Over the years, I have worked with many talented, intelligent, and dedicated doctors—both men and women who were compassionate and effective with their patients. However, not all of them were successful in business. The reason was that they lacked organization—and organizational discipline. That is to say, they lacked the business structure that would support a strong practice function.

Here's the catch corporate owners already know and most independents don't: none of this works without dedicated management. The practices that thrive as groups aren't the ones that got lucky. They're the ones that built management structure on purpose. That Shift — from a personality-based, one-doctor practice to a business built on goals and led by a team — is exactly what I cover in my book from 2001, The Goal Driven Business.

Increasing Engagement Look at yourself and your team as athletes playing in a health care conference. Are you winning? That's the question Jim Loehr and Tony Schwartz asked when they studied elite athletes for their book The Power of Full Engagement. Their conclusion: performance depends on managing energy, not just time. Like athletes, people perform best by alternating focused effort with deliberate recovery. Recovery time for your office could include:

Too often, doctors are distracted by the condition of their business...And, as a management coach, I often discover that their performance covers up their pressing concerns about their business, staff, and or overhead issues. It is not that they don't care about their patients, but their business needs as much "adjusting" as their patients. On the other hand, I have seen doctors take time to focus on their notes, on the x-ray and then on the patient in front of them...Happy p

Full capacity is when you are serving as many people as possible, given the available space, equipment, and staff. In other words, what is the maximum number of people you can see in a day – comfortably – given full support? This number will vary, of course, depending on how you practice. Full capacity is a vital goal for financial survival. You are already paying full price for your space, equipment, and team. With lower production, your overhead rises and your profits dec

56 delegates from 13 colonies got together in 1776 in a sweltering building in Philadelphia. Reports indicate there was a lot of bickering and that the delegates were pretty much a bunch of radical nonconformists. I can't help but see the connection between what these brave men fought for and what the brave men and women continue to fight for today in chiropractic and independent, integrative health care professions.

Scaling is keeping the basic proportions of an object the same but just increasing its size through multiplications. “Growing,” as opposed to scaling, is just adding things. For example, you may add more new patients, but you also add to your expenses.

A practice is a network of relationships – created and sustained through communication and service.

There are plenty of examples of these two success drivers in business and in sports teams. But these elements find their parallel in physics. When everyone (or everything) is moving in the same direction for the same reason -- a "flow" state is achieved. You may have felt it before. But it doesn't usually last. Staff change, you change, computer software needs to be updated, backlog found in insurance, and so on. Issues crop up. But with consistent leadership, you find new

It’s always the basics. The fundamentals. It sports or in your practice. This is what all efforts to improve performance – and health -- go back to. All of your efforts in practice management boil down to communication and control. All the books on procedures, patient management, and practice management can be distilled down to communication and control. Those are the basics you need to get to your goals and those of your patients.

There is real science behind this, but it is sort of obvious. People perform better when they have something, or someone, giving them feedback!

I don’t recall a single doctor telling me they wanted to be chained to their practice so they could never leave it. Nearly every doctor I’ve worked with wanted a business that was not entirely dependent upon their daily production or constant supervision. Michael Gerber (The E-Myth) wrote about the system-driven business. I talk about a Goal Driven Practice. In every case, the objective is the same: The business should not depend on the personality of the owner.

Two Hidden Benefits: First, they reinforce wins for your patients. Second, patient reviews keep the WHY in mind for you and your team.

He had his son focus on the phrase “green and clean.” Not rules or steps, but an image. A purpose. Over time, once his son truly understood that the end in mind was green and clean, he could do the job on his own. The lesson is simple: when the goal and purpose are clear, performance follows.

“We never know how far reaching something we may think, say or do today will affect the lives of millions tomorrow.” B.J. Palmer’s 1949 book The Bigness of the Fellow Within

I learned this early on: subluxations and other dysfunctions of the spine and joints can be present long before pain or other symptoms show up.

Now, back to those Christmas catalogues from L.L. Bean and Patagonia. Both show how patient, long-term ownership and excellent management, products, and services can build generational wealth over decades of brand-building and customer loyalty. In both cases, the owners who resist the quick sale and instead focus on purpose-driven growth and lasting customer relationships can build legacy companies that dwarf what any early buyer would have paid.

When opening a new office, the new business owner, of course, builds their new business on their behavior. It is their ambitious determination that is driving the initial growth of the practice. So, yes, a Personality Driven practice works at the launch of a new endeavor. What else is there? A dream, and the raw desire to manifest it. However, after the practice is up and running, it needs to transition into a Goal Driven and systematized business.

Everyone at work fills multiple roles. For example, the front desk may also include a collections role and a promotion role. The doctor may also have the role of CEO, Clinical Director, and business owner. In life, we also wear many hats: father, husband, sometimes handyman, etc. Just clarifying each role -- and its goal -- can help improve the outcomes in your practice.

What is the first thing you need to do to improve the number of new patients into your chiropractic and healthcare practice? Before you start promotions, improve what you are promoting – and never stop.