In coaching many DCs in practice, and directing hundreds prior to opening their own practice, I’ve identified a “theme” that recurs, not often thankfully, but recurs nonetheless.

It has to do with a person, we’ll call him “Ralph”, who is faced with some problem that has yet to be overcome.  He has already figured out the reason for his failure, or so he is convinced… at least at first. 

What I mean is I believe Ralph truly is convinced about “why” something is as it is, why something won’t work, or why he hasn’t been able to overcome… but there comes a time in coaching that it becomes obvious, maybe to everyone but Ralph, that he is so hellbent on defending his “reasons”, he would rather be “right” than embrace a solution and move forward.

It’s rather fascinating to ponder… I suppose we all might have weak moments when we’re guilty of such behavior.  But whether of pychological or spiritual origin, I wonder why certain, otherwise highly intelligent people embrace this Victim mentality… “I’m going to continue to fail, and here’s why”.

As one of my mentor’s has said, those who fail will always make excuses… or what they’ll refer to as “Reasons”.  We all get knocked down, we all face adversity, we all will find ourselves in a place where the answer is not readily apparent… No one is exempt from these moments.  It’s part of life, isn’t it?

But doggone it, do not stay there.  It may take work and searching for wisdom to figure your way out…The questions to ask yourself include, “Okay, now that I’m here, what next?”  “What’s my next step to put the failure behind me and to overcome?”  And when someone in-the-know is throwing you a lifeline with “Solution” stamped all over it, don’t be so proud, or bitter, or strangely comfortable in this role that you cling to your “Reasons”, choosing to remain a victim rather than climb out of the muck.  

Maybe the most interesting (and telling) of these cases is when the stated ”reason” for failure changes… just kindof morphs into something else… as solution after solution is offered. 

Here’s one example.  Dr. Ralph has too many of his new patients (most who truly need care) opt against care, or they discontinue their treatment prematurely. 

Dr. Ralph has it figured out… he must be charging too much.  “I’m pricing myself out of the market” he claims.   Interesting that other doctor’s in markets with nearly identical demographics to Ralph’s charge just as much or more for their care… but he is convinced.  He has his reason, and he’s sticking to it. 

With a little checking,  it turns out, Ralph has difficulty communicating the value of care to his patients… often a symptom that he himself is not very confident in what he offers. 

Well, how about working on that?  Ralph, what value do YOU place on the care you provide your patients?  How about comparing the ”life-changing” care you offer to a few hours spent in the ER for a kidney stone ($6,400… never mind this was not treatment of the stone, just diagnostics and some pain meds).  How about the cost of braces?… how much will a parent, in your community, plunk down to have wires fastened to their kids’ teeth… largely for cosmetic reasons mind you, not truly “health” related?… Between $4,000 and $6,000?  

What’s the cost of surgery on a wrist, or on the spine?  Surgeries which YOUR care might prevent!  I don’t know… what can your care enable people to do again??  What will it save them from??  Is it worth it to them??

“Well, that’s not it”, he says, “I do value my care, but my patients won’t”.  He’s convinced.  And the problem has bled over into all areas of his starving practice, because he defends this scenario, “even if people come in, they won’t value my care enough to actually pay for it.”  Bad place to be, concept-wise.

Okay then, if you won’t go there doc, how about this?…  let’s work out some new financial options your office can offer, allowing patients to receive your care while making more ”affordable” payments.

Problem solved, right?  I mean, if the whole issue of poor acceptance is monetary, than this should be the solution, right? (or at minimum, will offer many more patients the flexibility to work payments into a doable budget).

Nope.  Not this time.  His “reason” just morphed… did you see it happen?   Quick as Optimus Prime into a semi (my kid loves Transformers).  And it doesn’t really matter what it’s morphed into… it might be, ”Well, you know I’m really more of a “pain relief” doctor, and I don’t understand what “treatment for condition” nor what “wellness” are all about“.  Or it might have become, ”Well, you’re Italian and I’m Irish, so that solution won’t work” (what??)  Or, whatever… and what really just happened is, Ralph was never really looking for an answer anyway, because it might involve moving out of his comfort zone, and worse yet, would mean he’s no longer ”Right”. 

So here’s a question for you… is there an area in your life where you see yourself as a Victim? 

Do you have “reasons” for why you haven’t overcome? 

