okay, foot and ankle cases. Here's kind of where my gaps are. Okay. Where, where should I, maybe I need to get Thomas Schaub's book and start going through human motion again. Or, you know, here's the pictures that I, I kind of forgot about with anatomy. And Oh, by the way, here's my MDT notes on here's the most common reductive [00:38:00] movements.

ART. Oh, crap. I forgot about the soleus move or whatever it might be. And just start building that bank and library for your own self, but then for yourself down the road.

Dr. Kevin Christie: This has been great. Where are you guys traveling to next? And what seminar is it?

Taylor Premer, DC: Uh, well, Brett is headed towards, uh, to Britain. Uh, it's great Britain with a family vacation.

So I got a couple of weeks of just myself, but then, uh, we've got a DNS exercise to course in Raleigh with, uh, Lindsay Mooma, uh, that we're super excited about. Uh, that's the, the, in August. The last weekend in August, we're actually kind of splitting up. Uh, Brett is teaching a DNS, uh, baseball course in Chicago.

And then, uh, I'm doing the, uh, R2P, uh, alumni track on, on that Saturday, uh, where I'm going to talk about high school marketing and, uh, treating acute injuries and, and care for them and stuff like that. And so, uh, We've got all sorts of courses coming up. So we took a little bit of a break. We just had the DNS world Congress, uh, here in, in, uh, St.

Louis, which went great. We had 150 people, 14 instructors. And so that, that took me a couple of weeks to kind of, uh, come down from and, and, [00:39:00] uh, you know, recuperate a little bit, so, uh, but anyway, yeah, we had a, we have a, a new big intern group coming in, in the fall, uh, that we're super excited about. So we're already getting things lined up as far as onboarding and, and what that looks like.

Uh, you know, just trying to improve that experience for them and for us every single time, every time we get a new group coming in of, of, okay, here's what we, we kind of messed up on the last time. And here's, here's kind of why we want to approach it this time. So yeah, we're, we're super excited. So

Dr. Kevin Christie: good, good.

And where can they find out more information for these courses that you got going on?

Taylor Premer, DC: Yeah, it's Gestalt education. So gestaltedu. com. And, uh, yeah, we got our podcast up on there and, and a bunch of those, we've got a really cool podcast we're working on and hopefully, uh, while Brett's in Chicago, I'm going to fly out there and, and, uh, we've got a really amazing orthopedic surgeon that we're going to interview.

And, uh, we've got a bunch of, a bunch of good ones coming on. We've got to get you back on Kev. Talk about, talk about your new experiences. So,

Dr. Kevin Christie: yeah, are you going to be, you guys are gonna be in, I know he will, but are you going to be at a just a thon, the MPI just a thon? Oh,

Taylor Premer, DC: absolutely.

Dr. Kevin Christie: A just a thon is just marked

Taylor Premer, DC: on the calendar.

Yeah, there you go. We'll [00:40:00] do it then. Yeah. So a just a thon is just marked on the calendar. That is literally the Superbowl of, uh, of courses. And I've been lucky. I think this is going to be my 10th, maybe my 11th time taking, uh, being there. And it is just, the atmosphere is unmatched. Uh, the last two years we started doing a thing where, uh, I guess salt hosts a tailgate party on a Saturday night.

And so last, last year we had, uh, we had a stock trailer out there with a bunch of, uh, alcoholic beverages and music playing. And we did some interviews on there and, oh man, it's amazing. So, uh, now with the doctor track too, I think that's such a cool thing that, you know, even if you don't want to be in a room full of students, uh, you got, You know, a room full of doctors talking about manipulation and talking about palpation.

And, uh, it's just, uh, it's an unmatched seminar. If you haven't been, you have to go.

Dr. Kevin Christie: Yeah. Actually, believe it or not, this will be my first adjust a thon. I've been to all the other things and this is the first one. So I'll be there. I'm excited.

Taylor Premer, DC: I love it. I love it. I look forward to seeing you, my man.

Dr. Kevin Christie: All right, cool, man.

This was great, Taylor. I really appreciate your time.

Taylor Premer, DC: Yeah, no problem, guys. Thanks for having me on, Kevin. And, uh, yeah, we'll talk [00:41:00] soon, hopefully.

 EPISODE 390: Positioning Yourself as a Golf Injury Expert with Greg Rose, DC

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

Dr. Kevin Christie: [00:00:00] Welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I'm excited to bring To you, none other than Dr. Greg Rose of the Titleist Performance Institute. And we, uh, we dive into how to position yourself as the golf injury expert, but it really applies to you for anything you're doing in your community.

Maybe you're working with different types of athletes and we actually talk about other sports and some of the other sports that they actually have certification in like racket sports and baseball. And so if you're not, uh, you know, not trying to position yourself as a golf expert, you're going to get a ton out of this.

Cause this is someone who has. Uh, really over 30 years, uh, built up a, a level of credibility that has transcended the profession of chiropractic and it's been pretty cool to see. And it's been fun for me over the last 20 years, kind of being part of that ride and being TPI certified. And so this was a, um, kind of a full circle moment for me professionally to be able to interview, uh, patients.

Uh, Dr. Rose after, uh, learning from [00:01:00] him for many years. And so, uh, we talk about positioning. We talk about what he did, uh, to start out in his community, uh, how he went from his community into the Titleist Performance Institute, some of the really exciting renovations and opportunities coming down the line through TPI.

And so you're going to get a lot out of this episode because Dr. Rose brings a wealth of knowledge. So without further ado, here is my interview with Dr. Greg Rose. Thanks.

 All right. Welcome to the show. Dr. Greg Rose, excited to have you on. We've been doing this podcast for seven and a half years, and I'm finally got the gumption to invite you on. So thank you for taking the time.

Greg Rose, DC: Congrats for seven and a half years. And thanks for having me.

Dr. Kevin Christie: Yeah, definitely. And so before we dive into, uh, positioning yourself as an expert in golf injuries, uh, just give us a little bit about your background and we'll dive into it.

Greg Rose, DC: Yeah. So the quick, It's quick stories. My undergraduate was engineering decided. I hated engineering really quick and decided to go into chiropractic went to Palmer College of chiropractic graduated [00:02:00] 96. I was a golf nut worked at the golf course at University of Maryland. And I knew that I wanted to open a practice to just focus on golfers.

So my 1st practice was called advantage golf in the Washington, D. C. area. I was there for 9 years and then I had the fortune of working with a lot of top professionals because not a lot of people were just working with golfers back in the late 90s. And, uh, the golf company Titleist approached me, uh, the CEO, Wally Uline, one of your patients, Kevin.

Um, at the time, he actually, uh, approached me and said, Hey, you know, we run a, uh, you know, one of the largest, we run the largest golf company in the world and we have a lot of players that we sponsor, but unlike other sports, we don't really put any money into development of our players. He's like, I'm thinking about doing that.

Would you be interested in helping us develop that? So. I had the fortune of, of helping them design what's called the Titus Performance Institute, which is out in San Diego, California. I did that as a consultant for about two years, told him what I would build. And then two years later, he surprised me by saying, uh, I'd love for you to come run this for us and had to twist my arm.[00:03:00]

Me and a guy by the name of Dave Phillips were the co founders of this. We moved out to San Diego in 2003, and we've been there ever since. And, uh, it's been a heck of a ride. We're. We basically have taken care of all the Titleist players worldwide for health and fitness. Any of the players that need help, we try and assist them any way we can to make them play better.

And we realized real quick, Kevin, that we had more players than any team in the world. In other words, we had close to 8, 000 players that Titleist sponsored. It's not like a baseball team or a football team. We had a lot of players. So we said really early on, you know, we can't handle all the players. We, we asked Wally and Tylus, like, would you allow us to teach other professionals how to do what we do?

And so we, you know, And he was like, for sure, whatever you need. So we launched this TPI certification and we've been doing this, uh, TPI certification since 2006. Uh, we have over 30, 000 TPI certified professionals in 64 countries all over the world. Um, that, you know, uh, we've taught them how all the things that we've learned about working [00:04:00] with the greatest players in the world, how to work with golfers and make them play better.

And we try and get all of our players to work with TPI certified professionals. And now it's. Hard to name a professional golfer from the men and women's side that don't have a TPI certified professional on their team. And, uh, uh, it's, it's, it's one of those things where I didn't realize how big golf was until I started, but, you know, uh, it's all over the world, but it's, uh, it's a great sport to be in.

Dr. Kevin Christie: Yeah. You know, and I've been one of the earlier, uh, followers of, of your work. I actually, my first job was with Andy Wasserman down here in South Florida. Yeah. He, uh, he's a Maryland guy. And so I remember him telling about you and that was, that was the advantage golf days. And I, I have, I still have your advantage golf manuals that you had for training.

Cause you were early on, you know, doing the certification through advantage golf.

Greg Rose, DC: Yeah. We did seminars before Titleist. And that's why when we got Titleist and I realized how many players I was like, Listen, we need help. I'm like, I have a seminar business, but it would be a lot better if they were title is certified instead of advantage culture.

And he's [00:05:00] like, let's do it. And that's kind of started that whole thing.

Dr. Kevin Christie: Yeah, so I was 1 early on in that matriculation of the, of the 1, 2, 3, through medical and a bunch of the others. And it's been 1

Greg Rose, DC: other thing I can point out real quick that a lot of the contractors might see is, is 1 of the. Advisory board members that we brought on really early was a physical therapist by the, by the name of great cook.

And Gray and I, uh, back in, like, 2006, 7 and 8 developed something called the. Um, it's now pretty popular in a lot of the chiropractic schools. Um, so we started that certification and, um, we join I joined forces with FMS. So I became 1 of the owners of functional movement systems. So, so for movement screening, but.

Um, so the, the SFMA and TPI are kind of to, to, I call them to my brain childs, but, uh, have kept me busy for 20 plus years.

Dr. Kevin Christie: Yeah, it has. And I remember I was fortunate enough when I took level two and three medical, it was taught by Greg cook and it was [00:06:00] the SFMA and really diving into the, the, obviously the screening and then the correctives, which was great.

And the flow charts, they've got the flow charts and everything. So, yeah, it's been, been cool to see that. Um, That collaboration really work out. And a lot of the, the chiropractors that we work with and talk to, uh, are, are either TPI certified or SFMA or, or, or both, which has been, been cool. Um, you know, kind of the context of our podcast for the last seven and a half years was there really was kind of a blue ocean of really good evidence based chiropractors that, uh, weren't doing a lot with marketing and business development.

And so we started this podcast to, to do that. And we know the table stakes. Is having good clinical chops to, to grow a practice. But what are some of the things early on in your community, uh, that you did to position yourself in the community, uh, around golf, not necessarily at this point before TPI, but really just trying to build your practice, what were some of the things that you were doing?

Greg Rose, DC: Okay. [00:07:00] I feel like this is probably true in, in a lot of, uh, specialties, but, uh, for sure in golf is I feel like credibility is everything, right? So if you say you're going to work with golfers, golfers want to know that you understand the pain of being a golfer, right? They want you to be a great chiropractor, but they also want you to understand like, Hey, are you going to mess up my golf swing?

And, uh, yeah, I want to be, you know, like they're, they're just, they're, they're fanatics, right? And so I felt like 2 things were really important. I felt like. Understanding the needs of a golfer and what their body has to go through is really important, but having the credibility, I think, is the key. And this is 1 of the reasons.

That, you know, I, I was really excited about doing the seminars with title is because, you know, if you're a golfer and you walk into a, an office and you say, you know, I've got pain and you say to the chiropractor. Can you help me most of our action ago? Of course, I can help you. But if you walk into the office and you say, I'm a golfer, I'm in pain, the chiropractor goes.

I'm [00:08:00] actually certified by Titleist. If they get this, like, Oh, this is actually, this person has the credibility that I'm looking for. So I think that's true in all business. Like if we, if you have that stamp of credibility, it gives a little bit of a relief or I'd say hope to your patient, which is a big deal.

Right. Um, so I think, I think that was the big thing was first of all, understanding the demands that a golfer goes through. So you really have to understand the body swing connection, how the body affects the swing and the swing affects the body. Right. But then don't forget how important credibility is.

Dr. Kevin Christie: Yeah. And it's, uh, what's been cool is I actually had my title's bag on my name on it, that's got the TPI on it. It's a big

Greg Rose, DC: deal. Yeah.

Dr. Kevin Christie: Yeah. And I, and, uh, being in Boca Raton, Florida, I have quite a large audience of, of golfers and, uh, I get some golf teaching pros and that helps, but, um, it's, you know, obviously TPI has had enough of, um, a movement in a name where, uh, most golfers and, you know, credible golfers, they, they do know that name and it does give them a, yeah,

Greg Rose, DC: I [00:09:00] mean, I think if you're like.

If your kids in Peewee football, right? And you bring them into a chiropractor's office and the chiropractor just, it just looks like we're the chiropractor versus they walk in and they've got a shield from the NFL on their wall saying, I am a chiropractor for the NFL. It just, it's a different level.

That's, that's how they think. Yeah,

Dr. Kevin Christie: absolutely. It absolutely is. I think the other thing that was cool for me was I picked up golf at 22, a senior year at Florida state university, and I got addicted. I was a baseball player, so I had some athleticism and hand eye coordination yet. You have to kind of. Tame that's that, that swing for sure.

Um, but when I went through the full TPI stuff and I took the biomechanics course you used to have, and, uh, it really helped my golf game and I was playing a lot, but I got down into a nine handicap by, by age 31. So I was proud of that. And that, uh, when I would tell that patient that, you know, they'd ask, cause I play to a nine, like, okay, like you don't have to be a scratch golfer per se, but if you get to

Greg Rose, DC: the.

You actually don't even have to be a golfer. You just have to be able to speak the language and understand what they go through, [00:10:00] right? Like, we have a, we have a baseball certification to on base university, and we have a tennis on racket, and we have guys that specialize in all of these. They're not tennis players, baseball players and golfers, but they can speak the language like they are.

And that's what's really important.

Dr. Kevin Christie: Yeah, definitely. And so in your community, you were obviously speaking a language. Were you getting out and doing, uh, injury prevention workshops? Were you shooting videos back then? I mean, it might, it might've had to been a nine millimeter to, or eight mil. What is it? Uh, what's the old cameras we had to use back then

Greg Rose, DC: with the VCR tape on it?

The VCR

Dr. Kevin Christie: tape. But what were you doing in the community?

Greg Rose, DC: To me, you know, there were there was 2 things I think that led to my success timings. 1 of them for sure. I started when Tiger Woods started. So everybody was like, what's this new phenom? So it's golf kind of exploded. And then number 2 is I, I believed in the referral network and I believe in this to know me is to love me rule.

Right? So, I went to all the local Mid Atlantic PGA members where I was at, and I [00:11:00] said, I sponsored the Mid Atlantic PGA, I, you know, I've sponsored a tournament, gave him like, I think it was like a couple thousand dollars, something crazy, you could be a sponsor. And I said to all the PGA members, I'll treat you for free.

Now, and that's, that's like, you know, that's a 4 letter word for a lot of car parts free, but I was like. To know me is to love me. Once they, once I treat them, they're going to love me. And then when any of their students say, ow, they're going to go, Oh, you got to go see my guy, Greg. Right. So I treated them.

And then I also went to, and it's part where I don't see a lot of chiropractors do, I went to every gym in my 30 mile radius. Like go to 24 hour fitness and gold's gym. I walk in. I'd say, Hey, I'm a local chiropractor. I work with golfers. I really believe in getting my golfers on a workout program, but I want them to work out with the trainer.

Do you have somebody here that specializes in sports or golf? And they would always say, sure. And it introduced me 1 or 2 trainers. I have the same spiel I go to the trainers and go. You know, can I, I'd love to get your card. I want to send you some of my patients. And by the way, if you have any problems, I'd love to treat you.

I'd get the trainers it. So now I got, if you walked into a gym and said you were a [00:12:00] golfer and you had discomfort, or you walked into a golf course in my zone and said to the pro that I've got some pain, all the, the trainers, I had like 350 trainers and about 80 golf professionals in the Washington, D. C.

area. That if you said, Al, they're like, you got to go see my guy. And I literally, I never, I didn't have to mark after 4 years. I mean, I almost had a closed practice, Kevin. It was, it was like, we had like 6 month waiting list. And if a pro, you know, referred you, I would try my best to get you in as fast as possible.

But it was, it was incredible. I was like, this is a great business. And that's where I kept promoting this golf fitness businesses or golf medical business is a great business to be in.

Dr. Kevin Christie: Yeah. And I want to connect a couple of dots here, because you mentioned credibility earlier and then the referral network.

Um, one of the things that's been pretty cool once I did go through the TPI certification, meeting some people. And I remember quick story, uh, Andy Wasserman, uh, recommended that I go all the way down to like South Miami, which is like an hour and a half drive down there to hang out with this guy, Jeff Banasek, who was working at minor league golf towards the [00:13:00] time.

And he used to bring this old van, old, like back nine. Yeah. Exactly. And, and we, I saw him, I watched him work on some minor league golfers of, of, of no significance real and, and, but we just, Jeff Banasek and I kept in touch and then it was like fast forward to 2011. He needed help. And now he had, I think at the time, like three of the top 10 in the world, he was working with like Luke Donald and

Greg Rose, DC: I used to send Jeff home, I guess.

Yeah. He was great. And I go.

Dr. Kevin Christie: Yeah. So 2011, I wanted about five events on the, on the PGA tour and the champions to help with some of his players. And then I met, um, Troy van Bies in there. And then all of a sudden I started meeting, like, you know, you're going to have your network in the community of teaching pros and fitness pros that you want, but if you go through like a TPI cert and you really, really want to Work, you know, go to the summits and stuff.

You start to meet the other players, uh, when I say players, like in the industry that are going to be of influence,

Greg Rose, DC: all the sphere, all the people influencing that player. Yep.

Dr. Kevin Christie: Yeah, exactly. The sphere of influence. [00:14:00] And, and I've gotten a lot of referrals from those folks that I met 15 years ago, 10 years ago.

And I think that's a really good thing to consider as a referral network.

Greg Rose, DC: I started with trainers. And the golf coaches, but I can't tell you how many sports psychologists, managers, I mean, all send me their players. I mean, it's just like, it's just part of, we're part of the team. You know what I mean? Yeah.

Dr. Kevin Christie: And then the other one, I guess is a good one is, uh, obviously if you've got a fitting, uh, or a golf store and the equipment fitting is a big one, I think you got to consider. So yeah, I love the referral network on that. Um, and then the other thing on the referral network, which I do every so often, I just did it about three months ago.

