The new economy driving the healthcare marketplace today is forcing chiropractors across the country to transform the way that they do business on many levels. There is no question that times have changed. Many doctors who were once successful arc now experiencing difficulty in attracting new patients, and retaining them. Patients are coming in with HMO's that are not covering chiropractic; Open Houses, like Patient Appreciation Days, don't work anymore; and reports of findings don't get the same patient compliance. Most doctors went into practice to build a lifestyle, but have found that simple survival is a full-time job. To maintain your status, credibility and ultimate success, you must change. In order to capitalize on the new ways of business being driven by the Internet and other high-velocity trends, chiropractic practice members must embrace change. Change must become a part of your practice's culture. Winners realize this, and treat adaptability as a key differentiator in a competitive marketplace that has surprisingly few of them. In fact, the evolution of the healthcare marketplace is accelerating, which makes the words of Darwin more relative than ever: "It is not the strongest species that will survive, nor the most intelligent, but the one most responsive to change." High-Velocity Practices Eliminate Friction New imperatives are forcing chiropractors to rethink their fundamental business assumptions. Your practice is now under pressure to perform at increasing efficiency—and there's no letting up. More than ever, your practice is being driven by impatient patients and intensifying competition. Knowledge and speed are the primary forces behind the extraordinary economic expansion that America is now experiencing. Your patients are doing things smarter and faster than ever before—and so must you! There was a time when the most crowded room in a chiropractic practice was the Reception Room. This led to the room at the front of your practice being given the misnomer of the "Wait- ing Room". Doctors who practiced in the 1950's and early 1960's can remember a time when patients actually dressed up to attend their visits, just as they used to dress up for traveling on an airliner. They saw their physician as a sort of god and followed his or her recommendations un-questioningly; and, therefore, would wait unquestioningly for indeterminate periods of time to receive your services. Today's healthcare consumer is more savvy than ever about the options concerning their healthcare. They demand the highest quality service delivered in the most efficient time frame possible. Your patients' most valuable asset is, indeed, their time. Successful practitioners have learned to deliver a diversified menu of services with a sensitivity to time. More and more, chiropractors are incorporating diverse healing modalities into the menu of services they provide to their patients. It is highly likely that a patient entering a chiropractic practice today will receive a one-stop-shopping combination of chiropractic care, massage therapy, acupuncture, physical therapy, nutrition, or even medical services. This means that the successful practitioner must cultivate a mastery of "flow". Flow is the speed at which you are able to deliver your services to your patients. You should analyze your practice on a regular basis for "capacity blocks". A capacity block is a bottleneck in the healthcare delivery system of your practice and creates a major roadblock to the growth and expansion of your practice. A capacity block creates "friction" which slows down the efficiency of your practice. Today's educated healthcare consumers, your patients, demand convenience. Just as "location, location, location" is the mantra of the real estate profession, the mantra of your new practice paradigm is "convenience, convenience, convenience." Your patients demand one-stop shopping and their time frame of reference is now. The more immediate your ability to respond to the demand for diversified services delivered in a time sensitive manner, the greater the velocity toward success your practice will attain. You must adopt a perpetual drive to eliminate "friction" in your quest to optimize the flow within your practice. You must work relentlessly to address the time demands of your patients. And, the most successful practices are find- ing that they can address their patients' needs more effectively by performing an analysis of patient flow. Most practices have hours during the day that are more productive than others. Begin your search for friction in your flow by analyzing the busiest hours of your practice day. A helpful way to start is by asking your current staff members the following two questions: "What would happen to your position and what procedures would break down if we were to become 30% busier?" and, "What if we become 50%, busier?" The answers you receive will shed valuable illumination on the friction-generating capacity blocks within your practice. Administering a patient satisfaction survey in your practice on a regular basis also provides a wealth of priceless capacity-blockbusting information. I recommend "The Chiropractic Satisfaction Questionnaire" (Coulter, I. D., R. D. Hays, and C. D. Danielson. Topics in Clinical Chiropractic, Vol. 1, Issue 4, 1994, pp. 40-43). Just as a fish doesn't perceive the water it is swimming in, it may be difficult for you to perceive the capacity blocks within your practice— you're too close to it. A professional practice management consultant can provide you with an objective analysis of your capacity challenges and can make suggestions as to how to facilitate flow within your practice. Frequency of Communication Fosters Community Smart practices are not simply responding to patient demand. The world is moving extremely fast and, quite often, patients have no idea what they will want next. Practices must help their patients anticipate the changes and innovations that lie ahead. It is not sufficient to be merely "patient-driven"; practices must drive their patients, too. The next few years are going to continue to turn your world upside down. The sense of structured support and community that your patients used to count on is no longer readily accessible to them. The basic convention of the past—a stable career with its lifetime of employment—is no longer guaranteed. Your patients have lost contact with their neighbors and, in many cases, don't even know who they are! And it is more likely than not that, when your patients' children come home from school, one or both parent(s) will not be there to greet them. It must be an especially difficult time for children, as the future appears so uncertain to them. The frightening increase in school violence, as seen in Paducah, KY, and Littleton, CO, may, in part, arise from a lack of a sense of community and belonging among our youth. Your practice can serve as the foun-tainhead for a community of like-minded