12 Practice Killers

Building a successful practice means identifying not only things we need to do but also knowing what could kill a practice from growth and success. Without elaborating on the obvious numerous things like attitudes of positivity and love, smiling, dress code, a neat clean office, etc. I want to identify a dozen things that will kill practice growth and success every time they are not implemented.

1) Lack of Mission and Purpose

In short, your mission is your duty and direction and your purpose is why you are performing the duty. If you have no purpose you can’t have a mission, therefore, your practice would have no direction. If your mission was to serve as many people and their families through chiropractic care and educate them that they need to have a D.C. on their health care team to monitor their spine. Why? The purpose behind this duty would be because many health problems are a result of subluxations, and adjustments are to improve nerve integrity and wellness for the entire family. With mission and purpose, you have a reason to do what you do. With your mission and purpose in place you can now set goals which are merely points of achievement in life to shoot for.

2) No System

Without a systematic way of running your practice you can’t move from point to point with any predictability. Consistency of operation means efficiency in practice and patient management. Systematic communication is the most important because it works on what I’ve coined the “belief subluxation,” the one between the patients ears. Systematic procedures should be integrated with this communication to enhance the patient’s value to your purpose and mission so they become part of it. A system is crucial for patient compliance and retention, and doctor and staff CERTAINTY.

3) No Options

Within your system give the patient options. Most practices do this automatically, by giving different appointment times, days, payment plans, etc. One of the most important options to give the patient is on the first visit. Our history form asks the patient the type of care they want; temporary relief or maximum correction. In my seminar I teach doctors how to communicate options to patients so the patient doesn’t feel pressured to do something, yet is facilitated to choose the most empowering response, i.e. spinal wellness which includes correction then maintenance. They follow through because the option was available but they feel comfortable and comply because they chose it. They should also be informed that there are two types of chiropractors, those that do uncorrective spinal manipulation for back pain (musculoskeletal D.C.) and those that do adjustments to correct the spine to its normal spinal model to enhance maximum nerve integrity for optimum health potential (traditional wellness D.C.). These options give the patient the chance to choose what they want for their health care.

4) No Guidelines to Follow

Once the patient has chosen their option for care, payments, appointment days and times, they must be given guidelines to follow to get the best results. Without guidelines in your system people will miss appointments without calling, drop prematurely, not bring their family, not come to orientation class, etc. Your practice will stop growing because you’ll be spending your time and focus chasing people rather than having them take the responsibility themselves. Your practice becomes a headache versus a vehicle for helping them. One of my previous articles on guidelines to use in your practice can be read on our website

5) Focus – Neutral, Negative, or None

Focus determines actions, plain and simple. Focus should be enthusiastically on your mission and purpose. With all the previous points in place your system allows you to run from point to point without distractions or thinking of what your next move should be. This in itself improves focus. If focus is negative its usually on problems not solutions, its dwelling on the mistake, not on what is to be learned and changed. It could be on comparing yourself to someone else (America’s pastime) rather than God’s gifts and purpose for you. Neutral focus is simply having your focus on daily tasks without remembering the big picture. It’s robotic, scripted, rehearsed actions versus innate and purpose driven. No focus is apathetic survival. In all cases review your mission and purpose, move toward it step by step in a system.

6) No Specific Technique for Spinal Correction

Each doctor has to define his/her practice by the practice techniques they will use with their patients. This should be part of your mission and purpose or you’ll simply be popping backs indiscriminately. Your technique helps you define your patient management, how often they come, monitoring, criteria for end point, wellness care, etc. Your technique not only defines you as either a musculoskelatol back pain D.C. or a traditional/wellness D.C. but it gives the patient the option of choosing a D.C. for spinal correction and wellness care versus non-corrective spinal manipulation for back pain.

Stop practice death by starting to implement the first six principles in your practice. Next month I will continue with the next six practice killers. It is guaranteed that your practice will take on new life like thousands of D.C.s I’ve taught if you simply follow these principles.

Last month, we identified the first six practice killers. Hopefully you’ve started implementing some of these proven principles already; and are understanding that practice killers are not necessarily things we do but things we don’t do. So the first killer I want to talk about is …

7) Procrastination

The biggest killer of all is procrastination. It doesn’t only kill your practice but it will kill your relationships, your happiness, even your life. It’s a life principle we need to teach to our patients and apply ourselves. Simply put – DO IT NOW! One of my favorite versus in the good book is when James says, “Faith without action is DEAD.” You must take action. It is better to take action and fail then to take no action at all. Move, Start, Risk, Try. Mike Ditka said, “You are never a loser until you stop trying.” Patients can’t start taking care of themselves and expect to be perfect if they’ve procrastinated on maintaining their spine. “Tomorrow never comes.” Your practice success is exactly the same. Get off your duff, quit complaining, and take action. Implement the first six principles from last month, go to that seminar, make that call, schedule that talk or spinal screening, whatever it is, DO IT NOW! Too much analysis leads to paralysis and has also been found to be the leading cause of “crainorectal tunnel vision!”

8) High Pressure

Think of high pressure as high blood pressure. It kills!! Anything with too much pressure will eventually explode. There is no need for pressure if you have the right communication system in place because it educates and facilitates empowering decisions. That’s what CERTAINTY is all about. Making the doctor certain and the patient certain too. When there is no pressure, simply produce movement in a specific direction. CERTAINTY enables doctors to give the patient options and withdraw knowing that the patient will move forward enthusiastically in the most empowering way. Never pressure people, educate them on the options so they understand the benefits and consequences with the decision they make, then withdraw.

9) Not Persevering

“Persevering (through your struggles) builds character and character (builds) hope.” This is another verse that I live by. If your practice isn’t doing what you want, redefine your mission and purpose; check your system and operating basis. Are procedures in the system being done correctly? Review procedural tapes, revisit your seminars, ask questions to your mentor. But NEVER, NEVER, NEVER QUIT! Get this straight – chiropractors ARE NOT QUITTERS! If they were, we would not have chiropractic in the first place. When joining chiropractic, you are already joining a winning team. Character is who you are when no one is looking. Perseverance is the building block of character.

10) Not Confronting

Lack of confront means increase fear. We have to realize there will always be problems in life, but there will never be a problem bigger than we can handle. Remember perseverance? Confront is part of perseverance. The more you confront the simpler your life will be. Problems will be handled quicker and more efficiently and you will become a decision maker more readily. Confront also incorporates confessing and forgiving – one of the hardest things for humans to do. If you want success in your life and practice, remember, it is based on the relationships and confronting issues, other people, even yourself and your shortcomings.

11) Not Tracking

After every action you implement you have to evaluate the outcome. This is called “tracking.” When you do PR, establish a PR tracking sheet to track the mood, locations, procedures, overall attendance, percent of new patients coming in, etc. Track orientation classes, new patients that come in to your office, payment plans, start ratios, etc. If your outcome is unacceptable, check your procedures, focus, attitude, and overall system. If you don’t change your actions you will continue to get what you’ve always gotten. In the same way, tracking will help you see what works so you can continue doing it.

12) Not Balancing Your Life

Balance is the key. “Wherever your treasures are there you heart will also be.” When I was single and was just starting my family, I devoted most of my time to my practice. I shifted that balance as my family grew. Now I have six children! I have another company, I try to work with my church youth ministries, I spend more time with God and family because my heart has shifted. But the treasures I have now are greater than before. God blesses balance and I encourage you to seek it. Nature will force you into balance sooner or later. If you spend all your time in your practice making money, you may spend it in divorce or children’s therapy for the unbalance you caused in your life. You are in the balancing business as a D.C., so balance now and live your life with success and CERTAINTY.