Posts Tagged ‘Measure’

GROW YOUR PRACTICE IN 3 EASY STEPS

Thursday, November 13th, 2008

1) More word of mouth referrals

How many times have you been talked around by a slick sales-type offering you the greatest marketing opportunity yet? From Newspaper ads, to calendars and target audience magazines, to bigger and bigger Yellow Pages displays, to online directories with millions of visitors, to radio stations and even TV presenting themselves as the only way to convert prospects to buyers!

Have you worked this out yet? Some of your ads work and some don’t; but when you average the cost of all your campaigns against the return on your investment – you might be better spending your hard earned cash on something more reliable and sustainable.

What about spending some of that money on a practice resource that will consistently and persistently increase the number of word of mouth referrals you receive, AND, is a one-off investment?

Don’t we all know that word of mouth referrals are what have built this great profession? Nothing will grow your practice faster and stronger than a steady stream of new patients who have been recommended by an established patient – it seems to become contagious.

2) Impress your new patients so much that they commit to your recommendations

Do you hear this after you have examined and explained your recommendations to a prospective patient? “Why hasn’t anyone else checked me out this thoroughly before? You are the first person who has been able to explain why I am feeling the way I am! What do I need to do to fix this?”

If on the other hand you hear statements like this after conducting your report of findings: “So is it just muscles?” (they haven’t understood a word you said); “how long do you think it will take for my pain to go away” (you haven’t shifted their consciousness beyond how they are feeling to how they are functioning); “My doctor said it was lumbago” (you aren’t the expert in their mind and they won’t listen to you); “so overall I’m not so bad” (nothing you have done or said has shifted their denial mechanisms).

To make this quantum shift in practice growth in this day and age requires technology that demonstrates clearly, visually and impressively that the person has definite functional problems which need your help to correct (whatever it is that YOU do to help, regardless of how long you think this will take, and no matter how much you charge to do it).

3) Maximise your patient retention

Fred Barge used to ask the pointed question: “Are you the doctor, doctor?” Here’s the plain truth – if you are relying on how your patients are feeling to determine if they continue to see you – you are at the mercy of the retention angels: Some people will feel better, and will still stop coming to see you. Some won’t feel better and will stop coming to see you. Some won’t hang around long enough to even find out if they are feeling better or not. In other words you could be practicing in a leaky boat, and totally dependent on the flow of new patients in, to compensate for the outflow.

There are only three reasons why someone continues to see you, regardless of whether we are talking about for the next few weeks, or for the next several years:

a) They are consciously aware of the benefit/s that they have been receiving from seeing you: Do you have the tools to assist them to be completely aware of the benefits of your care?

b) They perceive that they will receive benefits in the future from continuing to see you: Do you have a tool that can demonstrate room for improvement, and justify them to continue to see you till their next re-exam and beyond?

c) They like you and your staff and will do whatever you say to continue the relationship: This may be enough to plateau a practice but it will never grow a practice.

Posture Pro Digital Postural Analysis Software is a tried, trusted, reliable and proven tool to stimulate referrals, improve conversion and increase retention for the following reasons:

1) Generate an impressive full colour posture report which people not only look at themselves, but they show it to others, and refer others to have an assessment

2) It is very quick and efficient to conduct an exam: Can even be performed by a trained tech CA. In exam mode you should be able to complete the assessment and print it in 5 minutes. Even quicker if using screening mode.

3) Is very visual requiring little translation: People usually can see the problems without any need for explanation – “is that really me – what do I have to do to change that?”

4) Is an objective functional assessment: Posture is an accepted functional outcome by many professions and has a substantial research base which justifies the need for corrective measures – It’s convincing!

5) Can be monitored and compared through time as regularly as you like – you don’t have to wait three months to re-exam if you don’t want to. Posture can be improved quickly and progressively through time, making it both a great short term and long term measure

6) Demonstrates both visually and objectively progress under care acting as a reward for positive response, and as a motivator for continued improvement under your care

7) Is an awesome quality assurance tool – I often get asked, does posture improve under your care? There are two answers to this: “YES”, and, “if it doesn’t then it’s about time you had the tool to direct you to improve your methodologies to improve your outcomes”.

