141:Chiropractic Authority Complex Pt 2Sep 17, 2023
Chiropractic Authority Complex Part 2 Chiropractors. Are you ready to get out of the cubby hole? 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 joined with my co host, Dr. Troy Fox. Troy, this is a piggyback on the last podcast we did where we were talking about how chiropractors accidentally inadvertently, inadvertently is probably the right word, inadvertently cubby-hole themselves and lose their authority with patients. And wind up becoming, instead of chiropractic physicians, we wind up becoming chiropractic technicians. So we want to, we want to put the right spin back into practice, if you will. So this week we told everybody we would come up with some solutions for them. If they're in that cubbyhole situation with some patients or all of their patients in practice, don't panic. We're going to help you out of the, we're going to help you out of the hole, so to speak. So yeah, you and I have come up with a whole list of just really simple places to start on this. So I'm going to let you jump on the first one and just, let's just dive into these. Yeah. So we've got a four piece that's we made it simple. This so four steps. So if you're writing them down, this is number one. Hey, here's how you do it. Right at the beginning, because all of you have practice members that have been around for a while and you have new people that are entering your practice, right? Step number one, and we'll get to actually something that probably preempts that step at the bottom, but we'll enter that at the very end. We'll talk about kind of, it's, it's the bow on top. All current or all new patients that are coming in, get an exam. No questions asked. If you're not doing exams on patients, you're going to start today. You're going to start doing re exams after six visits. You're going to, you're going to also with any current patients that are in the system right now, you're going to go back and review x rays. So all those patients that are coming in, any x rays that you have, let's say you took a scoliosis series on a patient. When is that supposed to be repeated? Look at those, right? Find out what needs to be done. So those are what you're doing. And then you're going to follow up exam with patients as well. So in other words, re-exams, new patient exams, and if a patient's been under care and we're doing a reexamination at the end of care to determine a new course of care, or where do we go from here kind of thing, um, we're going to follow through with all those. Right at the beginning. And here's what's great about that. Your new patients coming in the door. They don't know any different. Yeah. They don't know you're doing what you're, what you should have been doing, and I'm not impugning you. I'm just saying, if you're going to get back on track, there's a great place to start. So we're going to start with that. That's number one. What's number two, Mike? Number two is every patient that is already coming in. Is it time for a progress exam? Okay. If you haven't done a progress exam in a while, you have cause to do a progress exam and you tell the patient if it's been a while. You tell the patient, Hey, we need to do a follow up exam on this. Insurance requires us to prove medical necessity. Our malpractice company wants us to be doing these, but most importantly, we want to make sure that we're proving medical necessity so you can use your insurance benefits. If it's a cash patient, it's still kind of the same story. Hey, the, the process of delivering good care, the confines of good care is we need to do a progress exam and determine and document. Exactly where you are in care. So we know how to proceed. It's a super simple conversation. And don't, don't try this conversation cold, practice it a little bit, but it's super simple. And then this is something I did anyway, in practice, every patient coming in this week, I had my staff pull their x ray reports. If they had x rays and I go through those x ray reports and I'd look for things that needed to be re-evaluated. Oh, this guy has a grade three spondylolisthesis. We did x rays over a year ago. It's probably time to update these and make sure that's still a grade three or is it had, has it slid to a grade four? You know, what's the stability factor of it? You know, those are things that those are things that follow the red flag rules on x rays. So follow the rules That's all you're doing and you tell the patient you've got this unstable area in the low back We need to reevaluate it and make sure we still know where it's at And I love how you're throwing it back on malpractice and insurance, because now, now you're basically saying, Hey, this isn't me saying this, this is our industry saying this, which is a true statement. So it gets you off the hook for anything that you may not have done that you probably should have done. So next step in this process is. Having staff meetings and having some written procedures about how you're going to do this, your staff needs to know before we go there. I just thought of one other thing. Okay. Just thought of one other thing. It's just popped in my head. So five points, annual exams. If you haven't, if you've got patients that you haven't done an exam on it in a, in a year or longer, tell them, Oh my gosh, it's time for your annual exam and just be, just be matter of fact about it. They hear that exact same thing from their dentist, their medical doctor, their eye doctor. Okay. Every doctor they go to, there's an annual, at least one annual exam. You go to the dentist, there's two, you go to the eye doctor, there's two. Um, you, you have eyesight like me, there's three, you know, so