I go on your website. And look at the referral network that you've guys put together there. And I email and contact the, any new teaching pro or fitness person that's in the area that's moved in. And being in South Florida, we get a fair amount of people that are moving into here and I connect with them.

And so really try to build that network is, is, uh,

Greg Rose, DC: I think about, I said, I had 350 trainers. And [00:15:00] 80, I think it was 82 golf pros. So you're going, wait a minute, you're telling me you're treating 430 people for free answer. Yeah, I did. I literally said to those people, now here's the thing. If you're working with the right golf professionals that are giving lessons eight hours a day, you're not, you're gonna see them twice a year, three times a year, they just don't have time to come in.

So it's not like. All day you're working with these, these free. And so you want to pick the people that are busy and you want them to be out there busy. So if they're hurt, you want to get them back to working so they can refer you to people. And I got to the point where, I mean, I had 6, 000 patients.

Right. I mean, it was out of control. Cause like, cause like these 400 people only had to refer me a couple of people and I was done, you know what I mean? Yeah.

Dr. Kevin Christie: It's huge. It's awesome. And then that's how, you know, you can, you can ultimately transcend your community a certain point and like, obviously like you did there, uh, which has been great, um, what are some other things you would say, okay, now it's 2024, uh, we've got Kairos PT's, uh, physical therapists, um, uh, For audience that sometimes I say PTs and I think personal [00:16:00] trainers.

So just make that clarification, um, that are, uh, getting out in the communities, trying to do this. What are some things that you may do now? If you had to rewind it's 25 years ago and it's, you know what you know now, but you have to start from scratch. There's more technology. There's different things that you've learned.

What would you, what would you consider?

Greg Rose, DC: A couple of things that I would do now. So first of all, I didn't have social media, right? We didn't, we didn't, when we started, right? So. I feel like one of the, like, I, I'm give you a real example, over the last four months Mm-Hmm. . We just, we just decided finally a title is to launch a YouTube channel.

Right? So we have our, my team, YouTube channel. We've put stuff on YouTube before, but we haven't really, you know Yeah. Focused on, so we hired, uh, a guy named Matt, uh, he's a videographer and producer. He follows me around, right? And basically, he'll, he'll pick. One one player a week and he creates a video and puts it up on YouTube, Kevin.

I, I, I had to send out an email last week to [00:17:00] probably 200 emails that we've had from just people watching the YouTube channel saying that sorry, we're sold out for 2024. Uh, if you want to get a wait list for 2025 people going, I saw that I want to do that. Right. So, again, to know me is to love me. I think right now, social media makes it so easy.

You could, you know, with permission from patients, most clients say, hey, I think you got a really interesting case. Would you mind if we could film some of this? If they would let you do that. There's lots of chiropractors that do social stuff now, but I, I think it builds big followings and people get interested.

Right. So that that's 1 thing I would do that. I didn't do before. Of course, the referral network, I would do this exactly the same. I would never change that. That was that that worked great. I think the world of distance coaching is kind of interesting. And what I mean by that is. You know, there's this whole world of elite players from all different sports and in golf, you know, they're traveling all over the world and when they're home, they have their home team.

But when they're on the road, a lot of things, things happen, they get in [00:18:00] trouble and they want some advice. So there's trainers and there's coaches that have players that like, you know, they'll build them programs and they'll have them FaceTime connect with them. Being like the team doc for some of these, like, hey, if something comes up pain, they can, they can connect with you and do some virtual stuff.

It's a big business right now. I mean, and it's pretty easy to do on spare time and stuff like that. So. I would definitely look at that with your distance coaching and there's so many tools to make that easy. I, I'm, I'm obviously a big, still a big believer in specializing, right? I've instead of saying your sports chiropractor, if you say you're a chiropractor for fast pitch softball, it sounds crazy.

But that community sees you as an expert. And then all of a sudden, you've got 400 patients that are fast pitch softball and knowing more about that sport than anybody in the world. Right? So, I, I feel like I would still do that. Um, I think what else would be different now started, um, obviously cash practice.

I mean, most athletes are, are. [00:19:00] Willing to especially willing to pay. So, you know, the whole insurance world is a lot different than when I was in private practice before. So, I think you can do a lot with the cash practice now. Um, yeah.

Dr. Kevin Christie: And that's a reality of the golfers, right? They, they do have a level of affluency.

Uh, so, and they're willing to pay for, for results. And I think that's important to do

Greg Rose, DC: 700 on a driver. If they can hit a 10 yard park, no, no, actually,

Dr. Kevin Christie: I want to thank you too. I just bought new irons and I got my TPI discount, which is great. That's another, another benefit. Um, one of the things that I've actually talked about, and I'd love your thoughts on it is, um, Is parallel sports, right?

So maybe a pickleball is getting really big in your area. You could work and talk with the pickleball folks, but a lot of those pickleball players are also golfers, right? Or tennis is another parallel sport to golf, where maybe you're connecting with tennis instructors or tennis facilities. And then you're going to also meet some golfers through that.

Some of them are golf and racket clubs. Uh, [00:20:00] have you thought about, or had any experience with just kind of almost like Trojan horsing your way in?

Greg Rose, DC: Well, I mean, we launched racket fit, you know, uh, five years ago. So we have a certification for tennis for, for that exact reason. And baseball, we have our own base university for baseball and softball, because what you're pointing out is, is rotary sports or rotary sports.

You know, you can like, I went. I went to Beijing for the Chinese Olympic committee because they asked me to come help their table tennis. I'm like, I don't know anything about table tennis. I went in there and they were using our TBI golf screen for table tennis, right? I'm like, wait, what is going on? Like, but it's rotary athletes, rotary athletes.

So. I think what the, the unique thing, like, like, why did we have to do a different seminar? Why can't you just take the golf and apply it to baseball? Number one, you have to be able to speak the baseball language. Number two is you have to understand the different demands that each sport has, right? So, hands might be doing some different things, uh, the shoulder doing different things for your pitchers.

So, those specialties and. And I feel like once you understand that, then you can figure out the right [00:21:00] way to screen those players. But the core, like, the core of Rotary sports is the same, right? Um, but I don't like to say that. Hey, I work with Rotary athletes. Anybody come see me. I would, if you're going to say, okay, I'm going to work with baseball players, golfers, hockey players.

You really need to dive in so that you can communicate with them. Right. I it's really, really important that they know that, you know, their sport. I I'm a big believer in that. I don't like generalists. I just feel like when a specialist opens up, you lose. So I'm like, I want, I want it. Like if you say, Hey, I work with gymnasts, right.

And, but you don't really know anything about gymnastics and I open up next door and I'm a gymnast expert at the, what do you think they're going to go to? Right. They're going to come to me. Right. So. Um, I think you need to understand rotary sports, but like you said, you can, if the same community, if golfers are also doing X, Y, and Z, it'd be important to learn about those as well.

Dr. Kevin Christie: Yeah. And a couple of things on that specialist, um, concept that I want to dissect a little bit is one is I'm, I'm about 30 minutes from Jupiter, [00:22:00] Florida, which if anybody knows golf has obviously become a pretty special place with golf. And I've talked to some, uh, chiropractors that have been there for a while and they were more generalists and they used to see golfers and such, but then now Jupiter's attracted some of the best specialists in the world, um, as you can imagine.

And so a lot of the golfers are going to see those specialists and the generalists are, are losing out on that. And so that to your, to your point, um, on that, that's something that, that happens a lot. And the other thing I've noticed, I've had fortunate in my career, 19 years now, uh, done a lot with golf.

Uh, I was clinical director of an NFL combine training program for 12 years. So I've been in the combine and then I've done a lot with triathletes. So I've kind of really. Uh, done really well with those three and there's been some other ones, but, uh, I'll just take from the golf side of things is when people realize that I could work with high level golfers, my regular patients that weren't golfers, but, you know, we're wanting to get better there.

They said to themselves, like, well, if he's good enough to work with, [00:23:00] so and so golfers, then I'm sure he's good, good enough to work on my back, even though I'm not a golfer. And so sometimes I see that almost halo effect really good.

Greg Rose, DC: Well, just, and just think like, like back to the generalist, just think like, imagine if you're.

If your son or daughter's in 6th grade, right, and struggling with math, do you go to the 6th grade teacher, or do you go hire a math teacher to work with them? Right? I mean, I think it's like, yeah, your 6th grade teacher knows math, but if they're showing math, let's get them a specialist in math. Right?

Yeah. That's what athletes think the same way. They're like, you know, um, and like, to your point, you said, like, hey, if I'm working with some of the best, uh. weightlifters in the world. Let's say that's my, my thing, right? If somebody is like, I'm not a, I'm not a crazy weightlifter, but I'm starting in a gym program.

And this guy works with the best weightlifters. He can definitely, if he can help them, he can help me like, like that definitely happens all the time.

Dr. Kevin Christie: Awesome. And then just one more question before we, uh, just kind of, I want to get some updates on where TPI is at and what you guys are up to. Um, You know, you, you kind of are like a [00:24:00] secret marketer, right?

Uh, a lot of, a lot of, um, doctors don't want to think of themselves as having to market or marketers, uh, you know, what, what would you say, but you've done so many things, I mean, you were one of early on, you guys had a golf. Program on actual TV. Uh, that's a form of marketing, right? Uh, but it's a form of education based marketing, which I love the most.

Uh, what do you say to those, uh, chiropractors out there, those physical therapists that don't want to market, they don't want to come across as marketing, uh, but they obviously want to position themselves well, uh, any insights into that, or it is just something that you just kind of

Greg Rose, DC: definitely, I always feel like if you tell people who are great.

They don't tell you they're great. You just know they're great. Okay, so I, I agree with what you're saying. I agree with what they're saying. I don't get up there and go, I'm the best. Come see me. I said to know me is to love me. I just showed them what I do. And I know that the people that that resonates with that, they really like that.

Those are the ones that are going to seek me out. And those are the people I want to talk [00:25:00] to anyway. The people who don't like them coming anyway, right? So I just feel like instead of telling me you're great Just show me what you do, right? Show me what you do. That's what we've always done. It's like this is what we do This is what we believe.

Uh, this is how it works and I never say come see me but They, they find me, right? It's like, if I'm going to sell like a training aid, instead of saying this is the best training aid, I'm going to use it while I'm training somebody and more people are going to ask me, what was that tool you were using than if I would have tried to market the tool, you don't know what I mean?

Well, like you said, secret marketing, but it's not, it's, it's really just, just do what you're good at and show people what you do. And, uh, they're your, your cult, your following we'll find. I mean, that's, that's what I really believe.

Dr. Kevin Christie: Yeah. And I think, uh, not enough people are doing and showing, uh, I think what they do is they go, they, they think they can build their practice behind the computer.

Right. Cause they can just get on social media and comment and Facebook groups and do that type of stuff. And yeah, maybe there's some [00:26:00] traction there. Uh, but. Doing and showing is going to be great. And like you mentioned, you got out in the community, a ton too many people are not getting out in the community.

Let's get old school with it. But what's cool is you can, you can marry the new school with the old school, right? You could get out.

Greg Rose, DC: Yeah. It's crazy to sound a lot of people come to see me. They don't know I'm a chiropractor, right? Like, like a lot of people are still. People like you and I know everything about chiropractic because we're chiropractors, but a lot of most world still doesn't know what the hell we do.

Right. So they heard in four stories and they're like, so they're nervous. They're scared. They don't know what to expect. But if they saw what you do and they watched it, they're like, Oh, that was great. That's there's nothing. I want to go through that. They just, they need that comfort.

Dr. Kevin Christie: They do. And in like, you know, I did a lot of the public speaking locally to build my practice.

And if I had the technology now, what I would do is record that. And then you could take that. hour long video of you doing a injury prevention workshop for 10 golfers or whatever. And you can [00:27:00] actually load that video into something called opus clip and it'll spit out like 30 and 60 second reels. And that goes out like now it's just, it's, it's so much more fun.

And you can create

Greg Rose, DC: your in that too. I just, we just had a company, Kevin, that, that, uh, we sent the video to, cause we just redid a bunch of our classes and they're like, we'd like to show you what we can do. It's an AI company. And in 20 minutes, they sent us back our video. This was like a 30 second clip and it was in six languages and it was me speaking Korean.

It was my voice, like speaking Korean. I was like, what the, I mean, it's, it's crazy what technology can help.

Dr. Kevin Christie: That's pretty cool. I must say that's cool. So what's, uh, you know, speaking of all the modern stuff that we got now, but what's, what's the next five years look like for, for TPI? What's the exciting things?

I'm

Greg Rose, DC: telling you, there's some really exciting stuff. So, first of all, we. We started two years ago. We started with a complete renovation of, of TPI, uh, our facility out here in Oceanside. You know, we really [00:28:00] hadn't touched it since 2003 when we first redid it. So it's been 20 years. And, uh, we're in the middle of a 25, 000, 000 dollar renovation.

We literally bulldoze the entire facility about a year and a half ago. So, started over. We had. Uh, David kid, who's the golf course architect for band and dunes came in and helped us design a 9 hole course and our practice facility, which is really cool. We're building 7 new buildings on the property. We have a, something called the TLC, the titles learning center, which is a.

A 250 person auditorium for doing seminars and workshops. We've got something called the ARC, our Advanced Research Center, which has six new motion capture labs in it. So we have two for our golf ball R& D, one for clubs, one for player. And we have two of the labs are for baseball. We actually have a pitching and hitting area for our own base area.

We're actually building another building called the lab, which will have two more diagnostic labs in there. So all the latest technology from force plates to 3D and video. We built a building called the [00:29:00] pyramid, which is a place for our, our next generation and our tour players to come camp out and do their team meetings.

We built an incredible practice area for them. Um, we, we, we obviously have all the club fitting bells and whistles there to take players through stuff. So we're, we're, our goal is to be hopefully done by, by the latest mid 2026. But, um, I'm actually testing out our new golf lab next week when I go back to TBI, which I'm excited about.

Um, so all the latest research, like I said, on on ground force, we actually have, uh, platforms that we can test uphill, downhill, side hill lies with force plates, which is really cool. So just really understanding how players create power, transfer power and. And seeing where maybe they are doing things that might be injury risk or, you know, trying to prevent injuries.

We're building an entire recovery center at TPI, which we've never had. So it'll have everything from. Hot tub, the cold plunge, the infrared hyperbaric and trying to highlight to all of our players, all the things they can do to [00:30:00] recover because golf is one of those unique sports that our players have to play for over 40 years, right?

Not just, you know, five years. So yeah, we're putting two medical treatment rooms there so that they come with their, with their, their medical team and they can get their treatments up there, which is awesome. Brand new gym. Uh, we've always had life fitness as a partner and it's incredible what we're, what we're putting in, in the fitness side.

Um, I can just go on and on all the cool things that are happening facility. Um, we, we basically, uh, just redid our. Online education, so our level 1 class, we've just refilmed the entire online level 1 class. We just got completed redoing all of our level 2 classes. We have. You know, tracks for golf professionals, medical professionals, fitness power, junior coaches.

So we're redoing those. We'll, we'll launch, uh, 3 new. Level twos that, uh, this year we're about to launch our, our, we just launched our updated medical power and our fitness is about to launch. We're finishing our golf track right now. So that's coming soon. [00:31:00] Yeah, it just goes on and on and on. That's

Dr. Kevin Christie: exciting.

I've got a four year old and a two year old, two boys, and, uh, I'm gonna be throwing them into the junior stuff here soon, so it's, uh, I've always loved that I, we have a playground in our, in our neighborhood, luckily a nice park and convinced my wife that we're there at least five days a week. And they're just falling off, beating them still, you know, just whatever, but it's good for them.

Greg Rose, DC: We used to do, right. That's what everybody used

Dr. Kevin Christie: to do. Exactly. Exactly. Well, that's cool. And then, uh, you know, every year you're going to be having the, the summit, I think this year, um, it's coming up in October, right? Orlando.

Greg Rose, DC: Believe it or not, this is the first time since COVID, right? We used to have this every three years.

It's our favorite three days of the year. We have the, we just call it the world golf fitness summit. We're just calling it the TPI annual summit now, but it's going to be in Orlando. Um, it's, uh, October 25th, sixth and seventh. Uh, it's, we bring in some of the best speakers from all over the world. Um, we'll have probably there'll be five to 600 people there just in the world of rotary sports, golf specific and some [00:32:00] baseball stuff there too.

And, and, uh, it's just learning from the best coaches, the best trainers and the best medical professionals. And it's just a great place to network. So if you're in the business, you're interested, you definitely don't want to miss the summit. It's, it's really, really cool. Yeah.

Dr. Kevin Christie: Hey, I was at the 1st 1 and I was at a handful throughout the years.

And every year I go, um, I can't make it this year because I'm already out of town, but it's gonna be back on my radar because yeah, you just learn a ton. And then again, going back to building that network. If you're serious, like, if you're really serious about this, I think some things we struggle with. As, as humans is that we, we know in our heart of hearts, like I should be doing this, right?

I probably need to do that to get there, but you just don't do it for, for whatever reason. If you really want to work with the golfers, you just need to do the TPI stuff. And if, if you need to dip your toes into it, go to the summit first and go, and then get, cause I think you said 2024 certifications are, are, uh, filled up.

Is that correct?

Greg Rose, DC: No, I was saying the [00:33:00] 2024 was people wanting to come into the facility to the facility. Yeah. Yeah. So yeah. You can do the certification online and then we have a lot of classes as well, but, um, yeah. And by the way, all the certifications that we offer are accredited for chiropractic CEs, which is great.

Yeah.

Dr. Kevin Christie: Really helpful. So good stuff. Well, listen, you know, I, I really appreciate your time. This is a kind of a, you know, full circle moment for me and excited to pick your brain on, on some of this. Yeah, absolutely. And I know we'll talk soon.

Greg Rose, DC: That was good. Thanks, Kevin. Appreciate it.

Dr. Kevin Christie: Yeah. If, if you see my application to work at the new facility in San Diego,

Greg Rose, DC: okay, good.

All right. Perfect.

Dr. Kevin Christie: Well, listen, Greg, have a great rest of your day and we'll talk soon.

Greg Rose, DC: Thanks. Appreciate it.

 EPISODE 391: Breaking Through The Ceiling of Complexity

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, Brennan. I'm really excited to have you on, you know, know you for quite a long time and it's cool to, uh, get you on the podcast after some years of, of working together. So before we dive into our, our topics today, uh, tell us a little bit about yourself personally and professionally.