8) When you compare the initial cost to the returns from referrals, compliance and retention this software pays for itself in a couple of months, and then generates consistent increased returns for miniscule ongoing costs (paper and ink for your printer)

9) Can be completely portable making it great for presentations, screenings, expos and external events.

10) Is simple and easy to introduce and implement into any style of practice: Easy to install, email tech support, free upgrades, thorough instruction manual, plus a pile of bonus materials to help get you started or to maximise your results in diverse ways.

AND: Right now is the best time to purchase Posture Pro with our recession buster price.

Usually sells for US$1,795 (currently nearly AUD$3,000)
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This is the cheapest price I have ever offered – but guaranteed it won’t last for long, so avoid the disappointment of thinking “if I hadn’t waited I would have had that software for a killing”

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MAYBE THOSE PHYSICAL FINDINGS… AREN’T…

Friday, July 18th, 2008

THE MIND BODY CONNECTION

Within our chiropractic training and culture is a diverse range of physical indicators that we observe, measure and monitor to help us to diagnose our patients’ physical state: The history is used to narrow down our list of disorders or even diseases which may be causing the problem; Posture tells us how misaligned someone’s body and spine is; Radiographs show us how much decay and degeneration has developed; Range of motion tests measure how stiff they have become; SEMG assesses how tight muscles are; our palpation skills feel where there is contraction, restriction, fixation and misalignment.

And then we apply a physical therapy to try and intervene on the physical disorder that we have isolated.

It has almost become a cliché that there is a mind/body connection. But have we tended to minimise this relationship? Or have we even missed the point of this revelation? Are we persisting with the convenient separation and compartmentalisation of these two dimensions? We say, “oh yes the mind can affect the body, and the body can affect the mind” – but in saying this do we miss the paradigm of the mind/body relationship?

In other words the mind IS the body, and the body IS the mind.

When you are feeling certain emotions like anger, resentment, guilt, frustration – your physical body is different to how it is when you are feeling emotions like love, acceptance, peace, joy, reward. And if your physical body is different, then your thoughts, feelings and emotions are different. One doesn’t lead to the other – one is the other.

Let’s take another look at our list of “physical indicators” from another point of view, to see if we can see what they might really mean in terms of the mind/body:

The History is really someone’s story about the suffering they currently feel. And we are very good at asking questions about how the suffering feels: Where it hurts, how much it hurts, how big an area does the hurt cover, when does it feel a bit better and when does it feel a bit worse? But do we miss the most important question? What does the hurt mean – to them? Here’s another way of asking this question to help those who can’t make a connection – “if this hurt didn’t go away what would it mean you couldn’t do?”, or “if this hurt didn’t go away what aspect of your life do you think would be most affected?” Do you know that if something in your therapeutic relationship and encounter doesn’t allay or release this connection between their pain and suffering, that their mind/body will resist healing?

Postural Assessment: Why does anyone have bad posture? Because they don’t know they have it! Why would anyone carry their head too far forwards when that skull and its contents are as heavy as a bowling ball? Because they don’t recognise that it is where it is – they have poor somatic awareness. Here’s a thought – they will also have a proportionately poor psychic awareness. In other words they will actually have poor somatopsychic awareness. Check it out next time you examine someone with really bad posture: Ask them how they are feeling emotionally, ask them how aware they are of each of their internal bodily functions: More often than not the same disconnect will exist.

What about those protective buttresses that are being layered down inside their body – the ones you see growing around their skeleton on their Radiographs? Ask yourself this question: How strong, thick and solid are the protective mechanisms that this person has built around their emotions and memories? What will it take to chip away this person’s emotional fortress? The resistance, slowness of their recovery and the common poor prognosis could be reflective of their hardened interaction with the world in a more general sense.

And that stiffness that has built up in their Spinal Range of Movement, that you prescribe stretching exercises to reverse. Here is my observation: Range of motion is directly proportionate to range of emotion. My saying goes like this – “concrete body – concrete mind”. Observe how flexible these people are to suggested changes in their state of mind or lifestyle, and you may see a mirror image of their body’s flexibility.