individuals who embrace the philosophy of healthy living through chiropractic. Forging a strong relationship with your patients creates a sense of community in your practice that keeps your current and former patients connected and sharing ideas. You can share information with your practice community in the form of patient education classes and newsletters. The Internet can also be a great ally in the process of establishing lines of communication with your patients, though not in the way that it's generally been used. The Net's real killer application is e-mail, because it offers "frequency for free." Frequency of contact leads to a sense of community in your practice and, ultimately, to the key ingredient in any robust, long-term relationship: trust. You can encourage your patients to volunteer their attention by keeping in touch with your practice community through a weekly or semi-weekly inspirational, motivational and informational electronic newsletter. Relationship Builds a Network of Value Creation Forward-looking practices face a new set of challenges in the new economy. It's no longer enough to efficiently deliver high-quality service. Nor is it enough to build strong patient relationships through frequent communication. The practice of today must develop a network of value creation. It must not only build close connections with its patients, but also with strategic alliance partners. In the upcoming year, world-class practices will play the role of matchmaker—learning and anticipating their patients' needs and, then, capably addressing them. They must match their own resources and those of their strategic alliance partners to the preferences and priorities of their patients. This can only occur if the practices build strong relationships with a network of allied businesses and professionals. In order to build such relationships, practices will have to learn to collaborate with their business partners and to optimize their network as a whole. The goal of building a network of value creation is that not only do your patients refer to you, but that you have an ongoing referral relationship with other professionals and business owners. Referrals are a reciprocal relationship. You help me and I'll help you. You know the businesses that you use on a regular basis because they offer extraordinary products or services. Your patients would love to know whom you use and to experience the same type of service. The businesses and other pro- fessionals that you utilize would love to be introduced to your patient base, as well. By establishing strategic alliances, you form a proactive way to refer your patients to other businesses and professionals. It also is a way of adding even more value to your current patients, and serving them by sharing the exceptional people in your network with them. Using the concept of reciprocity, strategic alliances train other professionals how to refer to you. I recommend forming strategic alliances with 8-12 people. These are the professionals that you do business with that return calls promptly, that perform extraordinary quality work, that do things right the first time, and that offer fair prices and excellent customer service. Make it a point to meet with your strategic alliances on a regular basis. In fact, I recommend meeting with them once a month, maybe for an early morning breakfast, to decide and determine how you can best support one another. You should put together a strategic alliance mailing to your patients on a regular basis. You can do this as often as once a month. This would be an added value to your patients, where you simply list the best of the best resources available to them. You can also incorporate tips within this newsletter or flyer that someone in your strategic alliance group writes for you. Because there is a cost involved in writing and developing this type of newsletter and strategy, you can actually charge members of your strategic alliance to cover the cost. Something like $30 or S40 a month per strategic alliance would probably allow you to do a pretty terrific mailing or newsletter. You can even feature a profile of one of your strategic alliance partners each month. For example, you might profile a local podiatrist, with a letter that introduces who he is and the various services he provides. Your podiatric alliance partner may even want to put a coupon or certificate at the bottom of the letter that would be of real value to your patients. On the back of this letter would be located the other ads of services from the other people in your strategic alliance. It is critically important that you trust the people in your strategic alliance to absolutely, positively, 100% of the time deliver extraordinary service to your clients. If there's any doubt, leave them out! Make it a point, each week, to think of whom, in your strategic alliance network, you can make referrals to. Your goal should be to enhance their businesses in the way that they are enhancing your practice and referring people to you. I have a chiropractic client who specializes in sports performance, who formed strategic alliances with a dietician, with a personal trainer, and with a hypnotist. Ev- eryone in this doctor's alliance has the same mission and purpose in mind. What a great service and value to their patients. It's all about reciprocity. Chiropractors can even form strategic alliances with other chiropractors. For example, if you don't work with a particular type of condition, you may form a strategic alliance with a chiropractor that specializes in that condition. Don't be afraid to think outside the box on this! The Time Is Right The most undeniable truth of the new healthcare economy is that there is a surplus of exciting, challenging, and worthwhile work to be done. If you're a smart, hardworking, talented chiropractor, and your practice can't change, won't change, or doesn't even recognize the need to change, you may simply be in the wrong place—at the right time. The time has never been better for forward-thinking practitioners to capitalize on the trends propelling chiropractic to the forefront of healthcare. Is your practice built to capture its share of the boom times? Don't let the velocity of the new economy pass you by. If you're serious about success, act now to adopt these winning strategies. As President of Breakthrough Coaching, LLC, Dr. Mark Sanna coaches chiropractors throughout the country to help them achieve personal and professional success. He has lectured to chiropractic audiences nationally and internationally. As a practicing chiropractor. Dr. Sanna has helped more than 100,000 people gain and enhance their health. A second-generation chiropractor. Dr. Sanna believes that the future of chiropractic depends upon a commitment to the principles of chiropractic, ethical and effective public relations, and sound business procedures. He can be reached at Breakthrough Coaching, LLC, by calling I-800-7-ADVICE.