Brennan Donahue, DC: Uh, yeah, I am practicing out of St. Louis, Missouri. So I'm about 20 minutes away from Logan. Uh, I got a wife and two kids and, uh, that's the, there's the business side and there's the family side. You know, there, there are two different buckets that keep me pretty darn busy.

Dr. Kevin Christie: Yeah. And so you went to the Harvard of chiropractic schools as well, right?

That's right. Can't pass that up. And you're from the area, correct?

Brennan Donahue, DC: I am. Yeah. So I grew, I was born and raised in St. Louis, so I wasn't one of the transplants that come in and stick it out after graduation. Yeah,

Dr. Kevin Christie: I got there and I was like, you know, I, I told my wife now, cause she never, she's never been there.

And, uh, I was like, you know, I could live there. I could live there. She can't see it cause she's a Floridian like I am and cold [00:01:00] weather gets to her, but, uh, it's a phenomenal area.

Brennan Donahue, DC: There's a lot of perks of living dead center in the Midwest. So, you know,

Dr. Kevin Christie: a lot of cots

Brennan Donahue, DC: do no beach, but that's, we can travel to that.

Dr. Kevin Christie: Yeah, exactly. And you do, and you do, and we'll get to that for sure. Um, it's a topic I want to bring up as far as taking vacations. Cause we had a cool conversation around that some, some time ago, but, uh, before we dive into that, uh, when did, when did you graduate and what did you do after you graduated?

Brennan Donahue, DC: I graduated in August of 2016, and I started on my own right out of the gate.

Um, I did originally I worked with a practice management company and that, you know, I learned I quickly needed to break ties with that. But. It was for about the first year. It was a good way for me to get my feet wet and know, uh, what, you know, what road to take as I met some forks. So from there, I started in a CrossFit gym, a room, I mean, it was probably 10 by 10, uh, very small rented that from the gym owner.

And from there I started building out my current [00:02:00] space. And so now I have about 1300 square feet and a little bit, 200 square feet of that is gym space and the rest is clinic space.

Dr. Kevin Christie: Nice. And then, um, how long were you in the CrossFit gym?

Brennan Donahue, DC: I was in the CrossFit gym for only about seven months. So by March of 2017, I was practicing out of my physical location.

Dr. Kevin Christie: Good. You know, and I, and I talked to a lot of chiropractors about that. And frankly, that's what I did. You know, I I've shared it before, but I started, I started as an associate at a full blown clinic, which gave me a lot of good learning experience. And then, then I went into a partnership and I was inside of a.

Training facility, and it was a shithole, but it was, it was good in the sense that had a lot of pro athletes and all that. But, uh, I was there and then got out of that after a couple of years into an orthopedic group, which was, was a nice situation. But every, every time I hear someone that start starts out of the gym or wants to, I think it's actually a very viable.

Um, [00:03:00] start like you did, it's low overhead, gets you going. Uh, but I think you have to have a plan to get out of that because, um, there really is nothing better than your own space for, for many reasons, but it definitely offers a lot more growth potential. And obviously, uh, I think you've seen that, uh, but I think, um, I wanna, I wanna segue a little bit.

Um, you're, you're an ART provider like myself. When did you get ART certified?

Brennan Donahue, DC: I was full body by the time I graduated. Um, and so I, I started early on, maybe try to try three and just started tackling one a year with the discounted rate they were given at the time. It made a lot of sense and I resonated with it.

And so that there were a few components when I was a student that I knew I needed, right. Adjusting soft tissue back then taping was big. And so I really wanted to hone clinical aspect of chiropractic as much as I could, before I graduated, knowing that I then was going to. Figure out the business side as we went.

So,

Dr. Kevin Christie: yeah, no, absolutely. And so [00:04:00] you're, you're kind of ART right out of the gates, which is, which is cool. And I, I do recall when you and I first had our, our initial discussions and stuff, you were doing some onsite care. Is that correct?

Brennan Donahue, DC: Yeah, it was. Yeah. Um, I wasn't doing it through ART. I was doing on site care that I kind of had established on my own with HR directors.

And so I had two locations that I would go to, I think it was once every other week. And then, you know, that obviously we did that up until COVID time and then it never, by the time we came out of COVID time, I didn't have that time to allocate back to that type of.

Dr. Kevin Christie: Well, you know, it's interesting because I had a lot of, I had six corporate locations at one time and it was great.

Um, I remember it, it, it provided me with some extra income. It allowed me to actually hire my first associate cause he was doing some of the corporate and he was doing some in our clinic. Uh, but then, yeah, I got to a time. Where we just had to make decisions and we did to get out of that space. But I think it's, um, [00:05:00] very fruitful for a lot of people and at least a springboard.

Uh, how did you get into those corporate locations? Was it patients that were HR director directors?

Brennan Donahue, DC: Yep. Yep. People I knew through my office that were HR directors that I just started talking to and, um, and some of them had already had massage, so they knew the concept. And I said, let's take it a step further.

And they, they worked it up the chain and it That's how I kind of got my feet wet.

Dr. Kevin Christie: Yeah, that's how it worked out with us. And, uh, I think, you know, I get a lot of people still reach out to me about that. And I, you know, how's the best way to do it? It's, it's typically through your patience, right?

Brennan Donahue, DC: I didn't walk stone cold into any offices.

I don't know if I would have back then. I probably wouldn't have, uh, had the skills to pull it off. So.

Dr. Kevin Christie: And I think one of the, the take homes I wanted to spotlight on that was, uh, and we're going to get to where you're at now in a little bit, but I think in a, in a chiropractor's, uh, progression. So you're now, uh, you know, kind of eight years into this thing, eight, nine years.

And what's cool is when you're [00:06:00] early on and you're trying to gain traction is that you might find yourself. Um, adding some things and doing, you know, uh, maybe some corporate work here or working for a high school there, or, you know, some ways of increasing your, your, your take home pay. But then you're going to get to a certain point where, uh, the practice, uh, really becomes your golden goose and you got to focus more time on that.

And there's nothing wrong with, uh, you know, Whittling down what you're doing and getting rid of things, uh, to, to do that. And one thing I remember I had a hard decision. I opened up my own practice in April of 2010 and it was 2000, early 2011. And at that point I did not have an associate. Uh, I got an opportunity to travel on the, on the PGA and the champions tour to work with golfers and, and I had to go like Tuesday through Sunday.

And I got paid well to go, uh, but I was losing a week's worth of revenue and I did about six of them and I realized like, okay, this, I got this under my belt. It was really good [00:07:00] experience. I got to work with some really cool golfers. Uh, it definitely springboarded me and, and I, to this day can. Tell that story to some of my golfing patients.

And I think it's cool. And it gives me some credibility, but I realized I had to kind of cut that out. If I was going to really get my practice to grow, uh, to where it did. So I think a take home point of that is, uh, you know, early on in your career, you might add some things, you might bring some revenue, but then you got to do the cost analysis of it.

And I'm sure you, you did that to make that decision.

Brennan Donahue, DC: That's right.

Dr. Kevin Christie: Yeah. And, uh, I think it's, it's worked out, right?

Brennan Donahue, DC: It has no, and that's, I at one point wanted to only focus on that. Right. But as you start, uh, looking at how much can you produce per hour, right. You start figuring out this travel and, um, Uh, communicating with that many different patients while you're in that type of setting makes sense, or is it easiest just to bring it back in house?

So,

Dr. Kevin Christie: yeah, no, absolutely. Absolutely. So, um, now tell us where, where you're at now, as far as practice, uh, [00:08:00] what's it looking like? Give us a little bit of a kind of bird's eye view of the practice, your team, and then we'll, we'll kind of go from there.

Brennan Donahue, DC: Yeah, currently right now we have two docs. So we have an associate that is about five or six weeks in.

Um, he was a preceptor. So he's really been in my clinic for right about a year now, maybe even a little longer. Um, and which that is a game changer when you're trying to bring on an associate. Um, I currently have another preceptor as well. And then we have front desk staff and a billing specialist.

Dr. Kevin Christie: Nice.

Yeah. And you've done a great job with your, your preceptor program, um, which has been cool to see. And then, you know, I wanted to, I want to have you kind of tell the story a little bit of where, so you, you've been in our mastermind since the beginning. And I think you actually were in our coaching program since the beginning.

And it's a, it's a testament to your, Growth mindset. Cause like you said, when you got out of school, you were with a practice management group to help you kind of get out of the gates and that you're always looking to, to, to grow from that. But you've been in the mastermind for a bit in this last one, we were just in [00:09:00] Chicago, uh, and you kind of texted our group that, uh, you were, you were in Chicago and actually making money.

So tell us how, tell us about that and how that felt.

Brennan Donahue, DC: Oh, you know, it's it's one of those that anytime you travel, whether it's with your family or for seminar, and it's a Thursday, Friday into the weekend type thing. And as a solo doc, you always got to try and weigh those pros and cons on when you close when you don't close.

And how much money are you losing? Right? Um, I didn't take a trip for the first 5 years. I was in practice and that was because I was afraid to not have an income for a week when I had a staff that I had to pay, whether I was here or not. Um, but that had, you know, Fast forward to this past weekend and I was out Thursday, Friday, and we had patients being seen.

Staff was in office. The associate doc was there. Um, that just, it also eases your week because when you travel, you're cramming patients in left and right, where. I knew he was going to be here. And so it's like, nah, you're going to see Dr. Devin this week and we'll be back next. And I, [00:10:00] I want to know, you know, we, we go over seeing different docs.

Like we want our patients to be able to be interchangeable, but the whole scene collecting money while out of town was, that was a pretty darn good feeling. And I, I hope others can experience that too.

Dr. Kevin Christie: Yeah, it's huge. And one of the, I want to spotlight, I want to give credit to Dr. Doug Krebs, who's in our mastermind is, uh, cause a lot of people are always like, Oh, you know, how do you get your patients to see their doctor and things like that?

And he had a, a huge insight this past weekend where he talks about the care team. And so the patients are introduced to whether it's the associates, uh, maybe the preceptors, maybe it's the CAs. And you're, you're all introduced as part of the care team and you're developing a team around them so that it's somewhat interchangeable.

I'm, I'm, once I came back here from that, I started implementing that. Is that something you're going to look into to do a little bit more of?

Brennan Donahue, DC: It is. And we actually talked on our website, you know, it's meet our team. Most people have that page on their website. I think what we're going to do is we're going to print it on a piece of paper and have [00:11:00] that, you know, we use Cairo up and we use a few other sources that we put into a folder and it's like, let's put everybody's face on a piece of paper that's inside of that.

And here's meet your team, whether they've seen our website or not. So that's cool. We're going to implement it.

Dr. Kevin Christie: Yeah. And I think that's, you know, I've seen, I've seen some really good clinics do it. So I know it can be done. I know sometimes it's a mental hurdle. I've done it. Um, you know, I, I definitely could see how it could be a mental hurdle for some, but it's, it's a game changer when you get that clear with that.

So that is, um, that is great. Now I want to, I want to move back. You kind of mentioned it offhand that you didn't, uh, take any trips the first five years. And I remember, uh, we were down in, in Delray beach and. I think it was in 2019. It was probably December of 2019. And, uh, I got to meet you and your wife Caitlin for the first time.

And, uh, we was for the CSA retreat we had down here. So it was kind of a, an eclectic mix of, of chiropractors and students. And I remember having that conversation about. You got to take, you [00:12:00] got to take vacations, you know, you got to take trips. And I think, um, I think you guys have been doing that for the last handful of years, right?

What was the mindset shift on that? Even cause this was before you had an associate and it, how did you kind of overcome that and realize it was still worthwhile, right?

Brennan Donahue, DC: Uh, 1 when we got back from Delray, the practice was still alive, you know, and that was there was a great debate on whether we were both going to travel for that or not.

That was 1, but 2 that that 1st time I took a week vacation. We took a week off. We took the kids to Disney. Um, I was with my, my whole family when we were down there and. I came back and we had planned for it. We put money aside and I realized, I mean, we had our next, uh, three quarters of vacations planned by the time the wheels touched back down in St.

Louis after one trip. And it was just, it was a really eye opening experience. We now travel at least once a quarter, two of those quarters with our kids, two of those quarters. Uh, we, me and my wife do a trip, whether that is a elaborate trip or just a little getaway, a staycation, uh, something like that, because, uh, we just, it really [00:13:00] recharged our battery being gone for a period of time.

Dr. Kevin Christie: Yeah. And I think something that you've, you've, uh, Caught on too quickly is that, you know, you really got to build this practice to, to serve your family and you, you gotta be able to prepare for that. And you know, the sinking funds can do that, right? Just tuck away a little bit of money when you got good months and good weeks, tuck it away.

And if, uh, you know, let's say that vacation costs you 2, 500 and you lose 2, 500 in the practice, cause you're gone. If you're a solo practitioner, that's 5, 000. That's obviously real money. But if you. You know, over a year time or however many months tuck that away. Uh, and then once you do leave, you, you throw 2, 500 into your personal account to, to pay for the vacation at 2, 500 in your operating account for your business.

And, and it's no sweat. Uh, I, I do believe people that are, you know, Solo practitioners still need to take vacations. You just need to probably prepare a little more financially, uh, than if you have a team, uh, and obviously an associate doctor or a locum [00:14:00] tenants to do it. So I just think it's the biggest thing that chiropractors have to wrap their minds around is, is you still got to take the vacations.

Brennan Donahue, DC: I mean, the amount of energy I had when I returned, that was, that was the deciding moment, right? It was like, oh, and you, I mean, you also hear, unfortunately, those people that have been 10, 15, 20 years into practice, and they do not vacation and they, you see, they're, they're, they're struggling mentally there.

I don't want to, I don't know, burnt out or not. That's not my, um, position to say, but you can see that they are, they aren't enjoying it as they once were early on in practice.

Dr. Kevin Christie: Yeah, no, absolutely. It's, uh, it's definitely a real thing for sure. And you know, I've gotten to know you over the years and you definitely push the envelope as far as practice or even the fact that you train for Ironmans and races and things like that.

And, uh, you know, you gotta have that, you gotta have that outlet for sure. And there's no doubt that you've probably faced, you kind of abutted up against that burnout sometimes. Have you felt like you've hit that occasionally?

Brennan Donahue, DC: I have. And you know, it's kind of [00:15:00] funny as a younger doc, it's, In today's world, everybody picks on the youth.

And so you also don't want to be too soft. And so you sit there and question like, is this burnout or am I just being a little, a little chicken? You know what? Um, and so, but I have definitely approached those times where I've struggled. And luckily, I, part of that goes back to being a part of the mastermind and the coaching group.

I, you, if you are on an island by yourself, you're going to struggle by yourself. Right? But it has the mastermind has, um, Allowed me to continue to think big, but also see big and have a tribe around me that is able to help me know how to venture through some of those, those storms. So,

Dr. Kevin Christie: yeah, it's important to do.

It's kind of, it's like that quiet desperation that many have. And, uh, if you, if you don't have an outlet for that, it could be problematic. And I do think it's, uh, you know, it's sometimes. Understanding that we're a lot more resilient than we give ourselves credit for. Um, I think it's also understanding that no matter who it is, you could see chiropractors out there that are, [00:16:00] you know, just killing it and doing great.

They run into it occasionally. They have their doubts. They have their points of exhaustion. It's okay to. Get close to it and recognize. I think that's what happens as you get a little bit further in your career, as you start to see it coming a little bit quicker, you know, it's like, uh, okay, it's, it's, it's getting there.

Um, it's not there yet, but I need to, uh, take some free days. I need to take a vacation. I need to do whatever it may be. Right. Um, Maybe, uh, you know, for me, I'll give an example. What I've realized was I, I got out of the habit of hobbies. Um, you know, I, I, over the years I've had certain things like golf, um, kicking your ass and ping pong.

I mean, sorry, that was a, that was

Brennan Donahue, DC: a pretty,

Dr. Kevin Christie: we had a good ping pong match in Chicago, but, uh, no, like for me, it was, it was playing sports and I got away from it. And, and that was something where it's like, you know what? I need to go and shoot hoops a little bit more. I need to go play golf. I need to do stuff like that.

Uh, not only take some free [00:17:00] time. So I think you just, you realize when it's coming, be okay with it. Like if you're, you know, I think it's okay to work hard, right? Like there's nothing wrong with that. Uh, I want my kids to see that I work hard. I want, uh, I want to see the fruits of working hard, but I do think the old school thought of just suck it up buttercup with like, I am working hard.

That's not the right answer either. Uh, you know, I get. There's definitely a, a middle ground and I feel like, um, I've, I've had the pleasure of, of running into enough people and not just, not just, uh, chiropractors, but what's cool about what we do for a living is we talk to a lot of people in our day-to-Day treating patients, and, and we treat, we treat a lot of people that are, are successful and, and I'll pick their brains on it.

You know, I get someone that's a, a CEO of a, of a big company or a COO and I, I'll ask 'em like, yeah, what do you do to like, kind of. Recharge the batteries and I want to hear their thoughts on it. Um, but aside from vacation, what are some other things that you and your, your family do to just kind of [00:18:00] recharge the batteries a little bit?

Brennan Donahue, DC: No, I think, I mean, we're, we're kind of in the fitness world. I, that's been a part of, I, I was a collegiate athlete, soccer. And afterwards I, I had a phase of my life where I didn't exercise at all. And then so we came back to that. And so I do that also though has built my, uh, it's the weird combination of that friendship that you were just talking about with your patients is my group of friends have evolved because now I circle myself around other people that are high achievers, growth mindset people.

And it's not to, uh, to move on from my friends too quick, but. Put yourself in the room. Don't be the smartest person. And the 10 people you surround yourself with is kind of where you're going. So, uh, it's, I've leaned into that a lot on what me and my family do and who we surround ourselves with. And, um, we don't have all that much free time.

So how are we spending that free time is really important to us.

Dr. Kevin Christie: Yeah, absolutely. And you, you kind of mentioned there for a second. I'd love to workshop it a little bit [00:19:00] is, you know, sometimes not to use the word cut ties with people, but yeah. And your life as you, you know, as you move through, you know, I remember I had a ton of friends growing up.

I've just always been fortunate to have a lot of friends, but, um, you know, to this day, I'm not friends with it. Anybody free Florida state university for me. And it was because just the area I grew up in and, and, and the, uh, the friends I had growing up, like they just, they stuck, they stayed in the hometown.

