The 8 Steps to Have Your Patients Happily Stay, Pay and Refer!

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2 Page 2 The 8 Steps to Have Your Patients Happily Stay, Pay and Refer! " " " By Dr Russ Rosen and Dr Angie Meyer" " " " " All rights reserved. No part of this book may be reproduced or transmi:ed in any form or by any means, electronic or mechanical, including photocopying, faxing, ing, pos=ng online or by any informa=on storage and retrieval system, without wri:en permission from the publisher. " "

3 Page 3 " Table of Contents! Introduc=on 4 Chapter 1, 3 Pillars and 5 Systems 5 Chapter 2, System 1 - Headspace and Personal Growth.. 8 Chapter 3, System 2 - Opera=ng System and Dream Team 19 Chapter 4, System 3 - Communica=ons/PreConsulta=on 28 Chapter 5, Visit 1 Doctor s Consulta=on. 36 Chapter 6, Visit 1 Doctor s Examina=on.. 40 Chapter 7, Visit 2 Report of Findings.44 Chapter 8, Daily Interac=ons.. 53 Chapter 9, Re- evals Re- reports.. 65 Chapter 10, System 4 - New Pa=ents.72 Chapter 11, System 5 - Flow and How to Handle Growth 81 " "

4 Page 4 Introduc)on The purpose of this book is to help you rise to become the very best chiropractor that you can be. It is very likely that if you follow the steps in this book you can expect to have a greater influence in your community, increase your collec=ons whilst also decreasing your stress and =me at work. When you u=lise the strategies that we show you in this book you ll have a reproducible and highly effec=ve blueprint that will allow you to effortlessly have your pa=ents happily stay, pay and refer. I know this might sound like a stretch, it used to for me too. That is, un=l I uncovered the 3 Pillars and 5 Systems that we will dive deep into throughout this book Before we go any further, let me tell you what this book is not: - It is not promo=ng any get rich quick scheme - It s not about sleazy or cheesy high pitched sales pressure campaigns - It s not about pa=ent scare and manipula=ng pa=ents into care they don t need or want. If you are a real person who s got some skill, genuinely cares, has the ability to help others and the willingness to work for what you want, this book is for you. "

5 Page 5 Chapter 1 3 Pillars and 5 Systems Dr. Russ Rosen: Aloha! This is Dr. Russ Rosen and with me I have Dr. Angie Meyer. Today we re going to talk about the three pillars and five systems to pay and refer for a life=me. There s a tremendous amount to this. We ll start with the three pillars. We talk about the three pillars and that s head space, congruent strategies and con=nuous right ac=on. If we want to have success and we want to run a successful prac=ce the only way we re going to pay and refer for a life=me is if they re having a great experience and they re gefng their needs met and we re running a successful prac=ce. We need to 5have these three pillars down. The first one is head space. All we really mean by the term Headspace is that we re very clear inside our head, what our goals are and what we re trying to accomplish with people; and that philosophically we know who we are and what we do. So in the category of headspace we are really talking about those things that go on inside our head. And we re going to talk much more about that in just a moment. We then need to make sure we have congruent strategies. So I m sifng here in Maui right now and Angie is sifng out there in Canada if I want to get from here to Canada, I can have a strategy which is I m going to go out to the beach and I ll start swimming and hopefully I ll end up over there, probably not a great congruent strategy. Or I can have a very clear

6 Page 6 congruent strategy; I m going to get on the plane in Maui that s going to take me over to LA. LA is going to take me to Canada. I m going to get on a bus. I want to have a congruent strategy. Once we re clear in our head and we know what our goals and our objec=ves are, we want to have very clear and congruent strategy. The challenge is for most of us our strategies are not congruent. Some of us are not clear of what we want in the first place. But those of us who are clear about what we want when we really look at our strategies, they don t get us there. They don t actually work. Then the third of the three pillars is con=nuous right ac=on. This is where a lot of people simply blow it because they start to do a good job on one piece and they stop spinning that plate and they start spinning another plate and all of a sudden all of the plates start crashing down. If we want to have a successful prac=ce, the three pillars are clear and we must have all three. Congruent head space, congruent strategies and con=nuous right ac=on. Now, we re going to look at the five systems. So if I want to pay and refer for a life=me they ve got to be having a tremendous experience so they re happy to reach into their pockets and pay us for care. And they can t wait to tell their friends and their family about the wonderful experience that they re having.

7 Page 7 The five systems that we look at are: 1. Headspace and Personal Growth 2. Opera=ng System and Dream Team 3. Communica=ons 4. Marke=ng and New Pa=ents 5. Flow and How to Handle Growth Those are the five systems that Angie and I are going to dive into right now. Angie, why don t you start to take us through some of the things we need to be clear about in System 1 which would be head space and personal growth so people want to stay, pay and refer for a life=me?