What about that tension that you see on their SEMG? You may interpret it as physical tension: And you might ask; “maybe you are working too hard”, “maybe you did too much gardening on the weekend”, “maybe you aren’t sitting up straight”? How about this one – muscle tension is proportionate to neurological tone, which is dependent on emotional state. Maybe their body hasn’t been working overtime – maybe their mind has.

And all those things you “feel” while you are Palpating: Stiffness, resistance, swelling, and misalignment. Have you ever taken a moment to ask yourself while you have a direct connection with this person’s field of intelligence: “What am I feeling as I palpate this person?” You may be great at palpating, but, if you get good at feeling, then you will get even better at FEELING. You may even glean more insight into that person’s state of wellbeing in thirty seconds of palpation than sixty minutes of talk…

How does any of this help you to become a better healer, or a more profitable businessman? When you GET IT, that you are a body/mind and that your practice members are body/minds – Then you will experience greater quality and wholeness in your life, and your customers will receive greater quality and wholeness from you as a healer – and people pay for quality

(ps. If you think that this is suggesting that you have to become more of a psychologist or counsellor to be a better chiropractor – then you have missed the point – this has nothing to do with analysing and identifying the past hurts and experiences and helping someone to cognitively overcome the related dysfunctional thoughts and feelings. What this is about is that there is a whole new dimension awaiting you when you become more conscious of the mind/body synergy – what you are doing right now therapeutically will offer a much deeper meaning for both you and your practice members. In other words I am not talking about a change in procedure – but a change in consciousness.)

Find Out More About Training To Help You Make This Transition at http://www.torquerelease.com.au/TRT-Training.htm

POSTURE - THE SIMPLEST AND MOST POWERFUL PRACTICE TOOL

Monday, October 29th, 2007

A Picture Paints A Thousand Words!

Many Chiropractors analyse their new patients’ posture, and then scribble lines on a stick figure chart that is supposed to represent the person’s postural distortions? Try showing the hand-drawn diagram to the person - IT WILL MEAN NOTHING TO THEM - And it’s not a very convincing communication medium. Try showing the diagram to another chiropractor - I bet they won’t even understand what the markings mean. Then try using this diagram at the re-exam - How could you objectively measure, let alone demonstrate to the client that any sort of change has occurred?

Some others have entered the twentieth century and have started to take digital photos of their practice members’ posture. I’ve seen some who print the photos and then draw lines all over the picture to highlight the problems. But the question remains - How can you objectively track and demonstrate the changes that are occurring in their posture? And, how could you store, file and retrieve all those images?

There is a twenty first century technology that is cheap and effective for storing, analysing, calculating, retrieving, and comparing digital postural analyses - And it takes about the same time as a traditional postural assessment…

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WHAT IF YOU WERE ONLY ALLOWED TO MAKE ONE ADJUSTMENT?

Wednesday, October 17th, 2007

Imagine if every Australian was allowed to receive one adjustment per week, and that adjustment was covered under Medicare? But here’s the condition: You can only deliver one adjustment per week, per person, and you have to demonstrate the measure benefits of those adjustments every three months using impartial objective outcome tools. I guess there would be a minority of DCs who would think they had found easy street and delivered any old adjustment, in any old fashion, without much consideration for where or how they delivered that adjustment - just so long as the cheques kept rolling in. But for the rest of us, we would want to be completely diligent in ensuring that this one adjustment was a good one, a really good one, and that we adjusted the segment which most needed to be adjusted, and in the right direction because you can’t just hit it on both sides - you only get one shot!!

Think about this in the context of how you currently prioritise how you deliver your adjustments each and every day:

1) Do you start at the bottom and work your way up, or some other variation of this theme? Check and adjust the low back, check and adjust the thoracics, then roll them over and check and adjust their neck? Most DCs have an order in which they adjust everyone. It may not be the order I mentioned, but in most cases it will be a “routine” based on the practitioner’s habit as opposed to some patient-centred findings dictating where you start and finish. STOP IT: Take an extra few seconds to analyse your patients’ spines and make a decision about which is the most important adjustment to make on that visit.