I didn't get to college. A lot of them, they, they kind of were, uh, stuck for a lack of a better term. You know, did you run into that a little bit too?

Brennan Donahue, DC: Absolutely. And like, it's, I think we all probably have those friends that every time you see them, they tell you a story from like 5 or 10 years ago. And I'm like, dude, I have no idea what you're even talking about, but it's the difference between living in the past and looking at the future, you know, and I kind of have my sights headed north into the future instead of looking in that rear view mirror too often.

I mean, I, I use it, but. I don't, uh, stare out the back window all day long.

Dr. Kevin Christie: Yeah. And [00:20:00] that's kind of like what Dr. Asterix spoke about in Chicago, where you mentioned Dan Sullivan's quote about, you know, always make your future bigger than your past. And, and those are the types of people I want to be around, whether it's personally or professionally.

And so, uh, I still have a lot of friends for Florida State University. A lot of them are doing big things in, in different arenas. Uh, I've got a lot of friends from chiropractic school that are obviously doing awesome things. And it, as I grow professionally and colleagues, it's, I love. Getting in rooms like strategic coach or obviously our mastermind group and making friends with people that are, that have a bigger future in mind.

They have a vision and they're looking to, to achieve, but do it in a way that's serving their patients and also again, serving their, their family. And it's okay to sometimes, uh, cut ties with, and it doesn't need to be like. Aggressive, like, Oh, I'm never talking to you again, but it's just like, you know, you may text with him a little bit here and there, but you're not going to fall into the trap of where maybe you, we were in the past.

And I'm just going to say, you know what? I'm going to surround myself with people [00:21:00] that, that are like minded and see a bigger future for themselves.

Brennan Donahue, DC: And I think it organically happens. You know, I think just as if you, the listeners out there, if you're a chiropractic business owner, your, your friend's not in the profession, well, they will not understand, um, what you're doing, who you're talking to, the struggles that you go through.

And so I had to find a group of people that just, they get it. And, uh, And that's what's changed some of my friendships, which, uh, it's been a really, really positive thing.

Dr. Kevin Christie: Yeah. And it's cool to get, get into rooms sometimes where there's people that are, um, a little bit ahead of you just, you know, by years, right.

I know I say within our group, you and Kurt have. obviously connected a lot and it, it Kurt's a handful of years ahead as far as how many years he's practiced. And so I know there's been a lot of, uh, insights on that, but then on the other side of it's been cool is the, is the younger crew and the mastermind has, has shared a lot of, um, I think insights and energy and new fresh ideas [00:22:00] to, to those that are in the older cohort.

So it's been a pretty cool back and forth.

Brennan Donahue, DC: Yeah, I think in like managing that old, uh, inferiority complex, right? You know, I kind of it knowing that it's okay to be in those rooms and there is things that younger docs can offer and you don't need a massive practice to have great insight on business. Um, Acumen, right?

Dr. Kevin Christie: That's for sure. Right. Like, cause it's, there's a lot of ways to slice it. And some people are curating a practice where it's like, yeah, I want to be here. And then I'm going to carve out more time for myself. I'm going to carve out, um, a side thing that I'm going to do some, some of this, right. There's a lot of different ways to do it.

And I used to run into that, right. Go into strategic coach a lot. Cause there's some, some big hitters in there. And I'm like, oh, I'm just a chiropractor in this group, you know, and this, this gal's the CFO of a, you know, a hundred million dollar company. I'm like, what am I doing here? Uh, but you know, it's, it's just [00:23:00] ideas are ideas and vision or vision.

Uh, sometimes when you're in a room of entrepreneurs and you're the chiropractor and you got tech, tech people, it's just, we're hitting singles all day in healthcare, right? They're hitting, they're hitting like grand slams sometimes. Yeah.

But, um, so I want to hear, you know, I've kind of put you on a spot here a little bit, but, um, five years from now, five years from now, what's, what's the practice look like?

Will you just kind of give us a little bit overview of what your vision is looking like?

Brennan Donahue, DC: Yeah, and it's vision kind of changes with time, but it still stays within the realm. Right. And so I once thought I wanted multiple locations across St. Louis. And now I've decided that that's not in my vision. Um, 5 years from now, I'd love to be in a new space with the gym involved.

Um, I would love to have 3 to 4 chiropractors. As part of the team, I would love to only be treating Tuesday to Thursday so I can have a free day and then I have an admin [00:24:00] day, you know, uh, CEO day, whatever we want to term that where I'm thinking big, doing big things. Um, I think the space is the biggest thing that I will be working on sooner than 5 years for sure, which will allow for the team to continue to expand.

Um, I always want to have a preceptorship part of my practice. I love the mentor, the being a mentor to other people. Um, that way I can pass along knowledge that has been handed down to me. So that's kind of where our vision is.

Dr. Kevin Christie: I love that. I want to just touch on, because I think, um, sometimes people create a vision and then it changes and they kind of beat themselves up over it.

And I try to tell people it's like, no, the vision is definitely not, you know, carved in stone. It's, it's, it's a, it's a. You know, it's a North star for sure. And if you don't have a vision, that's when you're just all over the place and you get, you [00:25:00] fall for all the shiny objects. Um, but if you have a clear vision, you can start to make progress and work hard towards that.

And then what happens is as you're getting closer, it's kind of like, you know, when you're playing those video games and all of a sudden you get to a new level and certain things unlock. He's like, oh, I didn't know that was going to go. You know, it's the same thing. Like certain things unlock and you're like, okay, well, now that I'm here and I have my vision and I have accurate numbers and all, all the things I can make a new, accurate decision.

I wouldn't have been able to make that decision a year ago because I didn't have all the facts. And so it's okay to, to change course a little bit. And then obviously there's so many variables that, that do change. Right.

Brennan Donahue, DC: Uncontrollable variables at times. Right. Exactly. You control your controllables, but adapt when it's things that you can't control along the way.

So,

Dr. Kevin Christie: yeah, I mean, I, I bought my office space in 2013. I bought 3000 square feet more than I needed. I was in there with all the [00:26:00] insurances. We were only in business for three years and the trajectory that I was on with the corporate stuff, like, I was like, yeah, we're going to see 300 people a week in this place.

And then the insurance. You know, knocked our knees out. And so I went out of network and kind of went a little more boutique ish and higher cash rate. And so then I rented some space to a PT group instead, and like, just changed the vision a little bit, but it didn't really change. Like all that much is different.

Brennan Donahue, DC: Yeah. Yeah. You're, I mean, you're still filling your buckets just in a different way.

Dr. Kevin Christie: Yeah. Yeah. And, and you gotta, you know, it's okay to make those changes, but the vision is gonna get you on that course. And, and actually, I think it also, it keeps you fascinated and motivated, right? When you get clear on a vision, it, it, it starts to get you into a place where.

You got a lot of positive momentum moving forward, which then actually creates opportunities that wouldn't have been there if you didn't have the vision and you weren't making that forward progress. And you were kind of in that malaise that happens for some chiropractors. [00:27:00]

Brennan Donahue, DC: And I think like people are afraid to block out time to think of that vision because they, they don't think it'll be productive, but it does.

It brings them out. It brings me out of that Malay space. Right? I mean, you get in the, it's just redundant at times. You're treating patients, treating patients. How many new patients can you see? How many patient visits can you get? Um, you know, it's, it's kind of the rat race a little bit. And so you have to step outside that hamster wheel every once in a while.

Um, to, you know, there, for sure. To get a clear path,

Dr. Kevin Christie: there was a, there was a, I forget which Facebook group or who, what, what, where, and what was posted, but it was, um, someone saying, you know, about 10 years in, and, you know, this is like the third time I've questioned being a chiropractor. Um, you know, and, and, and I've gotten to know you, like we've mentioned, and there's been times where it's been hard and it hasn't always been easy and there's frustrations and there's ceilings of complexity.

Uh, but I think what. What I've always respected about you is a level of perseverance to [00:28:00] get through that and overcome that and get to the other side of it. And I, and I just want our audience to know, like, it's not uncommon, right? Like I've had it many times and it's not uncommon to feel like, man, I'm up against a rock in a hard place here, or I'm having a hard time seeing that vision, or how do I do this for another 20 years?

I think there's a lot of things that creep into our mind and it's something that, uh, it's, it's very normal. Have you started to get a little more comfortable when you get there and understand like, okay, I know I can overcome this. I just need to find some resources with it. What's your, what's your Thought process on how you're working.

I

Brennan Donahue, DC: think there's, um, and I'm pretty open about this. And it's like, when I hit those phases now, I actually like, I remove alcohol from my, my diet and it's like, I'm ready to, we got to, I got to clean up my own mind and not be putting certain things in me that allow clarity for a period of time [00:29:00] to work out of that.

Right. And I know you've talked about it a lot and it's, uh, I read the gap in the game one time a year. I have like five books that I revisit each year. And, um, then I, I read a bunch of new books on top of that. But there's certain books that allow you to know when you're in the suck. And, you know, it's, it's one of those things that you learn to embrace it.

Cause you know, it's not going to last forever. You just got to find what works for you during that time of embrace. And, you know, previously I'd probably would have consumed more alcohol cause we're stressed and we're, we're freaking out, you know, and so. I've learned that like, Nope, we're going to hit pause for a short period of time.

We're going to come out of this and we're going to be better off on the back end of my fitness goes up and all those things. So,

Dr. Kevin Christie: yeah, I think you, didn't you also, cause I know you did the Ironman, you trained for that, or it was the marathon. Yep. Um, Didn't you even remove some like just training for a little bit just because you, you obviously were working hard and training hard.

Did you do that as well?

Brennan Donahue, DC: I did. Yeah. So after the Ironman, it was like, I had dedicated a lot of extra [00:30:00] time. So I was burning candles at both ends, early mornings, late nights, trying to train. And um, as the business was also growing at the same time, it was, I had to. It was consuming my energy rather than feeding to my energy.

And so I do an audit oftentimes on what, what is robbing me that once was feeding me that I have to alter the frequency of. So

Dr. Kevin Christie: I like that because most people don't think of it that way. Right. So obviously on one hand, the, the alcohol, as far as just, Hey, I'm going to clean it up for 30 days or whatever that, that makes sense for some folks.

But then on the other, they may not realize like sometimes the things that are, Well, obviously we would consider training for an Ironman healthy. And why would you remove something healthy? Uh, although I would argue that training for an Ironman is not necessarily all that healthy.

Brennan Donahue, DC: I definitely cross my sanity line on that one.

Dr. Kevin Christie: Yeah. Yeah. Uh, but no, sometimes it's even the healthy things that maybe you're, you're doing, you just kind of, you know, I need to take a step back from this right now. And, and I'm going to do that. It could be, for [00:31:00] instance, right? Like I get up at five, uh, Uh, a. m. Monday through Friday to get some work done, but I can feel I've been doing that shit for now, like a year and a half, but I'm getting close.

I was telling my wife the other day, I was like, you know what? I think I need to take a break from the 5. Soon and just get to like 6 a. m. Uh, you know, and so obviously most people say, yeah, getting about 5 a. m. is great. And I do go to bed early and all that, but like, It's kind of like, you know, I need to probably sleep in a little bit.

I need to kind of focus on my sleep a little bit more, uh, for a period of time. So sometimes it's just stepping back from things that do serve you.

Brennan Donahue, DC: I couldn't agree more.

Dr. Kevin Christie: Awesome. Awesome. Love it. You know, it's, uh, it's been really cool. And I wanted to just like, you know, um, going back, it was, I'm going to put you on a spot again.

We. Back in Chicago, we had the, uh, the wisdom session with a couple of our, uh, experienced docs have been practicing for a while and, and, uh, someone asked a question about like knowing what, you know, now, uh, you know, age 40, what would you [00:32:00] tell yourself, but, uh, you know, if you're speaking to your, your graduating self, or you're speaking to that younger chiropractor, that's listening right now, uh, what would you say to them to just realize like, look, Okay.

Um, you know, eight years in 10 years in whatever it is, uh, you know, it's going to be okay as long as you do X, Y, and Z. But what would you, what would you speak to that chiropractor? How would you, what would you tell them?

Brennan Donahue, DC: Yeah, I would be saying that like. I still think the sky's the limit, but you must remember you can only grow so quick, right?

And I, I wanted to grow quicker than I did. I had friends that grew quicker than I did that are still really good friends. But for me, it's that like staircase analogy, like you got to take one step before you, you can't skip five steps or else your systems will fall apart. Um, and so knowing that like, you can still dream big and it's okay if it takes a little bit longer to get there, just, Don't quit too soon or else you don't know what you'll never get there if you quit too soon, right?

Dr. Kevin Christie: Yeah. And I think that does happen sometimes people can't see the [00:33:00] forest or the trees with that. And that's where you, you know, reaching out to folks and having, getting some help, uh, you know, to, to work through that is always helpful.

Brennan Donahue, DC: Yeah, yeah, and that this profession could be really fun to it. I don't think I realized that in the early years.

It was that there's some shitty years back there, but, um, it's, uh, it's definitely it's it's real. It's fun to watch everything you work towards start to. Blossom out a little bit. And you get to see that you get to have a little bit of fun and a little bit more freedom. And as long as you, you stay with it.

So,

Dr. Kevin Christie: yeah, it's hard, right. But usually hard things have rewards and what ends up happening, you know, it's that delayed gratification. And what's cool is if you do it right, uh, when you get to about 40, give or take, right. There's no set number. Uh, you know, however many years of practice you could start to carve out.

The practice for yourself. Right. And it's, uh, and that's where it gets fun. It's where you start to carve out and say, you know, yeah, I get to work Tuesday through Thursday and, uh, we're making the money that we want to make. And we're contributing to our [00:34:00] 401ks and we're, we bought a bill. Like you start to slowly build up this thing.

And then, you know, when you're 55, you look back, it's like, yeah, we've got a good life. Like we were fine with retirement. It wasn't easy, man. Those thirties were hard. Uh, my twenties, I didn't know what I was going to do, but, uh, you look back, it's like you kept on working towards that. That vision and it becomes an accumulation over time.

It's just not, you're not going to be that 27 year old tech entrepreneur that gets a zillion dollar buyout. Right? So, uh, you gotta just keep on working towards it and you will build something that is serving your family.

Brennan Donahue, DC: And I want to hit on that really quick, if you don't mind. I mean, when I first kind of joined the rooms and I heard people maxing out their 401ks and adding even more money to other, or other retirement buckets, you know, that, that topic can be overwhelming at times, but it was just one step that like, I think the first year I allocated, I think it was like 20 bucks a week or something.

I set up with my financial guy and it's like just auto draft. And now we've obviously, each year we reflect. How much should we increase that buy? How much should [00:35:00] we increase that buy? And so, um, it's, it's just one of those things that, that money will be spent elsewhere if you don't allocate it. And so I had to learn real quick that I needed to set up that, that auto draft, even if it's small.

And that starts accumulating really fast when you do it the right way.

Dr. Kevin Christie: Well, you're right. And it's been interesting as, as a business owner, 'cause I have a, like I offer a 401k to my, my team and all that. And so I've had a handful of employees with a 401k and, and, and some aren't, aren't here anymore, but.

They still have the money, the 401k, and I have access to it since I'm the, whatever the trustee of the, of the 401k. So I see whose accounts have, you know, kind of what in it. And I got a, you know, a past employee where it's like, wow, like just a little bit was going in for a while, but now they got over 25, 000 in there and they're not, it don't even work for me anymore.

You know? Um, and it just keeps on compounding because of the, you know, stock market has been good and all that. And, um, Yeah. It's amazing. If you start doing stuff like that, uh, down the road, it, it, it turns into a million bucks when you're 60 years [00:36:00] old. That's

Brennan Donahue, DC: right. Hopefully. Yeah, it will. It will. So,

Dr. Kevin Christie: Hey, well, Brendan, this was great, man.

I love having you on here and just kind of talking shop. And I think, uh, you know, my, my goal having you on here was to just show like. You know, in, in within eight years, eight years may feel like a long time to you. I noticed that hasn't been, uh, you know, the, with COVID and all the things, right. It's been a lot, but, uh, in a short period of time, you can really build something really cool if you keep on working hard and overcoming those obstacles.

So I give you a lot of credit for doing that.

Brennan Donahue, DC: That's right. Thanks, Kev, for having me on. And, uh, you know, it's just exciting. It's one of those, I say it all the time. It's like, we're just getting started. Like it's going to be fun. And, and I look forward for the future for everybody. That's part of the group and things like that.

So

Dr. Kevin Christie: absolutely. Thanks for your time today, Brandon.

Brennan Donahue, DC: Thanks, Kevin.

EPISODE 392: Technology Update Show

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. 

Hey, chiropractors, welcome to modern chiropractic mastery with your host, Dr. Kevin Christie, where we discuss the latest in marketing business and professional growth with some of the leading experts in the industry.

Dr. Kevin Christie: Welcome. We got a solo episode today and we're going to just go over a little bit of a technology update show. Occasionally we'll be doing this since as you can imagine, technology is. Uh, changing really fast and it's impacting our practice mostly positively. But if you're not ahead of the curve or at least keeping up with it, it could impact you negatively.

So, uh, we'll cover about five different things today, uh, five different topics within the technology aspect of it. But before we do that, uh, I want to let you know, we're excited about launching an online course through MCM. We haven't done this in quite some time. This, this will be a paid course. For right now, if you're interested, um, you just sign up to let [00:01:00] us know that you want us to let you know, uh, when it will be, uh, coming out.

And so just go to, uh, bit. ly B I T dot L Y four slash. MCM 30 K. So it's three. Okay. So bit. ly forward slash MCM number 30 K. And this course is going to be about how to generate 30, 000 per month revenue average for your clinic and why that is important and what that's going to do for your practice. It's going to allow you to have a great team.

It's going to allow you to pay yourself a professional wage. It's going to allow you to have great. Profit margins and ultimately, uh, focus on your unique ability and not get burned out. And we're going to develop a substantial course around this. This isn't going to be just a. a little, you know, great little sizzle and marketing around it.

And then there's no stake to it. This is going to have a lot of substance and we're going to really walk you through how to do that and still be patient [00:02:00] centered and, and frankly, um, do it ethically. All right. And I think that's the big thing, uh, that evidence based chiropractors are looking at. is how to ethically prove your revenue and still be patient centered and you can do that.

And so check that out. If, uh, you know, check the link in the show notes, you can go to our Facebook group. Again, we have a Facebook group, modern chiropractic marketing. com. You'll see the, uh, Uh, I'll, I'll, I'll pin it up there to where you can sign up for that and then we'll let you know directly when that is available.