 Or, do you rather see yourself as Responsible, knowing with the right direction and the right wisdom applied, you will, without a doubt, no matter what your present circumstance, rise above any setback or “failure” you experience?  Are you looking for answers, or to be ”Right”?

Are You looking For Answers, or To Be “Right”? is a post from: AMC Right Start

I was clueless back then.  Not just in a culinary sense, but in my concepts of what things were really worth my time and attention.  I was so focused on getting through all the requirements, while maintaining my 3.something GPA.  Then came state Boards.  Being from a suburb of Buffalo, many people have asked me how I settled on North Carolina as the state I would live and practice?  My honest answer?  I placed my finger over Buffalo on a map, and traced an imaginary line due south!

Using no other line of reasoning than climate, I decided it would be Virginia or North Carolina, wherever I could first find a decent associateship.  How’s that for strategery?! 

So end of 1992, my headspace was all about graduating and passing these two state boards… which I did, Saints be praised!  And in February of ’93, I was blessed to land a decent associateship (I know, most often an oxymoron) in Durham, NC.

You see, I knew I wasn’t prepared to run my own practice.  It had nothing to do with my “book knowledge” of patient care.  I just somehow intuitively knew that real-world practice was going to be quite different from what I or my classmates really understood.  And other than going the Associateship route, I was unaware of any specific resources or coaching/management where I could obtain that knowledge even had I wanted to immediately open on my own.

But today, a real, workable game plan does exist.  There are preferred ways to go, and not-so-preferred ways as well.  The key is following in the footsteps of success, and to learn from other people’s experiences who learned lessons the hard way.  A smart man learns from his mistakes, but a wise man learns from others’ mistakes, so that he won’t have to make them himself. 

In economics, it is called “Opportunity cost”.  When a decision to go in a certain direction is made, one not only pays the consequences if it is a bad one, but also misses out on all the good that would have come from making a better decision. 

In the context of the total number of years (hopefully) you intend to practice, one bad decision may cost you hundreds of thousands of dollars paid out in needless overhead, not to mention grief and frustration.  In opportunity cost, that same bad decision might mean touching far fewer lives through chiropractic care, and millions of dollars in lost revenue you otherwise would have earned.   

 So what are students thinking??  Here are some of the things I’ve heard at our recent college bootcamps… “I’m going to need (somewhere between) 80,000 to 300,000 dollars to open my own practice”.  ”I’m going to practice in ______ because I grew up there and will have a good start with all my friends and family”.  “I’m going to look for the most affluent areas I can to open a practice because it’s easier to grow where people have lots of disposable income”.  ”I’m going to open a practice in Myrtle Beach because I love the ocean and I love to golf”.  “I’m going to open in the big city because that’s where all the people are”.  “I need to purchase all the latest equipment, like digital X-ray, and (basically) build out a Taj Mahal practice”.  ”I’m going to cover my walls with ’Discover Chiropractic’ posters, and display all sorts of products for purchase in my reception room such as pillows, vitamins, Biofreeze, etc.”

How do these thoughts sound to you?  Do any of these seem like good ideas?  Let me know and we’ll talk.  Someone has gone before you and has already figured these and a thousand other decisions out.

Successful Openings – Is There A Plan That Really Works? is a post from: AMC Right Start

If I get hit by a truck, take me to the ER.  If I have a heart attack, call 911.  If I have a genetic anomaly or inexplicably develop a disease such as diabetes or a cardiomyopathy requiring  life-sustaining medication, then give me that medication.

Some conditions are beyond chiropractic care to be enough.  Not that one won’t still be better off with chiropractic care than without it.  But in cases of life-threatening emergencies, or health issues either not associated with subluxation, or too far gone beyond full recovery, then give me the best that Allopathic care has to offer!

But for most everything else… I’m looking for my good colleague for an adjustment.  Some of you don’t get this.  Particularly if you’re a student or a new grad.  But thousands of DCs in practice today haven’t gotten this either.

I have an ongoing conversation currently with a newer grad who has been open in his own practice for about six months.  An extremely bright and intelligent young man.  Yet maybe due to the chiropractic education received from his Nurturing Mother, he has little confidence in his abilities beyond pain relief and improved joint mobility.   His main hangup is that while he’s aware there is research “out there” on the effectiveness of the adjustment beyond pain relief, he has not (yet) witnessed any such cases with his own patients. 