2) Do you adjust the same segments in the same order, any three visits in a row? I thought your practice members were supposed to be getting better and progressing to a new level of health - why then would they continue to have the same subluxations? If you are activating retracing in their body then surely the next layer of subluxation should appear and need to be corrected? And, since they last saw you a lot of different stresses have presented, so they may have a new and different layer appearing on the next visit. Why do we say that the body is a self-healing adaptive organism and then fail to adapt and change our adjustments to keep up? BEWARE: If you check your notes and see that patients are getting the same mix of adjustments on every visit then there’s only two options - A) you put the stuck pattern there with your repetitive habituating stimulus, or, B) their spine isn’t evolving under your care - either way you need to try a new strategy.

3) Do you have a system that allows you to make a live analysis and differential diagnosis of which subluxation wants to be adjusted at any given moment in time? When we teach TRT we show you 14 different indicators of subluxation and train you in the differential diagnosis technique that gives you absolute certainty and precision in making this vital decision…

Click Here To Find Out More About TRT Training…

An interesting question arising from my hypothetical above is for our profession as wellness providers. I used the weekly example based on the observation that:

1) If I could get adjusted as often as I liked I would probably get an adjustment every week;

2) I conducted a highly informal survey of a group of my practice members when I asked them “if you could get adjusted whenever you liked and it didn’t cost you anything, how often would you get adjusted?” The most common reply was “I’d come every week”;

3) I have been using functional assessment technologies in my practice for over a decade and have observed qualitatively and quantitatively the biggest changes when clients are getting adjusted weekly (go beyond three weeks and you will see a significant percentage of clients start to deteriorate functionally);

4) Many chiropractors I have met who claim to be wellness DCs get adjusted weekly and recommend weekly adjustments.

But, how much would this cost the community if every man, woman and child was adjusted weekly: Using the round figure of 20 million people and $40 per adjustment, that comes to $800 million per week.

Here’s the ultimate challenge: We would have to be able to demonstrate without a shadow of a doubt that we were saving the Australian economy at least $1 Billion per week? Can we do this? Your thoughts are welcome…

PROVE IT!

Monday, September 17th, 2007

Gill and I have just gone through a major change in our practice and personal lives. After 18 years of owning and practising in the one location, we have handed over ownership to another chiropractor. So it feels like an appropriate time to reflect and to share some experiences, and some insight into the challenges and potential of our great profession.

It was an emotionally charged time as we started to tell our patients and practice members that we were going to be moving on and that we were going to be handing over their care to a new chiropractor. And there were three groups whose reactions really impacted me: The first group was those old faithful regular clients who had been seeing me for 15 to 18 years. Some reminded me that they had seen me in my first weeks of practice. A couple of people even reminded me that they’d seen me in the first days of my practice. And they reminded me how young and “green” I was; and many thanked me for how much I had grown up and evolved in that time.

Now, this raises an interesting question: why would someone see a chiropractor consistently, and regularly over a period of 18 years? I can guarantee you that it wasn’t because I signed them up with an 18 year prepayment plan. But instead, they must have some conscious value for the benefits that they receive from their adjustments. And they have enormous experience in terms of how chiropractic has helped them – beyond the relief of an acute low back episode

The second group that probably affected me the most was a group of 18 to 22-year-old’s, who when I told them that I was going to be moving on, and that they were about to be under the care of another chiropractor; they looked at me with sorrow and surprise and even disappointment. And most of them said to me, “what am I supposed to do, you have been my only chiropractor for my entire life. You have kept me healthy for all these years?” - Many of them since birth. And it reminded me of how much children intuitively love chiropractic care when they have a good experience. You don’t need to educate or intellectually explain the benefits of chiropractic to a child who experiences them. It’s like a seven-year-old boy said to me once, “I love getting adjusted, you recharge my batteries”.

The third group that probably surprised me a little was a significant group of people who’d only been seeing me for weeks, perhaps months, maybe a year or two: In the bigger scheme of an eighteen year old practice, not a long time. But they too were shocked and disappointed that I was going to be moving on. I guess every chiropractor has patients like this: People who’d been to every other doctor and had all sorts of medical tests and been to other alternative practitioners. And then they stumbled upon you and the healing magic started to occur. And I realised that this group associated their healing with ME and perhaps not so much CHIROPRACTIC. They also place an enormous amount of value on our adjustments. The next part of their journey, being under a new chiropractor, will be to discover that their healing comes from chiropractic, not from Nick Hodgson.

