Chiropractic Marketing

w/ Dr. Kevin Christie: Doing It Right, Marketing Chiropractic, & Book Release

Today we’re going to be joined by Dr. Kevin Christie of the Modern Chiropractic Marketing Podcast and we’re going to talk about marketing chiropractic of course but more specifically, marketing responsibly and marketing the right way.  But first, here’s that sweet sweet bumper music
Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!
Do it do it do it.  You have found yourself smack dab in the middle of Episode #130 Now if you missed last week’s episode, we talked about Chronic Pain and Exercise. That episode had some excellent stuff in it from Craig Liebneson, Annie O’Connor, and several others. Great stuff. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.  On the personal end of things….. When we have a guest, we typically dispense with personal practice observations. Other than my sharing with you all that it looks like I’m about to fully entertain hiring an associate. You know I’ll keep you all updated on this process and how it goes. Something that is that big of a change is, of course, stressful as hell. Throw in a pandemic and you might just say I’m up to my damn ears and eyes but sometimes, you’re led one direction or the other. Sometimes opportunity knocks and you must answer the door. We’ll see how it goes.  Right now though, let’s get to our guest today and let’s get to marketing chiropractic.  Kevin Christie understands the unique pressures of the evidence-informed chiropractor. Kevin has run his own practice for over fourteen years. With two offices and multiple staff (plus associates), he knows how important it is to not just be excellent at treating patients but being a great leader and marketer as well.  Kevin has worked with the NFL, PGA Tour, and has been featured on ESPN and Fox Sports.  Using the best tools available to us in the digital age, Kevin empowers evidence-informed chiropractors to achieve their own dreams of running a successful practice. Tools that help with marketing chiropractic. Welcome to the show Dr. Christie, can I call you Kevin and you call me Jeff?
  1. First thing’s first, congrats on the new baby. Are you getting any sleep?
  2. Tell me a little about you. Being located in Boca Raton now, did you grow up in Florida?
  3. What’s your chiro story? Why, of all of the things to be in the world, did you choose chiropractic?
  4. I first became aware of you through your podcast. I was doing a little chiro podcasting research when I decided to turn my weekly blog into a weekly podcast. Then through your podcast, I sought out and joined your Facebook group by the same name. Your funnel worked on me. What got you so interested in podcasting, marketing chiropractic, and Facebook groups?
  5. While I am mostly about research and evidence-based, patient-centered practice on this podcast, marketing is something I’ve done a lot of work on and is a big part of what I do day-to-day. It has definitely played a big part in what I talk about here on the podcast from week to week. I haven’t personally heard you weave current research literature into your marketing teachings but I know you are very evidence-based in your practice approach. How does being evidence-based and patient-centered play into your strategies and techniques for marketing chiropractic?
  6. You have teamed up with Dr. Bobby Maybee to create a group called Chiropractic Success Academy. Tell me about it. How is it different than the run of the mill guru practice management groups? What doctors fit this group the best?
  7. You do so many things, what does a regular week pre-COVID, look like for you?
  8. If there were a younger chiropractor, fairly fresh out of school that wanted to be a Dr. Kevin Christie, where would you tell them to start and what steps would you tell them to take? What have been your career ‘game-changers’?
  9. Speaking of younger chiropractors, when we met face to face in St. Louis at the Forward ’19 event, you told me about preceptors. I went an applied at Logan and I’m in. But I think there’s something more appealing about a young chiropractor going to Boca Raton rather than Amarillo, TX. I can’t quite put my finger on what it is but, for some of the older docs out there looking at needing some help and they have a teacher’s heart, can you share some of your preceptorship experiences with our audience?
  10. Tell me about this new book you have coming out that Parker is publishing. How’d it all come about? 
I really appreciate you taking the time. There’s literally something for every chiropractor in this episode, good luck with the book, thanks for helping others to learn marketing chiropractic ethically, and I know I’ll be buying one.  Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.    Remember the evidence-informed brochures and posters at chiropracticforward.com.   
Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism

CF 126: No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism Today we’re going to talk about Immune boosting via spinal manipulative therapy, we’ll talk about coconut oil and it’s a mirage, and we’ll talk about autism and screen time. It’s a good one today folks! But first, here’s that sweet sweet bumper music 
Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!
Do it do it do it.  You have found yourself smack dab in the middle of Episode #126 Now if you missed last week’s episode, we talked about current knowledge on making a robust low back pain diagnosis. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.  On the personal end of things….. We’re still hanging in there. For me personally, I shut down in the beginning for two weeks. Completely shut down. Some stayed open the whole time and never made a lot of changes. So at this point, understandably, they’re ahead as far as getting their patient base back to 100%.  For me, I’m more around 65%-70% of my normal load. While the entrepreneur in me is not real happy with that, the business owner that was needing to take a breath and breathe a little bit is happy about it. At this point, it is what it is. Literally. There’s only so much we have control over. I am a saver by nature. I started a multi-account system years ago that socks money away for different purposes. I have about 7 or 8 different accounts that I move money to at the end of each week. So, fortunately, I don’t take loans. Other than student loans and house loans, I don’t get into much debt at all.  That only goes so far and I’m not willing to drain it all just to keep employees when I don’t have enough business but, if things continue to go well and we see the numbers coming back to a more normal state and then hopefully stabilize, I don’t believe I’ll have to do anything like drain accounts or let employees go. I love my staff and I’ll fight for them. But I won’t go broke for anyone. Except maybe my kids or my mom.  So far so good. This crap has a time limit. We won’t be stuck with it like this forever. Maybe longer than we want but not forever. One foot in front of the other, one day at a time. We’ll get there.   Item #1 Let’s start out easy today. This one is called “Association of Early-life social and digital media experiences with the development of autism spectrum disorder-like symptoms” by Karen Heffler, et. al. (Heffler K 2020) and published in JAMA on April 20, 2020 and that’s a hot one folks.  Why They Did It They wanted to answer the question, “Are screen media exposure and social and demographic factors associated with the risk for autism spectrum disorder on a modified checklist for autism in toddlers at 2 years of age? How They Did It
  • Data for this cohort study were derived from the National Children’s Study, 
  • A total of 2152 children were enrolled at birth from October 1, 2010, to October 31, 2012. 
  • Data were analyzed from December 1, 2017, to December 3, 2019.
  • Caregivers reported whether the child viewed television and/or videos (yes or no) at 12 months of age, hours of viewing at 18 months of age, time spent by the caregiver reading to the child (number of days per week compared with daily) at 12 months of age, and frequency of playing with the child (daily or less than daily) at 12 months of age
  • Prematurity, maternal age at birth, child sex, household income, race/ethnicity, and caregiver English-language status were included in analysis.
Wrap It Up “This cohort study found greater screen exposure and less caregiver-child play early in life to be associated with later ASD-like symptoms. Further research is needed to evaluate experiential factors for potential risk or protective effects in ASD.” Basically, “Less screen exposure and more parent-child play at 12 months of age were associated with fewer ASD–like symptoms at 2 years of age” Before we get to the next item this week, I did a thing Being an evidence-informed practitioner can present a set of problems at times. Mostly problems with regard to patient volume because we don’t typically treat patients with long-term recommendations. So we see them come and go depending on if they hurt or not. It can lead to lulls, disappointment, and boredom if there’s not a steady stream of new patients coming through your pearly gates each and every month. I have taken various courses over the years at Udemy so when I decided to create a course, I immediately thought Udemy would be a good place to start.  While I’m still building the course and adding content every week, it’s live and ready to go for those interested in getting started. I’m putting the link to the course at this point in the show notes. You can go to chiropracticforward.com, go to Episodes and find this episode and just scroll till you find it.  https://www.udemy.com/course/marketing-evidence-based-chiropractic/?referralCode=36A4D91C66B48300360B Over the last two years or so, I’ve averaged almost 80 new patients every month as a solo practitioner. If you’re interested, I created, basically, my playbook for marketing and my thoughts on each topic or technique. I also have created downloads, checklists, and examples to show what my stuff looks like.  Just go to udemy.com and do a search on Marketing An Evidence-Based Chiropractic Practice and check it out. It will grow and expand in the coming months and if you get just one patient from the ideas shared in it, it paid for itself. Now imagine if you get a bunch….well then it’s priceless. udemy.com and the course is called Marketing and Evidence-based Chiropractic Practice. Item #2 Item #2 is called “Coconut Oil’s Health Halo A Mirae, Clinical Trials Suggest” by Jennifer Abbasi (Abassi J 2020)and published in JAMA on April 8, 2020….hot cakes, smokin’ hotcakes.  This one is an article so let’s just get to the highlights.  She starts by saying that clinical trials don’t support the public’s positive perception of coconut oil. She points to a study that was published in Circulation that found coconut oil actually increases low-density lipoprotein cholesterol (which is the bad kind of cholesterol) and offers no benefit for weight, blood glucose, or inflammation markers.  She says coconut oil has been marketed as a miracle for about a decade and a 2016 New York Times survey showed 72% of Americans consider it a health product. This while on 37% of nutritionists felt it was beneficial when compared to other oils.  What they’ve learned more recently include:
  • Compared to nontropical vegetable oils, coconut oil significantly increased total cholesterol. 
  • Coconut oil did not significantly affect triglycerides or markers of glycemia, inflammation, and body fat compared with others
  • Researchers calculated that coconut oil use could translate to a 6% increase risk of major vascular events and a 5.4% increase in teh risk of coronary heart disease mortality. 
There’s much more to the article so I encourage you to find it and read it if you’re interested in coconut oil but in summary: Coconut oil should not be viewed as a healthy oil for cardiovascular disease risk reduction and limiting coconut oil consumption because of its high saturated fat content is warranted and it offers no proven health benefits compared to other cooking oils and seems detrimental on important blood lipids. As such, the prudent approach would be to avoid it in comparison to other cooking oils” Item #3 Alright here’s we arrive at the main event. This brand new article coming out on May 4, 2020….there’s a serious amount of sizzle on this sucker and not just because it’s brand new but also because a large number of chiropractors are going to call shenanigans on it. The topic of chiropractors helping boost immune function through spinal manipulative therapy has been such a hot topic on social media since this pandemic started that I won’t get on and read a general chiropractic group and it’s posts. I won’t do it. My eyes start rolling out of my damn head so why intentionally punish myself? Honestly.  This article is called “A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity” and is authored by the biggest of the big chiropractic researchers that include Pierre Cote, Andre Bussieres, JD Cassidy….hello stroke research…Jan Hartvigsen, Greg Kawchuk, Charlotte Leboeuf-Yde, Silvano Mior, Michael Schneider and more than 140 signatories.  It was published in Chiropractic and Manual Therapies just a week or so ago as I mentioned.  Background – As I said this pandemic has made chiropractors lose their minds. Including myself, if I’m being honest. Not about the immune system. But about safety and keeping myself and my people and patients safe.  Anyway, they say that during this time, the ICA posted reports claiming that chiropractic care can impact the immune system. These claims aren’t in line with the WHO and the World Federation of Chiropractic.  The researchers reviewed the two reports posted by the ICA on their website on March 20th and the 28th. They explored the method used to develop the claim that SMT can boost the immune system and they discuss the scientific merit of the claim. They go on to explain why the claim lacks scientific credibility and is dangerous to the public.  Get this; over 150 researchers from 11 countries reviewed and endorsed this article and response.  Some of the more notable quotes include: Advancing extraordinary claims without providing extraordinary evidence should raise significant concerns about the scientific validity of the ICA’s position. In their reports, the ICA claims that individuals who received chiropractic care during the 1918 Spanish flu pandemic were 51 to 91 times less likely to die than those who were treated by medical doctors.  These effect sizes are too large to be trustworthy and are a red flag of pseudoscience because extraordinary claims require extraordinary evidence. Using data from a 100-year-old non-published, non-randomized controlled trial to suggest that chiropractic adjustments reduce mortality from the flu is scientifically and socially irresponsible. We consider that proclaiming the benefits of chiropractic adjustment/spinal manipulation on immunity during a pandemic is plainly irresponsible and demonstrates a lack of understanding of science, the coronavirus pandemic, and public health risks. By only citing basic science experiments, the ICA appears to have overlooked the WHO guidance on implementation research, which clearly states that basic science experiments do not provide relevant justification for the implementation of a health intervention We call on the ICA to explain why it does not adhere to internationally accepted standards of research implementation but instead rely on unconnected basic science studies when linking chiropractic care to immune system function. Pseudoscience has the potential to mislead and misinform at any time; even more so in the midst of a pandemic when the public is vulnerable. The current coronavirus pandemic demands that we act responsibly by adopting sound public health practices as recommended Their conclusion is that, in the ICA reports, they provided no valid clinical scientific evidence that chiropractic care can impact the immune system. Not only that but they call on political and regulatory forces to hold accountable those making the claims.  Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Key Takeaways Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     
Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Abassi J (2020). “Coconut Oil’s Health Halo a Mirage, Clinical Trials Suggest.” JAMA 323(16): 1540-1541. Heffler K, S. D., Subedi K, (2020). “Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder-Like Symptoms.” JAMA Pediatr.

Chiropractic Scoundrels, Chiropractic Safety In Kids & What Is Chiropractic?

CF 116: Chiropractic Scoundrels, Chiropractic Safety In Kids & What Is Chiropractic? 

Today we’re going to talk about chiropractic safety for kids and then we’ll spend some time talking about a paper attempting to define what chiropractic is. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #116

Now if you missed last week’s episode , we talked about epiduran steroid injections and why to give them the heave ho, asap, mi amigo. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

I’ve had some wah wah news to share with you guys since my Dad’s stroke in November and issues with my office getting broken into, and my bonus dad having his hospitalizations and all that. I’ll just get to it. 

I lost two friends this week. One on Monday and one on Tuesday. While I can’t consider them my inner circle friends, they were friends over a course of many years and it’s never fun. More importantly, when they’re your age, it makes you consider your own mortality and honestly, who the hell wants to consider their own mortality?

Certainly not me so we’re going to keep trucking. 

The week of recording this episode, my interview with Dr. Jerry Kennedy on RocketChiro’s podcast went live. Other than there being video where you can see my ugly face, I thought it was a lot of fun and we covered all kinds of topics most of you would probably find interesting. You can find that at rocketchiro.com and click on podcasts.

This week, I also spent an hour and a half on the witness stand testifying in court in regard to a car wreck patient of mine. I haven’t seen him in a couple of years. I haven’t had to testify in a few years. 