Alright, so let's dive in. Uh, you can't talk about technology update show without talking about ai. I am not an AI expert. I keep up with it as much as I can. I don't dive into the weeds of it. It's not my unique ability. I delegate it as much as I. Possibly can and then give you a little bit of an overview and you can take it from there.

But the first one, and I mentioned this before, but I want to reiterate it. I'm really, I'm really liking what I'm seeing from Opus Clip allows you to take [00:03:00] some of your longer form videos, put it in there, and it'll generate, uh, shorter length videos that you could use for IG reels. And you can say 30 seconds, 60 seconds, 90 seconds, whatever.

And it'll be about that timeframe. Uh, and it's been really cool. I've been, uh, putting some of those out. So check out Opus clip. That is o. P U S space clip C L I P Opus clip, uh, something we've been using. If you're using zoom, uh, zoom's got AI capabilities now. And in our group coaching calls, we are able to create summary notes out of our calls.

You just click a button beforehand and use the AI to, to do that, which has been pretty cool. Another one within the AI realm is Grammarly. If you're not using Grammarly, I highly recommend it. I've been using it for many years, but it's But you can see it's improving and it is using AI. And if you're new to Grammarly, it's pretty cool.

It's a plugin to your desktop or laptop, and it can be like, for instance, I've [00:04:00] got it set up to where, um, if I'm writing an email, it's checking it. If I'm on just a regular word document or a Google doc, it's checking it. If I'm on MailChimp and I'm writing an email, it's checking it. Right. So it's, it's set up into your browser and everything you're typing Being grammar checked, it does it on when I'm writing my Facebook posts.

It's, it's, it's rather remarkable and thank God for it. And it is improving and it is utilizing, uh, some, some AI, uh, next is EHRs are going to start really making, some of them already are, And they're going to be making your life easier. I know Genesis uses AI, uh, Cairo up has launched an EHR, a beta test to their members and they're using AI and I'm hearing good things about that.

Um, speaking of Cairo up, they've, I've been, um, I'm a member of theirs for a while now, and I can't recommend them enough, but they actually have updated their condition [00:05:00] reports, uh, I think a few weeks ago, and that's been really cool. And it's, um, it's just, it's just the functionality of it's amazing. And so that's on Cairo up.

So check that out. Not necessarily an AI thing as far as their condition reports, but I just wanted to make mention of that technology update on, on there. And so that's my, AI updates of this particular call. Um, so, you know, keep up with it. It's changing, uh, quite a bit, quite a bit. Uh, next I got for you is, uh, there's the FTCA virtual summit coming up on October 11th.

And you can go to, uh, bit. ly bit. ly forward slash FTCA business and sign up for that it's a low cost, high value. And I put this in this show. Virtual stomachs is still a, uh, really cool technology and it's a technology platform that allows you to learn more. And, uh, I will be speaking for the FTCA virtual summit [00:06:00] as well.

So check that out. And I utilize, um, our, when I say our Dr. uh, Dr. Mabee and I, partners in CSA, you know, he, he, he owns and operates FTCA and that's the virtual summit there. But him and I are partners in the CSA chiropractic success Academy and I, um, I'm presenting for the virtual summit through FTCA and I'm utilizing our CSA digital dashboard during my talk on, um, how, how to have a credibility enhancing community outreach and how to really plan and organize and cultivate a great network in the communal.

Community, uh, utilizing four different tools within the dashboard. Uh, I'm really excited about the progress and updates we've made within the dashboard and the technology of that and how you can really, uh, utilize it to, you know, to grow your practice and, you know, And it's whether it's the marketing planners we have in there and the practice analytics, but in the virtual summit lesson that I, uh, that [00:07:00] I recorded already and submitted, um, I go over four tools.

Uh, that is the events calendar we have in there, the my network tool. So how to organize your referring and potential referring partners in a way that, um, really helps you cultivate those relationships, the allied health network, which is your list of providers that you. connect with that you refer to in the health and performance space.

And then lastly, the referral network, uh, that we have in there, the referral directory, sorry, the referral directory tool, uh, that allows you to leverage, uh, referrals within the patient practice. Uh, example, patient comes in with shoulder injuries and, uh, and they have a personal trainer. It's a process that we teach to connect with that personal trainer in a way that serves the patient because you're going to talk to that trainer about that person's condition and make sure you're working together as a team, but also a way to connect with that trainer and develop a relationship that hopefully, you know, ends in a referral, a [00:08:00] referring relationship.

So, uh, yeah, so check out the FTCA virtual summit. That is at B I T dot L Y forward slash F T C a business. Check out the CSA digital dashboard. I do the lesson on that, but you can actually go to a www CSA digital dashboard. com forward slash sign up. If you're a CSA member, which is only 99 a month, there's a ton that comes with that membership at the dashboard does come with that.

and it's a part of the membership. Um, if you're not a CSMR and you really want this dashboard only, you can go to the signup and it's 20 a month and it's well worth, uh, that price there. So check that out.

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 [00:09:00] words are behind my, uh, comprehension, but it's just amazing work that she does. And if you're really going to get results with Google, you have to make sure your website is SEO optimized. And I really don't want you doing it yourself. as a chiropractor. So 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 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 propellyourcompany. com slash chiropractor and schedule your free SEO website review. Review, you won't regret it. She gets great results. Your website needs this. Your search results need this head on over there to propel your company. com slash chiropractor to get your free SEO website review.

Dr. Kevin Christie: And next we have is, [00:10:00] um, you know, cash practice software. I've, uh, been fortunate enough to get to know them. Um, they'd been in the chiropractic space for quite a while. They, they do many things. Um, they've got a suite of things they do. for chiropractic practices. And they, they even do like email drips to people.

And we've, um, we've given them a whole desk jockey series of emails that they're, some of their members will utilize in their email marketing. Uh, but I've, I've, I've enjoyed getting to know them, Miles and Holly, uh, Miles Bodson and Holly Jensen. And they, um, Um, we've been implementing over the last six months cash practice software in our, in our practice, uh, for the merchant processing, but it's a lot more than just your typical merchant processing.

It really does a phenomenal job of cash packages and payment plans. And since we've added shockwave, we've always done cash packages, uh, for our regular treatment [00:11:00] in, um, Not big ones, you know, eight visits, but then we have shockwave therapy and we have packages and also payment plans for shockwave and cash practice software does a phenomenal job as a technology, uh, to make that very easy and also integrate certain things like chirohealth USA.

If you use them, It, it has all the documents that a person would need to sign off on to store a card and run it automatically and it auto, if you do the payment plans, it auto debits it without you having to go in and do it. It tracks it for you really well and it's just been very good and it's a great technology for chiropractors looking to have.

The cash packages and payment plans. And again, it does a lot of other things, but I'm bringing it up because of what we're using it for currently in our practice. And also a little bit of a collaboration of giving us giving them content for the email service.

Let's take a short break for one of our great sponsors, Trackstat. [00:12:00] It is a new type of software plugin for your EHR that combines patient communication, marketing, automation, and statistics with patient and employee tracking. 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.

Dr. Kevin Christie: All right. Lastly, running it out. Instagram. A couple of years ago we [00:13:00] used to do and talk about when some are coaching the IG takeover strategy and it was this kind of elaborate way of getting another business to take over our IG account temporarily.

You'd have to give them the password and, and do a whole thing and it would go to their audience and it was pretty cool. But luckily IG has come up with something with collaborations instead of having to do it that way where they get to give a password and then change your password back. So if someone doesn't have your password, uh, you can now actually post.

Reels and stories and such, but let's just talk about reels as an, as a collaboration. And so when. You do that. It would go out, let's just say two businesses, ours in a gym. When you do the collaboration feature, and I'm not going to run it through it to the, through the details of it. You could figure it out.

You could look it up however you want, but now both people can post the same, say real, and it's going out to the chiropractic audience in the gyms audience at the same time. And so now it's a collaboration on a real, and it's a really good way. Imagine if [00:14:00] you go out.

To a particular business and do a short reel or a post and you start collaborating with these businesses, you're going to get your content in front of the other audiences. And so that's something that we're, we've done a few times and we're going to look to do more of that in our practice into Q4, uh, and moving, moving forward with that.

So check out Instagram collaborations, uh, in your marketing.

Let's take a short break from today's episode to tell 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. [00:15:00] 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. 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 [00:16:00] 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.

Dr. Kevin Christie: All right. That is all I got for right now on the technology update show. I'm sure I'll have to do another one of these in six months and it'll all be different and updated, but just keep up with it. You know, there's, um, you know, there's, it's never too late to learn and keep up with it.

I think for, you know, for some of you, One of the things I want to kind of end this show on is that, um, if you feel like your practice is not keeping up with it, um, you know, we have this vision of what an antiquated old school chiropractic practice used to be. And it's, you know, old tables from the 1980s and you know, travel cards and paper notes and, you know, shag carpeting, but that's not the reality anymore.

Like, and your practice actually could be outdated or antiquated. [00:17:00] If you're not keeping up with technology, uh, you might have a nice office and good new tables and all that. But if you're just not keeping up with the technology at all, uh, let's say you're stuck in 2016, right? Uh, not that long ago. Uh, you're, you might be outdated and we've actually have a whole program on how to modernize practices where we come in and essentially help you modernize your practices.

Practice from a technology standpoint, not just marketing, but business processes. And so if you're interested in that, just check out modern chiropractic, marty. com. You'll, you'll see a tab on the top on our coaching. And there's a one on there about modernizing your practice, where if you know a chiropractor that may need that, uh, let them know about it.

It's a service that we're proud of, and we do help chiropractors get their practice up to date to help. Um, compete in the marketplace to become profitable and ultimately build a practice that is sellable. So, uh, have a great week and I hope this technology updates will help you get into the right direction.

And maybe you got a couple tidbits out of it.

[00:18:00] 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, check us out at modern chiropractic marketing. com. Look at the MCM mastery tab, watch the short video on there and check out what we're 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 Sullivan 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 [00:19:00] 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 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 393: The 4 Seasons of a Chiropractic Career

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. Stephen Franson back onto the show. He was actually one of our first guests. I think in our first 10 episodes back in, uh, probably early middle of 2017. So it's been about seven years.

And this particular episode, we talk about the four seasons of a chiropractic career and just like in life, there are stages of life and there are stages of the career. And it is important, um, depending on what your vision is and your goals is to, is to move along into different seasons of a chiropractic career.

And Dr. Franson is one of those who has done that? And he is from the remarkable chiropractor, he's built and sold practices, and he's going to dive into the four seasons of a chiropractic career. And we talk about other aspects as well. And one of the cool things we bring up in this particular episode is the percentage of the U.

S. population that is deemed to be entrepreneurial, And maybe the percentage that is within the chiropractic profession, which is higher. And I think because [00:01:00] chiropractic self selects, and so we dive into the four seasons of a chiropractic career. And as this episode comes out, we are shortly going to be releasing in November of 2024, for a How to get to 30 K per month in revenue and practice.

And I know many of you are, are, are above that, but I know a lot aren't. And, um, I think that is a big number to, uh, get to one of the next seasons of your chiropractic career. And we're going to really break that down in an online course format that's going to drip out to you. And it's going to be very, uh, Uh, well thought out and actionable, not going to just be theoretical or just random lessons.

It's going to be methodical and step by step to help you get there so that you can get to the next season of life. Just keep a lookout for that. I'm not going to send you anywhere right now, but just look in our Facebook group, modern chiropractic marketing. You can join our Facebook group. There's 4, 800 chiropractors in there.

You could go to our website, modern chiropractic marketing. com. To keep tabs on that. If you're on our email list, I'll be emailing you, but probably the [00:02:00] easiest way right now is just get into the Facebook group is a lot of great information that is in there from a lot of great chiropractors. All right.

Without further ado, here's my interview with Dr. Steven Franson.

Dr. Kevin Christie: All right. Excited to have Steven Frenson on the call here. Um, people may not know, but we, uh, had a podcast episode probably six or seven years ago, early on in the way of this, of this podcast. A lot has happened over, over that time, but since it's been a while, uh, let's reintroduce yourself to our audience.

Tell us a little bit about yourself personally and professionally.

Stephen Franson, DC: Yes. I'd love that first. Thank you so much for asking me back. Um, my dad always says it's one thing to be asked to come over. It's another thing to be asked back. So, uh, I appreciate that, man. Uh, and I want to share just a quick, uh, Dr.

Kevin story in this podcast. Um, uh, I wrote you this, I don't know if you remember, probably it was close about a year ago, year ago, where I was at one of our live events, uh, one of our remarkable practice, live events. Uh, and as I was standing in [00:03:00] back of the room getting ready for Friday night to really kick off, right?

So, um, I was miked up and ready to take the stage and this young guy comes up to me and he's like shakes my hand He's like, dr. Franzen. I'm so excited to meet you in person. He's like, I want you to know that, you know You've changed my life. I love your podcast. I love the coaching and blah blah blah and uh, and i'm like Thanks so much, man.

I love to hear that. I love to meet people in person and he's and he's like I'm like, how'd you find us? Who referred you over? And it was like, Oh, I listened to Dr. Kevin Christie's podcast. And that's where I heard you for the first time. So thank you, man. It was just so awesome to have that full cycle completed like that.

So, so thanks a lot. So yeah, I'm a chiropractor. Uh, so, um, I am, uh, uh, been a chiropractor for about 30 years now. I'm married to my favorite chiropractor, uh, Dr. Camilla Franson. Uh, she and I, uh, met back at life university, uh, about 30 years ago. Which is crazy to say it, uh, we, um, we went through school together, we did an internship together in Arkansas, um, we did an [00:04:00] associateship position together in Virginia, um, and then we opened up the original Remarkable Practice in Boston, Massachusetts, just north of Boston, which is where I'm from.

She's from Sweden. Uh, I'm from Boston. We wanted to be close to one of our families so that we can take care of our families. Uh, so we inspired both of her sisters to become chiropractors. So they're over in, uh, well, at least one of them's in Stockholm taking care of their family over there. And the other one's down in New Jersey.

So, uh, yeah, we've got eight chiropractors in our family and I think we're raising a couple more. Uh, so yeah, we're the, we're the chiropractic Cosa Nostra up here on the Northeast. Um, our practice was phenomenal. Um, we were just truly blessed, uh, great success. Uh, in Beverly, Massachusetts, um, we attribute that success to, uh, serious clinicians, right?

So we want better health outcomes for our people. Uh, we took patient education very, very seriously. Uh, we called it the double edged sword. Uh, we gave people back hope by teaching them the truth about what they should do. expect from their [00:05:00] health and what's possible, uh, and, um, how their body really works and how their body really heals.

Uh, and then we gave them back personal responsibility. So, uh, we taught them that behaviors matter and they matter a lot. Uh, so we taught them, you know, what to start doing and what to stop doing. And a big part of that was getting their spine and nervous system checked regularly. So, um, we delivered excellent care.

Educated our patients and then everything else was systems. Um, I'm the system guy. So we systematized everything, you know, all, everything should be systematized. Attraction, conversion, retention, team building collections. Uh, and I think my superpower is building world class teams. Uh, and a big part of that was our associate doctor program.

So we had almost 40, we had 39 associate doctors over about a 17 year period. Uh, and it's not, I like to say it's not cause I'm a horrible boss and they quit and I had to replace them. Uh, but it was more of like a two year apprenticeship. Uh, so we could raise up and train up and launch, um, all these doctors into the world to reproduce what we did.

And [00:06:00] really that's where I fell in love with developing chiropractors and teaching them. The systems and the processes that help you become more successful, which means make a bigger impact. You know, I make a bigger income and that's where I fell in love with coaching. Uh, so that's really where the remarkable practice was born and taking all those doctors through all those cycles.

Uh, so at one point, uh, I had pretty much maxed out what you can do, or at least what I could do, uh, in a brick and mortar business and, uh, still had a lot of rubber on the tires and wanted to give more to humanity and do more to develop chiropractic around the world. So started the remarkable practice coaching business.

Uh, and we've been blessed again. Uh, for the second time in my life, I get to say I'm doing exactly what God hardwired me to do. And that's coaching and developing chiropractic teams. So, uh, we now have thousands of doctors in our ecosystem all around the world. Um, we have 15 coaches. We coach everybody on the team from the, uh, CEOs office managers and clinical directors and the DCs and the associate doctors and all the CAs, all the [00:07:00] way down to the front desk.

Every, everyone on the team, we have coaching programs for, uh, and, uh, we've just had so much fun doing this and creating. What is now known as the remarkable practice coaching business. So here we find ourselves, Kev.

Dr. Kevin Christie: That's I love it. And I wanted to touch on something you mentioned about having, I think, 39 associates over a period of time.

It kind of reminds me of a story I heard about McKenzie Institute, which is, uh, for people listening, like a research institute, that's massive. I mean, it's a multi billion multinational company, but one of the things that they've, they've done. Interestingly done with branding is that a lot of people leave McKinsey Institute, but everybody that leaves McKinsey Institute always reference that I used to work for the McKinsey Institute.

And it actually, uh, they leave on good terms. They tried to get people to graduate in a sense from McKinsey Institute to a certain extent. And when they go out, they want them to obviously talk highly about that. And it actually has been part of the positioning and branding for the McKinsey Institute.

And it sounds like that's kind of been something that you've been able to achieve, which is pretty cool.

Stephen Franson, DC: It's [00:08:00] exactly what we set out to do. I'll say one thing. It was the right thing for me to do with our business. It may not be the right thing for everyone to do. And you know, the probably quick criteria is do you love to coach and develop people, right?

Because for some docs, that's not what resonates with them. It's just, I'm a natural born coach. I love doing it. So for me, I found my, my stride there and my, and I really loved developing chiropractors and it allowed me because I got that reputation and being able to, um, take those top. Potential top doctors early in their careers and groom them, accelerate their success.

And they knew my plan was I was kicking them out, right? So it's launching them after two years. So you could actually really attract all comers, whether they're what we call caregivers or business builders, or even entrepreneurs, we were able to take all comers and make sure that they had a track to follow.

Uh, and it was about them achieving their success and their personal, professional and financial goals.

Dr. Kevin Christie: Well, yeah, and it's going to be exciting. I'm like, we're going to talk about the four seasons of a chiropractic career, which is a [00:09:00] framework you've developed. And you mentioned, you know, the first one is launch.