The origin of his lack of confidence in this area could take multiple blog posts to address.  I would request multiple comments from students who are being fed the “when all else fails, try adjusting your patient” gruel at their school… the “a subluxation does not exist” drivel that too many at our institutes of higher education are being misled to believe as scientific truth. 

We therefore have an entire generation of new grads and soon-to-be-grads, as well as gobs of DC veterans, who have NO IDEA who they are nor what they can provide for a suffering humanity who are desperately seeking their care in their community. 

If you are in practice, and are not aware of any conditions that have ever improved or resolved in your patients other than their pain symptoms, then you’re either not asking the right questions, or in some cases you’re not treating beyond simple relief of pain.

I used this example with this new doctor…  “I live in central North Carolina.  I have heard some claim that there are mountains in NC.  Some have stated, anecdotally, that the Atlantic ocean can be reached without leaving my state.  There is even proof of this in the geographic and travel resources.  However,  I have traveled to the outskirts of Wake, Chatham, Durham, and Orange counties, but have yet to see any mountains, and have not seen a coastline… since I’ve not seen it myself, I cannot believe these claims to be true.”  The real truth is, either I haven’t traveled far enough, or in many cases, I’ve just been looking in the wrong direction.

Didn’t plan on this post going in that direction, but just as well that it did.  This one can’t be ignored.  Our profession will never be #1 when so many of our fellow “Doctors” are practicing as glorified physical therapists.

What else needs to happen before our profession rises to it’s rightful place in the American public’s healthcare decision making?  We’ll dive into this one more deeply, but I’d love to hear your viewpoints.  Feel free to type out a quick comment.

“til then…

Are We #1? is a post from: AMC Right Start

What was in the FedEx package?? is a post from: AMC Right Start

  Cold.  Rainy.  Grandpa.  This fella’s choice of transportation was either due to a late-life crisis, or my guess is “the economy” had something to do with it.

  The “bad economy”, or the perception of such, has caused a lot of people and businesses to do wacky stuff.  Now I don’t deny that some businesses have been hurt, nor that people have lost their jobs due to the shift in where dollars are being spent.  But how did it all spiral out of control so quickly and so deeply?

  It’s true risky business decisions were behind the banking industry’s virtual collapse.  But I contend that part of the reason this downturn has cut so deeply falls on the shoulders of the news media.  National and local news outlets, whether television, radio, internet or newspaper, pervading every community around America. 

  Some of you are probably nodding your head in agreement.  And I can hear some of you right now… “Has this guy lost his mind??”  Here’s what I mean…

  Bad news sells.  Fear sells.  And no matter which network or news outlet, when there are only so many “news” pieces that are prepared for airing, the same bad news is repeated again and again, all day, day after day, ad nauseum. 

  One doesn’t need a BS in Economics to understand that the stock market and other economic influencers are themselves influenced by the public’s confidence and perception of reality.  It works in both directions, spiraling upwards or downwards.  How much of the “bad economy” is self-fulfilled prophesy, accelerated by those purveyors of fear, the aforementioned news media??

  Have you heard the story about American Indians in Montana?

  It’s late fall and the Indians on a remote reservation in Montana asked their new chief if the coming winter was going to be cold or mild.  Never having been taught the secrets of his ancestors, when he looked at the sky, he couldn’t tell what the winter was going to be like.

  Nevertheless, to be on the safe side, he told his tribe that the winter was indeed going to be cold and that the members of the village should collect firewood to be prepared. 

  But, being a practical leader, after several days, he got an idea.  He traveled to the nearest outpost that had a television and listened for the weather forecast on CNN.

  ‘It looks like this winter is going to be quite cold,’  said the CNN reporter. 

  So the chief went back to his people and told them they should collect even more firewood in order to be prepared.

  A week later, he traveled to the outpost again to watch for any forecast updates.  

  The man behind the CNN newsdesk reported, ‘it’s going to be a very cold winter.’  

  The chief again went back to his people and ordered them to collect every scrap of firewood they could find.

  Two weeks later, the chief checked one more time.  He watched until hearing the reporter say:

  ‘It’s looking more and more like it is going to be one of the coldest winters we’ve ever seen.’

