We all experience both rewards and frustrations that come with the territory when running a chiropractic practice. Most of our frustrations arise when we find ourselves trying to juggle the clinical aspects and the business side of our practices simultaneously.
Was Charles Revson lucky? In 1932, he and two partners combined their talents and $300 to form the Revlon cosmetics company. By the time Revson died in 1975, Revlon was selling 3,000 different kinds of products and had annual sales of $605,000,000.
Most of us would be happy to achieve even a percentage of that type of success, so what was his secret? Revson had a reputation as a demanding perfectionist, but his success, like many of those who have turned struggling small businesses into international corporations, resulted from providing reliable products and consistent services. Furthermore, successful companies establish procedures that ensure consistency, regardless of who performs the work.
Here are some steps for ensuring consistency:
- create a clinic system;
- have a compass and a map;
- assign positions;
- work from written procedures.
The Clinic System
For an example of reliability and consistency in business, simply take a look your favorite franchise. In his book “The E Myth Revisited,” Michael Gerber applauds the franchise phenomenon. According to Gerber, the “Business Format Franchise” is not so concerned about the product or service delivered, but in the way it is delivered. As a result, franchises fail at a rate of 25% over five years, compared to 80% for independently owned businesses.
Franchisees purchase a complete system. This system is one that has been tested, refined, retested and then written down. Usually all that’s needed for success is making sure the business system is followed, completely and consistently.
Chances are, nobody handed you a clinic system manual when you began practice. Don’t let that slow you down: Make your own. But you may say, “At this point I already have a system in place, and I don’t have time to start over.” What I am recommending is spending a little time recording your current system so you truly understand how it works (and so you understand the aspects that may not be working as well as could be). Do it with the idea that if you refine the system well enough, you could even franchise your clinic system.
Your first assignment will be to define what you provide. Gerber calls this the commodity. The “product” you actually deliver may be reassurance, safety or guidance (hint: adjustments would not be defined as the “product”). If you don’t know what your product is, ask your patients why they come to see you. Charles Revson is quoted as saying, “In the factory, Revlon manufactures cosmetics, but in the store, Revlon sells hope.” Until you acknowledge exactly what you provide, you will struggle to retain and attract new “customers.”
A Map and Compass
With your “product” clearly defined, every other business decision can be analyzed for its effect on delivering the product to the patient.
Those decisions will be made easier if you are able to answer the following questions:
- Where do we want to be?
- Where are we now?
- What steps will get us from where we are to where we want to be?
The questions are simple, and you are probably already answering them occasionally, whether you realize it or not. Now you need to make that an official part of your system. Record your productivity goals for the clinic, yourself, and your staff — the number of calls you get (and make) on Mondays, the number of cervical films a week, number of visits per employee per hour, hours spent in the community, etc., etc. The goals must be specific, detailed and recorded.
Your new system will also include a way to record your work. It means that for every goal, you will have a log. Additionally, you will establish a schedule where you total and review the statistics you have kept and compare them with your goals. These numbers, more than anything else, will tell you where your attention needs to be focused.
More importantly, tracking the numbers is the tool you need for refining and improving the quality of the product you deliver. For example, how do you know which voice-mail greeting leads to more new patients making appointments: “It’s a great day at Cheerful Chiropractic,” or, “Are you aware of the exciting things being done at our offices to eliminate fatigue?”
With a system of recording and reviewing numbers, you will begin to make changes because they bring in patients, rather than making those changes on emotions or whims. Don’t limit yourself on where you can take this. It can be fun, especially when you see the small efforts more than pay for themselves.
You may even choose to track how many people accept care during your report of findings, depending on what type of clothes or uniform you and your staff are wearing or the scent of air freshener being used. Remember, it is no accident that all McDonald’s restaurants are identical in their layouts, menus and uniforms.
Positions and Procedures
In early practice, besides your role as doctor, you may have also been your office’s receptionist, CA, rad tech, and janitor. Eventually your business grew to the point that you needed help with some of these roles. Whenever you hire an employee, you should be able to list the employee’s duties and responsibilities, and establish the line of reporting.
Regardless of the size of your practice, an organization chart lists the varied positions that will eventually exist when the clinic is functioning at full capacity, including the chain of command. The chart should be posted where employees can see it, with employee names filled in — even with a staff of two. This organizational chart allows everyone to focus on his or her part of the clinic orchestration.
When the phone rings, for example, three people shouldn’t stop what they’re doing to answer it. Or, every time a patient comes in for an appointment, the same smiling face should be there to greet the patient with the same, consistent invitation for herbal tea or spring water.
Additionally, each job should be specific in its procedures. Does it matter if you do therapies before or after the adjustment? There may or may not be a physiologic difference, but how does the patient respond? Do you attach the electrodes to the area of complaint first and then attach the cords, or visa versa?
Having procedures as part of a system increases efficiency. It leaves time to perceive special needs and provide that extra something on every visit, because the routine tasks are accomplished on “autopilot.” Make sure each employee has a complete and detailed description of how to perform his or her duties.
Attention to the details creates the consistent products we all expect to find in the franchise-style business. No matter where you are in the world, when you see those recognizable “golden arches” at a McDonald’s restaurant, you know what type of eating experience you are bound to find. This is because this experience has been repeated time and time again. Does that mean the product or décor never change? No. Improvements are continuous, but they are based on positive customer reaction, and once a change is made, it is implemented consistently.
“What’s your product? What feeling will your (customer) walk away with? Peace of mind? Order? Power? Love? What is the customer really buying when he or she buys from you?” Gerber answers his own questions by stating, “The truth is, nobody’s interested in the commodity. People buy feelings.”
More than anything else, we like to feel in charge of the purchases we make with our hard-earned money. When we choose to make a purchase from a certain business, we do so for many reasons, both logical and illogical. Most of our purchasing decisions are made subconsciously. The subconscious mind perceives pleasant smells, colors, sounds and emotions. When certain needs are met in a way that also creates a sense of pleasure or fulfillment, repeat purchases are bound to occur.
Take some time to work on your business, creating a consistent patient experience, so your cherished customers can rely on you for a lifetime of care and pleasant purchases.