The idea of testifying once mortified me. Absolutely petrifying. Lol. Some of you can relate because it probably scares the crap out of you too. 

The thought of having your notes up on the big screen….ugh. You better be a good note-taker!! When you’re teaching staff to take good SOAP notes, tell them that their notes can be up on a big huge screen with your name underneath them!

Anyway, it was weird, the friendly attorney, the one that asked me to come testify, he asked me questions for roughly an hour and a half. When it was the bad guy’s turn, he asked me like 3 little simple, insignificant questions. Like, he had nothing. Nothing to ask me. Lol. 

I don’t know if it’s because I was doing a good job throwing out research findings and whiplash injury factoids that he wanted me to shut up and get off of the stand……or…..if I was as insignificant as a fly and he had no use for me. Lol. 

For my own sanity and mentality….I’m going with option #1. I’m sure you understand. 

This podcast folks, it’s really started to take flight in the last few months. More and more people are starting to latch on and I couldn’t be more pleased to see that hard work does actually pay off with consistency. 

And that’s what I’ve tried to provide you all consistent, high-level information tainted with a bit of personality and entertainment. Maybe….just maybe it’s an effective combination. I’m not where I’d like to be but we are certainly moving in the right direction. About 30,000 downloads for a nichey little podcast like this just isn’t bad, folks. 

If you have helped me along the way, I want to tell you thank you. If I see you at an event, I hope you’ll come to introduce yourself and we can hug it out. I’m a friendly dude. What can I say?

All I can ask is, if you know someone that would be interested in the information you find here, please share us with them. Pump our tires a little bit and show them how to find us and connect. That’s all. That’s it. And thank you. 

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that. 

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp since for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, activities of daily living, & for their exercises. 

This save you so much time – no more explaining & re-explaining your patient’s care, because they have access to it right there at their fingertips. 

You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Item #1

This first one is called “The safety of spinal manipulative therapy in children under 10 years: a rapid review” by Corso, et. al(Corso M 2020). and published in Chiropractic & Manual Therapies in February – dammit that’s some hot fresh smart biscuits, people…

Why They Did It

“The safety of spinal manipulative therapy (SMT) in children is controversial. We were mandated by the College of Chiropractors of British Columbia to review the evidence on this issue.”

How They Did It

  • They conducted a rapid review of the safety of SMT in children (< 10 years). 
  • They aimed to: 
  1. describe adverse events; 
  2. report the incidence of adverse events; and 
  3. determine whether SMT increases the risk of adverse events compared to other interventions.
  • They searched commonly used databases like MEDLINE, CINAHL, and Index to Chiropractic Literature
  • They searched from 1990 to 2019 – That’s a pretty large search I think most would agree. 
  • They used rapid review methodology recommended by World Health Organization

What They Found

  • Most adverse events are mild (e.g., increased crying, soreness).
  • One case report describes a severe adverse event (rib fracture in a 21-day-old) and another an indirect harm in a 4-month-old
  • Whether SMT increases the risk of adverse events in children is unknown.

Wrap It Up

The risk of moderate and severe adverse events is unknown in children treated with SMT. It is unclear whether SMT increases the risk of adverse events in children < 10 years.

OK – looky here. I may be a country bumpkin. I may just be a Texas Flatland dipstick but here’s my take. Even in politics…..it’s all about the kids, isn’t it? Haven’t you noticed that? If you can bring the kids into it, BAM!!! You have an instant impact statement, don’t you?

Chiropractic

So, with the powers that have waged war on the profession of chiropractic for generations, don’t you think that if there were indeed any real, consistent, and common adverse effects from chiropractors working on kids, that we’d damn sure know about it by now?

Honestly, they searched almost 30 years of records. Are you stepping in what I’m tossing down? Let’s be honest, some goofy stuff happens here and there but this paper doesn’t ell me it’s unclear. Knowing this profession and the medical profession and the history of conflict there, this paper tells me there’s nothing to see here. Keep on trucking and getting the kiddos to feeling better if they need it. 

Don’t work them over for no damn reason but if they have a complaint, by all means, help them. Please. 

Item #2

This second one is called “So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies” by Jan Hartvigsen and Simon French(Hartvigsen J 2020). Published in Chiropractic & Manual Therapies on January 30, 2020 

Nothing but steamy plates of fresh filets of brain food, folks!

The authors start the abstract by saying, “This commentary brings the 2017–2019 thematic series What is Chiropractic? to a close. The 18 papers published in the series contribute to a better understanding of what chiropractic is, where chiropractors practice and function, who seeks their care, what chiropractors do, and how they interact with other healthcare professionals. “

Several papers in the series highlighted deeply rooted disagreements within chiropractic about fundamental issues pertaining to ideology, acceptance of scientific evidence as the basis for clinical practice and the future of chiropractic. 

If the chiropractic profession is to remain relevant in today’s evidence-based healthcare environment, there is an urgent for the profession to undertake further research to describe what chiropractic is, what chiropractors do, and provide evidence for the value of these activities to patients and healthcare decision-makers.”

Boy is that an understatement…..

They close out the body of the paper with what struck me as some powerful thoughts.  

“Papers in this series have again revealed deeply rooted disagreements within the chiropractic profession about what chiropractic is, and what it should be, as a profession, as well as disagreements and variation in relation to the education of chiropractors and chiropractic clinical practice.” 

In our opinion, it is ironic that while chiropractic has a strong presence in large parts of the world, is taking on increasingly important roles in disability prevention [6, 7, 17], in the military [5] and in interprofessional care [8] as well as growing research capacity [16], discussions about fundamental values and direction of the profession are unresolved. 

This unresolved issue creates confusion for stakeholders and threatens to impede professionalization and cultural authority. If chiropractors are to remain relevant in today’s evidence-based healthcare environment, there is an urgent need to agree on, and further describe, what chiropractic is, what chiropractors do and importantly to provide evidence for the value of these activities to patients and societies.”

Dr. Hartvigsen and Dr. French are dead on target here but it’s 100% pointless. You will never unite this profession until the old guard changes or dies out. Some say, ‘what does it matter as long as we’re getting people better?”

Here’s why it matters. Many of us have worked our asses off raising our game and there are knuckleheads out there parading around as experts, scaring patients into long-term contracts, and making us all look like straight-up idiots and I don’t appreciate it. I don’t like to walk into a room of medical doctors and see the way they look at me when someone tells them I’m a chiropractor and know the reason is because of these knuckleheads. 

So, if you’re a go along to get along type of person…..THAT’s why it matters 

I happened to be on Reddit kicking around the Chiropractic subReddit and came across a girl who was a patient of a chiropractic clinic on the West side of St. Louis. Saint Charles to be specific. 

The issue started out because this office was leaning HARD on her to market them to her friends and family and get her to get patients into their office. 

OK let’s start there. I am not afraid to ask a patient every now and then if they have remembered to tell everyone they ever met about this amazing new office and the results they got here. I do it in a non-pushy, comical way but at the same time, I am encouraging some word of the mouth stuff to happen. Make sense? I hope so because it makes sense to me. 

Now, that’s OK. But what she was describing was the doctors on her at every visit and coming close to harassing her about it. 

OK, not cool but not a deal-breaker but then she started to go into more of her story with these knuckleheads. Here’s what she said. 

I signed a one year contract with what they call a “wellness center.” 

Two chiropractors run it. I have already received 5 months of treatment and have 7 to go. 

The payments are due over a 10 month period of time, but I will receive 12 months of treatment in total when it’s done. 

Anyways, my chiropractor every day pushes his clients to refer to other clients. I am new to the area and I’ve told him that I’m new. 

Also, I’m not his marketing team. Like sheesh. Well, today he said to me “you’ve lived here long enough, you have someone by now you can send in here and save their life with chiropractic.” I’m started to feel harassed.

Save their life with chiropractic. Look folks…..I’m all about valuing chiropractic and what we do for our patients but ‘Save their life?” That and turn the power on type stuff makes me want to throw up in my mouth a bit. I’d rather run a cheese grader on my legs than hear that crap. 

Anyway – she continued

But here’s my main issue: 

When I signed the contract, they said the RETAIL for 12 months of care is over $5k. Since you will be signing a contract it will be taken down to $3,350 

So I pay $335 every month for ten months. I’ve already paid 5 months. They said if this contract is broken early, you will then owe the difference for each visit you have received of what the “retail fee” would have been since you are being discounted for having a long term contract. 

I believe their “retail fee” is $55/visit and my “discounted fee” is $36 per visit. I’ve probably had close to 40-50 visits so I’d back owe close to $1,000. 

She concluded by saying, “Please help me! I was snaked by these people because I just wanted pain relief!”

If you agree with the tactics this clinic is using against this woman, just stop listening to me. Put your phone down now. I can’t with you or anyone like you. It’s shameful and it pisses me off. 

To scare them into a contract, to make them feel they’re locked into the contract and they’ll owe a fortune if they try to get out, and to carry on as a healthcare practitioner or to carry on as anything other than a snake oil salesman out on the street corner…..I just can’t. 

So here’s what she’s going to do. Or what I hope she’s going to do. I hope and am encouraging her to contact the state board of examiners for Missouri and tell them her story. If there is an issue there, they’ll open a complaint. If there is not an issue, I’m going to open up a complaint with the Board of Chiropractic Examiners in Missouri. Lol

I’m fortunate enough to be in Texas. Texas chiropractors can’t pull this crap anymore. Thank God. 

I’ll repeat what I’ve said countless times on this podcast

  1. There is no place for contracts for your healthcare. Ever. 
  2. It is a profession with A LOT of room in the scope. Chiropractic is not a modality. It’s a profession. 
  3. It is not a church. It’s not a faith-based system. It is a scientifically validated profession but only when you’re using evidence-based research. Not piddly case studies that fit your bias or studies performed by the stakeholder of the system they’re selling. 
  4. Professions have a birth. Then they have learning and progress into the current state and construct you see. They do not have a birth and then remain in the same place with the same amount of information and techniques for over 100 years. The medical field doesn’t do that. Physical Therapy doesn’t do that. Chiropractic shouldn’t do that. 
  5. Be a doctor. Don’t be a salesperson. It’s gross and, even if nobody says it to your face, it’s embarrassing to you and to the rest of us. 

Well, how many enemies have I made right there? Lol. Honestly, I don’t care at this point. Let’s be honest with each other can’t we? We’re all mostly grownups I hope. 

Be an a-hole, take advantage of people, scare people, bully people, and screw people and you’ll find that maybe you make a lot of money but that doesn’t come without consequence. Whether it’s turning your soul a shade of blackish/gray or whether it’s the snickers, sneers, and giggles behind your back as you walk by, or maybe whether it’s the eventual realization of what you’ve done to the reputations of not only your family and friends but also to your colleagues. Whatever forms it takes, there are consequences to living and behaving like that. 

On the other hand, be a good person. Be smart. Be ethical and have a moral compass. Then good things happen. You can walk upright and proud.

Always. 

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Corso M, C. C., Mior S, Taylor-Vaisey A, Cote P, (2020). “The safety of spinal manipulative therapy in children under 10 years: a rapid review.” Chiropr Man Therap 28(12).
  • Hartvigsen J, F. S. (2020). “So, what is chiropractic? Summary and reflections on a series of papers in Chiropractic and Manual Therapies.” Chiropr Man Therap 28(4).

TEN Keys To Chiropractic Success

CF 114: TEN Keys To Chiropractic Success

Today we’re going to talk about some of the things I would tell myself about chiropractic success if I were just starting out. How would I mentor myself at this point in my life? How would I counsel and mentor ANY doctor? I believe old dogs certainly can learn new tricks because 22 years into practice and I’m learning new tricks. Better believe it. 

But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #114

Now if you missed last week’s episode, we were joined by Dr. William Lawson of Austin, TX and we talked about a paper he participated in that was concerned with setting treatment guidelines for neck pain. Newer paper and newer information so make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

Alright, nothing blew up this week. We had some snow last week so that was nice. Kids stayed home from school and I stayed home in the morning but made it to work that afternoon. It was a nice change in the schedule.

I’m actually headed to the Florida Keys on Thursday morning. I’ve never been and that’s exciting! My wife has massages and facials booked and when I put an s on the end of those words, I’m serious. Every day starts with either a massage or a facial and that’s the stuff that makes me feel warm and fuzzy inside. Count me in. 

Here at the office, I have 5-6 massage therapists. I pay for my own massages. I don’t take advantage of them. But I try to get at least one per month and more when time allows. I’m a junkie. So it should be a great long weekend there in Florida. Plus it’s not too hot this time of year. I’d probably meltdown there in the Summer.

I got the news last week that the legendary Stu McGill will be joining us on the show in March. That’s some cool news right there. How do you ask someone like Stu questions that he doesn’t normally get that are still thoughtful and insightful?

The short answer is I don’t know but I’m listening to some past interviews and trying to be prepared for the back Jedi. The ninja, if you will.

I’ve been a little lazy about getting guests lately but I really enjoyed having Bill Lawson last week, I’m looking forward to Stu, and I think more guests are in order! I’m sure you get tired of hearing me ramble on so I’m making a resolution here and now more guests! 

This week, I’ll be recording a podcast with Dr. Jerry Kennedy of Rocket Chiro, previously called BlackSheepDC. He has been kind enough to invite me to speak with him on his podcast about marketing and promoting chiropractic through research. Using research to communicate what we do and why and what to expect in the results according to research. I’m looking forward to that so be looking for it. I’ve only been a guest once before on a podcast called Health Nuts but it was fun. This one should be too. Dr. Kennedy and I line up very well in how we see things. 

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that. 

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp for well over a year now. I’m going to tell you whant it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, activities of daily living, & for their exercises. 

This saves you so much time – no more explaining & re-explaining your patient’s care because they have access to it right there at their fingertips. 

You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Ten Keys To Chiropractic Success

For today, I want to cover something outside if our norm here. This is more of a mentor post if I may be so bold. If you’re new to the podcast listenership, we typically cover some personal points over the previous week and then jump right into covering 2-4 research papers having to do with the activities we are involved in every day in our offices. 

I happened to see a post by Dr. Kevin Christie with  The Modern Chiropractic Marketing Facebook group last week. He asked the group, “What is your one piece of advice to the younger Docs that you wish you knew or followed in the earlier years of practice?”

This one post of Kevin’s demanded over 90 comments the last I checked. Some of the recommendations were goofy of course. It’s a fun group. You expect so of that. Some serious, some were fairly irrelevant and off-target. 