  Concerned, the chief walked over to a payphone and called CNN.  He was able to get the reporter on the line and asked him, “are you absolutely certain this is going to be one of the coldest winters ever?

  ‘Absolutely,’ the reporter said.  ‘It’s shaping up to be one of the most severe on record!’

  ‘How can you be so sure?’ the chief asked. 

  The reporter replied, ‘The Indians are collecting firewood like crazy.’

  Remember this the next time you watch, read, or listen to the “news”!

  So what do you choose to focus on; to think about?  How much of the daily news do you watch, listen to, or read?  Do you feel you must read your morning paper or morning I-net news source so you can stay current?  Are the national or local news stations played frequently in your household?  Are you a fan of talk radio, so that you’re constantly bombarded by someone else’s viewpoint of current events?… 

  If so, may I suggest putting yourself on a “fear and negativity detox plan”, whereby you decide and then act upon going at least 30 days without any news from a paper, TV, radio, or  Internet… a mass news-outlet fast, if you will. 

  Instead, use that time to read, watch, or listen only to things that will build you up spiritually, mentally, emotionally, and feed positively into your dreams to achieve whatever it is you were placed on this earth to accomplish.   You might find that you become more productive than you’ve ever been before.  You might find you’re daily outlook change for the better. You may find it easier to focus on the things in your life that are truly important and meaningful.  You may even decide to make a lifestyle choice to continue your fast beyond the 30 days.  Give it a shot. 

I’d love to hear what difference it makes in you.

Economic News You Won’t Hear on Oprah is a post from: AMC Right Start

   A chiropractor in private practice is really an educated entrepreneur. 

    And

  …the skills and information needed to be successful are over and above what you’ve been trained for in school!

 If you’re reading this and you are still a student, you have learned some concepts that place you light years ahead of your colleagues, and yes, ahead of many a practicing DC trying to build a practice and earn a living.

 Why do so many of our brethren and sistren(?) struggle?  The answer lies in ”The Two Techniques”.  There are two techniques that you must be aware of and attempt to master to be successful in your practice…

 Ready to hear what they are?  The first is the main adjusting technique you plan to utilize in your patient care.  So much focus, time and effort are put into learning an honing our treatment skills.  School, continuing education, seminars, certifications, in some cases investing in special equipment… all to become good if not great with our patient treatment.  Yes, extremely important.  But unfortunately this is where it begins and ends with most docs.  What is missing is the 2nd technique…  And here it is… you MUST become a master of…

 Logan Basic Technique

 Just kidding.  Did anyone panic, even for a millisecond? 

 The second technique is… Business/Patient Management technique.

 Here’s how it often plays out, in any profession.  Let’s say, an attorney, or a CPA, or a plumber.  That person may have come right out of school, but often times goes to work for someone else first.  And that person becomes very good at the “doing” of their work.  The attorney has learned to research cases, build arguments, and has become a whiz in the courtroom.  The CPA is a magician with the numbers, and is trusted with some of the firm’s largest accounts, etc.

 And then that day comes, when he or she reflects on this question, “Why am I working so hard and making all this money for my boss?”  Followed by this assumption,  ”I can be doing this for myself.  I’m going to leave this place and start my own firm/company/business”…

 And THAT is where the “Fatal Assumption” comes into play (see last post about E-Myth’s Michael Gerber’s coined term).  Which in our example means this… just because an attorney, a CPA, a plumber, a doctor,… has become very good at the technical work their job requires, this has absolutely ZERO correlation with their potential to succeed as an entrepreneur running their own business!

 This is a HUGE concept to grasp, and it’s significance cannot be overstated.  If you’d like to read a bit more on the two techniques written by a leader in the chiropractic profession, take a look at Dr. Todd Osborne’s blog post from a couple months back:  http://www.drtoddosborne.com/2009/12/08/two-techniques-required-for-success-in-chiropractic/

 After checking Dr. Oz’s post, come on back and let me know what you’re thinking.  ‘Til next time…

Why Most Chiropractors STRUGGLE In Practice – Part II is a post from: AMC Right Start

  If you’re a newer visitor here and you have a few minutes, go ahead and review some or all of my prior posts.  No really, go ahead… I’ll wait…

  I’ve focused on why so many DCs struggle in practice.  Really and truly, with what we have to offer a suffering humanity, we should be the #1 Healthcare choice in America and throughout the world.

