The Top 10 Questions to Ask Yourself if Considering a Chiropractic Franchise
FRANCHISING
Chris Tomshack
JUST A SHORT TIME AGO, IF YOU WERE LOOKING FOR SOME HELP IN BUILDING A REALLY SUCCESSFUL PRACTICE YOU PRETTY MUCH HAD ONE CHOICE, WHICH WAS TO OPEN UP OUR TRADE MAGAZINES, FIND AN INTERESTING AD PROMOTING A COACH, HIRE THE COACH, IMPLEMENT WHAT YOU WERE TAUGHT AND HOPE FOR THE BEST. MY HOW TIMES HAVE CHANGED. OBAMACARE IS PROLIFERATING. PATIENTS ARE LOATHE TO PART WITH THEIR CASH. INSURANCE AUDITS ARE EXPANDING. MARKETING FOR NEW PATIENTS IS LESS EFFECTIVE. AND NOW EVERY GURU IS PREACHING “EVENT MARKETING.” ONE THING IS FOR SURE, WHEN THE “HERD” MOVES IN A DIRECTION, YOUR BEST BET AT SUCCESS IS TO MOVE IN THE OPPOSITE DIRECTION.
So how are you supposed to learn how to build your practice correctly and successfully? Well, you’ve got options on where to seek help. Although the ranks of chiropractic coaches aie thinner than in the past, there are still some that you can hire as a coach. There’s no shortage of practice-building seminái s that you can attend: sort of a “one and done” approach. You can work for someone else as an associate or go into business with a partner. You can navigate the waters of an integrated practice.
You can keep going it alone. You can investigate aligning with a chiropractic franchise. There really are a number of choices for you to seek support and assistance. There is no need to be a lone warrior unless that’s your choice.
My expertise is in chiropractic franchising, so that’s what this article focuses on discussing. At first glance, the terms “franchise” and “chiropractic” may seem incongruent, and if so, that’s only because the synergy hasn’t been correctly explained to you yet. And did you know that a franchise is one of the most successful business models?
But first things first. Before ever performing any meaningful and time-consuming due diligence of investing in and converting your office to a chiropractic franchise or even identifying which model better suits your needs, I’ll make the subtle suggestion that you should carefully think about the 10 questions that you should ask y our self if y ou aie considering a chiropractic franchise. The questions can relate to any of the practice models as well. Let’s dig in!
1. What is the benefit to your patient if you convert your practice to a franchise or launch a new franchised clinic from scratch?
You’re probably wondering why I put this question as the most important, and that’s a great question. The answer is simple. This is the most important question because I believe that eveiything we do in practice should first focus on the benefit to the patient. Many doctors routinely make practice decisions based on what it means to them personally. This is just plain wrong, in my humble opinion. Focus first on the quality of the patients’ experience and the care they receive. Then focus on the benefits to you and your team.
So first, before all else, analyze the model of care that the chiropractic franchise espouses. Is it congruent with what you want to provide your patients? Is it 100% adjusting only? Does it incorporate rehab for better soft tissue healing? Is the rehab the most simple and effective so that it affords amazing results without skyrocketing your overhead? Does the franchise dictate that you adjust your patients in a certain manner with a specific technique? Is there a focus on wellness care or is it acute-care based?
Along these lines, you must also consider the question of “Does the franchise evolve for the benefit of both the franchisees and the patients they serve? Or is eveiything based on serving the doctor as opposed to the patient?” Truth be told, all businesses need to evolve to stay fresh and relevant or stagnation inevitably sets in. I just finished Delivering Happiness, a book authored by Tony Hsieh, the CEO ofZappos.com, Inc. This is a phenomenal book, by the way. I give it two thumbs up and strongly suggest you read it. In the book, Tony states that a business’s core values drive its culture and ultimately its success or failure. You absolutely must consider what the core values ai e of the franchise that you ai e investigating. Ask about their core values. Do those core values reflect your core values? If not, run away. And those core values must, in my opinion, be patient centered, not doctor centered.