8 Page 8 Chapter 2 System 1 Headspace and Personal Growth Dr. Angie Meyer: Sure thing Russ. I think when it comes to head space, a place that chiropractor s miss the most is star=ng with the big picture and the end in mind. The first thing and we hear a lot throughout the profession and in the business world is about mission and vision, and it gets really complicated! I really would like to simplify it here. I can t speak enough to gefng a crystal clear vision of what you re actually trying to accomplish. I would describe vision, if I was going to use one word, it would be your what. What am I trying to accomplish in my prac=ce, and at the end of my career? What is the point of my prac=ce en=rely? What end am I trying to reach? Many =mes people just have a prac=ce, they show up day in and day out, and it feels like they re running on the treadmill. Having an end in mind of what you re actually trying to achieve can be that big picture. It is our vision and our head space that makes us a:rac=ve and keeps us mo=vated during =mes where either it gets tough, or it keeps us excited to reach our goals. Vision is really what you re trying to accomplish. So, if your vision is what you re trying to accomplish, your mission is how you re going to do it. So this is really simple in a chiroprac=c realm. It s really chiroprac=c care and whatever else you do, whether it s educate about lifestyle choices, empower people to get healthy and stay healthy

9 Page 9 etc. However you are going to accomplish your vision, is your mission. We don t want it to be too long. We don t want it to be really wordy and lots of abstract ideas. The more clear, concise and concrete you can make your mission, the be:er. It should be something I can call you up in the middle of the night and you can say to me half asleep. Not, Let me go to the office and find that paragraph deep in the drawer. Vision is what you re trying to accomplish and mission is how you re going to do it. Your purpose is your why. Why did you become a chiropractor? Why do you want to accomplish your vision so badly? Why do you work so hard at it? Why do you get up out of bed every morning? So, it s really important from a purpose perspec=ve, that your purpose be really solid so that you spring out of bed excited for your vision and your mission. Next is your culture. I think this is an important one that many of us don t define. It s defining the environment, what realm are we going to operate in? What kind of experience do we want to offer as a prac=ce, for our pa=ents or patrons? Iden=fying what culture and what working environment you want to operate from and serve from, is really important point.

10 Page 10 Lastly is your values. These values are your guiding light. They re your North Star. So iden=fy these values. Every decision comes back to your values so that you can decide whether to hire or whether to fire, or whether or not to do specific marke=ng based on your values. This is a very important aspect. Dr. Russ Rosen: Really clean and concise. That is great. Here s the challenge. Most doctors don t get it. They don t take the =me to get very clear in their head about vision, mission, purpose, culture and values. You know Albert Einstein was right when he said, Energy precedes form. So when we re coaching people we re always looking at head space and procedure. And usually we need to work on both of them. So again, this whole beginning part is to get clear in our head so we can then come up with congruent strategies or procedures. Some of the things we need to get clear about in our head are the business. So, what is your business and what is your product? You need to answer ques=ons like, Who are you and what do you do? What s the product that I m bringing out to the marketplace? Is it ice cream? Is it t- shirts? Is it neck pain? Is it op=mal health? What products are you bringing to the market? You and your team want to get clear about what problems you re trying to solve. What solu=ons are you trying to generate? Why would somebody want to see you? Why would they want to con=nue to see you

11 Page 11 and stay, pay and refer for a life=me? Those are really good ques=ons that you re going to want to get clear about. From there, you can start to come up with clear goals and clear objec=ves. And of course, you re going to need to have ways to monitor those goals. One of the things we talk about is, Am I just trying to get people out of pain? Is it more about op=mal health? Are we trying to help people get healthy, stay healthy and have the best life possible? You need to get very clear about it in your head. If my product is I help people get healthy, stay healthy and have the best life possible, the next ques=on would be, how do I do it. For us it s simple, correct the nerve interference or subluxa=ons and show them ways not to recreate it. If we were to accomplish that, what could they hope for? Well, they could hope to feel be:er. They could hope to prevent problems in the future, reverse the effects of the aging process in other words, be healthier in five years than they are right now, and have a be:er life. Is that a product I can go to the market with? Absolutely. Classically, Angie and I will ask people what s your product and we ll hear answers like love, hope, good feeling. You can t go to the market with those. So you got to get very clear. And of course depending upon your niche market, you might have a different story if you re working with athletes, if you re working with the elderly, if you re working with children, if you re working with families, if you re working with Olympic

12 Page 12 athletes. You might have a different product that you re going to sell. But again, those are things you want to be extremely clear about. Angie, what are other head space issues? Dr. Angie Meyer: You know you re absolutely right. I think certainty is the absolute founda=on. I think along with certainty comes, which you touched on, how I measure my outcome. So, once I m clear on what my business and product is, how do I know that I achieved it? How do I know that we got there? And if I didn t, what are we going to do? Another one that s so key is that not just that the doctor has the right head space, but the en=re team has the right head space, procedures and ac=ons. So those three pillars are so important and it s not just the leader of the prac=ce being the doctor/the owner, but it has to be to be all the associates, all the CAs the en=re team! We ve got to ensure that they are just as mo=vated, just as congruent in their head space and procedures and they know exactly what ac=ons to take. Many people have a love- hate rela=onship with goals. Generally we find that doctors are are gunshy about sefng goals. And that our bigger goals are not aligned with smaller ones and ac=on steps to reach them. So we ve got to set some SMART goals that are specific, measurable, a:ainable, realis=c and =me bound. They got to align with bigger annual goals.