It got me to thinking; if I have done this for over 22 years and I been successful at it, are there any words of wisdom I could share that you would find valuable? I hope I’ve not been sampling my own brew too much but, I have to say I think I can pass on some nuggets to you. 

First thing is, you can learn something from ANYONE. Even if it’s learning what NOT to do. Lol. Sometimes you can learn both of those from the same person and I think I certainly fit that bill. I’ve made mistakes, people. Mistakes that are hard to admit. 

Next, I don’t own multiple clinics. I haven’t franchised. Hell, I don’t even have an associate; even though I should have had one year ago. So, let’s keep it in context and let’s be honest about it. I hate people that inflate their numbers. It’s obnoxious and gross. If I’m anything, I’m honest. Sometimes to a fault. My wife calls me a damn boy scout. She means it to tease but I’m kind of OK with that. I am not comfortable with lying and have alway liked ethics and high morals so in that spirit, here we go. 

This is purely meant to demonstrate why I probably have some good stuff to share. Although January and February always bring a bit of a slowdown, on average I see about 18-23 new patients per week. Over the course of 2019, I averaged 73.4 new patients per month and 726 visits per month. My PVA was about 9.8 visits. And then you have to understand that I have massage and acupuncture thrown in on top of that stuff. 

We’re doing alright. It’s a BIG overhead and super busy office. I’m one of those guys. Not necessarily on purpose either. It’s by necessity. I know some docs that can see 6 patients in a day, command and outstanding fee, and do just as well. All I can say to that is…..freaking teach me. Please. Lol. I’m busy as hell at almost all points during the day and it can be exhausting. But that’ll be covered a little more later. 

Now, standing where I now stand, what would I tell new docs? What advice would I pass down to myself if I were just starting out in business? Here we go, let’s work through it:

#1 – Value Yourself & Value What You Do

What is the #1 reason you are a chiropractor? Maybe it’s to help people. A very noble reason and I would guess the reason most of us got into the business. But let’s not make any mistakes, it’s called a business for a reason. You didn’t getting into the business to help people and starve. If you did, you’re a knucklehead. Straight up. 

Now, I have issues with money. I didn’t come from a lot of money so I guess on some level, I’ve always felt guilty about making it or prospering in a big way. I’ve traditionally had a hard time giving recommendations for treatment. Even when I know for a damn fact that they are going to help address long-standing pain. I’m telling you, it’s a mental game. 

Because I struggled with money early in the game, I automatically allow my experiences to paint my handling of others when it comes to money or finances. 

Not as much 22 years into the game but I still struggle to an extent if I’m being honest. But I came to really begin to value my service, my office, my employees, my family, and I began to value my patients. This was a profound turnaround for me that happened when I started really immersing myself in the available research. 

How in the hell can you sell something you’re not sure the value of to start with? Look, it’s different now but, when I came out of Parker in ’98, it was a philosophy mill and I never fit that mold. From day #1. I was not a chiropractic philosophy guy. I didn’t fit anywhere and felt I had probably made a big mistake. 

It wasn’t until I started to seek out and find chiropractors like me and started paying attention to all of the high-level research that I started to see firm value in what I did and how I could help others. THAT’s when things started to click for me. 

OK, I finally see a clear path that makes sense, I start walking that path and I’m rocking and rolling. In fact, I start killing it. Conviction in your words really does matter it turns out. Now, what’s the most important thing?

#2 – Take Care Of Business

Remember I said it’s a business so that means you must take care of business. I saw the value and started killing it but I wasn’t trained in matters of the office. I did a lot of PI in the early days. A LOT of PI. If you’ve done it before then you know that you have to settle with the attorneys all the damn time. Frustrating, yes….indeed. But part of the game. 

Anyway, because of settling all of the time, Accounts Receivable was not necessarily an accurate stat. I kept an insane amount of stats but I was missing ONE KEY stat. It was the one that tells you your profit per appointment. Man oh, man. Missing that one stat taught me a very very expensive lesson several years ago. 

You’ve probably heard me say in previous episodes that I lost almost a million dollars over the course of about 3 years. This happened for several reasons. It makes a guy feel like an idiot to admit it but, it happened. It’s part of my life. I had an employee that I trusted, that I trained, and then trained, and then got trained more, and then provided resources for so she could ask any questions. I even got the training to come here to my office and work with her. 

I want to be clear, nobody was stealing. She just wasn’t disputing denials, re-billing, some of the billing just wasn’t done at all but she never said a word, even though I’d made it clear to tell me if she needed help or had questions, etc. Well…..she didn’t so I was dumb enough to think it was all taking care of itself. Once the timely filing deadlines have passed, that’s it. Done deal. That money is bye by. 

Hell, my stats showed me that I was seeing a ton of folks and getting a ton of folks better. I was killing it! So I thought. You could fall prey to the same mistake. That’s why I’m sharing my sheer stupidity with you. I’m not a proud man. 

I knew things weren’t jiving so I brought in an internal auditor to sort the mess and oh hell what a mess it was. I had no idea. One month, for example, I lost $40.00 per visit and another month I lost $21.00 per visit. LOST. 

So, my fault was in buying into my employees and rooting too hard for them. Getting personally invested in their success and fighting for them. That’s just who I am and that’s how it came about. I’m still that person today. I’m just a hell of a lot smarter about what I will and will not tolerate. That’s the difference now. 

I’m not a smart man but I know when my bank account is getting closer and closer to zero. Lol. 

At the end of the day, when I say take care of business, I mean that your business ultimately depends on the billing and collections. If you’re not billing or collecting, you’re not in business. Period. Either make damn sure your billing/collections person is a rockstar or outsource it to a professional and experienced company. 

Without question. Just do it and don’t second guess it. And never pay an outsourced business a flat fee. They should be on a percentage of collections. That way they have the motivation to get your AR to zero. 

You can use the profit per visit stat to help you determine where you are as far as collections. It’s the one stat out of all of them that could have saved me at least half a million dollars. That’s important enough to cover it real quick. 

You find your Profit Per Visit (PPV) by subtracting your Cost Per Visit (CosPV) from your Collected Per Visit (ColPV. 

ColPVCosPV = PPV

I’m going to tell you how to find those right quick so get out your pens and pencils ladies and gentlemen. 

Let’s start with the Collected Per Visit number. Find that by dividing your Total Collection Amount (TCA) by your Total Number of Visits (TNV). 

TCA / TNV = ColPV

So let’s say we’re doing last January for example. I want my collected per visit number so I’m going to look and divide my total collections in January by the number of visits I saw in January. Bam, there you go. One number down. 

Now we need to find our Cost Per Visit number. For that one, we just divide our Overhead (OH) in January by our Total Number of Visits. You should see how it all revolves around your Total Number of Visits right? Because it does. 

OH / TNV = CosPV

Anyway, it’s simple, you just have to be told how to do it. Now, subtract Cost Per Visit from Collected Per Visit and you will have your Profit Per Visit number. That number tells you whether you’re knocking it out of the park or sucking the dirt of all of those others that really are knocking it out of the park. 

I’d say if you’re Profit Per Visit is around $40-$60, you’re where you want to be. Some are more and some are less but that will all come down to where you are as far as your overhead. KEEP AN EYE ON IT. 

These equations are illustrated a little clearer for you in the show notes at chiropracticforward.com so go there and check it out. 

#3 – Chiropractic Statistics

The easiest way you can say it is like this; how can you know where you’re going if you don’t know where you’ve been? Honestly, it wasn’t until I joined a practice consulting group that I learned the value of keeping stats. Unfortunately, that group didn’t keep the profit per visit stat. Ugh. Anyway, moving on…..

It’s vital to be able to compare your current situation from past performance. Have you ever had a month where you were in the dumps because you thought your practice was slower than normal? And maybe you were ready to just go ahead and jump off the cliff or drive your car into a tree? Or something equally self-harming?

Well, I have too. But, because I keep stats so thoroughly, I’m able to pull them up and compare now to last year at this time. Not only that but I can compare to the 10 years prior to that and see the growth and then I don’t panic and I don’t feel like all hope is gone. It’s really nice to know where I’ve been. Plus, it can help you plan where you want to go and set realistic, reachable goals. 

Outside of valuing my services, keeping stats has probably been the most important change I’ve made over the years. It’s that big of a deal. 

#4 – Chiropractic Marketing

If you’ve listened to my podcast any time at all, then you know what I think of marketing. And it can be summed up in these words, “You must be a marketer of what you do. Not just a do-er of what you do. 

The names you most associate with a particular industry aren’t usually the best. They were just better at telling people how good they are. Put it this way, do you really think McDonald’s makes the best hamburger? Hell no they don’t. Yet, there they are. Around the world, absolutely killing the burger industry. 

Also, a Dan Kennedy classic you’ve heard from me before. It’s YCDBSOYA which stands for You can’t do business sitting on your ass. You better be someone that becomes a mover and a shaker because the success will not belong fo the meek and the mild in this story. It will belong to the ones that aren’t afraid to tell people what they do in an honest and ethical way. 

If you’d like some great thoughts and ideas on marketing an evidence-based practice, check out the two-part series we did on it. They were episodes 98 and 99 and are linked in the show notes. They were called Big Ideas On Marketing Evidence-Based Practices and published on October 31st of 2019 and part two was published on November 8 of 2019 so go find them and get to work. 

Part I

Part II

#5 – Control Chiropractic Overhead

Here’s the honest truth, I suck at this one. I like toys and I like having extra hands to help. Here’s the deal, when you have an office of employees, none of them…..NONE OF THEM cares about your business as much as you do. Even my most valued employee doesn’t value it as I do and she’s amazing. 

They find reasons to be gone. They wake up with a cough, their belly hurts, blah blah blah. I’ve heard them all. And on a side note, I do it as schools do it. If you have a fever, keep your butt at home. If you do not have a fever, get your butt in gear. If you miss work, you better have a doctor’s note. Plain and simple. Remember it’s a business and you have to take care of business. 

Anyway, I am usually one person over-staffed because I got tired of being short-handed all the damn time. I saw someone on Dr. Christie’s post say that people need to remember that overhead walks on two legs. Meaning, employees are the biggest aspect of your overhead. And it can get out of hand fast. I used to think a $42,000 per month overhead was the most ridiculous thing I’d ever heard of. A colleague of mine told me that was his overhead and I was about half of that at the time. Now, I’m around $5k-$10,000 beyond that on average every month. 

It sneaks up on you so keep an eye on it. Protect it. When a salesperson calls me, I tell them straight up, “I’m not just out looking for more reasons to raise my overhead so if it doesn’t blow my shorts off, it’s a no from me.” Pretty simple. 

#6 – Background Checks

Speaking of employees, I about pulled a dummy a year or two ago. I hired a girl with front office healthcare experience. Hell, she worked at a cardiologist’s office for quite a while! I was so excited. I hired her and she was just killing it at the front desk. I mean killing it when we’d been through several that were just awful. i was so excited. Then, one of my other employees told me she’s pretty sure this new girl has a mugshot out there somewhere so she went looking. 

Dammit if she didn’t find a damn mugshot. So, I called up one of my besties who happens to be a copper copper crime stopper and guess what? This girl working my front desk for the last two or three weeks….turns out she was just in jail for stealing from a cardiologist’s office. At about the same time, a friend of mine that works at that cardiologist’s office called me to see if I’d hired their ex-employee….Lol. I felt like an idiot but, we caught it in time and we went ahead and let her go before she could do any damage. 

But the lesson was learned. Do background checks. They may be so good and capable and smart so that they can figure out how to manipulate your system to steal from you. Just a thought. 

#7 Never Stop Learning

We never know it all, folks. If we ever get to a point that we can stop learning, then we should be traveling the world lecturing and teaching other doctors to be clinical ninjas. 

I’m not there and I’m betting only about .05% of chiropractors are there. Always learn. I just finished the ortho diplomate and now I’m on to Stu McGill, Donald Murphy, and the latest research that is continually coming out. 

I can’t remember where I heard this quote but, “be a learn it all, not a know it all.” This also means to always be taking advice. Be quick to take advice! Seek it out. I remember when I was growing up and my Dad saying, “Son, just remember, no matter how big and bad and strong you get, there’s always someone out there that can beat your ass to a pulp.” This is true. Lol. 

But what else is true is that no matter how smart any of us think we are, there is always someone smarter and more capable. The best part about that is that we can learn from them! Without them beating our asses to a pulp, by the way. Lol

Dr. Greg Kawchuk says we should consume at least one science per day. Meaning, find the papers and consume them. If you have the time to go beyond the abstract, please do. But consume at least one science per day. It’s good for your brain, your soul, your profession, and your patients. 

I just told my wife the other night….I’m going through Stu McGill’s ‘Back Mechanic’ book right now. I told her it’s amazing that I’ve been through Murphy’s CRISP protocol book and I’ve been the through the ortho diplomate program and it’s amazing and so cool that even in the first 30 pages of Dr. McGill’s book, I’m learning even more stuff to stick in the toolbox. 

It’s exhilarating. Keep the foot on the gas pedal folks. Never stop soaking up material at the quickest pace possible. 

#8 – Chiropractic Mentorship

I waited for 11 years or so. I tried to do it on my own. Hell, I didn’t have the money to get a mentor in the first place anyway. But, if I were advising my new doc self, I’d say get a mentor…..as in yesterday. 

I can tell you that I don’t see the value in long-term contracts with them though. There is really only so much you can learn from a mentor so why would we pay thousands more when we exhaust the learning potential. Our chiropractic success is not typically going to lie in the hands of one person and, even if it does, you’ll learn what you need from them in a year or two. Anything beyond that is probably a waste.

At some point, you cease being the student and the group starts learning from you. This is the point that you should graduate into being a member at no charge because you are contributing as much or more than you are extracting. If that makes sense. 

I have had about 2 and a half mentors. One was outstanding and I damn sure paid a high price financially for it. The other was very philosophy minded and we just didn’t jive. I didn’t know how philosophy minded in the beginning but I got out once I figured it out. 

That doesn’t mean I didn’t learn from him though. I got a great hiring process out of that group. I got some great marketing techniques that I could tailor to my own evidence-based means. 

I always treated mentors or practice management groups like buffets. I took what looked good to me and worked for me and I left what I didn’t like and what didn’t fit me. 

I think buying into one person or one system and diving in 100% usually isn’t the best way to do things. Hell, I’m a Christian and I think that way about preachers too. People rallying around one personality and devoting everything and all energy to it……yeah….not my style. 