Now more than ever it’s all about the patient, which is exactly where the focus should be. So does the franchise that you aie looking at focus the bulk of its energies and resources on giving the patient an amazing experience with the optimal probability of incredible healing? If not, ran away. Patient experience is key and if you ai e to survive and thrive in this new economy, then your office must be patient centric. Ignore this advice at your peril.
2. What are the major benefits to you, the chiropractor, as well as your team, if you join a chiropractic franchise?
Backing up half a step, first you need to ask yourself “Hey, do I have the discipline to implement the policies, procedures and systems that this chiropractic franchise runs on?” Because if you don’t have the discipline to run the system on which the franchise is based, a franchise is most definitely not for you. This question is not one that you should take lightly. I’ve met a number of people over the years who truly believed that they possessed the discipline to implement the system, only to come back a year or so later and say, “I just don’t have the discipline to do this.” So self-discipline is a key issue. And self-discipline is also related to having the motivation to change and evolve you and your practice. If you’ve got the discipline and self-motivation to evolve, then you should keep looking at a franchise.
Another subtopic of question number two that you must satisfy is, “Does the franchise take anybody with a check and a pulse or is there a very selective screening process to ensure that only those who are the best fit granted membership in the franchise?” We probably really don’t need to delve deep into this particular question but it’s one that you should ponder. You see, a practice coach, in most cases, is willing to coach just about anyone. A franchise, however, is a longer commitment, and if you are not a good fit with the franchise then you should be screened out, or you’re just going to be caught up in a termination process initiated by you in the future. Investing in a chiropractic franchise is also about becoming part of something much bigger than yourself. Of the six basic needs that humans have, this is number six and when you become part of something bigger than yourself that will outlive you
and build a really cool legacy, you have a much higher chance of having true happiness in your life.
A franchise by definition is a business that runs on replicable systems for peak efficiency and profitability. The systems should be laid out in a recipe-like format that ai e straightforward. The systems, when all is said and done, should allow your practice to be ran in a turnkey fashion, relieving a great deal of stress from your shoulders and replacing it with a high level of certainty as opposed to the uncertainty of practicing in today’s environment. So take a careful look at the chiropractic franchise to ensure that they in fact have real, replicable systems that are
congruent with your personal philosophy. These replicable systems should be patientcentric first, and doctorand team-centric second. If not, this chiropractic franchise is not your best interest.
Hey, do I have the discipline to implement the policies, procedures and systems that this chiropractic franchise runs on?""
Something you should also consider is that a relationship with the franchise operations people is a longer-term relationship, not a simple month-to-month contract as with a practice management coach. And it’s this way for a reason, which means that a franchise should offer replicable solutions to virtually eveiything that you encounter on a day-to-day basis, whereas practice coaches tend to focus on one particular area of expertise. Most franchise agreements are for a 10-year period. Are you good with this?
Overall joining a chiropractic franchise should bring a sense of efficiency and calm into your practice and into your personal life and the lives of your team members. This is a massive benefit, but it is secondaiy to doing what’s best for the patient. A franchise is designed to bring systems into play inside your office that can allow your entire team, whether it’s just you or includes your thriving team, to accomplish far more together then you could on your own, without being tightly systematized. This means that the systems should be interlocking and work together to create a seamless experience for the patients and your team while allowing you to serve the number of patients that fulfills your vision. And if eveiything is systematized, it should be run in a professional, organized and fun way, which is centered on happiness. Anything less is not a solid franchise.
3. Who designs and is responsible for the patient care programs?
Wow, this is a huge one. At the end of the day, you’re the doctor. You are the one responsible for designing a highly effective patient care program so that your patients receive the very best level of care and subsequent results. Some docs are looking for someone to tell them exactly what to do with every patient. Not only is this wrong, it’s highly unethical. How can someone who has not examined the patient possibly know what to do with them? No one should be telling you how to treat your patients. No one should tell you if they are acute-care or maintenance or wellness care. You are the doctor and that is your decision to make.