  I noted that I believe part of the problem traces back to false assumptions made early on, while mere students in Chiropractic College.

       It’s time to flesh that out a little more. 

   Our Colleges and Universities teach us the technical aspects of “being” a doctor.  And that is their role, by the way.

   You’ll recall we’re first taught an understanding of the basic sciences… the “ologies”.  It should be comforting for students to learn that no patient has ever asked me how many times NAD+ enters the Krebs cycle.  And I can tell you exactly how many times I’ve used a microscope since 1992… uhh, once; and that’s because my eight year old wanted me to check out his snot under the lens of his new gift. 

   Where was I?  Oh yes… In school we learn to identify subluxation and other pathology, to diagnose, and to treat with chiropractic technique or refer out for further diagnostics.  Upon graduation, we are hopefully at least “competent” entry level physicians.

   Now some of us are “beyond competent”.  You or some of your classmates may be (have been) exceedingly skilled at the “doing” of chiropractic.  You’ve learned how to adjust people, and you’ve seen the results. 

             But that’s not enough if you plan to do well in practice!

   As a chiropractor, you are a doctor; however, once in practice you are not automatically within a physician referral loop.  Your practice will only grow and do what YOU decide and act upon to make happen.  In fact…

    A chiropractor in private practice is really an educated entrepreneur. 

   Stop and repeat that last sentence, and let it sink in.  If you plan to be in your own practice, like it or not you are an entrepreneur! 

   And the skills and information needed to be successful are over and above what you’ve been trained for in school!

   Michael Gerber, author of “The E Myth” refers to this as truth as “The Fatal Assumption”.  He writes that so many business owners have made this unfortunate leap in their thinking:  “If I understand the technical work of a business, I understand a business that does that technical work”. 

 In our case, the technical work is “being” a doctor and “doing” adjustments.  Gerber continues, “the technical work of a business and a business that does that technical work are two totally different things!

   Stew on that for awhile.  I promise we’ll continue with this idea in my next post, because although it may not be the whole enchilada, it’s at least the Grande Combo, and too large for one ordinary blog post to handle.

 Are light bulbs starting to go on?  Care for guacamole with that? 

How To Grow A Successful Chiropractic Practice… MAJOR MISSING INGREDIENT REVEALED is a post from: AMC Right Start

 Stories such as these are heard over and over in our profession.  Remember the “myths” we discussed in my last post.  Hers was a common one… “I was on fire for chiropractic… I didn’t need anybody to tell me how to do it”. 

      “I’ve got this”

      “I’m all over it”

      “A coach or a consulting group is for someone else… I’m smart, mentally tough, and I’m going to be THE doctor in my town… all I need is just to “get through” this academic stuff…”

 We can call it pride, or extreme self-confidence.  Doesn’t really matter because it really boils down to a (hopefully by now) familiar truth… You don’t know what you don’t know.  So therefore you don’t really know what you’re missing from your tool belt.

 It’s like building a house.  You’ve got:

• Lumber?  Check!
• Saw?  Check!
• Hammer?  Check!
• Nails?… Where are my nails??

 There’s nothing to hold it together.  Too many docs have their practice held together with duct tape and chewing gum.  More about that in the next post, as we continue on Why Most Chiropractors Struggle In Practice…

“When I came out of chiropractic school, I was on fire for chiropractic and I was determined that I was going to do this on my own…” is a post from: AMC Right Start

But dreams based on myths don’t come true.  Here are some of the most common myths about practice success that plague the minds of chiropractic students and graduates alike:

• If you graduate from “this” school…or hang “this” sheepskin on your wall…
• If you use “this” technique, that’s all you need… 
• If you use “this” piece of equipment… 
• Just get good results with your patients, and it’ll open up the floodgates of referrals into your practice… 
• “I’m intelligent, I’m a Go Getter, I’ve always been successful at  anything I’ve done, I can figure this out on my own… (How hard can it be?)”…  
• Or BJ’s famous, “just drive your car ‘til you run out of gas, and build your clinic there.”

  Maybe ½ or ¼ truths, or flat out untruths.  It’s remarkable to me how many students and new grads are in the, “If you build it, they will come” camp. 

 Speaking of which, chances are you’ve heard that quote before.  It comes from the 1989 movie, “Field of Dreams”. 