your patients are hearing that. Why aren't they hearing it from you? So these are simple, simple steps to start unwinding that cubbyhole that you may have yourself in. It's not hard to get out of unless you don't change. You've got to change. So start looking at this different new patients. Easy. They don't know any different new condition. Okay. Don't shortcut your care. They need an exam. Just be emphatic about it. You need to have an exam. You got a new, you got a brand new condition going on. Pull those x-ray reports. Do those annual exams. And you'll pick these off really easy and start pulling your authority back to yourself. Now staff meetings because this is the other side of the ledger that you can't give. You know what? Hold on. Yeah. Before we jump to that, because this is a great spot, but, but I really want to dive into this next part. Let, let's throw a word in from our sponsor right here. It's a little early in the show, but let's, let's come back and we'll really dive into this. So we're talking about how to regain your authority and get over authority complex in your practice. Simple steps to get there. So we'll be right back. SPONSOR MESSAGE All right, everybody. Welcome back to the KC CHIROpulse podcast. We're talking about how to unwind yourself from being in the cubby hole of a chiropractic technician and how to regain your doctor authority with your patients. So Troy, we went through some simple steps. I'm sure everybody's written them down. If not hit, rewind, listen to this again, you were starting to jump into the staff side of this. And I wanted to separate this a little bit because this part is so important. It is important. And you have a couple of factors when you do the staff side of this number one, they need training. But number two, as as Lucy used to say to Ricky, or Ricky said, I don't know, I think Ricky said it to Lucy, you have some explaining to do, you know, that was not a vert was a Ricky. I'm not a very good Ricky. But, uh, So you may have to actually explain to your staff why you've done what you've done, and that maybe you didn't do as good a job as you plan to do in the future, that your commitment to patients has been renewed. Um, here's what we're going to do, but you have to present it to the staff in a way that they're going to come on board with you because they're going to, if you don't handle this the appropriate way, there's the staff are going to be the one that are going to have to handle the rejection. And you're not going to, you're not, they're not going to enjoy that very much. So it has to be. Uh, from a standpoint of the staff meeting. In other words, you have to have written procedures. Now it does become very easy for staff when the doctor says unequivocally, if I haven't seen a patient in over six months, I'm going to do a re-exam on them. If I haven't seen a patient at over two years, they're considered a new patient. If I haven't seen a patient in over a year, they're considered a current patient, but I need, I need a more established, uh, or a higher level of exam. Um, and if I have all that written out, it's just literally hanging there at the front, which my staff has, it's really easy for them to tell a patient, Hey, here's what we're going to do. And if that patient says, well, I'll just go to blah, blah, blah. Okay. Well, good luck. You know, quite frankly, my whole. Process in my office is that I want patients that want the best care. I'm not necessarily the cheapest, but I'm going to make sure that when you do come in, you're going to get the best care and that you're going to get qualified care. In other words, I'm going to give you a good exam. I'm going to make sure that that exam covers all the bases, but you're going to pay for said exam. So as a result of my staff understands, that's how we do things. Then there's no, well, this patient didn't really want to pay for the exam. And conversely, you as the doctor also not walking up front and going, well, this guy lives five and a half miles away from me. He's kind of almost family member. Cause he lives so close. We're not going to charge him today. You can't start that either. So you can't start the poverty complex slash. Uh, identity crisis that you create. Yeah. That's how you get to that authority complex to begin with. Yeah. It becomes an identity crisis. You forget that you're a doctor, that you're supposed to provide all this stuff. So those are the things that you need to talk with, with the staff. And then you need to have repeated follow up meetings about that. That should be a small part of your staff meeting. It, once you start this for at least the next six months until everybody gets comfortable with it. Even if it's just a couple, three minutes, Hey, let's reiterate. Let's talk about, and here was a case that we had last week. How could we handle the verbiage on this a little bit better? It's because there is verbiage. There is. And, and you've got to have a communication strategy. And so think of your staff as your success partner. In large part, they are your mouthpiece with patients. And so if you're talking to a patient about. Next time when you come in, we're going to do a progress exam and they go up front and they say something about, well, doc wants to see me for something called a progress exam. And the staff says, Oh, we hardly ever do those. The staff just. Just yanked your authority right out from underneath you. So you have to be on the same page. So when that patient goes up the front desk, the pay or the yeah, when the patient goes up the front desk, the staff already knows before they get there. Hey bill, we're going to do a progress exam next time. This is super