I'm going to give a little preamble on that. And it's, it's fascinating. And I'd love to hear your, your wisdom from it, but you know, we've heard the term in raising a kid, you know, failure, failure to launch, right. It's the, it's a 31 year old. That's still living with. Parents and hasn't really, you know, left the nest egg there.

And, and I'm, I'm concerned a little bit seeing that a little bit in the profession sometimes is almost that failure to launch, uh, with the young DC. Are you seeing that a little bit, or are you, what's your take on the, I know a lot of the DCs were in a tough bind with COVID and that's where they were learning or they're getting out of school at that time.

Uh, what are you seeing from the 20 something year old crowd?

Stephen Franson, DC: It's

Dr. Kevin Christie: a,

Stephen Franson, DC: it's a really. It's an astute question. Okay. So, but it's also a very complex thing that we can definitely tackle here. So I'll try to do it from a high level. And if anybody has any deeper questions, of course you can reach out to me. So here's what we've discovered, right?

So I've got, I've got a coaching business, the remarkable practice, right? [00:10:00] So having worked with 10, 000 chiropractors and helping them grow their practices and become more sophisticated businesses, expansion demands people power, right? So they start creating teams and building, and very often that involves.

Going from build to scale. So they're adding associate doctors, et cetera. So, because we did that so successfully, so many coaching clients come to us for that specific reason. Hey, I want to figure out the associate doctor thing, right? So at the end of the day, what we found was their inability to find associate doctors.

And other a players for their team became an extraordinary bottleneck for them as a client to grow their business. So that became the constraint of the business. So the limiting reagent, if you will, right. That became problematic for me. So as we are building this coaching business, I don't want to put a ceiling on our clients ability to grow and go and be more and more successful over time.

So I said, you know what, we need to solve that problem. So to scratch our own itch, we actually created a separate and distinct business. Called Cairo matchmakers, which is under the parent company. Ideal [00:11:00] team Cairo matchmakers is all about helping people find ideal players to build an ideal team inside of chiropractic specifically, right?

So it's a separate and distinct company that we, that was one of the founders of and helped form to solve this problem. So I'm only telling you this because I want you to understand my credentials when I say what I'm about to say. Okay. So when we're, when we're placing chiropractors, what we recognize.

Is that there are different roles inside of a chiropractic office, right? So just like you'd play different roles on a basketball court or in a band, right? There's different roles that call for different sets of responsibilities, which call for different sets of skills, talent, a different genius. Would you agree?

Like there are domains in a practice, there's attraction or lead generation, there's conversion, that's sales. There's delivery, which is creating value and delivering value retention. There's team building. There's. The business office financials. Those are the five domains of a practice. Each of those [00:12:00] domains have roles tucked up underneath them, right?

And those roles have responsibilities organized underneath them. So what I'm getting at is there are different types of geniuses inside of each practice. Now, my philosophy is, is that we're building. We're building football teams, not ski teams. Okay. A ski team is a, is a, is a team of experts, right? So everybody's using the same skis and the same poles, the skiing, the same lines, the same gates, the same outfit.

And they're, Just racing against the clock. Ready? Go. Ready? Go. Ready? Go. Right. Those are just experts, right? So fantastic, right? A football team is different than a ski team because they're not just experts. They're not just expert football players. They're actually specialists in their position. Like, so if you were to look at a nose guard versus a wide receiver, right?

So a quarterback versus the kicker, right? So a D lineman, right? So each one of these is a very, very specific set of responsibilities. Experience and physical attributes, [00:13:00] right? So we're each position calls for a very specific human. Would you agree? We call those the genius, right? So same thing in a business and definitely inside of a chiropractic business.

So what we've done Kev is we've identified that there are in essence. Three different types of geniuses in chiropractic when it comes to DCs. And when I say this, you're going to go, yep, like every chiropractor we know is going to fit into one of these three buckets and they're all awesome. Okay, one is the caregiver.

One is the business builder and one is the entrepreneur. Okay, so the caregiver. The caregiver is the person that got into chiropractic because they wanted to do the doctoring. They love the doctoring. They want to do consultation examination. They want to do analysis. They love their technique. They love adjusting patient care, patient education.

They love the one on one, right? So they love the doctoring piece of it. Right. So that caregiver got into chiropractic because they wanted to be a doctor and they had a bit [00:14:00] of a holy shit moment at one point in school. They're like, wait a minute. It sounds like I also have to be a business owner. Right.

Like, and that to them was terrifying because they looked and they were like, Ooh, man, all of the risk associated with that, like creating things in bed, that's really stressing me out. Right. So that sounds a lot like probably a lot of chiropractors that, you know, awesome clinicians. Can I say it this way?

Hopeless business people, right? So they never signed up for that. Frankly, on the other end of the spectrum is the entrepreneur guys like you and me. That no matter what we did, we'd start businesses, right? By the grace of God, we were called to chiropractic. So we started chiropractic businesses, right? So we love the risk, right?

So we love, we have that gene that the stress actually energizes us. Right. So I don't want to speak for you, but I bet this is true, right? So you'd get bored stiff if you weren't charged, if it weren't all up to you. Right. So like, we love the idea of making something from vapor hiring, firing, running teams, being the rainmaker.

Right. So that's the. That's [00:15:00] the high risk tolerant entrepreneur, right? So we love chiropractic, love taking care of people, and we love owning, starting, and running businesses, right? That's the other end of the spectrum, right? In the middle, there's a bit of a hybrid, and that is the business builder. They are happy to take care of patients.

They love being a chiropractor. They're extroverted. They like to attract, convert, and retain patients. They love building a practice, but what they don't want is they don't want to start and own a business. And we recognize there's a difference between a practice and a business, right? So they're hardwired to say, if you owned a business, you could hire a business builder or a caregiver, right?

So a business builder would be somebody that you'd say, Dr. Kevin, I'm hiring you to build a business, excuse me, build a practice inside of my business. So the caregiver, you're saying, I'm hiring you to be the doctor here and you're going to deliver the care that we sold, right? So you focus on that, on the extreme.

Does that make sense when I say it that way? So perfect sense, three different buckets. And I'm guessing that every [00:16:00] chiropractor that, you know, Would fit squarely into one of those one of those three buckets. So, um, the instincts around this are usually right, but we don't guess we test and you can actually test the human mind and it's like doing a blood test to find out how somebody is hardwired because God makes entrepreneurs.

God makes caregivers and makes business builders. It's like righty and lefty. You're not born lefty and become a righty. You're not born righty and say, one day I'm going to grow up and become a lefty. It's just how you're hardwired. So you can actually test for this. And there's three tests that we do.

One is the cognitive test. One is the affective test. And one is the cognitive test with an N. So cognitive is what do you know, like boards. Affective is what do you love, what type of work energizes you, like StrengthsFinders. And then finally, cognitive, which is how do you behave? How do you take action?

And [00:17:00] Kevin, this is my favorite one, because we hire people for personality and philosophy, aligned philosophy and technical skills, but we fire for behavior. So I want to know how is this person hardwired to behave before I put him on the field to take a position, right? So that cognitive profile is really critical to answer the question that you just asked me.

Do you use the Colby index for that? Or do you use something else? Love Colby. Uh, Colby is a great one. Okay. But we use PDP. We use ProScan. That's the one that, you know, we tried them all, you know, we did, we had probably 15 of them that we used for a while and now we've done 10, 000 of these. And it just fits.

Specifically the chiropractor, but generally the chiropractic office, but specifically the chiropractor tells me everything I need to know. So PDP pro scan, um, is the one that we use for a cognitive profile. And this is important in a very long answer to your question, but I respectfully want to address this because it's a massive issue in chiropractic.

Okay. [00:18:00] And I'm going to say this, and it's going to be wildly unpopular and bring some people, some real peace. Yeah. Okay. We've done so many of these tests. Like I said, about 10, 000 chiropractors just south of 75 percent of chiropractors are hardwired to be caregivers. And about 15 percent are hardwired to be entrepreneurial.

Dr. Kevin Christie: Okay.

Stephen Franson, DC: Seven and a half percent of humanity they say is hardwired to be an entrepreneur. And I think that chiropractic as an industry has a tendency to attract more of the entrepreneurs, which is why I think we're seeing about 15 percent entrepreneurs. Does that make sense? The balance in the middle is that that oddity that business builder that's extroverted but not dominant Loves to attract convert and retain but doesn't want to be in charge They don't have to be the boss like you and I right so the caregiver Is incredibly stressed By the thought, the idea and the reality of having to start own and run a business, right?

So [00:19:00] when you asked and the way the question I heard and hopefully it was the right thing I heard was, are you finding that there's a lot of doctors that are sort of failure to launch, like go off and start their own practice? That's how I heard that. And I just want to make sure that you, what you're hearing from me is physiologically, psychologically, about 75 percent of chiropractors shouldn't own their own business.

They're just not hardwired to do it. And the, the good news, bad news story here is the bad news is, is most of our profession doesn't understand this. Okay. And you know, this, this, there's a sense of like, maybe, can I say shame or guilt or embarrassment? If somebody doesn't own their own practice, right? You hear this kind of attitude around like, well, I don't even own my own practice.

I'm just an associate. I'm just a chiropractor here, right? I don't own my own practice. Here's what I know to be true, uh, neurosurgeons don't own hospitals, right? So neurosurgeons are employed by hospitals to do brain surgery, right? So [00:20:00] there's no brain surgeons walking around your town, hanging their head saying, I'm just a brain surgeon.

You know, I don't own the hospital, right? So as a profession, it's time for us to grow up and to recognize that the reason we exist is to deliver chiropractic care, right? So never say that somebody is just a brain surgeon. A chiropractor or just an associate doctor. All they do here is adjust kind of thing, right?

That is the reason we exist, right? So we need to learn how to recognize that edify that and compensate that in such a way where as a business owner, we recognize that our purpose. Is to create environments where people will be more successful with us than without us. And that means creating an environment where we could hire those awesome caregivers and business builders who are not hardwired to be entrepreneurs and give them a place where they can be wildly successful, fulfilled, and happy.

Dr. Kevin Christie: And you mentioned something about compensation. And I was, I kind of wrote down here in my notes as you were speaking is, is, do you feel like there's a disconnect between the, the compensation, the money that a, um, that an associate can make? And [00:21:00] I, I see that a lot of times they, um, they would love to just be an associate in a practice and grow in there and really do that part and feel congruent with it.

But then at the same time, they're like, well, I got to make 150 or 200, 000 and live in today's society. And the only way to do that. Theoretically is to open up my own practice. But then unfortunately, what I see a lot of times is they make that leap thinking that that's how they're going to get to the promised land and they weren't well equipped for that.

And they actually oftentimes make less money chronically as a practice owner than they would have if they found a good clinic to work on and be that clinician. Are you, are you seeing that disconnect financially?

Stephen Franson, DC: That's right. 100%. So, um, the statistics are is, is in 2022, the average chiropractor in the US made just north of 147, 000.

So let's assume that the average full time chiropractor made 150, 000. And that's going to include both owners and associate doctors. Right? So. Um, [00:22:00] 150 case is the is the average, right? So what I know to be true, um, is most the average associate doctor makes less than that, right? So, but what we've seen in the last 5 years, placing.

I think we've placed 250 odd chiropractors last year. The average chiropractic salary has gone. We've seen it go up from like 69, 000 up to like 93, 000. Right. So right now the joint is a hundred thousand dollars starting salary for a DC. So just to give you context on that, um, if you don't think 1500 joints by the end of next year is going to influence.

The draw, the pull of DCs and what they're getting paid. You need to pay attention, right? Uh, so, and you know, at the end of the day, some people sitting there going, what's a hundred grand for an associate? Yeah, 100%. We have so many of our, I mean, we have associates in our system that make 250, 000. I mean, if you look at some of the bigger, better organizations, like, uh, um, a Cairo one up, uh, Chicago.

They run a fantastic organization and their average chiropractor is making about 265 and they're not, they're [00:23:00] not owners, right? They, their associate doctors inside of a corporation and their top earners are ordering, uh, are doing over 800, 000, not as an owner, right? So as an associate doctor, so, um, I know that those numbers seem crazy to a lot of people that are listening here, but at the end of the day, you just have to model your business properly.

Um, because it is a wildly successful and very productive and profitable relationship if you get it right.

Dr. Kevin Christie: Yeah. And modeling your business the right way you mentioned is like, you know, I'm in kind of the evidence informed crowd of, of the profession and a lot of our, our listeners and people we, we kind of collaborate with and talk to and, There's, I'm not going to get down that rabbit hole, but there's a whole problem with the way they're structuring their business and the actual capacity of, of what they can bring in and revenue.

And so a lot of the owners are not making six figures. And so then they try to pigeonhole, but they want the freedom, you know, they, they're 40, they become 40 years old and they're not making what they want, but they want the freedom of having an associate. So they bring on someone and then they. Kind of want to, you know, have [00:24:00] these cockamamie schemes of compensation and everything and it just ends up burning them.

And so it's, uh, definitely a problem. We probably need a part two episode on, on just that alone, but let's very happy to

Stephen Franson, DC: come back and do that. Cause I'm super passionate about this piece of it because this is a, it is literally, there's only two choices here. Win, win, win. Lose, lose, lose. It's the only two choices because it's, if you do it right, it's a win for the owner, it's a win for the associate, and it's a win for chiropractic because it's a win for the patients.

It's a win for the team. It's a win for the practice. Right? So if you don't do this, right, the only choice is lose, lose, lose. So it is a lose for the owner. It's a lose for the associate and it's a lose for chiropractic. 68 percent of these relationships go sideways, which is a terrible statistic. Yeah, that is a terrible black eye.

Dr. Kevin Christie: It was one of, I had, I had Jay Greenstone and I, uh, hosted a, a salon dinner in Vegas when I spoke at Parker Vegas this past year. And Alan Miner was, was uh, at the dinner with us, and I believe you guys are partnered on the chiro [00:25:00] matchmakers aspect. Yep. That

Stephen Franson, DC: atch. Yep. Yep. And

Dr. Kevin Christie: I was surprised to talk to him and he said like a lot of times when you guys get on the phone with a, an owner doctor that's looking for an associate, you'll ask the revenue.

Question. And if it's not a certain number, like you're not ready to hire an associate, it's just flat out. And it's, it's not the answer that the owner wanted to hear when they got on the phone with you, but it's, you're just trying to prevent that. Lose, lose, lose.

Stephen Franson, DC: 100%. I mean, you know, there's most Kairos and I'm, and I'm really trying to Couch my language here.

So most chiropractors are brilliant clinicians, but hopeless business people only because we've never been educated. We've never been taught, like when you spend seven, eight, nine years studying the human body, something's got to give, right? So most, most chiros were never taught the economics of a business.

Like if you do not understand economics, you do not understand business. If you don't, if you don't speak accounting. You don't understand your business. So there are very specific economic, we [00:26:00] call them break points that you have to understand in your business. Like, so there's a metric that most people don't know, and you absolutely need to know to do this while it's called RPE or revenue per employee ratio.

The revenue per employee employee ratio is incredibly informative around the, the health of your business. Right? So we talk about like wellness markers, like. Heart rate variability, right? HRV, right? As a wellness marker for how well your autonomic nervous system is adapting readily and appropriately to stress, right?

So HRV would be a wellness test, right? RPE is the HRV of a chiropractic business, right? So RPE or Revenue Per Employee Ratio, your business as a single brick and mortar business should be seeing 250, 000 per full time employee equivalent. For The break points are every 250, 000. So 50. Right? So those are called break points.

And in this situation, in this conversation, we're talking about team building in this [00:27:00] conversation. The break points are where does your team start to break? Right? So we all understand pain lines, right? There's an inferior pain line. And a superior pain line. The inferior pain line is if we dip below these numbers, the business breaks economically, right?

Superior pain line is if the business grows, we're at capacity and it starts to break, right? So wait times back up. New patients can't get in. You name it. People quit because they're overwhelmed. Superior and inferior pain lines. These are economic factors and you need to understand this in your business, the break points for every 250, 000 per full time employee equivalent.

You've got to be able to figure that out and say, where am I in my hair and my hiring arc, right? So if you've got two employees. So it's the owner does not count. So the owner plus two employees is you plus two people, right? So two times two 50 is 500, 000. So if you're at 500, 000, it's, and it's one doctor and two CAs, for example, you're at that second break point.

You're going to be at capacity, right? So you're already behind in hiring [00:28:00] your next person because you want to hire ahead of your capacity. So you continue to grow and pull the business forward. Yeah. Does this make sense? Perfect. So you hire into that next power band of growth. And, and so the way I teach docs is for every 20, 000 per month in collections, it should be a trigger for you to start the hiring process.

So 20, 000 a month would times 12 would be two 40. So you're approximating 250, 000, right? So if you get to 20, 000 a month in collections on average, 20, 000 times 12, excuse me, For every 20, 000. So at 40, 000, you're at 40, 000 times 12, which is four 80. So now you're approximating 500, 000 at 60, 000 a month.

You're now 60 times 12 is seven 20. You're approximating break point three, 750, 000. Do you see it? So as you're trying to figure out, like, when do I start the hiring process? Because it's not easy to hire. Is it right? So this is an example of. Once you understand the economics of the business, you can model the business properly.

Okay. And of course, this is only one number. Okay. [00:29:00] I'll say one numbers of fact, two numbers or a story like in the remarkable practice. We don't just coach people on how to build their practice. We coach them about the business so they understand how to run the business regardless of how you practice.

You need to know how to run the business. Okay. And the conversation you and I are having right now. Is a business conversation.

Dr. Kevin Christie: Yeah, absolutely. I love it. That was, that was good. And I want to go and kind of segue into the four seasons of the chiropractic career. I think we really tackled the, the first one, which is launch.

Can you state the next three and then we'll, we'll dive into it.

Stephen Franson, DC: Absolutely.

Dr. Kevin Christie: So we created this

Stephen Franson, DC: construct called the four seasons of the chiropractic career to really organize conversations like this. Right. Um, And as well as our content and all of our programs and all of our clients, our coaches, our experts, et cetera, everybody gets organized into these four seasons, right?

So the first season is launch, which is your first year in business, not your first year in practice, your first year in business. Then there's build, which is you're an established [00:30:00] practitioner, but you are a solopreneur, right? So you are the. Solo practitioner, your sole practitioner, you are the one that owns the practice, but you are the one that's head down, bum up, taking care of all the patients, right?

