109: Chiropractic Practice Burnout

CHIROPRACTIC PRACTICE BURNOUT

 

Burnout or rust out as the song goes. Welcome everybody to the KC CHIROpulse Podcast, brought to you by Cats Consultants. I'm your host, Dr. Michael Perusich. I'm joined by my co-host, Dr. Troy Fox. 

Troy, before we jumped on here, you were telling me about an email you got from somebody about chiropractic practice burnout.  Actually, you said you got several. 

Yeah, I have, and it's interesting and it's that time of the year and I think people also are probably aware of, of some of my past story about burnout as well. So I tend to be an advisor sometimes to people that have struggled with a little bit of that . Sometimes too much of a good thing is a bad thing.

I think as well, we have good intentions going into the first of the year.  and sometimes even those things are a little bit overwhelming. The emails that I got were basically, here I am like the third year in a row. This is the gist of the combination of all three emails that I got here we are kind of like the third, fourth, fifth year in a row that I'm trying to pump myself up at the beginning of the year and get myself going again.

You know, I'm. Setting these lofty goals of what I want to achieve in my practice this year, but I always seem to be burned out by the end of January and I'm kind of back to normal. How do I avoid that? Yeah. So that's, uh, we could probably do a five-part series on that.  That’s chiropractic practice burnout.

Yeah. There's a lot to unpack with that for sure. I think we both become expert at that from experience. You know, and it is, this is a weird time of the year. You know, you get through the holidays and you know, things kind of slow down a little bit at times and you relax and you're around family and you're having a good time and you know, who doesn't love opening gifts and, you know, just spending time with family.

And then bam, all of a sudden it's the new year and you wake up and it's like, I gotta do something. My practice is down a little bit and you know, if you're like a lot of our listeners, you're in parts of the country. Where, winter is just, you know, it, it drags a little bit.

Yeah, the nights are long and the days are short and it's cold and it's dark and it's dreary so much of the time. And,, I think it's easy to get kind of burned out. It's just. It's such a shock to your system when you, when you slide into January thinking, oh my gosh, I gotta wake up and do something.

And oh my gosh, I've hit January this same way every year since I've been in practice. And it does kind of weigh on you, I think, just a little bit. I think also what plays into this as well is, and you guys that are in practice notice this, I think from Thanksgiving through Christmas with, with the whole, uh, uh, let's call it, uh, you know, basically sympathetic, parasympathetic, just haywire.  And chiropractic practice burnout hits.

Yeah. Um, our patients are harder to adjust. They're under more stress, even though it might be happy stress. Maybe they have family members coming in or maybe, uh, like. My mom died pretty close to Christmas last year. Yeah. Um, you know, those things play havoc on our systems. So when we have patients that come in and we're grinding our wheels, trying to make sure that we take care of those patients, I think in a lot of cases, once we get through Christmas and New Year's, we're a little bit worn out as well, just from trying to maintain.

Patients that are even harder than ever to take care of. So I think that's another thing that plays into the holidays. And then another thing that stacks on top of that, as we get into the beginning of the year and we worry about our practices, is most of the time, the beginning of the year is where we receive the lowest numbers.

You know, if you're gonna have lower numbers, it's usually gonna be in January or February, March, maybe a little bit into December. Uh, in our practice, we see it more in January. So, you know, sure. You always worry about that too. And I think sometimes we weave that into the sky is falling rather than just looking back.  This throws us into chiropractic practice burnout

And I think you and I've talked an awful lot about that, that this isn't a 30 day cycle. That we work with, right? As we work with client clients, we look at trending, right? And we look at trending throughout the years. And so I think you can speak to that a little bit. Maybe talk a little bit about how practices evolve from that month to month setup.

I think that helps some people. Yeah, I think you, you, you've really gotta get out of that. We start over every, at the end of every month or the beginning of every month. Mm-hmm. , um, mentality. And I, I think the way we have traditionally tracked our statistics in our profession, and it's not just our profession.

Okay. . A lot of professions, a lot of businesses have a tendency to do this. Mm-hmm. , you've gotta look at the bigger picture. Okay? So every January you're down. Is that normal? Let's look back at history. Should we expect to be different than down? You know, if history tells us that we're traditionally always down or we had that one one year where we were up a little bit, it, it would be absolute insanity to think.

You know, all of a sudden this January's gonna be better. Well, I raised my goals, so with this January is gonna be better. No, I mean you've gotta be realistic about the big picture. Mm-hmm. . And so don't just look at a month at a time or a week at a time. Or some doctors look at a day at a time. , it's, it's good to look at that microcosm, but you've gotta look at the big picture.

And if the big picture says, Hey, January, February, always gonna be a little bit down, but March, april, typically pump right back up, we hit mm-hmm. , uh, may, June, numbers are great. September, October, November, boom, we're shooting the lights out. It all levels back out. So, and I, I see a lot of doctors and I, I think Troy, maybe this plays into it a little bit too, and maybe we're guilty of.