13 Page 13 Where most people fall down in reaching their goals is just in that third pillar of ac=on. We set a goal for three months or six months or a year out and we don t break down what has to happen every day, every week to get there. Classic example of someone wan=ng to lose 20 pounds or 10 pounds, that s such a big chunk no pun intended that we can t see What s that going to look like today? What am I going to eat today? How am I going to burn calories today? What am I going to do to build strength today? Many =mes people are good at sefng goals and they may or may not be SMART goals. They re certainly not aligned with bigger goals but we usually don t break down the exact ac=ons that go along with it. Something that we coach people on all the =me is their level or organiza=on. How organized is your life? It s not just our en=re prac=ce that needs to be very organized having a system for everything, but open=mes we don t have the systems to manage our life! As a chiropractor you wear a lot of hats in the prac=ce. Especially if you re an owner as well, there s all this admininstra=ve stuff, marke=ng, staff and leadership and pa=ent communica=ons. And you re a mom or a dad, you re a spouse, you re a friend, you re a brother or a sister. You re involved in the community. If we re not structured and organized, we are in survival and we don t have space to take on more. We become run-

14 Page 14 ragged and we re ineffec=ve as human beings, not just in our prac=ce. Any state of overwhelm shuts off the capacity for growth. I find that many chiropractors, from a head space perspec=ve, don t have the ability to dis=nguish working in my business, so doing the tasks of the admin or doing the tasks of adjus=ng. But many of us don t schedule a =me in the grand scheme of things to work on our business. When am I doing my vision, my strategy, my planning and execu=ng thse things? When am I working on my business? And so many of us are overwhelmed working in my business because you don t have a system or not organized. We can t possibly find =me in that survival mode to work on the business from a bigger perspec=ve. For me, personal schedule and self- management is such a big part of actually being able to be organized and have a system for everything. One of the wisest things I ever read, I think it was from the author Tim Ferris. He said something like, You cannot manage =me, you can only manage yourself. We all only have 24 hours in a day and many people who are high performers who get a lot accomplished in the same 24 hours. And when we re coaching people and they say, Well, there s just not enough =me. It really comes down to how we manage our self within that =me. It s about sefng up systems and structures so that we can manage ourselves well and be really successful and be high performers.

15 Page 15 Another big perspec=ve I think to look at when it comes to head space and it probably should have been men=oned earlier in the coversa=on, is having tools to deal with the nega=ve or limi=ng beliefs. We can t emphasize enough how much that affects your energy, which affects your state of a:rac=veness. So if we have limi=ng beliefs (which we all do) that we developed as young people, they have held you back your en=re life. They certainly are holding us back in prac=ce. We have got to look at tools to turnaround those beliefs so that they can actually be produc=ve. We need to have our head space be suppor=ve and make us a:rac=ve and energe=c, instead of something that s always going to self- sabotage our best efforts. Dealing with those nega=ve and limi=ng beliefs that we all carry around is such an important part of head space because it s like driving around with the emergency break on. It s holding you back! Looking at the concept of the glass ceiling and how we limit our selves with our headspace is important to see the impact. Many of us have internal thermostat where we have an idea of what s possible and we limit our self with this glass ceiling. So it s really important that we address that and be able to break through it to really reach our goals. We have an amazing hour interview with Dr. Russ, Dr. Tony Croke and Dr. Angus Pyke that we will share with you. It can change your life so don t miss this one. Just go to

16 Page 16 A big one that I believe affects chiropractors, especially if we re going to prac=ce in this op=mal health realm, is that we need to be leaders and lead by example. We need to lead by example in the community, lead by example with our own health. We ve got to make sure we ve got high reserves, we have low stress in our physical realm, our emo=onal realm, our mental and spiritual realms. We must take care of ourselves like we re high performers. That means having down=me and taking rest. It means performing more like a sprinter when you re in the prac=ce and then having that down=me of rest and recovery. Instead of like a marathoner who just goes and goes and goes at a slower pace for a longer =me. It means being really healthy. And if you re not there, I really suggest from a congruent place that you do everything in your power to start to lead by example when it comes to personal health for you, for your pa=ents and for your community. You can lead by example in becoming more healthy, by being on a similar journey as your pa=ents are. But either way you need to own it, and lead. Last but not least, I think we ll hit on beliefs about money. Many of the nega=ve and limi=ng beliefs we touched on could be about failure, they could be about success. They could be about not being worthy. We also have to look at our beliefs about money and get clear on any nega=ve beliefs about money. We absolutely have to address these, because again

17 Page 17 it affects our energe=c and a:rac=ve state and it s going to be a profit hole in your prac=ce every =me you re giving a report of findings and you re trying to guess how much they could afford versus recommend what they really need. That s going to affect you. That s going to affect them. That s going to affect their overall results in care AND your prac=ce. We absolutely have to deal with our beliefs about money and make sure they re posi=ve and healthy ones. Dr. Russ Rosen: Great stuff, Angie. Along the lines of headspace another very important concept is growing your prac=ce really comes down to two things one, make space and two, fill it. It s as simple as that. So we need to make space by reorganizing we will get into that in the System 2 and then you got to fill that space and that s really about System 4. So, we make the space, we fill it. Reorganize, we make the space and fill it. Reorganize, we make the space and fill it. That s how you grow your prac=ce. Now there are really 4 ways to grow a prac=ce. One is I can increase the number of quality new pa=ents. Two, I can increase my sign- up rate. So if I have 20 new pa=ents but no one signs up for care my prac=ce is not going to grow. So I can increase my sign up rate. Three, I can increase my reten=on or my PVA. So I can have 20 new pa=ents. All 20 of them can sign up for care but they can all quit aper visit two. That s going to be a