So here is the big question: Do you underestimate the value of the benefits from YOUR chiropractic to the health and wellbeing of your patients and your community? Are you aware of the changes that are happening in the lives of your practice members?

I know there was a time in my practice life where I underestimated the value of what I did. And I remember sitting in a packed theatre at a Dynamic Growth Congress on the Gold Coast, on a Friday night. And one particular speaker was sharing a case story of someone that he cared for over a long period of time. This patient was in a wheelchair as a result of previous injuries, and as the story unfolded, we saw photos of this guy, looking sickly and drawn, in his wheelchair; through to a time when he was no longer in his chair; and then he was holding a newborn baby; his own son in his arms: Both events that should not have happened – but for a chiropractic miracle. And I can remember sitting in my chair, feeling really tense, and then I broke into a cold sweat, and then tears started to well up in my eyes. And later that night, I was tossing and turning in bed, trying to get sleep, and I realised that there was a deep burning question building up inside of me; and it sounded something like this: “Nick, where are your miracles, where are the miracles in your practice?”

Now you might be thinking that when I got back to practice on Monday morning, that there was a guy in a wheelchair, or a deaf or a blind person, waiting to see me, who had a miraculous healing after I adjusted them, and that from that day on I produced miracles of my own. No, my outcomes didn’t change: But instead what happened was my awareness changed. And over the next few weeks and months I started to notice changes and miracles that had already been occurring in my own patients – I just had never taken the time to notice. And as a result I developed a deeper appreciation for the changes that occur as a result of my adjustments. So, let me ask you again: Do you underestimate the value of YOUR chiropractic care?

How do you start to identify and become more aware of the changes that are happening in your practice? In the past, the main way we used to help ourselves to become aware of our miracles was through the patient testimonial. When we had a patient who had a dramatic response to our treatment, we would get them to write a short story about their experiences. And after a while we would have a collection of a range of these testimonials. But what about all the other patients in your practice? How do you know what changes they are experiencing under your healing hands?

Now is one of the best times to be a chiropractor, because we have so many fantastic tools and technologies to measure and demonstrate what happens as a result of an adjustment: We can use health questionnaires to record someone’s state, at any given time. Anything from a neck disability, or low back pain questionnaire; through to specific health problem questionnaires, like asthma or ADHD or any named illness for which I guarantee you can find the questionnaire that matches the ailment; through to health and wellness, and quality of life questionnaires.

And there are also numerous functional assessment technologies, which can measure almost any aspect of your patient’s physiology. From taking digital photographs, and then using software to analyse their postural alignment; Or digital radiographs, where we can store the images on our computer and draw angles and measurements and calculations to be compared later; Through to surface EMG, paraspinal thermography, and pain algometry, and flexibility inclinometry; and now even heart rate variability, brain EEG, skin conductivity, and bio feedback assessments: You name the thing you want to measure, and the technology probably exists to demonstrate the changes.

So what are the benefits to the average chiropractor of utilising these technologies? The first and most obvious reason is that it helps to identify the miracles that you might otherwise miss. Often people don’t tell you about some of the less predictable changes that have happened in their lives until you see the changes in their physiology, and then they’ll say, “oh so that’s why I’m sleeping better, or playing better golf, or feeling happier?” And like me you’ve probably noticed that sometimes people have short memories. Those people who, when you first met them were in a terrible state, and were struggling to do even daily activities. And after a period of being under your care life is now going pretty well. But then, they say to you, “why do I need to keep coming? I’m not sure whether I’m getting any value out of my adjustments?” And you think “what are you talking about, don’t you remember how bad you were? Can’t you see how much you have improved?” So the benefits of using outcome tools is that you have a “snapshot” in time of what they were like back then, and you can show them and remind them as to how far they have come, and how much value they do receive from chiropractic.