Driving this force a little bit as as mm-hmm.  advisors. But, uh, you know, you get down towards the end of the year, you hit about Thanksgiving and you start thinking about goals, what do I want to do next year? Mm-hmm. . And so you start setting goals. And when we set goals, do we typically set goals lower than what we did last year?

Not typically. You know, we're, we're constantly driving ourselves forward and that's good. There's nothing wrong with that, but I. When we set those numbers for goals on patient visits and new patients and, and, uh, collections and those kind of things. Mm-hmm.  and the bam January hits and you're gonna be down.

Probably not everybody's down. January was always a great month in my practice, but, you know, typically you're gonna be down. And if that's a down month and you've raised your goal, I think it, I think it makes it feel even worse. You know, not only am I down.  i totally missed my goal this time. And so you gotta look at that big picture or chiropractic practice burnout sets in.

This is why I like step goals. And I know we're not talking about burnout right here, but I like step goals because step goals take into account that history and that statistical trending that we do with our clients. And it says, okay, we want to raise, um, our new patients to see an average of, you know, 5% more this year each.

But are we gonna actually do 5% each month or are we gonna have one month where we're down five, next month we're up 10 and it balances out to five. So you gotta look at the months that you're traditionally down and traditionally up to help balance that out. Otherwise, you're just driving that burnout process.

I think even harder on yourself. , I think you need to throw in here as well. And, and I know this is something I experienced, so I can speak from wisdom on this. Um, you know, and, and really, uh, you know, one of my favorite quotes is the grass is not greener on the other side. Take it from a guy that jumped the fence.

Here's what happens sometimes, and here's what, here's what happened to me during these key moments where we were trying to figure out how do we, how do we generate income and how do we service more patients? Because really for me, it wasn't the income, it was actually the amount of patients I was servicing and taking care of that was very important to me.

So we would devise a new strategy. Here's the problem. What if I met my capacity ceiling of what I can?  And now I try toto stuff more stuffing into the bear, you know? Right. At that point, all I do is make the bear angry. So basically all I did was put more on myself. 

Created a situation where I was even more miserable than I already was, because I thought it would make me happier if I could figure out a way to have a higher capacity. Here's what happened, was... Yes, maybe I had a higher capacity during January or a higher level during January and February, but I was right at my capacity ceiling.

And then when your practice goes back up naturally and normally in those next few months, you're not prepared for it. Right? You're not prepared for that adi, and now you're under more stress and your practice is more chaotic than it's ever been. Right. And, it sounds like a good problem to have, but if you're not prepared for it, it creates absolute misery for the doctor and the staff.  This is one place where a practice management advisor can help.

It does it. Y hit the nail on the head there, in a lot of different ways. You know, you've gotta be really careful about how you look at growth, how you look at capacity, and how you do those things, and this is where I always go back to, instead of driving so much by these just kind of arbitrary numbers, which a lot of the numbers that we throw out sometimes are just kind of these arbitrary things.

You say, well, I think I want to see, you know, a hundred more patient visits a month. Okay, great. What's the backstory of that? How are you getting there? Do you have the capacity? Do you have the scheduling? Do you have the staff? You know, how are you driving it? I like looking at the economics of a practice more than I like looking at just the raw, simple numbers, because to me that really helps kind of drive the practice in a more sustainable way, calm way, which I think helps kind of push down that burnout process a little bit. Now, burnout's a natural thing too. You know, we have to sometimes look at burnout and say, okay, this is just my body, my way, God telling me that I just, I need to level out for just a minute. We don't always have to be on a growth pattern.

In fact, a lot of today's business gurus suggest that, and I think this is true, suggest that that could be actually damaging to your business, because you just, you can't keep your arms around it. And you and I both had this issue at one time in our chiropractic practices. Yeah. It was grow, grow, grow, grow, grow, grow.

And all of a sudden we woke up one time, we're like, holy cow, what happened? You know, you, you, you can't keep your arms around it. And then you're spinning off all kinds of other problems. Creates even more burnout. So yeah, you don't have time to prepare for the next step if you don't have a lull in the action and go, okay, here's where we're at now, here's where we, instead what happens is you're just climb, it's like climbing a mountain and, and it's just straight up the a, a sheer face, and there's no, you know, you get halfway up and you go, well, I can't go down.

I can't go up. I'm stuck right here. Right. And that's exactly what ha. And so basically what happens is you just push forward. Rather than strategically planning for that next step and that next bit of growth. Okay. Do we need to add more staff? Do we need more equipment? Do we need to change hours at this point?

And it, you know, and that may not be the only reason that you're burned out. It could be your burnout because your practice is not doing as well as you would like to, and it hasn't over the last few years. In that case, it's probably time to get some advisement, some practice coaching. It is, yeah. And that's, you know, that's a lot of times what we do when we take on a new client.

A lot of them come to us because of chiropractic practice burnout and those kind of of things or, or I can't figure out how to grow again. And we pick their chiropractic practice apart, and we go back and we look at the economics. And we put our finger on what is good. Let's start with what's good. I'm gonna quote the great philosopher Troy Fox, who once famously said, “it's all good under the hood.”