18 Page 18 problem. And the fourth way I can grow my prac=ce is that I can increase my money by increasing my fees or increasing my services. Those are the only four ways we can grow our prac=ce. So, if I m just looking to increase my number of people I see, it s increase the number of new pa=ents, increase the sign up rate and increase the reten=on or PVA. If I m also talking about my income, the amount of money that I bring in, increasing the amount of money by increasing our fees or increasing our services. And obviously if you are talking about NET then you would need to look at your expenses too. Again, I think that s a great overview and will help you start to think in ways that might be able to help you out. One of the things that we recommend is we have a 15- page ques=onnaire that you can fill out. It s on the three pillars and the five systems. And if you go to You ll go to the webinar and you can watch this en=re webinar then you can download a 15- page ques=onnaire which will help you get very clear on the specific things that you might need to improve upon. So there are three pillars, five systems. System 1 is Headspace and Personal Growth and System 2 is Opera=ng System and Dream Team. If we re going to get people to stay and refer for a life=me, we need a good business strategy and we need a great team. Angie, why don t you dive into that part of the program?

19 Page 19 Chapter 3 Opera)ng System and Dream Team Dr. Angie Meyer: So Russ, we absolutely have to have the team on board. And there are four major aspects here to do that. We call this the opera=ng system of your business. This is how your prac=ce runs. First is we ve got to get the team to grow the prac=ce. They absolutely have to be on board and be ready to grow. That s a huge piece! Open=mes we re excited to grow and we have a team who is resistant. It is like driving with the emergency break on. It might mean more work for them, it might mean they are not mo=vated or don t know how to grow the prac=ce or it might mean that they are already overwhelmed. So, we got to make sure that we get the team READY to grow the prac=ce and we re going to dive into the details of that in just a moment. The second piece is really having a structure to manage, having rhythms and rituals, in the management of our team. This is where it becomes really important that everyone knows what to expect with mee=ngs or trainings and we re going to dive into the details of that. But having a structure so that it s predictable and it s very proac=ve. We don t want to do reac=ve management in which we only have mee=ng or trainings when something isn t working and is symptoma=c. We want to make sure they re proac=ve mee=ngs, proac=ve trainings so we ll get into the details of that in just a moment.

20 Page 20 The third aspect that s really important is the idea of a leadership versus management. I very much like the idea of empowering our team members to step into their own power in this posi=on that they re in. People want autonomy in their posi=ons. I recommend star=ng to lead our team in the prac=ce, we can start to learn how to lead our pa=ents to make changes in their lives and stay with care and how we can step into a leadership role in the community. I think to be able to get to that, we ve got to lead our team instead of manage them. It s not a micromanage and it s not manage by abdica=on, You deal with it and I am never going to check in on you. We ve got to lead with accountability. There s so many pieces to that leadership. But I think it s an important thing to touch on. So in essence we want to manage by objec=ves. We set clear objec=ves and support the team to do their best in achieving them. The fourth is to really use the business framework. Have annual and quarterly objec=ves not just for the doctor but also for the team and that s a really important piece. So, Russ if you would to dive into some of the details of that. Dr. Russ Rosen: Yeah, and great overview Angie. So, here s the deal. As Angie was discussing we really want to have the team on board which to me means that it s not a job and it s not a career but it s a calling. And if you ve had any of those CA s where this is a calling, they can literally build your

21 Page 21 prac=ce. And when it s just a job or just a career and they re just punching their clock, it just doesn t work. Now, you may have go:en lucky and hired one of those amazing CA s. More open than not, we need to cul=vate them. And in this en=re process you need to walk people through to cultlivate that dream team and we don t have a lot of =me for that at this =me. But just know that you really want to have people who are 100% behind you your mission, vision and purpose. We use to call them Rosenites. These are Rosenites. They just can t wait to help grow our prac=ce so we can a:ain our mission and serve more people. We have a module called get the team to grow the prac=ce. And in it we go through a lot of things but it s one of the things where we take the team through, where we help them understand that we need to run this business like a business not like a mom and pop store. So many chiropractors run their businesses like a mom and pop store. If you ve read the E- myth Revisited, you have a be:er understanding of that. But you want to have a very specific business frame, run it as it were a franchise, make sure you have automated as many systems as possible, make sure you re very clear about the three hats the technician which is the one doing the adjus=ng; the manager which is the one who manages the whole office and then the CEO. And the CEO posi=on is that one with the vision.