exciting. We get to see where you are in care and how well you've progressed and what happens from here. Aren't you excited? And of course the patient's going to say, yes, notice what I did. I got engagement from the patient there. So you teach your staff, these little communication strategies that just nail the process. So the patient's going, Oh, this is the normal route. This is what I should be doing. Everybody's excited about it. I guess I should be too. And I just said yes to the entire process. So we must be doing this. This is how you get your authority back. Your staff really should be there to help you with this now. This takes practice and Troy, you said it, you got to have this built into your staff meetings, probably for the next six months where you're practicing this, discussing it over and over. So staff understands the importance of the direction you're going with your, your, um, your, your new procedures and so forth, if they're new. Yeah. And so they've got to be bought into it. Now, on top of that communication wise, and this was kind of our fourth point that we were talking about was communication. It kind of blended from staff into doctor. But if you listen to us on the last show, we talked about some things we talked about, like loss of disc height. We talked about, uh, you know, mechanical motion of this and deg. And degradation to this, we talked about Wolfe's Law of Plastic Deformation. We threw out some terms that you guys all remember from school and maybe you're not using them every day. I will tell you that they're powerful tools with our patients. What you have to develop is your story. Which is the chiropractic story. What happens when that kinetic chain no longer functions as it should. What are the steps that it goes through? And every one of you should be able to pull out a piece of paper and really quickly, probably write down half a page. A really nasty stuff that happens to the human spine when that kinetic chain falls out of favor with the human body. Yep. We all know what happens. Isn't that the story that you should be sharing with your patients? Isn't that the story? You remember the iceberg poster that people had hanging on their wall? Here's your pain, here's your condition. Isn't that the story that we should be telling our patients is the real story about what happens? You don't see medical doctors or surgeons holding back when they say, Hey, you have gangrene in your toe right now. Probably not any big deal. Don't worry about it. As long as it doesn't hurt, I wouldn't worry about it. Put some bio. We'll give you some bio freeze on it. Um, but what, what happens is, is they take it seriously and they say, here's, what's going to happen long term to you. And here's what 20 years from now. As I look with patients, I do the same thing and I start with that story up front and you know why I do that? I start with that story up front, day one when I'm working with a patient with pain because I want them to understand what type of practice I am. We're a health and wellness and maintenance practice. And what does that mean? Because patients have been in maintenance practices. Some of them say, well, yeah, I get chiropractic care once a month because it makes me feel better. Okay, well, my job's done, right? No, it's not done. They don't even understand really the actual benefit that they're getting from getting periodic care, right? They just think it makes them feel better. It's not a whoops. It's not about feeling better. I got excited. There fell off my desk. It's not about feeling better. It's about removing the cause of forces that caused the spine to fail. Ultimately, yeah. It's, it's that plastic deformation when that kinetic chain is off of its normal axis. That leads to slow degradation of the spine, which ultimately leads to spinal failure. And I'm using orthopedic terms. When I say that you can go look it up and in spine magazine thing. This is how the orthopedist talk. It's about spinal failure. So Yeah, this is how we need to be talking to patients. It's yes, what we do feels good. Yes, what we do patients get up from the table and walk out and they feel great and they come back periodically to get that renewal adjustment as I like to call it, but it's really about maintaining a spine in its normal. Posture. I'm using air quotes if you're listening so that we avoid as much of Wolf's Law's effects on the spine as we possibly can. Yeah. Did you guys grab that nugget? I mean, just like 45 seconds ago, you just nailed 40 and chiropractic practice. I mean, nailed it like with a big old hammer sledgehammer. What did you just say? You talked about talking in terms like an orthopedic surgeon. Why would me not be talking in the same terminology as an orthopedic surgeon about damage to the human spine? Are we dealing with a different spine? No, I'm dealing with the same one that the orthopedic surgeon deals with when we can't have the effect that we want and they end up down a road where they end up having to have surgery, unfortunately. That does happen now and then with patients. Are we dealing with the same degradation, the same damage, the same loss? Absolutely. We are as a cultural authority, I need to be talking about those things. I don't withhold and say, well, yeah, you've got a joint that's in or out of place. Mm-hmm. , and that's what we need to work on. How about we talk about what really happens? Yeah. It's the same physiology. How. How about we use the physiology and we start talking about the things that happened to the human spine. That was the, might be the biggest caveat that you might have picked up today is use your cultural authority. Start using your big, big boy and