And you know what? Sometimes you just gotta open up. That's for everybody out there. That's a joke from 30 years ago. Oh gosh. Yeah.  

I dated you there, Troy. Yeah. you know, for all the bad that you might see under the hood, you know…is the engine running? Yes. Then something good is going on inside there, so let's open up the hood.

Let's find out what's working, and then let's rebuild a more finely tuned engine from there. Instead of just saying, well, this isn't working and throwing that out and this isn't working, let's look at the good side first.  I think if doctors would do that more and look at the good side of what's happening in their chiropractic practice, maybe practice burnout wouldn't hit so hard and so often for some of us, yeah.

Here's a really great example. You have a car and you've had it for quite a while and it's a really good car. Mechanically sound and runs great.  But all of a sudden you get a tear in one of the seats, right? Next thing you know, you're in a new one. 

Whoa, you spent a whole bunch of money, and so what I see with chiropractic practices is two things.  Either one, you bought a practice and you're working within that practice and it doesn't fit your style. So you're trying to put a square peg in a round hole and you can't figure out how to make it work.  That works for you and you need a little bit of direction to push you. Right. Other times what happens is we get into a practice situation where we start to see chiropractic success.

And our practice morphs, kind of out of our control a little bit. And again, we get in a position where we're looking around and we just can't quite figure out, we need some diagnosis to figure out how do I sort out what I have here and how do I move forward? And that's really where chiropractic advisement and chiropractic management comes into play.

Because I think you and I have seen just about every scenario up to this point, lacking one or two. I think in the last year we've seen one or two kind of new scenarios that we go, whoa, haven't seen that before. You know?  So there's been a couple of new things, but for the most part, it's almost like when you have a patient come into your practice with low back pain and a little bit of pain running down the right leg.  We help you figure it out.  That’s chiropractic practice management.

Just just to that point  and so I don't, as doctors I don't have to tell you what's going on there. You already know before you laid the patient down on the table exactly what's going on with that patient. In a lot of cases we see that as well. From an advisement standpoint, I think there's a lot of benefit sometimes to have somebody take that 30,000 foot overview and look at your practice. 

So you know, very much so. That's one way to change chiropractic practice burnout really quickly. We're in a position where we go, here's a punch list of a hundred items. Get started, right? We typically say, here's what we see. Here's the most important things that you should and  can change today. Yep. And then here in the next few weeks, once you get comfortable with that, let's take a couple of other steps.

I think when you go step-wise through that, you can also integrate it into your goals for the next year. Cuz I think sometimes we also struggle to figure out what, what am I gonna do? Okay, well I guess I better bump my goals by 10% in all areas this year. We don't even know if that's achievable. So we, and you may have just added to your frustration, we actually help you set realistic goals that are gonna make your chiropractic practice better.

Maybe we're going to make you more profit. But yet you're not bringing in 10%. Maybe you're only bringing in 2% or 3% more income, but maybe we increased your margin by 10%.  There's a lot of ways to make practice more fun and more profitable.  And more profitable. Almost always it's more fun.

Absolutely. Absolutely. Yeah. So I'm just gonna inject something here real quick, just because it's a, a good entree into this. If you're feeling burnout or you're not meeting your goals, your practice isn't where you want it to be. You're not profitable. Whatever the scenario is, before you throw the baby out with the bathwater, go to our website, Katsconsultants.com.  In the top right corner, You can schedule a breakthrough call. In fact, that button in the top right corner that says schedule or something like that, forgive me, I, I haven't looked at the button in a while, but says something about scheduling in the top right corner. You can't miss it. Click on that button and go straight to my calendar.

Jump on my calendar. Let's talk about your chiropractic practice. What's going on? You know, we do this for free. Troy and I have been doing this, and Patrick and Marisa…we've been doing this for so long. We'd just like to see doctors have a leg-up.  I'd just like to see you putting yourself in a position, whether you become a client or not to just know how to manage your chiropractic practice and your life and your chiropractic success just a little bit better. 

So jump on my schedule. Let's do a breakthrough call and let's just talk about your chiropractic practice. So, Troy, this is a good one. I like this. Yeah, I appreciate, andthose docs out there that sent these questions.

And if you, if you want to send a question in to hear us, bannered or around, you can send it to Troy, [email protected]. That's Kats with a K A T S. Send it to Troy and we'll put it on the air. And, as you heard today, we don't ever use anybody's name.

 

Awesome. All right, everybody. Hey, thanks for listening to the KC CHIROpulse Podcast.  This week we are brought to you by BarlowBrainandBody.com.  The Barlow Brain and Body Institute, helping doctors learn functional neurology without all the complicated stuff. So if you've been looking to add brain-based therapies to your chiropractic practice, BarlowBrainandBody.com. Go check them out.  Again, that's BarlowBrainandBody.com. 

 

And from all of us here at Kats Consultants, thanks for listening to the KC CHIROpulse podcast. We'll see you.