Just treat them like a buffet and you’ll be fine. I like the idea of a mentor or practice management group that lines up with your way of practicing and I like them mostly because they can keep you focused and keep you accountable for your stats and your practice goals. 

I’m in a great spot in practice and I’ve still considered jumping into a new one just to see if I can get some new, fresh ideas. You should too. Just don’t make an egomaniac more and more rick while they are actively in the process of propagating garbage and ruining our chances of getting this profession where it belongs. Please. 

Good ways to get started for an evidence-based chiropractor would be joining the Chiropractic Success Academy, joining the Chiropractic Forward Facebook group, joining the Forward Thinking Chiropractic Alliance Facebook page, and joining the Evidence-Based Chiropractor Facebook page. 

Look, I get that this next one isn’t a popular topic but hear me out before you tune me out.

#9 – Join Your Associations

What you get out of your involvement is directly equal to what you put into it. By sitting on the Board of Directors for the Texas Chiropractic Association, I made more connections and friends than I could ever count for you or explain to you. It was a dramatic turning point for me personally and professionally. 

These doctors I was on the Board with became life-long friends to me. They’ve helped me solve countless problems over the years when I needed them the most. When I had the billing debacle I mentioned earlier, guess who gave me the way out? A Board member that I called asking for suggestions on billing/collections companies. 

If I’m thinking about ideas for my business, for expanding, for integrating or making any sort of changes, who do you think I ask?I have a network of about 15-20 high level, successful doctors here in Texas and we help each other. We pass advice and information back and forth. 

It was never that way before I became a TCA member and got active. I was by myself making it up by myself with poor information to go on. 

My involvement in the TCA got me into getting a Diplomate. Connections through the TCA is what setting me up for the next 5 years. 

Yes, your association needs you and your talents but more importantly, YOU need your state association. In ways you don’t realize or ever thought of. I thought it would be a time suck and a money suck. I couldn’t have been more wrong. 

Something on this point that I can promise is that if you just join and continue to sit in your office and do nothing, you’ll be helping your association but you’ll get little out of it. At least in regard to what I just described. 

BUT, if you hop in and volunteer, you’ll be exposed to a whole slew of other chiros that will eventually become your comrades in the battle. Your connections will be deep. It’ll happen. Trust me. And you’ll appreciate it. 

Besides all of the things I just mentioned, our state and national associations NEED to have more and more evidence-based practitioners helping steer and advise this profession as we proceed into the next 10, 20, 30 years and beyond. 

Just do it. It’s worth it. 

#10 Don’t Forget About YOU

It’s easy to get caught up in practice. It’s easy to feel like your practice owns you rather than you owning your practice. Hell, I feel that way right now. It happens to everyone. But what I’m trying to do these days is to learn to set aside more time for me and my family. 

Burnout is very real and it doesn’t do you, your family, your employees, or your patients any favors at all. I’ve been burned out at various times so many times. It’s miserable. And it can get to the point that even a long weekend doesn’t make any damn difference. Because all the stuff piles up and you have to wade through it when you get back. It sucks. 

To battle back, I try to have a trip planned at least once per quarter. That way, there is always something to look forward to and plan for. Something on the horizon. 

Now, there is a big difference between taking some time for yourself and being a lazy ass bum. Nobody likes a lazy ass. Everyone respects a worker and a giver so don’t take this one to the extreme. It just means to fit yourself in some time too. That’s all. 

Remember that nobody will be on the death bed and will be thinking, “You know, I really wish I had spent more time at work.” It’s the truth. 

Some trips are big and you can write off as your yearly shareholder’s meeting. Some are just 5-6 hour drives to Dallas or up into Colorado Springs or the New Mexico mountains. The point is, get out of your office. See no patients. 

See your family. That’s the point. 

Certainly, there are more things an old wolf like me can share. There are a lot of things I have yet to learn but I’m seeking. I’m searching it out and soaking it all up. Every single damn day. 

If you have anything to add to the conversation, hop into the private group called the Chiropractic Forward Facebook group and share with the group. We’d love to hear from you. What would you tell a new doc going into practice?

I asked this question in the Chiropractic Forward group and asked the docs to share some of their recommendations:

Dr. Kenneth Chillson over in Cologne Germany says, “The number one cause of failure is the fear of failure. So, stop focusing on fear and start focusing on what you think needs to be done right now. Believe in yourself, because you are the only one that will. 

Dr. Craig Benton in Lampasas, TX says, “Have no fear we can help a ton of people that don’t even know it yet. Get your message out there.” I would add….but be responsible about what you’re putting out there as you message. Remember to be the doctor that you are and what you say and do reflects on the rest of us. Don’t make me or any of the rest of us look bad. We don’t deserve it. Be cool. 

Dr. Don White down in Ft. Worth says, “Never be afraid to say no to a “Good deal” for a contract as an associate if it isn’t a good deal. Better yet ask for more when you get the first offer. Have other people that know more than you do look at any and all contracts before you agree and sign anything. (Contracts for employment, a buildout, a lease, management group, etc)” He also said having a business plan is key for him. 

That’s it. That’s my top 10. I hope you enjoyed the show this week as much as I enjoyed the brain dump you go through when you start pulling out all of the old files in your noggin and searching through them. 

I hope you found value in it and found some things you can use to help you better, make your family better, make your practice better, and make your patients better. 

The best news is that there’s never been a better time to be a chiropractor in the last 30 years. You’re where you are for a reason and chiropractic success is more a certainty than it was 5-10 years ago. Just go out, grab it, knock it out, and take it back home! Lol.  

Key Takeaways

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

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Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Thoughts on Chiropractic Groupon, Gabapentin, & Weight Loss Research

CF 105: Thoughts on Chiropractic Groupon, Gabapentin, & Weight Loss Research

Today we’re going to talk about some thoughts on Groupon and Chiropractic, if you know me, you probably know where this is going and it’ll probably be fun. We’ll find out. We’ll talk about Gabapentin and we will talk about a couple of papers I encountered recently having to do with metabolism, intermittent fasting, and things of that nature. 

But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. So feel free to crack one wide open would you?

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. 

Do it do it do it. 

You have plopped down into Episode #105 just like a comfy easy chair. 

Now if you missed last week’s episode talking about our TWO YEAR wrap up, make sure you don’t miss that episode. It was a lot of fun to put together and to reminisce on some of the amazing episodes we’ve had over the past two years. Good good stuff. 

Something new I found out here…..Did you know that if you have an Alexa product, you can now just say something like, “Alexa, play The Chiropractic Forward Podcast on Apple Podcasts” and kablooey! 

You automatically start to hear the golden throated stylings of yours truly! Lol. You can say skip ahead 30 seconds, play previous episode, and on and on so pretty cool right there. 

On the personal end of things, we just found out that Dad started moving his left leg today for the first time and that’s exciting. It’s the first REAL solid sign of big progress since his first stroke on November 9th. As you can imagine, we are ecstatic about this. Good stuff. Keep on keeping on Pops. Strong like bull!

Before we dive into the reason we’re here, it’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Item #1

Alright let’s dive in. We’ll save Groupon until the last because if I know me, it’ll be what I have the most to say out of all of these. 

Let’s start with Gabapentin shall we? The most recent article I’ve come across was in The Atlantic. It was authored by Olga Khazan and called ‘Chronic Pain Is An Impossible Problem’. It was posted December 9, 2019(Khazan O 2019). 

That’s got some sizzle on it!!

Some key points in the article are that 

  • Chronic pain affects about 1/5 of American adults
  • For years those in the medical field thought it could be treated with painkillers like Oxy but that was proven wrong when basically three planeloads of Americans started dying of opioid-related causes each week
  • Now, they’ve turned to Gabapentin, an anticonvulsant, to help treat it. 
  • From 2012-2016 prescriptions of the medication went up 64%
  • There is emerging information that Gabapentin may not be as safe as previously believed. Certainly when combined with other sedating meds. 
  • When taking it long-term, patients can develop tolerance so more and more is required to reach the desired effect. 
  • There is also a withdrawl effect when trying to get off of gabapentin. 
  • People are now starting to use Gabapentin in combination with Baclofen and benzos like Xanax to increase the intoxicating effect. We can see where that is going can’t we?
  • The article goes on to say, “not only does gabapentin appear to exacerbate or create overdose risk, it also doesn’t work well for chronic pain.” They site a study that we’ll cover in a second. 
  • The paper wraps up by saying they’re essentially out of option when it comes to chronic pain. Which to me says they’ve run out of pills basically. That doesn’t mean they’re out of options though. 
  • Arthur Robin Williams, an assistant professor at Columbia University says “The medical community should take a closer look at non-pill remedies such as physical therapy and psychotherapy…I would add evidence-informed chiropractic… These treatments are often not covered by insurance, take longer to work, and take more of providers’ time. But for many, they might be a better option than yet another pill that has yet another pathway to abuse. “The reality is, a lot of the pills that change how you feel in the next 10 to 30 minutes,” Williams says, “carry addictive liability.”

Well…..no kidding? Who would have ever thought that? Hmmm….let’s see. Oh yeah, every chiropractor and PT that ever lived. 

Let’s combine that with a systematic review and meta-analysis from just last year that was in the Canadian Medical Association Journal called “Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis”(Enke O 2018)

  • Nine trials compared topiramate, gabapentin or pregabalin to placebo in 859 unique participants. Fourteen of 15 comparisons found anticonvulsants were not effective to reduce pain or disability in low back pain or lumbar radicular pain. 
  • There was high-quality evidence of no effect of gabapentinoids vs. placebo on chronic low back pain. 
  • The lack of efficacy is accompanied by increased risk of adverse events from use of gabapentinoids, for which the level of evidence is high.

It is painfully obvious (no pun intended) that pills aren’t cure-alls and aren’t curing the pain problem. And they won’t sure the pain problem so isn’t it time to look elsewhere? In the year 2020?

All of this is cited in the show notes at chiropracticforward.com. Go get the article and the paper. Use it to educate your community on gabapentin. Set yourself as the reasonable alternative to it. 

Item #2

Fasting and weight loss. I want to be right up front on this, I’ve always wanted to make nutrition and weight loss a part of my practice in some shape form or fashion but, if I’m being honest, I’m just straight up a big big dude. Like I’m 6’4” and, depending on the time of year, 280+. I was a college offensive lineman. I played center and i anchored that line pretty well with my overall biggness. Lol. 

Cat-like reflexes people but big as a damn house. So, I’m not going to teach you how to implement weight-loss into your practice here but I am going to give you some interesting research I cam across recently that might make you think a bit. 

The first paper on this is called “Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis”. It was published in Reviews in Endocrine and Metabolic Disorders, authored by P Marianna, C Iolanda, et. al. and published December 2019. (Marianna P 2019)

Hot to the touch. It’ll burn your  damn finger prints off. 

Why They Did It

Restriction in meal timing has emerged as a promising dietary approach for the management of obesity and dysmetabolic diseases. The present systematic review and meta-analysis summarized the most recent evidence on the effect of time-restricted feeding (TRF) on weight-loss and cardiometabolic variables in comparison with unrestricted-time regimens.

How They Did It

  • A total of 11 studies, 5 randomized controlled trials and 6 observational, were included
  • All selected studies had a control group without time restriction
  • Most studies involved the Ramadan fasting

Wrap It Up

Time restricted feeding regimens achieved a superior effect in promoting weight-loss and reducing fasting glucose compared to approaches with unrestricted time in meal consumption. 

As we’ve covered, systematic reviews and meta-analysis are, ideally, high-level research and, considering the majority of the included studies involved the Ramadan fasting regimen, I went to search it up to see what the what. 

So, what exactly is a Ramadan Fasting Regimen? Well let me tell you. And I’m not going for the fancy stuff because I’m tapped for time here so we’re just going to hit up Wikipedia real quick and Wiki says that the basics are:

  • Fasting from sun up to sun down
  • Abstinence from sex, food, and drink
  • It also means one should refrain from things like
  • violence
  • anger
  • envy
  • greed
  • lust
  • angry/sarcastic retort
  • gossip
  • and you’re supposed to get along with others better than you normally do

In America at least, I’m certain we’ll all just do the food part because everyone’s so busy looking for a reason to be offended that I’m certain being nice and getting along is off the table for now. 

So, if you have any personal experience with intermittent fasting, if you’re an expert on the topic, shoot me an email at [email protected] Let’s talk about it. Maybe we can set up some guests and do a full episode or two on the topic to educate our community of docs on the matter. Sounds like a great topic so hit me up. 

Now, the last thing I have here I want to talk about is Groupon. 

This one is a bit of a trigger for me honestly. Looky here. I am well aware that people are struggling. I’m well aware that I am fortunate and to sit and judge can seem disconnected and unfair at minimum to some. I definitely get that. 

What I also understand is that a whole bunch of those that are struggling are in a profession they really shouldn’t be in because they’re lazy and want to sit behind their desks and hit a few buttons and be magically transformed into a master chiro with an office stocked full of patients and never ending new patients. 

That’s magic time dreamland stuff. 

There will always be supposed shortcuts. There will always be business hacks or whatever you want to call them. But at the end of the day, shouldn’t you make decisions while keeping several things in mind? Meaning, you have to do what is best for your family. You have to do what is best for your office and your employees. But don’t you feel like you should make decisions based on what is best for your profession and for your colleagues?

I would hate to think that I’ve done something that damages my profession . Obviously I don’t mind calling out BS business practices and unethical chiropractors. If that’s damaging my profession well then, I’m guilty as hell. 

But when you are making the deals some of these guys and gals are making on Groupon, you are demeaning, lessening, and trashing what the rest of us take a great deal of pride in. 

Imagine, you go through chiropractic school, you survive 21+ years in practice while steadily getting more and more education, you take on a Diplomate program and finally complete that, and you are fighting on the state level for your profession and your profession’s image…..and then you open your email. 

Yes, I get emails from Groupon with their best and newest deals. I open it up and BAM….It almost seems like all of that work can just be flushed down the toilet. It’s depressing and it makes me want to club baby seals. 

Before we start talking about the article, I did a quick search for Groupon deals in my area and, right there next to Reflexology deals popped up this:

  • 10% cash back – Sounds like a damn car deal
  • Consultation, exam, x-rays, adjustment, and one full-body vibration plate session for $70. Way to value your services. Great. Way to look awesome. Assuming they actually need vibration plate. Assuming they actually need x-rays, assuming they even need and adjustment. Blah
  • Then this one, it’ll make you tickle – One laser lipo session w/ two vibe plate sessions for $45. See…..in Texas, you can only have laser lipo if you’re trying to increase function. Not just look better. So, that’s not necessarily legal as this implies to me it’s for looks. Unless they have a medical director and I’m here to tell you they do not. 
  • When you go to the bigger cities, it only gets worse. I found a $564 value for only $43.70!!! What a damn deal!!!