So scale is when you take that job that you love and turn it into the business you've always wanted, right? By adding multiple practitioners, that's either done through partnerships or typically more typically through associate doctors, right? So, and it also includes if you're an enterprise, in other words, multiple brick and mortars, right?

So that's in scale. And then finally, the fourth is exit. So when you're going to scale, when you go from build to scale, this is when you take the job and turn it into the business, right? So, and a business is scalable, durable, and transferable, right? Scalable means you can do more, give more, love more, serve more, make a bigger impact, make a bigger income, but everything doesn't have to be done by you, right?

You learn how to leverage, right? Leverage other people, team members, systems, technology, communications. Durability is the next level. Okay. So everybody does some level of scalability. Durability is what's rare, which [00:31:00] is where you can give more, love more, serve more, make a bigger impact, make a bigger income, even in your absence.

Which is what you just described as people trying to get their time freedom back. So as people mature in practice, they, they're like, man, I got to get, I got to get some of this off my desk. I got to share these responsibilities. I got to free up my time. It'd be nice to be home for dinnertime, bath time, bedtime, right?

I'd like to get my weekends back, maybe go on vacation, right? Like without having to shut the place down. Right. So you want an expensive vacation. Shut the practice down while you're gone, right? That's the best way to pay for your vacation twice, right? So that's durability, right? So that's what we call the remarkable standard of a remarkable business durability.

And then there's the third piece, which is transferability, which is transferable value, where a sophisticated buyer could come in and find your business very attractive because it has transferable value because that four season exit, this is just a black eye in chiropractic, right? So, because most people try to go from build to exit, right?[00:32:00]

And build does not exit well because nobody wants to buy your job. Right. They want to buy a business. So launch, build, scale, and exit. Like I said, we organize all of our content programs, our coaches, our experts, all of our clients are in those four seasons. And our job is to optimize the season you're in and help you navigate gracefully and profitably into the next season.

Dr. Kevin Christie: Yeah, I love that. And then what would you say is the biggest or a couple of the biggest sticking points for the chiropractor getting from the build to scale? So I want to focus on that for the rest of the time we have. Like, how do we, what are some of the things you're seeing that kind of ceiling of complexity of getting from the build to the scale?

It's

Stephen Franson, DC: such a great question because I love what Dr Pete says, my, my partner in the remarkable CEO podcast, he always says we live and die in our transitions. We live or die in the transitions. Right? So, you know, what we teach the way we coach our clients is launch to build, build to scale and scale to exit.

Right? So recognizing there's an [00:33:00] arc and you want to be looking ahead, right? So you understand the concept of begin with the end in mind, right? So beginning, Stephen Covey taught it best. Begin with the end in mind, have a very clear picture of what success looks like to you and begin with that vision in mind, right?

Because this Kevin, ultimately this whole thing, launch to build, build to scale, scale to exit. This is all an oak tree conversation, right? So, you know, when's the best time to plant an oak tree. 50 years ago, right? When's the next best time to plant an oak tree? Today, right? Start today, right? So this conversation we're having now is how do I build with an eye on scaling and how do I scale with an eye on exiting, right?

So that's the oak tree conversation because it's, you know, compounding benefit. You know, it's going to be really hard if you wake up one day and be like, I think I want to sell my practice this year. I can tell you what, that's going to be a lot of pain. There's going to be a lot of pain, very disappointment, very disappointing.

It's a cold shower, right? So you have literally got to be so [00:34:00] intentional about building a business that would be attractive, dare I say, irresistible to your ideal buyer so that you create a horse race where you have ideal buyers that are competing with one another to buy your business. Right? So 82 percent of practices will never sell.

They'll, they'll shutter. Think about that. 82 percent of practices will shutter. They won't even sell. Okay. So not even a fire sale. Look close. Okay. That to me is tragic. Right. So here's what we know to be true. Traditionally, we see about a thousand practices a year in the U. S. transition. In other words, doctors go into exit.

Well, because of the confluence of three factors, number one, the post COVID hangover, number two, the aging baby boomer population, which is like the pig in the python of an aging populace moving along a timeline, they're aging out of the profession, and number three, This let's call it pending economic uncertainty as people a bit [00:35:00] jumpy.

Right. So what we're seeing is over two X increase in those doctors that are transitioning. So 2000 a year in us only, which means in the next five years, we're going to see 10, 000 chiropractors transitioning out. And if 82 percent of those never sell and they just shutter, we're 000 chiropractors. And that would be tragic, right?

So this is why I'm very passionate about this.

Dr. Kevin Christie: Yep.

Stephen Franson, DC: So this whole conversation about building it to sell it is not only a one day happiness thing. Right? So we're like one day, you'll be really happy that you did this. Thanks France. And thanks for that. Right? I'm so glad that I listened to you five years ago, 15 years ago, whatever it is.

And I built this thing to sell it. It's not just a one day happiness thing. The day you sell, it'll be a Monday happiness thing because whether you're in build or you're in scale, if you interfere in launch, launch to build, build to scale, scale to exit, it's You'll never regret building a business to sell it.

It's a great operational construct. Those businesses are more [00:36:00] productive. They're more profitable. They're more fulfilling. They're more fun. Right? So I love this concept of begin with that end in mind. Go through this build to scale, scale to exit

Dr. Kevin Christie: process intentionally. I love that. And it's just a good framework and it, and it is definitely the path you have to get on and you gotta get on it sooner than later.

And you were, uh, kind enough, you and your team to, to give our audience a, a gift. Can you tell us a little bit about that? We'll put it in the show notes also. Um, tell us the, the podcast that you and your co-host have. I'd love to hear that for our audience as

Stephen Franson, DC: well. 100%. So Dr. P Kimmel, if you like this conversation, you're going to love our remarkable CEO podcast, right?

So it's the remarkable CEO podcast for chiropractors. Um, I co host that with Dr. P Camilo. So it's, we're about five years in now, almost five years of posting every Tuesday. So there's so much content there. Like I said, if you'd like today's conversation, you're going to love that. Um, and we unpack what I'm about to give you guys more in more detail.

So this will be a quick high level description. [00:37:00] So the, what I'm going to give you guys is something called the practice value drivers cheat sheet. Okay. So the value drivers cheat sheet, which is a way for you to identify, like, what are the things I could do to my practice today, starting now that would make my business more attractive in the future to my ideal buyer, right?

So selling a business is just like selling a house. In fact, I think it's in 18 states in the country to be a business broker, you actually have to be a realtor, licensed realtor, because there's so many, um, similarities and there's very often real estate involved, right? So if anybody's ever sold a house, you know what I'm about to say, when you go to sell a house, there's two checklists for you.

One checklist is these are the things you have to do. To sell a house step 6. All right, there's a sequence of things that you have to do to sell a house legally, right? There's also a second checklist. And the second checklist are these are the things that you could do to make the house more [00:38:00] attractive to your ideal buyer.

In other words, these are the things that you should do, right? So, and there's a list of things you should do. Hey, you got to fix that roof. Hey, you got to fix that jacked up master bedroom, right? So that, uh, the tiles in the shower and the master bedroom, they got to go. The shag rug in the basement has got to go fix those cracked steps in front of the house.

Fix that mailbox, do some landscaping. Curb appeal. We all know the story, right? So it's like, fix your house up before you go to sell it, right? Mm-Hmm, . So it's gonna in, it's gonna make your house more attractive to your ideal buyer, which does a few things. Number one, it increases the chances of that house ever selling.

Number two, if you attract your ideal buyer, nevermind multiple ideal buyers, you start a horse race and that causes the price to go up, compresses the time and reduces the stress. Same thing when you go to sell your business. There's two lists. There's a roadmap of things that you have to do to sell the business.

And then there's the list of things that you could do to make your business more attractive to your ideal buyer. In other words, these are the things that [00:39:00] you should do, right? So if you make your business more attractive to your ideal buyer now, you are gonna attract multiple ideal buyers Who are going to be competing to buy your business which drives the price up compresses the time reduces the stress So this cheat sheet I'm like a contractor buddy.

Who's also a realtor that flips houses showing up at your house before you get it appraised and be like, Kev, you got to do this. You got to change this, do this, right? That's what this is. It's a cheat sheet of the, my 20 favorite things that you could do to your business that would really drive the value of the business by making your business irresistible to your ideal buyer.

Uh, so we're going to give away that checklist. Uh, it's just a great starting point for these docs.

Dr. Kevin Christie: I love it. That is, that is great. And I really appreciate your time today. This was a very valuable, we went down a, a path I wasn't expecting, but I think it was necessary and our audience needed to hear some of that.

And, uh, uh, we'll probably have to dive into it some more. So I really appreciate it for your, your time and your wisdom today.

Stephen Franson, DC: That's awesome, man. It's my purpose [00:40:00] and pleasure to be here. Uh, and if you guys, I don't know how, um, you exchange information, but if you have show notes where people can ask questions or make comments, uh, if they reach out and be like, Hey man, have Francine back, cause I really like to hear him unpack that revenue per full time employee equivalent.

How do you calculate full time employee equivalent? Right? Like I said, you can check us out on our podcast, or I'm very happy to come back and do a deeper dive on any part of what we talked about today. Sounds great.

 EPISODE 394: Building Gait Happens

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 on Dr. Kevin Christy. Dr. Courtney Conley. She is from Gay Tappans. You might have come across that Instagram profile that is, uh, blown up over the years and the hard work that she's put into that has paid off.

. Uh, we talk about, uh, what it's been like since she was on the Peter Ortea podcast and what that's done for her practice and positioning as well. And what it took to get there. Um, you know, she specializes in the foot and ankle, only sees patients in the foot and ankle, but if you're a chiropractor and you know, the foot and ankle, uh, doesn't interest you.

You can take a lot of what we talk about today and apply it to other aspects of building your practice. Cause not only has she built a great practice, she's obviously built a great online following. And then now is a industry transformer and you know, maybe that's not in the cards for you. But if you do what we talk about today and some of the things that she's learned [00:01:00] over the last 25 years, it'll be amazing how you position yourself in the community.

And that's what we talk a lot about. We talk about her story, how she was able to position the community, build a practice of her dreams. And then ultimately it has progressed from there. And so there's a lot of. We even dive into a couple of sidebar topics like, you know, mastery, what it's like to try to get there.

Uh, we also, uh, talk about the MPI Gates seminar coming up that she's going to be presenting it with Dr. Thomas show, Brett Winchester and Mark King, which is gonna be exciting. What quite a lineup. I just highly recommend you go to that. I've gone to the Gates seminar in the past and, uh, I highly recommend it.

And it's going to, it's going to be exciting. Be even better this year, uh, with Dr. Conley's efforts. And so, you know, I just, it's cool to bring on doctors that are clinical doctors. Like, you know, the, the heart of who they are is a clinical doctor, but then [00:02:00] has used content marketing to, to really separate themselves.

And I know a lot of you. you know, maybe think of marketing. If you're listening to this show, maybe you've kind of passed that. But a lot of chiropractors, when they think of marketing, they think it's not for them or they shouldn't have to do that. Uh, but it's great when you see really good ethical chiropractors who've done it tastefully, uh, build a practice in a, in a professional career that is bigger than they could have imagined.

And Dr. Conley has achieved that. So without further ado, here is my interview with Dr. Courtney Conley.

All right, Dr. Conley, I really appreciate your time on the podcast today. Before we dive into certain things like positioning yourself as an expert in a community, uh, building gate happens and, and all things foot and ankle. Tell us a little bit about your story and how you got to where you are now.

Courtney Conley, DC: Yeah.

Thank you so much for having me. It's very exciting to speak to our colleagues. Um, I, Have [00:03:00] always, been interested in the foot and ankle ever since I think I was very young. I was a ballet dancer. Um, I spent a lot of time in pointe shoes, um, which never were comfortable for me. I would always look at all these other dancers and.

Like, how do they do this? It just, I just never liked it. And I developed bunions at a very young age. Um, so I just always kind of struggled with foot issues. Um, as I went through school, I knew I wanted to do something that, you know, with activity, with movement, that was always very important to me. And my father was a very big chiropractic fan.

And so we would have long discussions about. Chiropractic and he kind of guided me in that direction. So I went to national, um, and I was lucky enough to study under Dr. Sean Allen. So, he was 1 of the instructors there who really had a [00:04:00] very good handle on foot and gate mechanics. The only thing that was disappointing to me was that we didn't have.

Enough of it. We only had about I want to say maybe a half a semester and at the time it was You know, we'd learn how to manipulate the foot, but there wasn't a lot of functional strength. There wasn't a lot of education on what the foot actually is doing and how important that is for the rest of the kinetic chain.

Um, you know, it was orthotic heavy and that's kind of what I knew when I got out of school. And so When I graduated in 2003, um, I was, I already was starting to, you know, gravitate towards the foot and ankle and, but what we were doing is casting a lot of orthotics. That's what we knew. And. I was, I had a lot, a lot of pairs of orthotics.

I transitioned from being a ballet [00:05:00] dancer to a triathlete. So now I was running and swimming and biking a lot. And my feet, I was always struggling, like grinding orthotics here and sending them back and trying to keep tweaking things and, you know, long story short, I ended up moving to Colorado. Um, and I worked in a couple of orthotic labs out here and.

We did some great work and I still work, you know, pretty closely with one of them and I think there's a time and a place, but what I was starting to realize was that we're treating the foot very differently than we treat the rest of the body. And then I started to self explore I've had, uh, the blessing of.

Being surrounded by some very, very smart people. Dr. Tommy showed being one of them. And I kind of went deep. I dove deep into human locomotion. I think I've read that book like 45 times. I talked to him last week. He's like, I'm pretty sure you could recite this book. I'm like, I think I can, [00:06:00] Tom. Um, so yeah, so I started exploring a lot of this and my feet started feeling better.

I started removing my orthotics. And here we are. It was kind of, it's been kind of a mission of mine to spread this word, because I think it's extremely important, especially with all the current research that we're seeing with the importance of foot health and foot strength.

Dr. Kevin Christie: Have you convinced ultra to build a, uh, pointing shoe for ballet dancers yet?

That's your next, uh, next venture, right?

 Obviously, you know, the, the ballet dancers foot and ankle is, is a problem. Right. And I think that's where you probably had a lot of interest. And like, for me, I was a baseball player, pitcher shoulder was my interest.

I got into the foot and ankle for sure. But sometimes I think people fall into that early on where it's like, what is a problem that you've had? And then you kind of try to figure out your own solutions that you're, is that [00:07:00] your MO sometimes? Trying to solve your own problems and then

Courtney Conley, DC: sure, it's like taking out the community, you know?

Dr. Kevin Christie: Yeah. Absolutely. And, um,

Courtney Conley, DC: Wild thing to think about because, you know, you'd think that now I specialize in foot and ankle. That's all I do. Yep. And I'm always very honest with my audience in that I have bunions. I have had neuromas. I've had all of these things. Um, and so I think it's relatable.

Dr. Kevin Christie: Yeah. Yeah.

You know, it's like, for instance, uh, as a, as a chiropractor treated disc issues all the time until I had my own disc injury six years ago, I couldn't fully relate until I had it. And then like, you have this level of empathy, uh, with your patient now. And it's the same thing probably with you with the, with the foot and ankle.

And then you obviously have been able to, um, take your own self and do better. And so it gives you, uh, that credibility to, to help others with it.

Courtney Conley, DC: Yes. Every [00:08:00] time I kind of struggle with, if I have a foot and ankle injury. Um, I'm always, I have to take a step back and view it as a blessing because I am reminded of how difficult it is to stay active when every step that you take hurts.

And it really can introduce a cycle of chronic pain and lack of movement and, you know, the sequel of depression and anxiety. So I really, um, take my work seriously in that it's not just a, a physical wellbeing. When you pay attention to the stuff, it's emotional, mental and emotional.

Dr. Kevin Christie: Yeah. And a lot of times I try to try to take nuggets out of an interview and relate it for other chiropractors.

And I think one of the things I'm seeing from a lot of younger DCs, and I'm sure it was the same way when we were coming up, uh, but It takes a certain amount of effort and time and commitment to develop mastery and something, right? Uh, and I think in, in a lot of the younger DCs, they're getting exposed to so many [00:09:00] cool techniques and treating everybody part in the world and, and all the things.

And they're having a hard time developing a layer of mastery. And just to give our audience a little bit of context, when do you feel like And I know it's, uh, you're probably going to say, uh, you know, I'm still trying to find mastery, but when did you feel like you really started to get a grasp of the foot and ankle to where you felt very confident with most of the things coming in?

And I know that we're always trying to get better, but when, how long did it honestly take you so that our audience can say, okay, yeah, like I'm two years out of school. I probably got a little bit more ahead of me to get to that level of mastery and whatever it is within chiropractic.

Courtney Conley, DC: Yes, I mean, of course, I have to preface this with saying, um, just when you think, you know, what you're doing.

Yes. Get 1 of those cases where you're like, okay, I'm going home and, you know, reading and research and but I think that keeps us humble as a clinician [00:10:00] and which is 1 of the pieces that I love about it because you're always just, you know, you should never be bored. Because there is no protocol looking at each person rather than a diagnosis, I think is extremely important.

But, you know, I kind of live, eat and breathe this work and I've been doing it for a very long time. It's probably been about 25 years. Um, it's interesting now that I have other chiropractors, um, under me in my office.

Dr. Kevin Christie: Um,

Courtney Conley, DC: and I see their, you know, their eagerness to learn, but , it can be a very, you know, a part of the body that people tend to shy away from just because the complexity of the foot and ankle.

you know, when did I feel like I mastered it? Gosh, that is, I feel like I still have so much. Yeah. Well, obviously the

Dr. Kevin Christie: way you answered the question right at the gates is, is a level of mastery because you know, when you don't know something, and I think [00:11:00] early on, we, we think we know everything. And so it's a, a good sign of mastery is when you realize you don't know something.

Courtney Conley, DC: Yes. Yes.

Dr. Kevin Christie: But yeah, I think it is ultimately, uh, chiropractors have to realize that it's going to take some time and, and don't feel discouraged if you're not getting it right away and, and, and keep at it obviously. And, uh, you know, you mentioned your practice and you got some docs working for you now. Just give us a little bit of a, you know, 30 foot, 30, 000 foot overview of what your practice looks like, where it's located and, and just kind of what that's, uh, uh, looking like these days.

Courtney Conley, DC: Yeah, I've had the, um, opportunity to open up different practices. So I was first in Chicago when I graduated, I worked as a, an associate for three years, which I'm very grateful. I think that I did because, you know, I worked with other doctors. I wasn't by myself. I was kind of guided. I could see what I liked, what I didn't like.