So which tools should you be using in your practice? Here’s a really big question that you need to be asking yourself: What do you claim to change? What changes do you expect to see in your patients when you adjust them? A useful bit of homework to do is to take a blank sheet of paper and down one side list what are the major changes that you focus on that indicate that your chiropractic is working? And come up with a short-list of what are the most important functional improvements that you expect. Is it an improvement in posture, a change in a cervical curve angle, a reduction of muscle tension, improved flexibility, less pain and daily dysfunction, or an increased state of well-being and quality of life? Then, next to each of those listed changes, you need to identify the tool that you can use to prove that you change what you claim to change.

I’ve noticed that this can be really, really challenging for many chiropractors. And there seems to be only two possible reasons why a chiropractor would resist utilising these tools: The first is that they perceive these technologies as being expensive or time-consuming: In fact most technologies are now more than affordable and cost effective than ever before, and can usually more than pay for themselves via the extra revenue they generate: Some can be delegated to staff members who are usually more than enthusiastic to get more involved in the clinical and healing process.

And the second “excuse” appears to be a degree of fear of exposure. “What if I don’t change what I claim to change?” And I guess that are only two possibilities to this scenario: either chiropractic doesn’t work or YOUR chiropractic doesn’t work! But this perception is best resolved by putting the outcome tools to work – You either discover that your chiropractic is working; it’s not working as well as you would like (in which case you can modify your management plans and procedures); or it isn’t working (in which case you will need to discover a way that does work): Any of these three possibilities leads to improved quality in your products and service to your community – a win-win situation for everyone.

It is now the 21st century, and if you are practising in the same manner as you were in the 1990s, then you are not a 21st century chiropractor. Assessment and treatment technologies have evolved greatly in the last decade, including the chiropractic adjustment – there are new ways of adjusting which are gentler and faster, which work as well as, and perhaps even better than the “old” stuff. And there is no doubt that the chiropractic profession needs to redesign its packaging IF it wants to be seen as the leaders of the wellness revolution, as opposed to just another provider of drug-free back treatment.

What will happen if our profession doesn’t embrace the technologies and opportunities of the 21st century? There’s a saying, “put up or shut up”: Show your evidence and be listened to and respected, or stay silent and have your ways of life dictated to by others. I know there was a period in my practice life when I was waiting for the definitive study that proved that chiropractic did what I thought it did – improved state of wellbeing, maximized health and optimised human performance. And that once this paper was published in a legitimate scientific journal, the rest of the world would sit up and listen to us. It’s been eighteen years, and I am still waiting! And the profession is 112 years old, and we are all still waiting. That’s not to say that
there haven’t been some good papers – but the “breakthrough” has not occurred.

Here’s what I have discovered to be a fact: The evidence that chiropractic works exists inside the four walls of each and every chiropractor’s office – they are just not using the tools to prove it – they are waiting silently for someone else to present the evidence – maybe someone really famous and trendy who will receive a chiropractic miracle and do a testimonial on national TV, and then everyone will want to get adjusted??

Imagine if every DC used outcome tools in their practice, and that as a result they had enough evidence in their practice to publish just one case study in their career: That would mean that the Australian chiropractic profession would contribute 2,500 case studies to the evidence base. And the US contingent could produce tens of thousands of case studies. Case studies are a legitimate means of scientific endeavour, and the registration boards can’t silence you from sharing this information with the world.

But here’s what happens if you stay silent, and have no evidence to “put up” – third parties start to dictate to you the terms and conditions of your practice life… When the chiropractic profession shuts up, we wake up one morning and discover that our patients cannot share their success stories with the outside world; we wake up and discover we can no longer use the title Dr. What wake-up call will it take to make you put up your proof? Waking up to discover that it is now illegal for you to care for children; waking up to discover that you can no longer adjust necks because some other profession thinks it’s not safe; that you must discharge your practice members once their symptoms subside; or that if their symptoms haven’t subsided after four weeks that you must refer them to another profession anyway?

Maybe we shut up because we lack certainty? THE BEST solution to a lack of certainty is EVIDENCE: Evidence that what you do makes a difference in the world – and the most convincing way to collect the evidence is through the use of relevant outcome tools to measure what it is that you claim to change. You see, nowadays I have complete certainty that MY chiropractic works exactly as I thought it did; it improves state of wellbeing, maximizes health and optimises human performance – I know this because I have used the tools to measure what I claim to change, and they change!

Please join me in the 21st century…