22 Page 22 So we don t want it to be mom and pop store. We do want it to have a business frame. A business frame might be star=ng with our purpose, our mission and our vision and having very specific values and making sure all of the decisions that we make are based in our values like Angie was talking about earlier. Then, we want to make sure that we have strategies that are aligned with our mission, vision, purpose and our values and those strategies to grow the prac=ce and strategies to market the prac=ce and strategies that we can manage by objec=ves. So we have to have very specific objec=ves. When we re looking at those objec=ves we have objec=ves for the business itself. We like to have the team come up to 10 objec=ves for the business for the year. Then, we re going to narrow those down to the 5 objec=ves we will commit to for the first quarter. What types of objec=ves? That objec=ve might be hifng a specific number of pa=ent visits or par=cular reten=on or a certain number of new pa=ents or we ve got the 13 th month perpetual marke=ng calendar up and running or we ve got the office manual up to date or something. But it would be a very clear objec=ve. So we have 10 business objec=ves for the en=re year. We then break those down to 5 objec=ves for the business for the first quarter. We don t worry about second, third and fourth quarters. We will get there when we get there.

23 Page 23 Now, each person on the team is going to look at each one of those quarterly objec=ves and ask themselves, What can I do? What can I do to help make that happen? If we re wan=ng to increase the number of new pa=ents, is there anything the CA can do at the front desk? Sure, she can be be:er at answering the phones. She/he can be asking for referrals. She can be promo=ng the internal referral program that we have. She could be outside of the office and meet people and give them a card and tell them to come in. There are all kinds of things that most all of us can do to hit all of these very specific objec=ves. Obviously some are just for one person or one role. But most of our objec=ves will be affected by each person on the team and therefore each person on the team will have a specific objec=ve that they will work towards so we as a team can hit the 5 quarterly objec=ves for the Business. So we have 10 annual objec=ves for the year. We have 5 quarterly objec=ves for the business. Now, each person is going to have 5 quarterly objec=ves of what they can do to make those things happen. So, it s really, really important that each person in each role knows exactly how they are going to help the business hit the objec=ves. Some of the classic things that can make such a difference are like the front desk CA can get most everyone to pre- schedule and pre- pay, all of a sudden their whole life is going to get a lot easier. There are very specific things that each person on the team can do that can make such a huge difference in the prac=ce. We just need to make sure they are mo=vated, they want to

24 Page 24 make the change and they are extremely clear about what the objec=ves are for the business and how they will help hit those objec=ves by accomplishing their own objec=ves. And in essence you really are looking at what we call the bonus appraisal form which is just a list of their tasks and behaviours. So you just look at their tasks and expected behaviours and have them grade themselves on how they think they are doing. Then you grade them and let them know how you think they are doing. Those are going to help you understand bang for the buck the things that each person can work on that would lead each person a:aining their quarterly objec=ves which would lead US as a team a:aining OUR quarterly objec=ves. Odds are you re going to want to have a bonus system in place. We re going to pay them a good, fair and reasonable fee for their services and for what they do. But when it comes to that extra energy and that extra excitement in going above and beyond, we want to reward the behaviors we want. And we want to make sure that we bonus these people for their above and beyond service. Again, we have an en=re system in place but these are some of the things you d want to do. Let s take a look at building a dream tea. I like to start with a defini=on of the dream team. A dream team is a group of people who work together as a team; who support each other to do their very best; a group of

25 Page 25 people who are well- trained, highly mo=vated and passionate about growing the prac=ce. If you don t have a team like that, you re going to want to cul=vate them. You re going to want to be very clear from a head space perspec=ve and get them to understand what you do. And it must be their mission to serve more people. We like the concept where we re going to serve more people in less =me and get be:er results. But it s got to be a burning passion for them to get out and help save the world with chiropractric. You re going to want very congruent procedures on how you hire the right person and how you train these people. Here s a hint when it comes to training. You re going to want to have some type of form that you use. We talk about the team training checklist. And whatever they have to do, answering phones, making reac=va=on calls, gree=ng a new pa=ent whatever it is, I m going to be able to check off the date that I showed them how to do it; that we talked about why we re doing it in this par=cular way so they know the why behind the how. We re going to make sure that we can check off the date that they can kind of do it on their own. We re going to be able to check off the date that they got it mastered. Once they have it mastered, they re responsible to add it to the manual and make a video. And then I want to know the next =me we re going to train on it. We re going to make sure that we train on everything. We re going to have a basic training mee=ng once a week

26 Page 26 maybe minutes. So, I m going to put down that Angie learned how to answer the phone. She has it wired. She put it in the manual and made a video. I m going to check her again in two weeks. If it s doing well, we ll check again in a month. If it s doing well, two months. But nothing goes over 90 days. I can guarantee that within 90 days people are star=ng to make mistakes. Doctors for you that would be that you would record live interac=ons with your pa=ents and listen to it once a week. This week is visit 1, next week is visit 2, next week is daily interac=on, next week is re- exam, re- report. And next week is back to visit 1. Just like if you were a professional athlete, just like if you were a professional musician, just like if you were a firefighter. Just like if you were any of those types of professions, you would prac=ce and prac=ce and prac=ce. That s what we have to do too. That is what our CA s have to do too! Just another =p again. We literally have five, six hours on this one subject but I m giving you some =ps that I think are really going to help you out. One of the things you ve got to do with your team is draw out this graph for them. So on the lep of the graph it says workload and on the bo:om it says ease, tools, skill level and =me. And in the middle of it at 45 degree angle is the zone. So if I have too much work and not enough =me or tools or skill level or whatever, that s going to lead to stress. But if