Then I was opened up just to myself in downtown Chicago, and I was starting to get busy about [00:12:00] two years in and. I didn't wanna be in Chicago anymore. And it was kind of a decision, it was very tough decision because, you know, the work that it takes to build a practice and the marketing that it takes.

Mm-Hmm. . Um, so I knew that I either had to, to leave then or I was gonna be in Chicago. Um, so I moved out to Colorado and this would be, the practice I have now is the third location that I have opened, um, just over the years. At 1 point, I had 3 office locations and I'm now down to 1, it was very tempting for me to, I'm going to have 3 office locations and I'm so grateful now that we have funneled that into 1.

I think it's more controllable. I'm not like bouncing around. Um, so currently we have an office in Lakewood, Colorado. I have, um, three chiropractors, um, myself and my business [00:13:00] partner. We have a physical therapist that works there. We have a massage therapist and we built out a big gym. So it's one of those places where you have the offices up front and you open up the garage door and then there's the gym in the back.

That was kind of my passion. I love movement. I love strength. So it was a very good, it worked very well for what we were trying to do.

Dr. Kevin Christie: Yeah, that's, that's awesome. And then when you got to Colorado and let's take the chiropractor that says, you know what? I want to, I want to definitely develop a following in the community around the, around the foot and ankle, whether they go all in and that's all they treat like you, or if it just wants to be a big, big part of that.

Uh, obviously the table stakes is to get good at foot and ankle under understanding the assessments and the treatments and all that. So let's say they're, they're on their way to there. They're doing good with that. Uh, what are some of the things like, should they be meeting with? podiatrists, uh, should they be meeting with, um, you know, gym trainers?

Like what, what would [00:14:00] you start to say to help that chiropractor? Let's put aside digital marketing for right now, but just in the community, what would you recommend they do to start building that expertise and that positioning?

Courtney Conley, DC: Yeah, I actually read a lecture on finding your niche and I think it's important because I think when we first come out of school, we're just grabbing me like we'll take any we just want to fill our offices.

And so you when you think about, well, if I just niche down and do the foot and ankle am I closing my doors to all the other potential and there's certainly two ways to look at that. If you do decide that, you know, You have a specific area that you love that you want to treat. I'm all for that because that's when you're, I love treating the foot and ankle.

It's all I want to do. So when you're passionate about that, it makes all of the, um, marketing, if you will, easy because it's enjoyable.

Dr. Kevin Christie: Yep.

Courtney Conley, DC: spent a lot of time kind of in my niche with like running and I would keep it [00:15:00] very specific. Do this marketing event and I'm going to do this and then it becomes overwhelming. And frankly, I didn't enjoy running around like that. I wanted to be around the people that I could talk the talk with.

Dr. Kevin Christie: Yeah, and how did you cut through the clutter of, um, you know, everybody else and or the fact that how do we get them to think of me, the chiropractor as the foot and ankle specialist?

How did you do that? Is it, was it a lot of working on people, demoing people, talking to them, having particular injury? Maybe prevention talks around that.

Courtney Conley, DC: Um, yes, I would do little talks at these running shoe stores, but I think the other thing, and you know, it's kind of a joke amongst my friends now, but you know, at every party I'm ever at, I'm always on the floor, like looking at people's feet. I'm, I'm in it. Like I talk about it. I, you know, I, I literally do.

live, eat and breathe this stuff. So they're, they're easy conversations to [00:16:00] have. And I think, um, and I'm happy to say, I still get very excited about talking about it 25 years later. And if I don't, if I'm not excited about it, I think it'll be time for me to call it.

Dr. Kevin Christie: Yeah, no, that's good. And then, um, your other DCs that are in your practice, are they only doing foot and ankle or are they doing other stuff?

Courtney Conley, DC: Yeah. So my business partner does other things. So she specializes in ERT. Um, she kind of has her own, she loves shoulders, which is good. Um, the other two practitioners, when they came on, they were both fresh out of school. So younger. Um, and They were kind of just trying to figure out what they wanted to do.

Um, but of recently, I see all of my overflow. So they are starting to become more foot in gates and ankle kind of specialists as well. One of the [00:17:00] chiropractors who works for me in my brick and mortar and liquid also works for me for my online company gate happens. So there's a, Kind of a carry over there, which makes it very beneficial for me, um, because I usually will do the initial consults and e mails and then.

Those two will do treatments and follow ups, and I'll do re examinations. So we have a nice little flow going there.

Dr. Kevin Christie: Yeah, and I suspect that overflow of patients was because of the podcast with Dr. Peter Atiyah, is that correct?

Courtney Conley, DC: Yes, it was, um, just to put this in perspective for you. Um, foot and ankle I think is a You know, there's not a lot of people that treat an ankle.

Um, there just really isn't it's my mission to change that of course. Um, but so we were busy before the podcast and I knew going on the podcast that. I was actually just thinking that we were going to get a couple more followers on [00:18:00] Instagram, and it was just going to be a good, you know, marketing tool.

And I was grateful to have the platform to share my message. The day after the podcast, we use a, online scheduler. You can see the wait list.

Dr. Kevin Christie: The

Courtney Conley, DC: next day, there were over a hundred people on that wait list. It was. It's absolute insanity and it's still that way now. So that podcast was in April. It's now September.

So it has been a wild, wild ride and it's even more, um, I'm even on a mission more now because I'm seeing all these people that are in need. That have had multiple surgeries that, you know, I think could have been prevented. Like, there really is a massive need for this work. So, you know, [00:19:00] it's just, um, they're good problems to have

Dr. Kevin Christie: Yeah. And you did a great job on an episode. I remember listening to it. I listened to most of his and, uh, you represented, uh, the foot and ankle very well, the profession very well yourself. And it's an interesting podcast because I know a lot of people are probably, uh, doctors of some sort that is his audience, but he also obviously has a lay person audience as well.

And it, I thought the episode did a great job of, uh, speaking to, you know, Medical and DC's like me and, uh, and then the regular person. And so that was cool to, to see that, uh, see that happen. And, uh, to, to, you know, it's, it's kind of a culmination of a lot of work you put in.

Courtney Conley, DC: Oh, I mean, when I, when he asked me to be on that podcast, um, I, I was like, okay, like, and that's exactly what my, um, my initial thought was, is that I'm going to be representing not only myself, but also our community.

And [00:20:00] I. Put a lot of pressure on myself, as I usually do things, but I really wanted to represent, um, us very well. And so I, when I tell you, I prepared for that thing, I mean, I was in it or many, many, like, I wanted to know my research. I went back and I read and I talked to Tom and there were a lot of hours, but I enjoyed doing it because again.

It's just helped me also have better discussions with patients and how to communicate. So it was a really great experience.

Dr. Kevin Christie: Yeah, that's great. And would you say that, uh, you know, your process over the years of, uh, building gate happens on say Instagram and that type of stuff, did that kind of lead to that opportunity?

Was that how he, how he found you?

Courtney Conley, DC: It was, um, His trainer, um, had found us on Instagram and then I started working with her and [00:21:00] then she introduced me to him. Um, and she has, you know, been instrumental kind of in that relationship and that's why I'm going to go back to that relationship thing. It's so important is building relationships with people and I think the.

You know, the beauty of social media is that you can, it has made our world very small. Um, and we have access now to meeting so many people and really spreading your message. Um, it is a lot of work.

Dr. Kevin Christie: Started.

Courtney Conley, DC: Um, I started in my Instagram account in 2000 and I think it was 16, maybe 17. And at the time it wasn't gate happens.

It was just Dr. Courtney Connelly. And a friend of mine had said, you really like this foot and ankle stuff. You should. And she was already kind of deep in the Instagram world. And she said, you should, um, [00:22:00] start posting about the foot and ankle. And I said, okay, well, when she's like every day. And I was like, are you serious?

So at the time in my practice, I was five days a week, nine to five. Just slammed and then I would come home and I would start to do these Instagram posts that I was terrible at and it would take me 2 hours to like, type it up and figure out the pictures. And I mean, I look back on it. I'm like, I can't believe I mean, again, hours

Dr. Kevin Christie: of time,

Courtney Conley, DC: but, um.

I was never really, you know, the things that I would post were always things I found exciting, always like patient cases or cool things I was seeing in my office. And I think that, you know, and I, I enjoyed it. And I think that that also kind of came across, but the consistency and I think the love for what I did.

Is what [00:23:00] really grew that and now it's its own animal.

Dr. Kevin Christie: Yeah, 250, 000 followers and i'm sure it's uh, It's been great and fun to do that And it's one of the things another nugget that I like to Kind of tease out of this with you know A lot of evidence based chiropractors when they hear the word marketing or they think of promotion or marketing They get a little bit queasy and I and I try to you know, dispel that myth and I Bring on a lot of people here that are clinicians first.

And that happened to also do a pretty good job. Sometimes it's like invisible marketing. You don't really look at them as like they're marketing. It's just a form of content marketing that they've done consistently and really have positioned themselves as an expert through that. It's not, you know, 27 You know, come in, get x ray ads and all that type of stuff.

It's, it's actual just educational content and nobody should be above that as, as chiropractors. And if you do it consistently, uh, you're going to benefit from it. Right. I [00:24:00] think, you know, the vast majority of chiropractors are going to benefit in their community. And if. If you get lucky enough and it goes past that and you like, like the opportunities you've had great, but I wouldn't don't assume that's going to happen for you.

But obviously your end goal should just to be positioning yourself as an expert, uh, in your, in your community. And I, and that's what's done. And then sometimes it transcends that, right. And it's even better, but for some people, I think a great scenario, it's kind of like, uh, the analogy I give sometimes is where a kid's rate, you know, parents are raising their kids and.

She happens to be a really good athlete, and then you just expect they're going to be a professional athlete. The chances of becoming a professional athlete are just so low. But if you get college paid for it, that'd be pretty cool, right? And that's what you should be like, that'd be really awesome. And it's the same way.

It's like, if you position yourself so good, In your community and something through content marketing, you may not become an international person, but what could happen is you actually will spread [00:25:00] outside of your town and you'll get people driving 40 minutes and 45 minutes and 30 minutes instead of you hear a lot of chiropractors radius of patients is like within a three to five mile radius of your practice.

And that's fine. But if you can get that, like people are coming from two towns over three towns, over, you're going to build a remarkable practice. And I think that's some of the things you can do with, um, with good marketing.

Courtney Conley, DC: Yeah. I mean, I also think if you're going to do something like marketing, enjoy what you're doing.

You know, I'm, I love creating content. That was always, um, you know, what I've always had a passion for. So if I was going to do it, I better be enjoying it because if I'm not, people feel it. Yeah. They can feel if you're doing something because you have to versus doing something because you want to, then it doesn't have to be this.

Oh, I have to go to this marketing thing. You're like, oh, I want to go to this running shoe store because I want to see the next you that [00:26:00] they're putting out. So, I think that's important to, you know, enjoy what it is that you're doing.

Dr. Kevin Christie: Um, I agree. And then on the clinical side, you know, obviously with the foot and ankle, there's going to be, uh, if you were to talk to a chiropractor that's interested in becoming foot and ankle, uh, I know there's the assessment of it.

There's the, the gate of it, the palpation, uh, there's the treatment. What are, you know, if you had to give, you don't have to go in the weeds of it, but, um, Where would you want them to get really good at? What aspects of the assessment, what does that look like, uh, in say your clinic, what about how patients and treatments and, and rehab, like what are some of the, uh, continuum there?

Courtney Conley, DC: You know, my mentor, Dr. Sean Allen used to tell me, especially at the foot and ankle, you have to know your anatomy.

Dr. Kevin Christie: No,

Courtney Conley, DC: because there's a lot going on there. So, in our, uh, functional gait assessment course, the level 1, [00:27:00] um, the 1st part of it is reviewing anatomy. There's 4 layers of intrinsic muscles, you know, we should be able to know what those muscles are and what their function is, especially if we're going to be treating the foot and ankle, like, we would the rest of the body, which is.

Does something need strengthened? And if so, how am I going to do it? So with a good foundation of that, then we can start to build. I think gate assessment can be very daunting because you're just like, there's so much to look at. Um, and I think, you know, surrounding yourself with people that can help guide you is extremely important because we've been doing this for very long periods of time.

So we've been able to break it down and say, okay, this is how we're going to simplify this for you. So, yeah, that would be my suggestion there.

Dr. Kevin Christie: Yeah, no, that makes a lot of sense. And I think, um. It is complicated, like you [00:28:00] said, and if you're, if your education is just what the school curriculum was, you're not going to get a whole lot of that.

And you got to go outside of that, which is cool. So you mentioned a particular course that you teach, uh, what was the name of that again?

Courtney Conley, DC: Yeah. So we have a functional gait assessment level one, which is our assessment course. So it's a two day. Uh, 16 hour CE certified course. So the 1st day is all gate assessment.

And then, you know, Dr Winchester always says this and I always steal it because I love it. Gate assessment takes you to the seat, right? Or to the stadium. I think it was to the state. Um, and then our day 2. We say day 2 is taking you to the seat, right? Because gait assessment, you're just, you know, you're looking at things, you're paying attention.

What do I need to further assess? Then you can go joint by joint. And that's what we do on day 2. So, um, it does [00:29:00] get a little technical as far as, you know, things in the foot, which is why we go through the anatomy part and on day 1. so, and then the level 2 course, which is the 1, I wrote last year is the treatment course.

Gotcha that is same thing 16 hours, but that's all treatment. So we want people to get very good at assessing. You can't treat if you don't know what you're looking for. So assessment. Get good. And then the treatment, which is the fun stuff, I think. Yeah.

Dr. Kevin Christie: And with the treatment, um, is it, you know, obviously maybe some recommendations, uh, some muscle manual therapy work, maybe some manipulation rehab.

Is there anything I'm missing on, on the treatment side that you guys offer?

Courtney Conley, DC: The first day we do kind of, I designed it. So we're looking at, um, treating the deficit first. So we're looking at breathing patterns and proximal stability, ranges of motion, strength, capacity. Um, [00:30:00] you know, I think people forget how, what a powerhouse the foot and ankle is.

Um, and I always repeat this statistic cause it's fun. We at a baseline, a standing single leg calf raise, we should be able to hold half of our body weight and do that six times. Okay. If you were seated and did a single leg calf raise, that's one and a half times your body weight. So that's like a baseline for return to run, which I have never seen when, whether I'm treating an NFL player or I'm treating, you know, a high school athlete, nobody really comes close to that.

So it's a very big opportunity for us. Um, and then in the afternoon we look at things like, um, motor control patterns, functional movements, making movement functional, um, plyometrics. You know, not forgetting that we actually have to train the spring, the foot. So, and then we do a bunch of case studies and everybody has a good time.

Dr. Kevin Christie: Nice, nice. And you mentioned earlier the book, uh, human locomotion. I, I walked past my associate Gage's desk and he had [00:31:00] that up because He'll be at the MPI gate seminar. We're sending him, him there. And you're going to be there with Brett Winchester and Mark King and Tom Michaud, and, uh, that's gonna be exciting.

That's on what? November 16th and 17th in, um, Troy, Missouri at Brett's place. Uh, have you been there before?

Courtney Conley, DC: Yes, I have. I'm very, very excited. This is just a. Quick story. Um, I had got human, I had bought human locomotion when I was in Cairo school, um, decades ago. And I had just, I've had an obsession with that book.

And the first, when I first started doing this, I wrote my first course and I was teaching in New York city. And one of the attendees had worked with Tom or had worked down the street from Tom. And after the course, she had gone to. See him and she gave him some very good feedback about the course So [00:32:00] fast forward like a week and i'm working with a patient in my office And you know how when you get an email it like come across the top of your computer.

Yes And it said, um, Tommy showed, like, from Tommy showed and I was like, I'd like to use myself and I leave and I'm reading the email and he's like, um, I just wanted you to know that. 1 of your attendees contacted me, and I just wanted to say congratulations on your course. I heard it was wonderful and. I mean, to this day, it was like the president emailed me.

I was like, cause your biggest mentor, your, I was his biggest fan and to have it come full circle that now I'm going to be teaching next to him. And also Brett is just an honor and I'm just so blessed and it's just a really wild, fun ride.

Dr. Kevin Christie: Yeah, it is. It's cool when they come full circle, I've had a couple of those.

In my career, and, um, I've attended the gate in the [00:33:00] past. I've, I usually send any of my associates to it. It's cool to see you added to the lineup. It's going to be, uh, pretty impressive to do that. What are a couple of things that you're going to be instructing on while you're there?

Courtney Conley, DC: You know, we're still discussing the, uh, lineup there.

I'm hoping to, um, you know, obviously do some gate assessment. Um, I also have a little section on tendons that I would love to talk about. I see a lot of post tip tendonitis Achilles tendonitis. Um, and I think there's a lot of information there that we, as chiropractors can do to benefit that.

Dr. Kevin Christie: Well, that'd be great.

And, uh, I highly recommend people attend that MPI gait course. And then obviously if they want to check out more with what you're doing, where can they, where can our chiropractors find out more what you're doing and try to keep at this, um, mastery journey, right?

Courtney Conley, DC: Yes. Yes. Um, gait happens. com. Um, on that [00:34:00] website, we have a section for practitioners, um, and we A bunch of educational courses, we have online courses, we have live courses all the way from gate assessment to, um, you know, foot strength, things like that.

The other thing that we have that I've really enjoyed doing is, um, we have a gate guru membership and we. I started that because I wanted to interview all the power players in our field. So we've been doing that for about three years. We've had Brett on there. We've had Tom on there. I've had the top researchers, um, around the world, giving us clinical expertise on how to treat the foot and ankle.

Um, and then every month we do case studies. So we have a live zoom call. Everybody can bring their, you know, questions and comments. I will prepare some case studies and, and I think also the [00:35:00] community that is built because we have a bunch of chiropractors, um, in that member. Ship and we're always like, help me with this or let me, you know, so it's a place to learn from one another.

So yes, that is, um, a bunch of, you know, great resources for everyone.

Dr. Kevin Christie: Well, perfect. I'll make sure they get there. We'll put that in the show notes as well. And doc, this has been a true pleasure. Um, I wish I was making it to the gate seminar, but I already have a previous, uh, engagement to be at, but, uh, I'll make sure that my associate gauge comes and says hello and, and, and just make sure he learns a few things.

Okay.

Courtney Conley, DC: Yeah. Thank you so much for having me. I really appreciate it.

 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.