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123: Self-Inflicted Chaos in the Chiropractic Practice

May 14, 2023

Perusich and Kallio 123 Self-Inflicted Chaos in Chiropractic Practice


Hi everybody. Welcome to the KC CHIROpulse podcast, brought to you by Kats Consultants, helping doctors keep their pulse on success. I'm Dr. Michael Perusich. I'm joined today with my good friend and one of our coaches, Dr. Alex Kallio. Alex, I want to talk about this idea. Sorry I didn't let you talk. I want to talk about this idea that I call self-inflicted chaos. Now, you and I have talked many times. Practice can be chaotic. Am I. Absolutely. Yeah. Yeah. And I think on the daily, we all find ourselves probably kind of feeling like we're, we're whether organized or disorganized chaos around us. Sometimes, unfortunately, on our own doing right. I heard somebody call it one time, it's quicksand with the bottom to it, so you don't go completely under, but you just can't get out of it sometimes by yourself, which I thought was a great analogy, but yeah. You know, I, I see us all the time in practice. We create sometimes more chaos. Than what we need to create, you know, chaos in the chiropractic practice is natural anyway, cuz you know, you get the emergency patient coming in, it throws the schedule off. You know, an exam takes longer than you anticipate and all of a sudden you're 20 minutes behind and it just snowballs from there. And, uh, you know, but we also do things that could keep us out of some of that chaos if we just put our mind to it. And one, one of the things that I'm, I'm really thinking of is, We don't use our calendars to schedule events. You, you were reading right where my mind was going first thing too, which Yeah. Yeah. I mean, you, you look both, both calendars, uh, of out, you know, non-patient events, but even just using the, the scheduler correctly to set yourself up, you know, stuff you don't necessarily correlate of getting your, giving yourself some time to get paperwork done, to have meetings with your staff. That right, you know, if you're not scheduling, if you're throwing one every. You know, haphazardly in the schedule and you're not leaving yourself any gap time. You know, at the end of the day, you're, you're going home to do paperwork or you're feeling like you're buried under and you're not catching up. And so there's so many little things on the calendar that that absolutely can make a huge difference. Huge. You know, and you go and you look at the calendar and, and you see a spot two hours from now that there's, there's a 20 minute. And you think, oh gosh, I'm gonna use that to get some paperwork done. But you don't tell anybody on your staff, and before you know it, they've scheduled a new patient there, which is great, but you just also lost your documentation time when a new patient could have been scheduled maybe at a different time. That would've worked just as well. And now you're one more step into that chaos, you know? So communication. Having great communication with your team is part of avoiding some of that chaos as well. Absolutely. You know, and I was talking to a doctor the other day, he was telling me he bought a laser like three years ago, and he said, I, I said, so how's it going? You, you really like your laser? I always love the laser. And he said, you know what, we've never used it. He said, I don't even know where it's at. Well, that's, to me, that's kind of a chaotic thing. You go spend this money on a great tool to have in your office, and you, you, you've used it so few times you don't even know where it's at. That's a little, that's a little nutty. Yeah. And that, you know, that lay, especially if you spend any time with your staff to, you know, hopefully train them on the, the benefits of that and, and how we're gonna bill it and how we're gonna schedule it. And you do all of that, that legwork and then not to use it. Right. Uh, you know, you've wasted. Time, money, and, and, and just energy on, on all of that. So yeah, if we're gonna have those kind of things, we, we, we need to have a game plan of, of how to schedule bill, you know, train, but then how are we implementing it? How are we keeping it top of mind too? Right. And, you know, implementation goes a long way. I know Marisa talks about this all the time. If we're not implementing, Doing nothing but really creating chaos. So, you know, have you implemented good procedures? Have you implemented time for staff development? Have you implemented time to teach everybody how to manage your, your schedule correctly? I mean, there's so many different levels of implementation. Well, and we, we've probably all run into this too, where we, we've had a meeting, we had a staff meeting. We talked about it, you know, okay, we've got these steps, but then we never got it. On the calendar, right? And so we had this great game plan, this great discussion. And then two months later, hey, whatever happened to this? We didn't get that going. And it's, well, yeah, it never got put on the calendar to actually, you know, in a due date and have those kind of things implemented on there as well. So, uh, best intentions, but, but the follow through just kind of fell off. It falls off. And, you know, that's a great place to create some implementation strategy is with staff meetings. You know, do you have somebody taking notes? Do you have somebody managing the notes and pushing it forward? You know, who's, who's developing the action steps And, you know, should always go back in your staff meetings to the last staff meetings, notes, and, you know, what do we talk about? What do we need to push forward? What was a dumb idea A week later? And, and so often we wind up just treading water from our staff meetings because we wind up talking about the same thing over and over because we don't remember what we talked about last time, but, and we've gotten into a point of trying to, you know, assign Okay, who's taking care of that? When, what's the due date for that? Right. And then, you know, circling back on that to make sure, hey, did we get, did we get this done right? And yeah, that's, which is a great point. Being able to come back and actually keep note from those meetings of who was supposed to do what by when, and actually following up on it. Yeah, exactly. You know, another place where we can talk about implementation too and, and more chaos is our treatment plans and our communication to our patients of those treatment plans. You know, if you've got a practice that patients are dropping out a lot, not finishing their care plans, not following through, or the ones I love, these are the ones that say, yeah, doc, I don't need that. Even though you were the doctor and recommended it and, and we let patients