27 Page 27 I have too much =me and I don t have enough work, I m going to get bored. Every =me you start to have growth, you must look at your team in the eyes and ask, Are you bored, stressed or in the zone? If they are in the zone, I m going to say, Great. You re in the zone. If when we hit our next objec=ve, will you s=ll be in the zone or will you be stressed? Any =me one person on your team is stressed, we must stop and reorganize. Remember, reorganize and make space then fill it. Stop. Reorganize and make space. Stop and fill it. So we always want to check in especially when you hit any higher numbers than you are used to new pa=ents, reten=on, sign up rates, pa=ent visits per day. You re always going to stop and check bored, stress or in the zone. Again, we have several hours on this one subject alone. But that should give you some great ideas and some =ps on things that you can do as a team so that you re having a great running prac=ce so people will have a tremendous experience so they ll want to stay, pay and refer for a life=me. So Angie, why don t we take a look at System 3 Communica=ons and this is a huge one.

28 Page 28 Chapter 4 System 3 Communica)ons/ PreConsulta)on " Dr. Angie Meyer: Absolutely Russ. Let s start with Visit 1. I think it s important regarding the en=re process of visit 1, visit 2, daily interac=on, re- evals and re- reports. We must try to take them from where they are to where we want them to be each and every visit. Here s what we re not going to do. We re not going to use pa=ent scare tac=cs where we inten=onally go in to scare them to get them to do what we d like them to do. Instead we re going to ask Socra=c ques=ons and we ll walk them through a series of steps of understanding to bring them across that gap between where they are and where we d like them to be. Open, it s a huge gap. We really need to empower people versus scare them. We re going to help them understand what s really going on with them and how we can really help them. We need to help them really understand how we can help, that we are not just back doctors. Then, we need to find out what they really want regarding their health and show them how to get there. When it comes to visit 1 it starts with how the phone is answered, how the visits are setup - whether it s sefng up just the first visit or both visit 1 and visit 2. It s whether or not we can get them to the healthcare talk first before they come in for the exam. It s how we greet them when the

29 Page 29 pa=ent walks in the office for the first =me. It s that en=re process that s the first step. We really highly recommend that the staff does book visit 1 and visit 2 when a new pa=ent calls. It not only helps compliance for the report or findings, but it lets them know the steps to the process. We absolutely love the idea that in some prac=ces, depending on how close to capacity you are, it s a good idea to pre- qualify new pa=ents by having them a:end the talk first. Once they re in, we have them watch a video or presenta=on that gets the new pa=ent to understand what we want to accomplish. An overview of the first visit, and what s the purpose of today s visit. We also want to get across to the pa=ent the chiroprac=c premise the nervous system controls everything. When there s clear communica=on between brain and body, your body is func=oning at its best. When there s subluxa=on and therefore unclear communica=on we re no longer func=oning at 100%. We need to help them see what the causes of subluxa=on are, what happens if they re lep uncorrected and what our goal is for care. We want to clarify that only chiropractors determine if you re subluxated and if you are subluxated, what the poten=al benefits of having them corrected would be. And of course only chiropractors can correct subluxa=ons. We want them to understand what things you might no=ce if they re subluxated and how having subluxa=on they don t know about have an

30 Page 30 impact them. We want the new pa=ent to understand their might be different types of chiropractors, both limited scope and more wellness/ op=mal health oriented ones. And in just a few moments you re going to meet the people who are going to take you through to make sure you re in the right place to get the care you need. So it s really important how we start visit 1 even the systems in which we approach sefng up before the new pa=ent ever comes in. Dr. Russ Rosen: We re going to ask Socra=c ques=ons. We re not going to memorize any scripts. We re going to have a ques=onnaire right in front of us that we re asking specific ques=ons from and they re going to be Socra=c in nature which means the person s going to have to think and they re going to come up with a reasonable and logical conclusion on their own. Hopefully that conclusion will be, I m subluxated. I don t want to be subluxated. These are the things I can hope for and I ll follow your recommenda=ons. If we have a CA who can go in and do a pre- consulta=on, we would have them do one. If not, of course you don t. In the pre- consulta=on we re going to have our CA ask very specific ques=ons to find out why they re here and what their concerns are and what they think is going on. Now we have an en=re hour on this module giving all of the reasons for each ques=on, how to ask the ques=ons and what we are trying to accomplish. Obviously we will not have =me for that type of detail but we will give you some great info right now!