It’s all just shady and sketchy. Luckily, there are only two in my area doing this stuff. And if they keep it up, we may have two less competitors here as well. 

Besides the shady, street corner huckster look it so convincingly creates, it’s potentially illegal based on the idea of fee splitting, Medicare inducement, and dual fee schedules and, if the state boards start getting their acts together and going after this stuff, they will be the ones to go down. 

What started me down this path today was an article I came across called “Legal Implications of Chiropractic Groupons.” It was written and posted on the website for Carlson and Jayakumar – attorneys at law. I’ll have the link in the show notes. https://cjattorneys.com/legal-implications-of-chiropractic-groupons/

Highlight of the article include:

  • Each day, numerous chiropractors contract with Groupon and its competitors to sell certificates for adjustments, examinations, x-rays and massages. 
  • Despite the variety of services offered, these programs all have two things in common: (1) the chiropractor is offering a significant discount –92% in some examples, and (2) the chiropractor is sharing the income from each certificate sale – usually around 50% – with the website. While we are unaware of any state board taking action against a licensee for a Groupon-style offering, we believe these programs could create significant civil and criminal liability for chiropractors.
  • most states have rules prohibiting the offer or acceptance by a chiropractor of any commission, discount, or other consideration as compensation or inducement for referring patients, clients, or customers to any person, irrespective of the practitioner’s membership, proprietary interest or co-ownership in or with that person. I was once offered the opportunity to buy in to an imaging center here in town. As badly as I wanted to do it, I made the mistake of hiring two different attorneys for their opinions. BOTH advised against and this is exactly why. 
  • With Groupon, money is paid by the chiropractor to the website in connection with a patient’s referral. The chiropractor essentially, albeit indirectly pays the website per patient that purchases the certificate. At their base, these agreements require the chiropractor to pay the website for soliciting, referring and/or procuring clients not he chiropractor’s behalf. Stuff you’re not supposed to do and can get in a lot of trouble for. 
  • Medicare’s Anti-Kickback Statute criminalized the payment of kickbacks for patient referrals. Subsequent laws expanded it to all federalpay programs. Kickbacks include “any remuneration,” a very broad definition, which includes coupons. The Office of the Inspector General issued a “Special Fraud Alert” regarding advertisements offering “discounts” given to Medicare beneficiaries. Then a “Special Advisory Bulletin” appeared on offering inducements to Medicare beneficiaries. Essentially, it said a provider could not offer a patient anything worth more than $10, and combined $50 in a year for multiple gifts.
  • Groupon-style deals are unadvisable as they may pose problems with insurance companies. Most insurance policies will not pay for any charges that would not have been made in the absence of insurance. Groupon offerings, which almost always charge a lower fee to the purchaser versus insured patients, could be viewed as creating a “dual fee schedule.”  Insurers believe dual fee schedules constitute fraud and over billing. Some argue that Groupons are merely a version of a prompt-payment discount. While California law expressly permits prompt-payment discounts, such discounts must be reasonable. Given the extreme nature of the discounts typically offered by Groupon and its competitors, such certificates likely would not fall under the prompt-pay exception.

They conclude that “Given their widespread use, it seems unlikely that the Board of Chiropractic Examiners would discipline each and every licensee who engages or has engaged in Groupon-style offerings. That said, there may be a rash of “test case” or “example” disciplinary actions that follow. Eventually, we would expect the Board to adopt a regulation, or the Legislature to pass legislation, that explicitly either proscribes or prohibits the use of these deals. In the meantime, we recommend that chiropractors abstain from these types of marketing campaigns….”

I couldn’t agree more with them. 

When I opened up a new place h ere in Amarillo, I printed flyers at Kinko’s and I walked from one business to another knocking on doors and meeting people and telling them about me and my new place. I marketed anyone that could send me business. For more on that, go back about 5 episodes and listen to our episodes called Big Ideas On Marketing Evidence-Based Practices. Link is in the show notes. 

You must know this just isn’t the way to go. Join BNI, join civic clubs, start working out at a gym and get tight with the managers and personal trainers, spend time volunteering, joint a running club if that’s your gig, combine those things with social media and a solid email list that you continue to build and work on. There are so many things you can do that are above the cuff. That are respectable and raise up you and your profession. 

Groupon isn’t one of them. It does exactly the opposite. It identifies those of us who are racing to the bottom of the barrel and dragging the rest of us down with them. 

If you’re doing Groupon, it’s my opinion that it’s time to stand up, stop doing it. Yesterday..if you catch my drift

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at [email protected] if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us that patients can get good to excellent results for headaches, neck pain, back pain, and joint pain just to name just a few.

It’s safe and cost-effective. It can decrease surgeries & disability and we normally do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, we can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Enke O (2018). “Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis.” CMAJ(190): E786-793.

Khazan O (2019) “Chronic Pain Is an Impossible Problem A “safe” alternative to opioid painkillers turns out to be not so safe.” The Atlantic.

Marianna P, I. C., Andrea E, Valentina P, Ilaria G, Giovannino C, Ezio G, Simona B, (2019). “Effects of time-restricted feeding on body weight and metabolism. A systematic review and meta-analysis.” Rev Endocr Metab Disord.

Big Ideas On Marketing Evidence-Based Practices (Part Two)

CF 099: Big Ideas On Marketing Evidence-Based Practices (Part Two)

Today, you’re going to hear Part Two of our two-part series about marketing. Specifically, marketing an evidence-based chiropractic practice. How do you do it and do it right?

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research. It’s like we’re talking about research over beers. Which is NOT like talking about research in a classroom or an institution of some sort. Accessible research if you will. I could be more professional but I’m not. 

Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. 

If you haven’t yet I have a few things you should do, like our facebook page, and go to our Store link at chiropracticforward.com and check out the goods. That’s it. Not bad right?

You have shimmied into Episode #99 and I hope you’re enjoying the Marketing series. 

Now, if you missed last week’s episode, it was Part I of this marketing an evidence-informed practice series. Stop now and go back and listen to Part I first. Then come back here and devour Part II. 

Because….make no mistake…..we’re serving it up hot and fresh here people. 

On a personal note, nothing special is going on around the office or in my work life balance. It’s just been business as usual. We’ve had a bit of a fall off from the Summer but it’s still busier than this time last year and we’re staying busy busy busy. 

So, nothing of signifigance to report here but, before we get too deep, it’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you don’t take advantage of this deal, I just think you might be crazy.

If you’re a regular listener of our podcast, you know I’ve used ChiroUp since about June of 2018. Let me tell you about it because I’m about to give you a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months which is pennies compared to what it’s worth. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

OK….now, back to Part II of our marketing series. We covered some general marketing thoughts and we covered internal marketing last week. We were just about to get into External Marketing and the idea of the first big three means of external marketing which can be thought of as shotgun marketing. 

So, let’s pick back up where we left off last week. Here we go. 

#2 External Marketing

Now, let’s move on to External Marketing. This is the traditional marketing we think of. Things like:

  • TV
  • Radio
  • Billboards

Let’s talk about those three first. We can call that shotgun marketing because you are hitting random people with random pebbles. You can’t laser focus marketing with a cannonball this way. You can only hope that someone that would be interested in you happens to see your message. Some will. Most probably won’t. 

Don’t worry if you’ve fallen for some of this crap. I spent $19k one year to have the front page corner of the yellow pages. Now, that was years ago when everyone actually used the yellow pages but, trust me, I’ve done stupid crap too. 

Back to TV, no matter how smooth the sales reps are, more and more are unplugging. They’re using streaming services like Netflix or Amazon. Disney and Apple are jumping in with both feet too so sooner rather than later, I think the majority will not see a message on traditional TV. 

Same goes for radio. Hello, every heard of Sirius radio? Or, if you’re like me, I’m listening to a podcast as soon as I get in my truck to go anywhere. I don’t even listen to traditional radio anymore. If you do, I think you’re quickly becoming the minority. 

Billboards may make sense if you’re right off the highway and it leads people to your front door. Otherwise, I think it’s probably mostly a waste of money. Don’t get too tied up in whether or not you see your face or your name up on a big board or up on TV. It’s not real. It didn’t happen organically because you’re awesome. You put it there with your money. And you may have just wasted that money. 

Shotgun marketing can make sense but only after all of the base coat has been painted and now you’re just going for exposure and saturation of the market. I really don’t care what the sales reps say and how many graphs they show you. Those are manipulated to take your money. 

Another negative about shotgun marketing is that it is hard to track. Marketing needs to be traced and tracked. Either through computerized means or on a simple spreadsheet. Better believe I know where every single new patient comes from, who to thank, and where my bread and butter lies. 

Unless you’re really tracking well, many times you won’t know if someone comes in from a billboard, TV, or radio. Sometimes they’ll tell you straight up but sometimes they just don’t remember. 

But what about other means of external marketing?

What about things like:

  • BNI
  • Chamber of Commerce
  • Charity and philanthropy. 
  • Social Media
  • Sponsoring teams and events
  • If you want to do personal injury, wouldn’t you figure out how to attract and market that demographic?
  • If you wanted more pain patients, where do they hang out? Where do they go? Wouldn’t you want to figure out how and who to market for those people?
  • Direct mail – yes, it can still work and you can target it like a laser
  • Brochures
  • Marketing representative
  • Creating authority – talks, appearances, book, podcast, content creation, etc…

I have so much on external marketing. The options are endless and we could talk about them for ever. I’ve tried them all. Trust me. 

Something I forgot to mention in the beginning is the fact that marketing is always changing. It’s not a set it and forget it endeavor. You have to be on it all of the time. Yellow Pages anyone? Hello….Bueller. 

#3 Who You Are

As I said before I add this third one because we are in a personal business. You’re not a big brand like Coca Cola. Coca Cola doesn’t have a face. It doesn’t have a name behind the brand. While some would argue that it does, in the context I mean it in, Coca Cola does not have a personality and it damn sure doesn’t have a relationship with it’s drinkers. 

You could say that #3 really has more to do with internal marketing but I think it’s a cross-over thing. Who you are, your vibe, how you carry yourself….that all goes into making your business what it is and makes your reputation what it is. 

For a smaller community, this is even more vital. For a city, still vital. You are attracting people or you are repelling them. It’s not very often that you have not effect or neutral effect on people. Right? Do you ever leave a conversation or a personal encounter with someone with absolutely zero feel about it? You get the point. 

So, what if you spent on average $150 per each new patient that gets on your schedule? There are some pretty good stats you can keep on this stuff. What if you invested $150, they come to your door, you’re having a bad day, rush through their exam, are a bit of a jerk about them doing exactly what you recommend, and then maybe there’s a snafu at the front desk when they pay out because you were too lazy to get the staff trained appropriately?

You may have made the $150 back up but you’re probably not going to profit on that patient because of YOU. Your vibe was crap. You didn’t want to be there. You didn’t want that patient there. You didn’t train your front desk right. And now YOU probably won’t have another visit with that patient. 

What if you are at an event, you woke up that morning and stepped in dog crap, and that just set the tone for the day. Now you’re at this event you don’t really feel like being at and everyone can tell. Mr. Sourpuss chiropractor over there sucking on a whiskey sour with his sour face. 

These are dumb simple little examples but who you are, how you are able to talk and communicate to people, and communicate what you do can make all of the difference in the world. If you’re positive, energetic, smart, and capable…..Boom. The battle is won. 

Eyore from Winnie The Poo on the other hand gets no patients. Only your mom is coming to see you. #66 in town, #1 in mama’s heart. 

More than personality though, you MUST be a real person. Don’t pretend. Don’t sell. Patients smell that garbage a mile away. Be AUTHENTIC. That’s a key concept in marketing. 

It’s the stuff you learned in kindergarten. Treat others the way you want to be treated. Honesty, ethics, forthright, stand up, and gentlemanly or lady like. Professional. These are so important. What about loving? Of course. You better love your patients and you better love your staff. 

Our practices are made up of lots of relationships and if you aren’t interested in people and relationship building, I’m afraid no amount of marketing will make it OK or will make you succeed. No amount of money. 

When you’re providing quality care with responsible recommendations, and you salt and pepper that delicious brew with a little love and personality, you got a winning recipe on your hands. I like cajun food so I add even more personality to my spicey brew!!

Boom snap pow!

I mentioned this earlier but, I think the biggest key to anything business related is keeping and tracking stats effectively. Do you know the exact number of new patients you got last month from Google or Facebook or Instagram or from referrals from your existing patients? Do you know how many new patients you got from your own staff referring people to you?

Do you know your PVA? Do you know how much you make per patient encounter on average and how much it costs you in marketing dollars to get a new patient in your doors? Do you know what your average profit per patient visit is each month or what it averages over the course of the year?

If you can’t answer these questions, you have to figure out how to answer them and you need to do it yesterday if you get my drift. 

These numbers and metrics aren’t only important to your marketing efforts. They’re important to your business in general. How can you possibly know your return on investment for anything you do in your business? It sounds crazy to say it, right? For so many of us, record keeping and stats are just second nature. But, I wasn’t always there. I had no idea where I’d been and not a clue where I was going.

I was like a drunk pin balling off of the walls trying to get somewhere and falling down every so often. 

I’m not just trying to relate to you on some level. That’s real talk. I was on an island for so many years. No colleagues to bounce ideas off of or to ask for help. No association involvement, no network. No real continuing education. I came late to the party. But, with knowing I was coming late to the party, I jumped in with both feet, man. 

Gimme the bottle of tequila, the bottle of vodka, and throw in some fireball on top of that. Let’s get there as fast as possible. 

That’s what I did with being a chiropractor. 

Now, as far as the stats keeping, I’m working on a solution for those of you that might be interested in getting some help with keeping stats. Something that will make it easy and fast. Yes, it’ll have a monthly cost but it won’t be ridiculous and you can only pay for what you think you need. Different levels…that type of deal. But, it’s in the works and I’ll let you know more about it when we get it up and running. You numbers nerds will love it. 