big girl words when it's appropriate. Absolutely. It is appropriate. Yeah. Patients need to understand why they're coming to you for care. And if you're treating the same osseous ligamentous structure that that's exposed to the same physiological conditions and, and so forth that the orthopedic surgeon is seeing. Yeah. You're seeing the same spine. Yeah. Your orthopedic surgeon doesn't dumb it down. Why would you? Yeah, you don't need to, I mean, yeah, there's as a result, if you're not going to dumb it down and you're going to start talking in those technological terms, guess what, when you start talking about an exam, number one, you better be on your a game when you do the exam and number two, you better do an exam because now, now you're talking about a very important structure that requires interaction and so now you jump in the middle of that. So practicing your communication with the patient is. Uber, Uber valuable because it shows you as an expert in the field of what you are an expert in. My gosh, people, you're so good at what you do. Show it. Yeah. And we just came full circle back around to authority. Yep. Yeah. And that's how you build and maintain your authority. So you stay out of the cubbyhole. You've got to talk and act like a doctor. Do your doctor stuff. You're not a technician. Okay. And if that's the kind of practice you want to have again, we're not, we're not thwarting your thought process. You know, I understand there are people who like to come in and just get a periodic adjustment and they feel good and that's great. However, you can. If you're wanting a different type of practice, if you're wanting a high end, high impact type practice that really is making a difference in the community and in people's lives, and you really want to build that doctor authority up and lead your patients. Instead of them leading you, I, if, if I was in your shoes and I felt like I was in a little bit of a cubby hole, I would go back and listen to the last podcast and this podcast over and over. I'd set my staff down and have them listen to it. And I would tell my staff, this is what we're going to do in our practice. We're going to start today setting strategies and putting action plans in place so that we can bring this kind of chiropractic philosophy into the practice and help our patients at a much higher level. Yeah And if we make you, if we made you angry today, good. That means that you're listening and that you're alive. And if you're listening and you're alive, we at least made you think about this. Because that's the whole goal. We're very passionate about helping chiropractors. We're very passionate about chiropractic. And I'm very passionate about philosophy as well. Which sometimes grates people in ways that you can't even imagine. Because there have been people mad at me. People either love me or hate me. You're, you're polarized when you listen to me, talk about philosophy, but the truth of the matter is I'm passionate about chiropractic. So if Dr. Perush and I angered you today, then we probably did our job. And our job is. To disrupt the common thinking process. Yes. And to help you just start to think in a different way. We, we, we like to be disruptive. That that's what we want to do. We want to, we want to help you think differently. We want it to help you think on a higher level instead of just going in and treating patients every day, head down, doing it the same way you've always done it. Maybe you haven't been in practice for 15 years. Maybe you've been in practice as long as we have. I'm not going to say how long that is, but our whole goal is to just create some disruptive thought process. So if we push the envelope on you a little bit today and last, last time, that's good. That's what we're trying to do. We're trying to get you to open up and just think differently. So, you know, do us a favor. If you want to send us some thoughts, um, send them, don't send them to me. Send them to send them to Troy at Kats, get @KatsConsultants.com, [email protected]. No, seriously, if you want to send us some thoughts and, and maybe it's some ideas for some follow ups to this podcast and what more you'd like to hear, please send it in. We'd love to hear from you guys. That's our whole goal is to get you thinking. Yeah. So hopefully we put a lot of thought process in your head this last couple of weeks, and, uh, we'll come up with something fun next time as well. Absolutely. Troy, anything to add? No, I think we nailed it between last week and this week, quite frankly, it, you guys take this information and go out there and I guarantee it'll transform your practices. Yes, guaranteed. Awesome. All right. You guys, if you haven't already go to KatsConsultants.com. We've got all kinds of things on there. You can, there's some free downloads. You can see our events, you can see everything that we do for coaching and helping clients out there. And if you're ready to get on the path to profit, give us a call. We'd be happy to do a breakthrough call with you and just find out what's going on in your practice. We just love talking to you doctors out in the field. So all right, everybody, thanks for listening to the KC CHIROpulse podcast brought to you by Kats Consultants. We will see you next time. See ya. The information presented in this podcast is not intended to offer any diagnosing or treatment of disease. This information is presented for education and entertainment purposes only and is not indicative of any results, or any promise thereof, that you may encounter in your business should you adopt any of the information presented. The viewpoints presented are merely the representative opinions of the speakers.