That being said, I firmly believe that all chiropractors should treat their patients with the very best level of care possible so that the patients get the very best level of healing. Just as automobiles get better and better with each passing year, chiropractic care is continuing to evolve year after year and you as a chiropractor should be exposed to the best advances. How you use those advances or if you use them at all should be totally left up to you. So does the franchise expose you to and teach you the very best evolutions in patient care each year so that your results improve with each year of practice? And are you then left with the decision on what to do with each and every patient that you are privileged to serve? If the chiropractic franchise tells you how to care for your patients, it’s a major warning sign.
4. What type of initial training does the chiropractic franchise give you and your team?
Is the initial training taught by seasoned professionals that have actually excelled in practice? It should be. Most important, when you leave the initial training program, will you be ready to implement the franchise systems into your office? This is no easy task. Change can be and often is difficult, especially when it’s a conversion franchise as opposed to a brand-new launch. So is the training program comprehensive? Do you know what happens after you leave the training program and you have questions? Rest assured, you’ll have a ton of questions.
The initial training program should cover virtually every facet of running your practice. I’m talking about the moment a patient or prospective patient decides to investigate chiropractic, to the time they pick up the phone or use the computer to schedule an appointment, to walking into your office for the first time, to the experience they receive, to meeting the doctor, to undergoing an examination, to beginning patient care and finally to wellness care. Everything should be taught comprehensively.
5. What support does the franchise give you once you are trained and either converted to the franchise or you have launched your new practice?
Here’s the deal: when you leave the franchise’s initial training program, chances are you’re going to feel extremely overwhelmed. This feeling is stemming from the fact that if you’re converting your existing practice to a franchise, you are essentially implementing entirely new policies and procedures, all of which should be systematized. To say this is an easy task is a bold-faced lie. You must put the time in to implement correctly and when implementing, questions will arise, sometimes by the minute. So what type of support would be given to you if you were a franchise owner?
Are preprogrammed coaching calls with a bunch of people on the phone the solution or does it go much deeper than this? Hint: it must go much deeper than this. The franchise absolutely must have an extremely talented and accomplished team that can get you the help, assistance and answers you
require in a moment’s notice. You should also have locally based support that actually visits you in your office to work with you and your team. Weekly team trainings, which are systematized for you are absolutely key in successful longterm implementation. Locally based regional trainings in which you and other local franchise owners and their teams get together to train provide a highly effective and synergistic model of accelerated learning and implementation. The bottom line is that your ongoing training and support should be never-ending and it should pretty much be occurring on a daily basis. Anything less is merely coaching and is not a true franchise system. If you are paying for a franchise ensure that you are receiving what a franchise is supposed to deliver.
6. If you are launching a brand-new office, what type of assistance does the franchise offer you so that this is done correctly with maximum efficiency, effectiveness and probability of long-term success?
If you are considering a chiropractic franchise and would be converting your existing franchise, this question means nothing to you unless your vision is to open a second, third or more offices in the future. For those of you who don’t have your own office yet, this question is integral in your due diligence process. A solid franchise system would help you first determine which city or area you’d like to set up practice. The franchise should then help you determine which specific areas of the city are most suitable, according to demographics and psychographics, for your practice/franchise to thrive. The franchise should then help you select the appropriate location and greatly assist with the lease negotiation or purchase contract. The franchise should also design your clinic so that it is best suited to run the applicable franchise systems for maximum efficiency and effectiveness.
In other words, the franchise should help you every step of the way in selecting your location and designing your clinic and assisting with the build-out. The franchise should tell you exactly where to place each and every poster, adjusting table, and computer along with everything else inside the office. And this is just the first step.
The franchise should then construct with you a highly effective marketing program to launch your new office and help coach you to successful implementation of the launch. Realistically, you should have at least 10 to 20 new patients on your schedule before you even open. The franchise should show you exactly how to do this. The franchise should also thoroughly train both you and your initial team member(s) so that you conclusively own the franchises systems and aie capable of 100% accurate implementation. Isn’t the reason that franchises aie more successful than non-franchised business because they aie highly systematized? The answer is yes. But the systems aie only as good as implementation, and if you’re launching a brand-new office you must have the implementation process down cold.