31 Page 31 We re going to ask them ques=ons about how it s affec=ng their lives at work, home and play which is so important because no one ever comes to see because of their pain. They come to see us because of loss or poten=al fear of loss. So, we ve got to have clarity about how this is affec=ng their life. And HOW we ask the ques=ons is cri=cal. If you were to say, How is it affec=ng you on the job? The most common answer you ll get from a man is, It s not that bad. I can handle it. So we have to be very clear. I understand that you re a roofer meaning you go up and down ladders all day long. You re carrying boxes of shingles. You swing and a hammer all day long. When you ve got that neck pain and you re working hard on the job, how is that affec=ng you? So, it s very cri=cal how you ask these ques=ons. In our modules, we literally look at each sentence and each paragraph. We clarify what we re trying to accomplish and exactly how we re going to go about accomplishing it. As a =p, the way you ask the ques=on makes all the difference in the world. We re going to find out about the three dimensions of stress. We re going to ask them ques=ons about their mental, emo=onal stress now and in their past, chemical stress now and in the past, physical stress now and in the past because we need to help them understand it s an Accumula=on of stress over =me that can lead to these types of health

32 Page 32 problems not your neck and back pain, but these types of health problems. We are already beginning to ship their consciousness. So we re going to ask very specific ques=ons and obviously if it was a trauma=c injury versus repe==ve injury, there s different ways to going about doing that. But you definitely want to help them understand accumula=on of stress over =me. We re going to ask Socra=c ques=ons like have they seen a wellness chiropractor before. Or do they have any concerns about seeing a chiropractor? We want to ask those ques=ons again to make them say, What? We want them to be having to think, Oh, wellness chiropractor versus limited scope. And we ll talk to them about it. We ll have our CA do that. We re going to ask them if they have any concern about seeing a chiropractor. The most common one is, Yeah. I m concerned about it hur=ng me or I m concerned about gefng my neck cracked. There s a very specific process we need to walk them through to get clear about that so they re no longer afraid. And the CA needs to let the doctor know so the doctor can then come in and address that concern. We want to find out how long they think it s going to take to get healthy. We re already using words like get healthy vs. out of pain. We want to take them through before and aper scans or before and aper x- rays so the CA can show them aper those Socra=c ques=ons. We re

33 Page 33 going to be doing these types of tests with you today. I want to show you somebody very similar to you. She had this and this going on. These were her scans. The scan means this. This scan means that. Or you can see on the x- ray this. Here s them a year later, (not a month later), here s them a year later. What do you see? Wow, it looks much be:er. What do you think happened to them? You get really clear on our touch, tell, ask, teach chart and you ll be able to get that chart. I ll show you in a few minutes where you can go to a link and get that. The CA would literally be showing them, This person had neck pain but they also had sinus problems and headaches. This person had mid- back pain but we also found indiges=on. That s not what they came in for but we found it. This person had low back pain but they also had pain down their leg and had PMS. Again, that s not what they came in for but look at them a year later. As we ve cleared up this subluxa=on and we cleared up their nerve interference. What do you think happened to all of their chief complaints? What do you think happened to all of these other health problems? It s such a great way of educa=ng them under the radar. And yes there is a ton to talk about regarding what you can and cannot say in your neck of the woods legally. And how can you be very clear with them so you are not offering them some type of cure etc. But we just don t have =me for that discussion at this =me.

34 Page 34 The last thing we want to do in pre- consulta=on is make sure that the CA talks the doctor up. There s nothing like a third party endorsement. We want the CA to say, I m so glad you re here. You know I come in and meet all the new pa=ents like yourself and you re going to love Dr. Rosen. He s absolutely the best. Everyone loves him. I personally see him. My children saw him the first day they were born and con=nue to see him. You re absolutely going to love him. Or something along those lines. Those are some of the things that we can do in a pre- consulta=on to begin to ship their consciousness. And that s really what we need to do. Remember there s a gap between where they are when they come in, chiropractors help neck pain, back pain and headaches, and where we want to get them to. We can help them get healthy, stay healthy and have the best life possible. This is the beginning. So they saw the presenta=on. They now do a pre- consulta=on where we start asking Socra=c ques=ons and they are thinking, Wow, I had no idea. I had no idea that you guys can help with those types of things. We re not telling them We don t care about your pain. We only care about your subluxa=on and gefng you healthy. We don t do that. It s too big of a gap. We just simply start plan=ng seeds in the presenta=on, the pre- consulta=on and now of course we get to the doctor s consulta=on.

35 Page 35 Angie, why don t you take us through some of the important highlights of the Doctor s consulta=on?

36 Page 36 Chapter 5 Visit 1 Doctor s Consulta)on Dr. Angie Meyer: So for the doctor s consulta=on, if the CA did a great pre- consult, it can be really quick and amazingly effec=ve in just a few minutes. Again, we have over an hour on this module with extreme detail, but we are going to go over some of the highlights and send you some materials from our modules so you can dive deeper if you choose to. The key thing the doctor needs aper the CA and doctor have done the huddle, and she talked the doctor up to the pa=ent and got the doctor up to speed about the pa=ent, the doctor has to go in to the room and build rapport and relieve concerns. Next, we want to be sure that we sum up what we know from the history form and the pre- consulta=on. We don t want to go in and say, So tell me why you re here? We want to sum up what we know from the CA huddle, and then double click and ask them, What s going on, how we can help? Obviously they are not going to appreciate filling out a history form, then speaking with your CA only to have you walk in and ask what is going on! So aper you sum up what you already know about them and ask them to please tell you more about it, they re going to pick 1 of 3 direc=ons. They will either talk about their pain, how it is affec=ng their life or their diagnosis or lack of diagnosis. Those are really the only three direc=ons