Some other random thoughts and musings:

  • Having something to talk about is always important. Especially on social media. If you’re talking, people are typically listening. Even when you think they aren’t
  • Make sure your website is doing what it’s supposed to do for you. IF you can’t do it, hire it out. It really is that important. 
  • IF you can learn YouTube videos, learn it and do it. Even if you think you suck on screen. It’s important. 
  • Eliminate the risk. Do what you can to remove any and all obstacles to coming to see you. Is your insurance staff making the payment process a little bumpy? Fix it. Are people wanting to fill out paper work online but you don’t have that? Fix it. Does the majority of your population want to come in from 5-6 and you’re closed at 5? Fix it. Not for just one or two people but if the majority needs that time block, give it to them. Just remove the obstacles. 
  • Be the expert that you are and be the expert everywhere your market will allow you to be the expert. Clubs, associations, boards, etc…
  • The secret to referrals is the difference between satisfaction and enthusiasm. 

Things NOT to do pretty please for the love of all that’s holy. 

  • Do not put your office and profits above your patients for any reason ever. 
  • Do not scare patients into care. It’s rude and it’s unethical
  • Do not use curve correction as a reason to manipulate patients into setting up 70 visits. It’s rude, it’s borderline unethical, it makes all of us look bad, your actions really do reflect on the rest of us, and there’s no good, non-biased research backing the notion that curve correction matters at all. 
  • Don’t do dinner with the doctor unless you truly are simply trying to build authority in your community. If you are using them as bait and switches where you get someone in for a $29 initial treatment and then scare the crap out of them to make them sign a contract for $3500 over the course of a year, then YOU are the problem with this profession. 
  • Oh yeah, contracts between doctors and patients do not belong in healthcare. It’s embarrassing. Please stop if you do it and never start if you don’t. 

Just be honest, ethical, put the patient first, behave in a manner that would make the chiropractor next door be proud to be a chiropractor, and take care of your patients by following industry standards for treatment. Keep learning and expanding your knowledge. Be the smartest in your town. The more real, research-backed education you get the better you’ll understand things in the profession and the better you’ll understand how to carry yourself. CCSP, Diplomates, etc. 

Basically, have a moral compass which sums it up.  

So, there’s the quick form of a marketing seminar.  We could spend an hour on each one of these little nuances to marketing and could go on and on and on. 

Again, if any of you want me to put together a more robust marketing talk and have me present it for your group or association, let me know and we can see how we can make it work. 

If you have any questions or ideas, shoot me an email at [email protected]

I hope you’ve enjoyed my marketing talk. I literally sat down and just started typing. Yes, I’m sure I didn’t cover everything as thoroughly as you’d like but, if you’re really paying attention, I gave you some good solid cement to build a base out of. 

Key Takeaways

  • Have a USP
  • Have a marketing meeting regularly
  • Set goals
  • Be honest, ethical, loving, authentic, and don’t sell people
  • Don’t push people and scare care is crap care. 
  • If it takes you 100 visits to help someone, you could get better at what you do
  • Internal marketing means as much as external marketing which means as much as who you are and how you communicate and carry yourself. 
  • Track EVERYTHING

Store

I will hopefully have something in place to help you track metrics soon enough. Also Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at [email protected] if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Closing Patients – Helpful or Destructive?

CF 088: Closing Patients – Helpful or Destructive?

Today we’re going to talk about what closing patients in chiropractic is, we’ll talk about where it comes from, and we’ll talk about if it’s a positive or a negative. Plenty here to be provocative I must admit. Listen up and then make up your own mind. 

But first, here’s that oh how sweet it is bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back with some important information to make you better which makes your patients better. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #88

No research today. Only Opinion. I didn’t even include any sponsors in this episode because it might be seen as controversial to an extent and, if there’s some sort of uproar, I don’t want them in the crossfire. Now….

I believe the business of being trusted and an authority of sorts is to be objective. Regular listeners have heard me talk about the medical realm and failed surgeries, etc. I state over and over that I am a chiropractic advocate. 

I am an advocate. Just listen to all 87 previous episodes and you will clearly see where I stand on the big stuff. BUT, if we do not have the ability or the honesty to police our own, then we’ll never be able to pull out of red-headed step-child status. 

We will forever be ridiculed and mocked. And that’s because the bad apples spoil the whole basket. 

It’s been a while since I’ve been able to just do a brain dump on a certain topic. I think the last time I did that was back when I talked about religion being brought into chiropractic.

I’ve been seeing more and more terminology like this lately and it’s time to address it and meet it head on. 

Let’s get something perfectly straight here: I’m about to piss some people off. Let’s also be clear on the fact that I’m already pissed off so I don’t give a damn if I do. I have been for a while. It’s been stewing and simmering and, after a while, it’s time to talk about it. 

Hell that’s the whole point of having a podcast. Promote what I agree with and find value in and spotlight cockroaches when I identify them. Having a platform to sound off on has been so cathartic. You have no idea. It helps in so many ways. It’s probably why I don’t have to go to therapy. 

As I have said, I am seeing the term ‘closing patients’ more and more and you know what? I’m mostly seeing it from wannabe gurus that aren’t even freaking chiropractors!!! They are trained at spouting their horns and touting their skills but never bought in enough to actually be a chiropractor. No, they just prey on chiropractors. 

Does that register? Closing patients! They’re fine with the term closing and the idea because it’s not their profession, their profession is marketing, so what the hell do they care if they trash the profession and whatever reputation we have scratched out? As long as they continue to fool well-meaning chiropractors into paying them, they don’t give one single damn what it takes.

As I said, the real unfortunate thing is that they go around jazzing up actual real chiropractors to the point that now many chiropractor actually think closing patients is a good and an acceptable idea.

Here’s the thing: it’s black and white. There’s good and there’s evil. There’s right and there’s wrong. Closing patients is straight up 100% wrong. And in my opinion, borderline evil.

I posted on our private Chiropractic Forward Facebook group the other day asking for opinions on closing patients. Good, bad, pros, cons, etc.… I value our tribe and their wisdom.

For a more general opinion, I asked in the Chiropractic Facebook group. That’s what it’s called…..just Chiropractic. You’ll find birds of all feathers in there so I figured I’d get some crazy answers and some in the middle answers. 

I really didn’t though. It seems that most, if not all, were essentially against the idea of closing patients.

Here’s what I got. Some that I highly respect say that if you’re NOT giving good solid recommendations and the telling them what it costs, then you’re not doing your job. 

One colleague wrote that patients want a doctor. Not a friend. Damn straight.

On this, all of us absolutely agree. 

Although a report of findings and recommendations and a financial talk could be viewed as closing patients,  that’s not necessarily what I mean when I refer to closing patietns. Not in my mind anyway. 

Being a doctor certainly comes with the responsibility of telling patients what you think is wrong, what you think they should do to fix it, and how much that would cost. That’s just being an ethical professional regardless of what business we are working in. 

I’m talking about manipulation of information and manipulation of emotions to get a desired effect that benefits the practice more than it benefits the patient. That’s what I’m talking about.

There was a reason I never really got down a good report of findings. It’s because I never felt comfortable with it. It never felt right because it wasn’t me. So I just went to what felt right. That doesn’t mean those of you that are good at a report of finding are doing something bad. I’m referring to a closing patients sort of ROF that I was once force fed. That’s what I’m talking about. 

What felt right was telling patients what I think, what I recommend, asking them if they have questions, and then getting started. It’s pretty damn simple honestly and I have more patients and business than I can handle. 

To tell me that my only way to succeed is to learn tactics and manipulation, we just have to disagree. Our values are not in alignment. Adjust that won’t you? 

I heard one guru say that our job is to identify or uncover what the patient’s pain is keeping them from doing or accomplishing and then leveraging that information against them by focusing on that shortfall in order to make a sale. To get a desired outcome.

Really? That’s what my job is? Are you sure? Because I thought it was to give my patients the very best recommendations that I can based on education and experience and then be there to help and guide them regardless. All these years and I was getting it wrong. All I needed was this 20 something person to help me get it right. Insert eye roll. 

When closing patients in chiropractic, he says we NEED to be focused on it. For example, if a patient comes to us with back pain, that’s not what we need to focus and work them over about. No….we should be working them over about what the back pain keeps them from doing…..THAT’s what they really care about so THAT’S what we pounce on like a grizzly on a salmon.

So, uncovering the ‘pain point’ of a patient just isn’t something I think smart, capable, educated doctors should be concerning themselves with. It’s called morals and ethics. 

They act like being unethical builds the fat wallets so that the fat wallets can further chiropractic. So…..I don’t want that kind of chiropractic being furthered. At all. Not a millimeter. Ever. I want it to die and go away never to be heard from again. 

A previous guest on our podcast, Dr. David Graber up in New Jersey is literally one of the smartest people I know and he had this to say about it, 

“When the Chiropractic profession started relying on business and sales techniques for practice building they did use approaches to ” close the sale” of care to patients. 

It’s a transaction- based approach with a winner and a loser. It’s positioned the doctor-patient relationship as a competition or Confrontation. This became especially prominent with long-term care and prepayments plans.

The alternative is open the relationship rather than close the sale, because there’s nothing to sell. A report of findings now is exactly that, a report of findings and options given. Respect for the patient’s autonomy in decision-making and service over sales. It’s becoming a partner not a competitor with our patients.”

He’s so damned smart. I wish I could have the eloquence to put things the way he does. He makes it look easy. 

What he’s talking about is being patient-centered, not doctor-centered. That’s really the whole point of the whole damn episode I think. Being a partner with our patients is being patient-centered. Not dominating them through whatever means necessary.

If you think some chiropractors’ shenanigans aren’t making it online? You’re crazy. People are posting it everywhere. Names, dates, events, quoting the doctors word for word. Things don’t happen in a vaccuum anymore in the year 2019. 

Here are a couple of stories I found on the interwebs while researching this episode about closing patients. 

This first one is an experience a woman had when she visited the chiropractor. Luckily, she didn’t swear off chiropractors completely after the experience but who could have blamed her if she did?

She preframed this sucker as a cautionary tale to all those who are easily persuaded by emotional sales pitches. She went to a fair and got on one of those spine check doohickeys that checks balance from one side to the other and high shoulders and all that crap. 

The lady told he she was carrying 9 more pounds of weight on one side of the body than the other and her head is 2 inches too far forward and one shoulder is higher causing her head to tilt the other way to compensate. 

All of the sudden, a care-free girl out shopping at the town fair who stopped to have her spine checked for a little fun change-up in her daily routines is thinking, “Oh damn…this sounds awful.”

No worries though, the chiro office offered her a $20 preliminary screening at the center to include 2 x-rays, a spinal exam, a foot screening….the whole shubang, for $20. Awesome. Way to value your services random chiropractor screening at a town fair that has nothing to do with health.

Luckily for this lady, her husband smelled a skunk.  

She went to the appointment, paper work, intial intake with the staff, and then the chiropractor arrives. She asked if she could do a few more exams of the spine. Following this exam, she said in a grave voice that she has some serious concerns about the neck and spine. 

IN FACT, she would like to take two more x-rays than scheduled in order to check out a few other things. She reassured me that I wouldn’t need to pay for these x-rays — they would just send the bill to my insurance, and if insurance wouldn’t cover it, they would eat the cost. 

The patient thought WOW, they must really care about the well-being of their patients to take this financial risk! 

Then, sent home with a follow-up appointment scheduled. Not before the chiro reminder her how urgent it is for her to come back and get treatment started as soon as possible. Makes me want to pull what is left of my hair out of my head. 

She left that first appointment sincerely afraid that there was something seriously wrong that only chiropractic was able to fix. She was leaving that first appointment basically in tears. She didn’t sleep at all that night. She was thinking, “What if I lay with my hnead at the wrong angle….would that make her neck even more crooked?”

Follow up appointment, seated in an education room when whe underwent a lesson in the philosophy of chiropractic. They told her that by the time we feel pain, our bodies are down to 40% health which means that if we feel healthy, we really aren’t. Holy guacamole. Crap fire and just save the damn matches won’t you?

All of our illnesses come down to subluxation which only chiropractic has the answer for, blah blah blah.

Then the x-rays. These are her exact words, “First we looked at the before and after x-rays of people whose lives and health were transformed at the Wellness Center. 

Next we compared *healthy* spines (people who have regular readjustments) with *unhealthy* spines (people who just don’t care about their health and don’t want to live past 65). 

Finally, we looked at the x-rays of a few tragic people who did not get the treatment they needed and whose spines were COMPLETELY COMPACTED. Dr. Amy then asked if I was ready to go look at my films — and I responded by bursting into tears.

She goes on, “When I saw my x-rays, my first thought was, “Wow, it’s not as bad as I thought! My spine doesn’t look like a 70-year-old!” But still lurking was the shadow of what might be — the ghost of future spines, if you will — if I didn’t pursue a full chiropractic treatment plan. 

Dr. Amy and I talked through my x-rays, and I learned that my spine is only at stage one degeneration (something they NEVER see in a 28-year-old!) — in other words, still terrible, but treatable. 

By this time she was fully convinced that 

  1. I needed chiropractic care, 
  2. it should start right away, 
  3. this Wellness Center should be the one to offer this care, and 
  4. it would save my life.

Guess what she got….you just guess! That’s right, she got a 12-week treatment plan, 3 visits a week for the low low basement bargain price of $2,800. 

The office, because they’re so giving and kind and genuinely caring offered her an 18-month payment plan at $140/month. For treatment she didn’t even need in the first damn place!!

Remember, even if you don’t hurt, you’re still sick? Good Lord jumpin’ jehovah. The lady told the doc that she needed to run it by her hubs before signing a contract. Like a contract belongs in healthcare in the first place but whatever. It’s outlawed now. At least in Texas. 

Anyway, the doc told her to come back the next day with her husband so that he could get a free screening with x-rays as well. Lol. These people. The hubs wasn’t buying it. She couldn’t believer her husband wasn’t more concerned that she was 28 years old and already had stage I degeneration of her spine!

He talked her down, she went and finally did some of her own research, and realized she had took a big swig of the snake oil. 

Yes, of course chiropractic could have helped her with her neck that had been a bit sore recently. Yes, a chiropractor’s office was exactly where she belonged. But no, not in an office like that where she was manipulated emotionally and almost financially. 

Here’s a lovely ditty about one of those beloved ‘free dinners with the doc.” Ugh. That’s a whole different episode, isn’t it?

Anyway, here’s what happened. the first thing is that the flyer advertising all but hid the fact that a chiropractor was the presenter. 

Quoted in this article was Robert Puleo of the California Board of Chiropractic Examiners. He said, ““It reeks of snake oil. There are some chiropractors out there who want to make a buck any way they can.” And: “The chiropractor holding such seminars tries to sign people up for months of office visits that can cost thousands of dollars.”