7. Does the franchise teach you how to run your office compliantly?
With all the audits running rampant, your practice, whether it be cash-based or insurance-based or a hybrid thereof, must be compliant. Yes, I know that there aie some coaches that still teach that if you don’t accept insurance you don’t have to worry about compliance. They aie wrong! Don’t take my word for it, call your state board and ask them that question. Whether your practice is cash-based or insurance-based or both, it must be compliant and if you are joining a chiropractic franchise they must teach you how to be compliant at all times. They should have certified experts on their team teaching compliance to you and your team. They should drill it down so that you exhibit proficiency. And because
the rules of compliance are continually changing, the franchise should be keeping you abreast of all the changes ensuring that you aie correctly implementing those changes in order to remain compliant, enabling you to sleep at night!
There is a ton of fear surrounding the compliance issue in chiropractic today, and with good cause. Audits aie continually demonstrating a very poor level of compliance in most chiropractic offices. The tide is beginning to change, which is a great thing. But please remember, compliance is continuing to evolve and you must know how to remain compliant. The franchise should teach you how to do this on a continual basis, and they should also routinely audit your office and your documentation to make sure that you aie continuing to stay compliant. Make sure the chiropractic franchise that you are looking at is capable of helping you stay compliant.
8. Will the franchise’s systems grant you more freedom in your life?
Time is one of your most important commodities. It can’t be replaced. Correctly designed systems with successful implantation should create more time in your day. In other words, it should give you freedom. I believe that the primary reason chiropractors invest in a chiropractic franchise is to gain more freedom in their lives. Almost all practices today and in the past aie dependent on the chiropractor’s personality. This is all well and good until you want to take some time off or perhaps retire from practicing and manage the practice instead. That’s when the practice fails. So your due diligence of a chiropractic franchise should reveal to you that the franchise’s systems ultimately give more time and therefore freedom to the doctor. The systems should be designed so that they are not personality dependent on the doctor. And the doctor should not be the one implementing and managing all of the systems. The team should be taught on how to help lift up the doctor and together achieve far more than a non-franchised chiropractic practice.
So how are you supposed to find out if the franchise will result in more freedom? This is an easy one. It’s called making validation calls to existing franchise owners. I’d highly encourage you to make a series of validation calls prior to joining a chiropractic franchise.
9. What does it cost to become a franchise owner both now and in the future?
In the franchise world, there are typically two basic costs associated with franchise ownership. The first is the cost of investing in a chiropractic franchise, which is typically a lump sum payment. That fee covers your exclusive territory and initial training. A franchise company does not “make their money” by selling franchises. Franchise companies earn then operating income and profit through a continuing franchise fee, which is typically called a royalty. Most franchises in America have anywhere from a seven to fifteen percent royalty, typically paid monthly. So if your business does not grow after converting it to a franchise, something is terribly wrong. The royalty should be merely a footnote if the franchise systems are sound and implemented correctly. The franchise company should have some data comparing its results to non-chiropractic franchise practices. If this data does not exist, make a ton of validation calls until you are comfortable in moving forward or away.
10. Are the leaders of the franchise people you are in congruence with, can work with, respect, and have you, your patient’s and chiropractic’s best interests at heart?
If you don’t resonate well with the franchise leadership, don’t make the mistake of investing in that particular franchise. Keep looking or go to Plan B. The leadership should be accessible enough for you to be able to answer this question one way or another. If they’re not accessible, move on. Is the primary focus of the franchise on delivering incredibly effective and successful patient care? If not, move on. If it is, dig deeper. Is the franchise’s secondary focus on improving your life and the lives of your team? Is the franchise’s third focus on the ultimate growth of our great chiropractic profession and preserving it for countless future generations? Your research should quickly reveal these critical answers.
Chris Tomshack, D.C., is CEO of HealthSource Chiropractic and Progressive Rehab® and currently oversees 366 offices throughout the nation. By supplying its doctors with a comprehensive set of systems, HealthSource positions its clinics to provide a singularly unique health care experience to patients, while focusing on community outreach and educational programs. HealthSource Chiropractic can be reached by calling 440-934-5858. For more information on HealthSource go to www.HealthSourceChiro.com