37 Page 37 they will go once you ask them to, Please tell me more about it. The trick is to ask that open ended ques=on vs. a direct ques=on i.e. show me where it hurts or when did it start. We MUST get them to talk about what is important to them and the only way to do that is to ASK them! We want people to feel heard. So the doctor s consult can be done in a very short, quick manner. It really does not need to take a lot of =me. Once they have talked about the pain, how it is affec=ng their life or their diagnosis or lack of diagnosis we want to do two things. First we want to commiserate. Let them know you care about them. Next we want to connect the dots. We will connect the dots to the en=re Whole Story which we will discuss in just a few moments. But the long and the short of it is immediately we need to start to connect their story to our story. It is completely under the radar and is quite a skill worth mastering! We finish up the doctor s consulta=on by giving confidence, by lefng them know its classic. Here s how it s classic, here s how it happened and how it s affec=ng you. So an error that we see so open is that at this point in the consult is we haven t done any examina=on yet. We have not even laid our hands on them yet. And the doctor will say, Well I m very confident I can help. Again they haven t even touched the pa=ent yet, so we want to give confidence by saying this is classic i.e. I ve seen it before. So its classic, in HOW it happened to you and it s classic in how it s

38 Page 38 affec=ng you. For example, You fell out of a tree and hit your head and now you have pain going down your neck into your arm just like on this nerve chart. We see trauma=c injuries leading to subluxa=ons and this type of nerve pain all the =me. Vs. something we here from docs all the =me like, Oh this is classic, you have neck pain and we see people with neck pain all the =me. It only takes a moment to make it personal to them of HOW it happened and WHAT they are experiencing. Obviously we want them to know that this is classic so they know they are in the right place to get the care they need. Contrast this to, Oh you have pain in your neck and it goes down your arm? Hmmmm, I don t think I have heard of that before... Well I am sure we can help... So lastly, before we move onto the doctor s exam, we want to give them hope. Hope is a really important piece in it. It s a second level of agreement in the doctor s consulta=on. It s important that we re able to stretch the consciousness of the new pa=ent, not just what they came in for that you can help them with but also what else we can do, so not only do we hope that we can help them feel be:er so they can golf again but also get to the underlying cause and really help stop recrea=ng these problems in the future so they prevent problems, get healthier and have a be:er life. So at the end of the consulta=on, we want to make sure that new pa=ent s tank is empty. They ve asked all the ques=ons and

39 Page 39 communicated to the doctor everything they need to. We want to say is there anything else that you need me to know before we move to the examina=on? So Russ, why don t you dive into the doctor s exam?

40 Page 40 Chapter 6 Visit 1 Doctor s Examina)on Dr. Russ Rosen: You know what and I hear this all the =me where doctors will say to me you know I want to spend 2 minutes with a new pa=ent and I want them to stay pay and refer for a life=me and my response is Good luck! If you don t take the =me to help the people understand the big picture or whole story they re not going to stay pay and refer for a life=me. Simple as that! Now, if I have a CA that did a 10 or 15 minute pre- consulta=on, the doctor can spend 3 or 4 minutes in the consulta=on, it s very simple to do. You don t have to spend a lot of =me and the pa=ent feels heard. More open than not, we rush in and we say, Hi, I m Dr. Rosen, great to see you. I see you ve got neck pain. Listen, I want to let you know that our main goal today is to take care of the subluxa=ons. I really don t care about your pain and I am confident we can help. Don t expect them to stay, pay and refer for life=me. Instead you re going to have a 15 or 20 p.v.a. or reten=on. So the doctor s examina=on is very, very simple. And of course we have a ton of informa=on in our modules but we are going to dive into quite a bit of it right now. We re going to transi=on into the examina=on. You saw the presenta=on? (Pa=ent) Yes. (Doctor) And it made sense? Great, any

41 Page 41 ques=ons? (Pa=ent) No (Doctor) Great, so you understand... Now, we re not going to tell them a hundred pieces of informa=on a hundred =mes. We re going to give them ten pieces of informa=on ten =mes. We re going to tell them what we re going to tell them. Then, we re going to tell them and then we re going to tell them what we told them and then we re simply going to ask them and they re going to repeat it back to us. So the transi=on is a simple overview where we discuss the brain, spinal cord, nerve root cells, if it flows, you ve got a be:er chance to being healthy. If it doesn t flow, well we call this a subluxa=on. Subluxa=ons can cause all kinds of health problems like the neck pain that you have. If you have subluxa=ons, the odds are we can help. Would you like to find out if that s going on with you? Now, there s obviously more meat on the bones but that s really what we need to cover. I need them to know that I m looking for subluxa=on and then within 15 seconds, I m going to find it. So I m going to let them know that I m not going to hurt them because so many people are afraid of that. I m going to touch the area of chief complaint. Again, I know a lot of doctors have a real problem with this. I had a teacher tell me NEVER to talk about pain or touch the area of pain. I had others tell me to always start the exam at C1. Others said always start at the pelvis. But if we think about it from a pa=ent s point of view it only makes sense to touch their areas of