Ummm….yes. Exactly. You think chiropractors keep buying dinner because they’re nice people? Hell no. They’re trying to scare people into a close and a sale. 

The attendee to the dinner mentioned in the article said it consisted of four parts:

  1. Trust building – that’s where the presenter talks about their education and why they’re super double awesome and should be trusted. Can I just say that I immediately do not trust someone giving a free meal to prospective targets? I just don’t. Regardless of education. 
  2. Medicine bashing – This is where they talk about the inefficiency and poor quality of the US healthcare system. You all know the dance. I know that waltz myself. I can tell you all kinds of numbers and frame out the inefficiencies in a bunch of different ways. When it’s there, it’s there and I don’t mind that dance because they don’t mind bashing on chiropractors all of the time. 
  3. The product being sold – he was selling some laser therapy for neuropathy. The same stuff I believe that I just saw where an LA doc was on TV being accused of selling stuff that doesn’t work. Guess what? That dude was selling at a free dinner as well. I just never wanted to be a salesman. I just wanted to be a doctor and help people. Maybe I’m crazy. 
  4. Recommending consultations – Basically come see me at the office for $29 so I can sell you on thousands. Whne the attendee asked how much the laser service costs, he was told, “Oh, the doctor sets that amount.” So…..you can’t just tell me the cost? And…is there a dual fee schedule? Like, the doctor sets different costs? Because it it’s not a dual fee schedule, then the price is already set and, in that case, you should be able to simply tell me the price. Right?

I guess being upfront, transparent, and honest doesn’t quite fit into the dessert menu does it?

Last thing I’ll touch on is the RELIGIOUS ROF – For a more extensive exploration of this, listen to episode #61 of this podcast. It covers it at length but, in short, I’m a Christian so let’s not think I’m an atheist bashing on Christians. That would be a biased discussion wouldn’t it?

This is a non-biased discussion about it so settle down fellow Christians. 

Here is a script from a management company that uses or used a person’s faith against them to close a sale, ““Mary, I’m concerned. I’m really concerned about you. When you don’t continue your plan to remove the subluxations that are interfering with God’s life force allowing it to innately flow from above down through your body in order to heal you, you’re not allowing God to do his part and heal your body. I understand that it’s hard getting here…but I have an opening at 5:30 tonight so we’ll see you then and let’s get you that life-saving adjustment tonight ok?”

You can’t make it up and, as a Christian, I find it dissappointing to say the very least that a fellow Christian would think this sort of manipulation and sales tactics is permissable in any way, shape, form, or fashion. 

It’s just awful. All for the sake of closing a sale. Are we really that desperate? Obviously some at least think they are and maybe there’s no other way to make money. 

You want to know how to build a company? How to build trust in a brand? I’ll share it right here. Instead of the religious manipulation script I just read, say this:

“Mary, I’d never try to tell someone how to spend their money or how to take care of themselves because that’s none of my business. My job is to tell you what I think would be the best for you based on the idea that you live right next door and have no travel concerns, and you have all of the time and money in the world. What would I think would be best for you? Then there’s reality and my job is to be here for you however you want to use me. We don’t hassle our patients about their recommendations. Just do me a favor if you can’t do what I recommend, don’t tell people that chiropractic didn’t work. OK? Tell them you weren’t able to do what the chiropractor recommended. Is that fair?”

See how simple it is?

Look, we all want to get rich while we help change the lives of our patients. But where does the switch happen where it’s OK to work patients to the point of emotional breakdown just so that they’ll sign up for countless visits over the course of a year or more? How does that switch go from being a new doc excited to work with the population into a manipulative street corner huckster schooled in the art of emotional manipulation? 

How does that moral compass get swapped approximately 180 degrees to the point that money is more important than superior patient care? And….reputation. I would argue that your reputation absolutely precedes you. Especially the smaller the town or area that you practice. 

One of my very respected colleagues, Dr. Gregg Friedman, who also happens to be a nationally known speaker, shared this thought with me when I asked about closing, “Closing a patient” looks like a sales technique and makes me want to puke. It does not create a positive image of chiropractic in the minds of the public we strive to serve. Just my opinion.” Spot on, nailed it. 

There are about 45 chiropractors in my area give or take. I know how about 80% of them practice because patients tell me. I’ll bet about 80% of those chiropractors know how I practice. For better or worse. I say worse because they only see my failures and I only see theirs. BUT….we still have a general idea of who the chiros in our area are, how they practice, and if they’re reputable. 

Basically, would you send you brother, sister, or mom to them? How about your child? If you’d send your family member to yourself, maybe you’re in a good spot. I can’t answer that. If you have systems set in place that manipulate information, manipulate a patient’s emotions, and manipulate words to make the practice a lot of money……and you’d still send you kid to that…..we need to talk. 

Let’s dive in a little bit more. Now, those of you that use this, and firmly believe in it, are going to be pissed right now. 

“Who the hell is this guy, what make him think he can question this or that, blah blah blah?”. I’ll tell you who I am. Nobody particularly special is who I am. In many ways I’m no smarter than the people that use some of this stuff. In some ways I am. 

I’m a bit of a research nerd – a dude with what I like to hope is an EDUCATED opinion and I’m a dude with an opinion that just happens to have figured out how to record and air podcasts, build a crowd, and talk about his opinions. That’s all. If you don’t like my opinion, go get your own podcast and crowd, go figure that out and talk about what’s important to you. 

There are already lots of them out there. Go call your company something like Chiro Closers, hustling chiros, chiro shrimp, or cervical correction academy specialist association or whatever the hell you can come up with that gets attention, or sounds important. Hell, I have half a mind to buy the domain www.chiroclosersareus.com and just have a landing page that says, 

“Hey, welcome…I’m not selling you anything. I just want you to know that closing people in healthcare is not patient-centered, it’s not quality care, it’s not being the doctor that you are, and you can be just as successful if you be the doctor, diagnose well, make good responsible recommendations for care, be a partner with your patient in their recovery, be sincere, really really care about them, and then be there however they decide they want to use you.”

Bam….secret to success nugget. 

Right there. If you didn’t listen or zoned off, rewind that about 15 seconds. You don’t have to buy it packaged up a million different ways from wannabe gurus. It’s really so so simple folks.

Back to the point: One of the most common reasons for big money, long-term plans I hear from patients when we’re talking about their previous chiropractor was that they saw an x-ray of their neck and it was straight. And to get that curve back, it was going to take 65 visits over 14 months at a cost of $4,500 (I’m making those numbers up but you get the point). All to get that curve back. 

Now, can we be honest a sec? You can go tell me to jump in the river. You can tell me I’m only about treating pain..and you’d have a fair point… You can call me a medipractor. You can call me whatever names you like but be serious, thoughtful, and maybe even non-philosophical for a minute. 

I believe, and my experience suggests, that a straighter curve is a consequence of simply being alive for a whole bunch of years. I believe that not having a curve when a patient is 50 years old is NOT going to impact their lives so much that they need to pay me as much as a surgical co-pay would be for surgery? What if I improve the curve a few degrees? Is it really that big of a deal that made that big of a difference?

The ONLY research I’ve seen on straight necks that made much sense was more recent. We covered it here on the podcast. It said it may lead to some degeneration of I believe it was C6/7 but, overall, impact of it was minimal. 

Other research you may have seen on this may come from other gurus that have conducted their own research. 

How nice is it to be able to say you conduct your own research, not have it peer reviewed or published in any respected journals, and then say it backs up your method so that people buy your products? That’s nice. Funny how that stuff works right? And so convenient. 

THAT’S what I mean by manipulating information. 

Let’s re-visit the title of this episode. Just repeat it a time or two. Closing patients. Let’s add a couple of words. Closing patients on care.

For me, that’s an oxymoron. If you care, are you going to manipulate patients with words and emotions? The correct answer is hell no you’re not.

Put yourself in the patient’s place real quick. 

Do you, in a healthcare setting, EVER wish to be closed? Other than an incision of course…. as my good friend Dr. Tyce Hergert in Southlake, TX says. Lol. 

The answer is no. At least I sure as hell don’t want to be closed. Not under the fear of losing my ability to function 30 years in the future. Not under a fear like that that no research I’ve ever seen can back up. 

As mentioned above, you want to be told what is wrong, you want to know how to fix it, and you want to know how much that costs. You might be interested in any other treatment options as well. You might want to know if you could just undergo a trial period of treatment first to see how you respond to care before deciding on anything else.

ALL OF THOSE should be on the table and your patient should know that, at the end of the day, your job is to be the doctor and give them your best recommendations while also understanding that you are there to help them to the best of your ability regardless of what they decide. 

Again, we should be our patients’ partners, not their boss, not dominating them, not running the show regardless. 

In the end, remember the three pillars of a patient-centered, evidence-informed practice. They are of course, 1) the best external evidence, 2) individual clinical expertise, and 3) get this…..pay attention….patient values and expectations. 

Not the doctors values and expectations. 

Key Takeaways: be a partner with your patients. Do not be a domineering, street corner snake oil salesman. Please. Those that do this give all of us a bad reputation. I have gone through the DACO diplomate program. Countless chiropractors around the globe highly educate themselves and take great pride in the results they can get for their patients. 

When you go about business like we’ve been discussing here, you discredit all of us almost immediately in the minds of those patients. Who then turn around and tell their family and friends and then go and post it on their blogs or tell a TV reporter about it who then tells everyone in the world in one way or another. 

Cut your crap. Enough is enough. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

CF 058: The Patient Experience, Lumbar Stenosis, & Fibromyalgia 

CF 058: The Patient Experience, Lumbar Stenosis, & Fibromyalgia 

Today we’re going to talk about the patient experience being more important than your marketing, we’ll talk about some research from JAMA on lumbar stenosis, and some research on upper cervical manipulative therapy on fibromyalgia. 

But first, here’s that bumper music

Integrating Chiropractors

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have clumsily stumbled into Episode #58 knocking lamps off of the end tables and generally making a mess of the place.

DACO

As with every week, let’s talk a bit about the DACO program and my progress. I was doing the Communication Drills but they kept referring to eLearning Episodes. So let’s break that down a bit real quick for those interested in the program. The bulk is made up of 40 Diagnostic Drills, 46 Communication Drills, and 17 eLearning Episodes. 

You get 2 hrs credit for each Diagnostic or Communication Drill and you get 3 hours credits for each eLearning Episode. 

Now, since Communication Drills kept referring to eLearning Episodes, I figured I would switch focus and go through them and then return to the Communication Drills. Still with me?

The eLearning Episodes are very much video based on a downloadable worksheet to take notes on. I take notes digitally though so I’m still getting my angle of attack down on these and how I want to best tackle them and have great notes I’m getting it figured out. 

DACO Classes

So far, I’ve taken classes on Adjusting locally and thinking globally about how a cervical adjustment can affect even the low back. The neurology is amazing. A class on blurry vision from a pain in the neck. Again, the neurology people. I don’t know how I made it day to day before this stuff. Then last weekend I took one on making sense of a headache. 

Outstanding information and all lined up to make you better, make you wiser in your decision-making, and making you a better communicator with your patients and colleagues. 

If you’re waiting to get started on the DACO, get started. I’ll be glad to help you if you’ll email me at [email protected]

I’m about wrapped up with some cool stuff that you all may be interested in on our website at chiropracticforward.com. If you’ll go there and sign up for our newsletter on our home page, I’ll be able to let you know all about it when it’s ready to roll out.   

Great week for listens Y’all. Thank you for tuning in. Everyone loved Dr. James Lehman’s episode. That was a big one for us! If you missed it, it’s episode #55. Candy for your ears. I see that sucker being the number one listened to podcast pretty quickly. 

Onto the Discussion

Let’s get to trying to make your practice better. This first one we’ll discuss is titled, “Patient experience five times as likely to drive consumer loyalty as marketing” by Christopher Cheney with HealthLeaders(Cheney C 2018). It was published on December 28, 2018. Once again, I know you dig the new stuff. 

If you’re getting after it. If you’re hustling, then you’re marketing. Marketing isn’t something you do once, is it? Oh no, it isn’t. It’s something you do every damn day if you’re doing it effectively. It’s exhausting, isn’t it? But it can be fun too. 

Marketing

Isn’t it fascinating that just changing the color of the border on your marketing material has the potential to elicit a different behavior from the recipient? Or changing the color of the shirt that the person in the ad is wearing affects the response rate? It’s amazing. But, it’s also exhausting to contemplate all of the different combinations of possibilities of words, colors, placements, and all of that crap. 

Good grief. You could make yourself crazy and how many chiropractors usually have the budget to hire a full-time marketing person that actually had a marketing degree? Not many would be the answer you’re looking for if you were confused on that. It was more rhetorical than anything. 

Here in this article, Mr. Cheney says that the patient experience while in your office is the primary driver of patients’ consumer loyalty at health systems, hospitals, and physician practices. He based this information on a recent Press Ganey report I would normally link for you in the show notes but it looks like a bit of click bate. As in leave your email and get the report crapola and I’m not doing that to my peeps. Ain’t nobody got time for that. 

Hell, I can hardly get you guys to give ME your email address and most of you are loyal listeners! Lol. 

Consumer Loyalty

Anyway, he says that consumer loyalty is vital for not only your profit at the end of the month but also helps you take better care of long-term patients with multiple chronic illnesses. 

Hell, that’s why we got into this business; taking care of people. I have to say that if you got into this business to get rich, you’re taking the long way around buddy. Lol. Most of us got into this business to take care of people when nobody else was able to get results with them. And then hopefully keep them that way!

Here’s what raised my antennae straight up, he said, “Patient experience is FIVE TIMES more likely to influence brand loyalty than conventional marketing tools such as billboards, or television, print, or radio ads.”

WHAT?

What was that? Let me repeat that just in case my DACO talk put you to sleep. Hey, wake the hell up and listen to this. “Patient experience is FIVE TIMES more likely to influence brand loyalty than conventional marketing tools such as billboards, or television, print, or radio ads.”

That is astounding. Of course, some of you already had this figured out and being 20 + years into this dealio, I have it figured out to an extent as well but FIVE TIMES more effective than billboards, TV, print, or radio?

I did NOT have that much figured out. Do you know how I know I didn’t have all of that figured out? Well, it’s because I am spending too much damn money on all that crapola. They interviewed over 1,000 adults on this survey. 