 In it, Ray (Kevin Costner) hears a voice whispering to him as he walks through his Iowa cornfield.  For the record, the voice says, “If you build it, HE will come”.  Later in the movie, Shoeless Joe repeats the phrase, “If you build it, he will come”, referring to a player whom Ray recognizes is his father as a young man.

 Anyway, it’s one of those often misquoted quotes, but I digress.

 How many of you have this vision of your practice?… find the location, fix it up nice, hang your diploma next to your license, turn the key to unlock your door on opening day, and “Here They Come!”… New Patients are coming out of nowhere, drawn to the great, new doctor in town… and thus begins the practice of your dreams.

 Like Costner’s movie, for most, it’s just a dream, a fantasy.  A very small percentage of doc’s might “make it” with that vision because the planets have aligned, or things just seemed to have randomly fallen into place.  It has happened.  But the odds are stacked high against that scenario.  

 For most of us… if you buy into the myths… let the struggles begin!

Are you clinging to one of the myths?  What commonly held beliefs have you seen that didn’t hold true in the real world?

Why Most Chiropractors STRUGGLE in Practice – Part I is a post from: AMC Right Start

Hello, and welcome!!  Last post we discussed moving a resolution or a goal from “thinking” to reality.  The above quote commonly attributed to Johann Wolfgang von Goethe is one of my favorites.  He was known as Germany’s “Shakespeare”, and he would have been a fan of this topic. 

How do I know?  Check out a couple more from the man, who incidentally is also credited with being the first to identify the Incisive bone, part of the Premaxilla (Ahhhh, flashbacks of Gross Anatomy):

“Enough words have been exchanged;  now at last let me see some deeds!”

“Knowing is not enough; we must apply.  Willing is not enough; we must do.”

As true today as when T-Rex caught the scent of our early ancestors…  There is power in “Action”.

We’ve talked about the power of taking (even small) steps in the direction of our goals.   Now if you’re someone who is a Go-Getter in all aspects of your life, and have a history of 1) setting goals, and then 2) making the necessary sacrifices to move towards them, then well done and carry on!  You are in an ultra-elite minority.

For most though, when resolutions or goals are made, various “reasons” crop up that keep them as “good intentions” only.  Necessary changes are never made, or sometimes steps are taken but are given up too early.  

When change seems to be too difficult, overwhelming, time consuming, or fill in the blank excuses here, the way to overcome is to first decide to commit to the goal, and then to take a step in the right direction, even if it’s seemingly insignificant.  Action!

How is this applicable to the student?

Are you a procrastinator?  Spent many all-nighters cramming for exams because you don’t keep up regularly?… Have to “drink from a fire hose” right up ’til the last minute before rushing to take a test?   I am very familiar with this strategy of studying, and through much personal sacrifice and peril have come to this conclusion… its flawed.  

How about this instead?  Take a small step.  Commit to read over your notes for just a few minutes each day.  Don’t even think of it as “studying”.  After a week, build up to five minutes per day.  Increase your review time as needed once a test date is still days away. 

Looking to save some money to fit your student budget?  Take a small step.  Order just the plain coffee instead of one of those Tensor Fascia Lattes.  Or make coffee at home instead of stopping by St. Arbucks.  Eat pasta or rice and beans an extra evening per week.  Eat your roommate’s leftovers when he or she is not home.  I’ve tried that one too… also flawed.  Who in the world dreamed up Tofurkey?? 

Have you given much thought to life after graduation?  If not, take a step.  The next time you have some downtime, such as on a Saturday morning, use it to relax.  Get your coffee, or Diet Coke, kick back, and dream of your future… only good things allowed.   Not the “How To” yet, just the destination.  

• Are you working in someone else’s office or in your own clinic? 
• Where is it located? 
• How big is the office (how many rooms)? 
• What does the decor look like?  
• What kind of patients do you serve? 
• What is/are your most used technique(s)? 
• Is your office “all cash”, or do you accept insurance? 
• How many patients do you serve in your ideal day? 
• What kind of income do you have?  etc.

Whether you’re in early Tri/Quarter, middle, or close to graduation, it’s never too early to visualize and prepare for  the real world ”beyond the four walls”.  Now take a step toward that dream.  Write me a comment on what you’ve come up with.

‘Til next time.

The Power of Action – for the chiropractic student is a post from: AMC Right Start