kind of get away with some of those things and not follow through on our recommendations, which to me, creates total chaos in your, in your practice because you, you can't predict now what your future cash flows look like, what your schedule's gonna look like if you're just letting patients manage their own care plans. So I think we've gotta get really better at, at, um, doing those kind of things. And I know you're great. Uh, and, and that's, that's why we just have this, this talk, you know, this week in meeting too, of, you know, if you're gonna, you know, I think we had it on, on doctor, the casual care plan, you know? Right, right. You know, if you're haphazardly having people come in, it's really hard to get a. A good gauge of your day, you know? Right. Cause you're gonna have way more walk-ins or call-ins and, and we're all gonna get those anyway, but Sure, sure. Um, but, you know, if you're managing somebody well of whether you're adding, Hey, we want to add, I want them back Monday for, you know, just dry needling, or I want them back for rehab, or I want them back for an x-ray, or whatever it is. But getting that, you know, having the foresight to prescribe. Put it on the schedule and not just, well, hey, let's see what you know, let's see how we're doing and we'll kind of wing it when you're in next time. Right. Um, just a recipe for your day to go sideways. Really quick. Really quick. And you know, when you're looking at your schedule and there's really no template to it, you don't have specific places for specific events. And when I say events like a new patient exam and we're just stuffing 'em in wherever we think they'll fit, that creates a chaotic. And chaotic schedule. I would rather have, you know, if I schedule somebody back for, for, you know, an adjustment of dry needling and we get to that appointment and we don't need to do the dry needling that day. Well great. I've earned myself, I've got five to 10 extra minutes Sure. To get something else done. I'd much rather have a little extra time somewhere than absolutely. Absolutely. So you've gotta have, in order to keep the chaos down, you've gotta have a really good relegated schedule. And so I'm gonna challenge the doctors out there listening to us. How long does it take you to do an exam? How long does it take to do an adjustment? How long does it take a patient in therapy? How long are all those events? And inside of understanding how long you spend on those events? Is where your schedule is. Well, and that, do you know exactly, do you know how long on average? And again, I mean, you know, throw us out, you know, umpteen different scenarios that sure are gonna change that, but on average, what are you, you know, what are you taking? Do you know how long you're spending on those? And then scheduling accordingly, or adding more time if you know somebody has a new injury or you know they're coming in for extra work, don't. On the schedule. Right, exactly. Don't just stuff 'em in somewhere. Yeah. So doctors have your staff time, you. Write down, you know, what, what is your average length of time that you're in the exam, for example. I think that, I think that's really a really important process and you know, those are a lot of the things that we as coaches really help our practices with is helping not have so much chaos, helping you guys have great procedures in place that fit your practice, not what somebody else did 20 years ago. You know, really helping your staff understand how to manage the practice while you're seeing your patients and those kind of things are important. If you don't have that 30,000 foot viewpoint from a coach, then you kind of lose that perspective because you're just in the forest and you can't see the trees. Yep. Well to that end, you know, an office that's updated procedures and. Right last year, the last five, last 10 years, you know, when was the last time that you've changed how you implemented or brought in a patient or how you took them through your clinic? Uh, you know, we've changed that several times over the last five years. Sure. You know, not just, you know, uh, okay. We've always done it this way, so this is how we do it. Patients have changed. Times have changed. You know, the way we onboard people has changed. So, you know. Has that been, have you stepped back and looked at just even the, the basics of how your patients are? How are they finding you? How are they getting your paperwork? How are they submitted to you? Do you know? What's your. What's your furniture layout in your, I mean, down to basics. There's so many things that Right. Hopefully have changed in, in your offices over the years. Uh, but if they haven't, that's, you know, that's, that's gonna be a starting point. Yeah, and that's a great point. You know, we always say that every 15 to 20 patient visits that you grow by per day on average, um, your procedures need to change. And your office flow may need to change. I can't tell you how many times we rearranged furniture and, and all kinds of things. It was just a constant thing. Um, and. You know, it's amazing when you do keep up with implementing those kind of strategies, um, it's, it's amazing how much more efficient your practice becomes. Oh, absolutely. And it's kind of fun patients, you know, that kind of stuff too. Oh yeah. They love it. Who've been coming in for a while. You know, that's the first thing. Oh. What, what'd you change up in here? This looks, looks great. This looks better. Yeah. You know, or just what's different right know kinda thing. And then it keeps people, again, you kinda get that, that, you know, burnout, you're coming three times a week or once a month or whatever for however long. You know, patients kind of, they come, you know, kind of store blind to what's around unless it changes periodically. Exactly. So doctors out there, there are ways to not create self-inflicted chaos. There's enough chaos and practice to begin with, just naturally. So let's not do things that make it worse. Alex, thanks for being on here today. You're awesome. We appreciate, we appreciate you, uh, coaching with us and, and, uh, gosh, I'm not even gonna say how long we've known each other, so. Everybody out there. If you haven't done so yet, go to cats consultants.com, check out everything we do to help doctors grow their practice, grow their profits, and have the practice of their dreams. So if you want to learn more about what we do, Go to the website, you can schedule a breakthrough call with us. They're free. We do these just because we like to get back to the profession. Let's see how we can best help you. So on behalf of everybody at Kats Consultants, thanks for tuning in to today's KC CHIROpulse podcast. That was a tongue twister! We'll see you next time.