I do have it figured out to the extent that I tell my staff that we are certainly in the healthcare business but they’re fools if they think we are not also in the customer service business. You better believe it. I tell them that I’d much rather a patient leave feeling the same but feeling great about the people they met and the experience they had here and feeling hopeful about what we can accomplish with them as opposed to them leaving my office sore because I either rushed through the appointment or thought we’d equate appointment success with a popping noise and pushed so hard that I finally got a pop sound but ended up making the patient feel worse. 

That goes for the front desk too, doesn’t it? They’re the first point of contact and the last point of contact. If they’re not friendly when people come in and greet them warmly and are very welcoming, well….we’re already behind the 8-ball there and had better make up some ground in the back of the office. And when they leave…..oh nobody likes to pay their own money out of their own pocket and they damn sure don’t like to pay it to someone they don’t like personally. 

Here is a quote from the report, “Healthcare organizations can tap the power of patient experience, the report says. “To harness that influence, providers should capitalize on the power of word-of-mouth marketing by viewing the patient experience as an essential part of their acquisition strategy. By gaining a deep understanding of what gets people talking about positive patient experiences, identifying opportunities to advance the conversation and disseminating key information, healthcare systems can naturally align the mission of delivering safe, high-quality, patient-centered care with the business of acquiring and retaining consumers.”

The Big 4

They went on to line our 4 Big One’s that should be a part of any healthcare facility’s strategy for getting and keeping patients. They were:

  1. Give every patient a voice – They’re not just talking about listening to them when they visit your office and tell you about their conditions. They describe delivering surveys via text and email as well as the standard outreach protocols. 
  2. Identify factors that drive and erode patient loyalty. They say to really know where you can improve, you gotta know positive loyalty metrics on things like the likelihood to refer or recommend your office to their network of people. Imagine man, being a former member of BNI, they teach that each person, whether they know it or not, has a network of 250 people in their lives. I get 55-65 new patients per month. That’s 13,750-16,250 potential work of mouth contacts that can either hear the good about our office or, if we allow them to catch us on bad days….that’s up to 16,250 people that can hear bad things about us. You can see why it’s so important to have positive patient experiences in your office just as often as you possibly can. Especially in the days of social media. There is no room for ego, for talking down to your patients or scolding your patients, or any of that crap. Patient-centered is more than an idea, it’s how you’d better be carrying yourself. 
  3. Use natural language processing to analyze comments. What the hell does that mean? Well, they say that it is language that allows aggregation of comments into clear brand equities and liabilities, allowing for proactive management of both experience and brand. That sounds like an overly wordy and annoying resume if I’m being honest. Basically, it’s using computers to analyze emails, customer feedback forms, surveys and things like that to identify the root cause of customer dissatisfaction or, we hope, customer satisfaction. I’d like to lead you further down this path but, obviously, I have more to learn on it myself. 
  4. Post ratings and reviews in physician profiles. Ensure that future patients have the most convenient access to all information they seek by including comments – both positive and negative. I can’t deal with negative comments. They hurt. Lol. 

Reviews

They also say that you need to be earning quality reviews online for Yelp, Google, Facebook, and all that good stuff. If you don’t know the value of reviews at this point, you just might be a lost cause. Lol. 

They also say you must address negative reviews online in a professional way while understanding that negative reviews are an opportunity to learn and improve. 

But, when it’s not right and borderline illegal, I believe it’s OK to have your attorney contact the person leaving that negative review. Here’s what happened. We offer a service. Not chiropractic but a service that a girl that treated here for some time decided she would begin offering here in town without being certified in any way to perform. 

OK, annoying for sure but then she, one of her little buddies and her boyfriend go online and leave us bad reviews for the exact same service. So there we were with 80 or so 5-star reviews. Not one negative review. And then three 1 star reviews popping up out of nowhere. Nope, she got a call from my attorney and they went away very quickly. 

Ain’t nobody got time for that crap, right? I know I don’t and I have little tolerance for people that want to try to tear down something others have built just to try to further themselves. 

Before my face gets too red and I start to stutter, let’s move onto the next topic. 

Next Paper

This next paper is called, “The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.” The lead author on this one is Ibrahim Moustafa and it was published in Rheumatology International in July of 2015(Moustafa I 2015). 

And can we just stop a second appreciate the last name Moustafa? Can we do that? Holy cow, if I had a good head of hair and a last name like Moustafa, I’d have the world on a leash ya know. But I don’t have good hair and my name is Williams (so boring) so let’s move on. 

Why They Did It

The aim of this study was to investigate the immediate and long-term effects of a one-year multimodal program, with the addition of upper cervical manipulative therapy, on fibromyalgia management outcomes in addition to three-dimensional (3D) postural measures.

It was a randomized controlled trial with a one-year follow-up. 

What They Found

The addition of the upper cervical manipulative therapy to a multimodal program is beneficial in treating patients with fibro.

I threw that one in for you Upper Cervical guys. You’re getting some love when it comes to treating fibro and I know fibro sufferers will appreciate that. 

I think, after learning more about the upper cervical spine in the DACO course, that it’s fascinating to think about. There is so much going on in the upper three segments in terms of sensorimotor and proprioception that it just blows your mind. 

Last Paper

OK, on to the last paper. This one is called “Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial(Schneider M 2019)”. It was authored by Michael Schneider, DC, Ph.D., Carlo Ammendolia, DC (who we have covered here before for stenosis), and Donald Murphy, DC et. al. It appeared in JAMA on January 4, 2019, and here’s how it goes. 

Why They Did It

The question to answer for them was, “What is the comparative effectiveness of 3 types of nonsurgical treatment options for patients with lumbar spinal stenosis?”

Now the 3 types of protocols they tested were medical care, group exercise, and manual therapy/individualized exercise. 

The medical care consisted of medications and/or epidural injections. 

The group exercise classes were supervised by fitness instructors in senior community centers. 

The manual therapy/individualized exercise consisted of spinal mobilization (because it works and is awesome I assume), stretches, and strength training provided by chiropractors and PTs. 

A combination of manual therapy/individualized exercise provides greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercises, although all 3 interventions were associated with improvements in long-term walking capacity.

Integrating Chiropractors

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient.

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out.

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

 

Bibliography

  • Cheney C (2018) “PATIENT EXPERIENCE FIVE TIMES AS LIKELY TO DRIVE CONSUMER LOYALTY AS MARKETING.” HealthLeaders.
  • Moustafa I (2015). “The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.” Rheum Inter 35(7): 1163-1174.
  • Schneider M, A. C., Murphy D, (2019). “Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis A Randomized Clinical Trial.” JAMA Network Open 2(1): e186828.

CF 045: Harvard Health, Low Back Stenosis, Allergy Autism

CF 016: Review of The Lancet Article on Low Back Pain (Pt. 1)

 

CF 052: Chiropractic Forward Podcast Year One Review

CF 052: Chiropractic Forward Podcast Year One Review

One year. I started this podcast exactly one year ago. 52 weeks. 52 episodes. We’re going to talk about the highlights of the first year. We’re going to talk about chiropractic today vs. chiropractic when I started a year ago. Has anything changed? The short answer is yes. Quite a bit has changed in just a year. 

But first, here’s that sweet like honey bumper music

Integrating Chiropractors

Welcome

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #52 and it feels good to say that. To be able to do anything consistently for a year straight, every single week, it’s an accomplishment for sure and it sure as hell feels good folks. 

DACO Program

Before we get into the highlights. let’s talk a bit about the DACO program. For those new to the Chiropractic Forward Podcast, I have been going through the Diplomate of American Chiropractic Orthopedists. I’m 92 hours into a 300-hour course. Ugh…that hurts just to say it. Lol. I don’t even feel close to being done. 

I figured it out that at the rate I’m going now, which is about 8 hours per week, I can be done around May I believe. While it seems way off, you know what? I’d be learning and educating myself anyway. Why not get something out of it, right? That’s the idea and May will be here before you know it. 

Hell, it seems like it was Summer just a couple of weeks ago. Lol. 

Products

I have been fast at work preparing some new options for you. I have noticed  a lack of what I would want in my office when it talks 

One-Year Anniversary

Let’s get on to talking about our one-year anniversary. I want to start by talking listen out our top 10 episodes so far and what we talked about that made everyone listen to each of them. I’m linking them all for quick reference in the show notes. So away we go!

Number 10

Episode #30 – Integrating Chiropractors – What’s It Going To Take? We discussed the medical field and what they are looking for in a chiropractor in regard to integrating that individual into the system. We went over The Lancet papers as well. Great episode to check out. 

CF 030: Integrating Chiropractors – What’s It Going To Take?

 

Number 9

Episode #25 – Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone. This episode revolved around a paper in JAMA from Dr. Christine Goertz where she and her co-authors showed additional support for including chiropractic as part of a multidisciplinary team for treating low back pain. Great paper by a great asset for chiropractic. 

CF 025: Vets With Low Back Pain. Usual Care + Chiropractic vs. Usual Care Alone

Number 8

Episode #28 – Will Chiropractic First Finally Take Its Place? In this installment, we went through a paper that showed non-pharma and non-opioid therapies are now the preference. Well, that’s chiropractic, right? We talked about some GREAT resources in this episode including the President’s Commission on Combating Drug Addiction and The Opioid Crisis report as well as a great paper by Jon Adams Ph called The Prevalence, Patterns, and Predictors of Chiropractic Use Among US Adults. That one had some marketing nuggets for the nugget pouch.

CF 028: Will Chiropractic First Finally Take Its Place?

 

Number 7

Episode #27 – Wanted – Safe, Nonpharmacological Means of Treating Spinal Pain. This episode went through treating spinal pain, thoracic manipulation, lumbar manipulation, guidelines from Canada, and the perceptions of our profession. We discussed a paper about how some in the medical profession think chiropractors go around herniating discs all the time. Pfft… 

CF 027: WANTED – Safe, Nonpharmacological Means Of Treating Spinal Pain

 

Number 6

Episode #9 – With Dr. Tom Hollingsworth of Corpus Christi, TX called The Case Against Chiropractic In Texas. We talked with Dr. Hollingsworth about the Texas Medical Association’s attacks on Texas Chiropractors and our rights. We talked about the latest in the current court case and the appeal process. 

Just a couple of weeks ago, in fact, this case had a decision that was reached and it wasn’t good for chiropractors. And I’m talking about chiropractors nationwide. We’ll have to do an updated episode with Dr. Hollingsworth because what may be on its way down the pike for all chiropractors…..well….let’s just say it’s no bueno. 

CF 009: With Dr. Tom Hollingsworth: The Case Against Chiropractic In Texas

 

Number 5

Episode #26 – Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues. The title is accurate. And researched fact. There are some that don’t like that language. Can’t we all get along? That type of deal and yes, we can all get along. Most certainly. My issue is with PTs being the first referral for non-complicated musculoskeletal issues when research shows they have decreased effectiveness when compared to chiropractic care. 

They have less patient satisfaction when compared to chiropractic care as well. In addition, research shows chiropractic care to be a lot less expensive. So why in the hell is a practitioner that is exponentially more expensive, much less effective on their outcomes, and patients don’t like as much…..why the hell are they the first referral? That still makes my pee hot when I really really think about it. It’s dumb. 

I don’t think we should be doing post-surgical rehab unless we take specific training in that. I think PTs and DCs can work very well together but there should be lanes and I don’t think PTs stay in their lane. Not when they’re out there taking a weekend course on adjusting. It’s BS and that doesn’t stand for Bad Students. 

CF 026: Chiropractic Better Than Physical Therapy and Usual Medical Care For Musculoskeletal Issues

 

Number 4

Episode #29 – With Dr. Devin Pettiet of Tomball, TX, still the President of the Texas Chiropractic Association. This episode was titled Is Chiropractic Integration Healthy For the Profession? We talked with Dr. Pettiet all about chiropractic integration into a medical based case management or medical team. 

This one was one of my favorites too. For sure. Devin is a great resource and a great personality. He’s all energy and has an awesome amount of information and experience.

CF 029: w/ Dr. Devin Pettiet – Is Chiropractic Integration Healthy For The Profession?

 

Number 3

Episode #6 with Dr. Tyce Hergert from Southlake, TX. This episode is called Astounding expert Information on Immediate Headache Relief. This one was all about headaches and highlighted one service that was dressed up and parading around as another. Yes, those pesky PTs are moving in on us and this episode talked about little bit about that along with some great papers showing chiropractic’s effectiveness with treating headaches. Fun episode. 

CF 006: With Dr. Tyce Hergert: Astounding Expert Information On Immediate Headache Relief

 

Number 2

Episode #13 – DEBUNKED: The Odd Myth That Chiropractors Cause Strokes. My favorite episode and my favorite endeavor as far as really putting together information to stick a fork in an anti-chiropractic idea or myth. This is actually a three-part series consisting of #13, 14, and 15. All three episodes really paint a picture of foolishness on the part of the medical field and a coordinated attack that is easily put to rest through common sense, correct context, and research. 

It’s really so simple when you take the time to listen, learn, and just think about it for a minute. They are the three episodes I encourage you to share the very most out of all of them I have created. 

CF 013: DEBUNKED: The Odd Myth That Chiropractors Cause Strokes (Part 1 of 3)

 

Number 1

Episode #11 – called It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring.

The most listened-to episode for our first year was Episode #11 once again with my old friend and colleague Dr. Tyce Hergert down in Southlake, TX. He has TWO episodes in the top 10 from our first year. That’s because he’s smart, he’s the ex-President of the Texas Chiropractic Association, and he’s entertaining if he’s had his coffee. 

In this one, we talked about current healthcare guidelines, why they matter to chiropractic patients and even non-patients, and whether MDs are getting it or not. Guess what? They’re still ignoring these guides!

CF 011: With Dr. Tyce Hergert: It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring

 

Wrap Up

So….there you have it, folks. That’s our Top 10 in a nutshell with all of the links in the show notes. We have had a great first year. We hope you have enjoyed the content we have been bringing to you as much as we have enjoyed gathering it for you. 

There is so much going on in our profession. Both good and bad. It’s important to stay plugged in now more than ever. We’ll talk about it in a future episode but the Texas Chiropractors lost their appeal and the medical kingdom will bring their dog and pony show to your state before you know it. Believe me. 

But, for evidence-based chiropractors, there’s still no better time than today to be a doctor of chiropractic. I firmly believe that to be the truth.

Integrating Chiropractors

 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point: 

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

https://www.chiropracticforward.com

Social Media Links

Chiropractic Forward Podcast Facebook GROUP

Twitter

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TuneIn

About the author:

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger