Empowering Women in Chiropractic – Are people dropping off care when insurance runs out?

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Are you good with patients, but it’s really frustrating when people drop off care, especially when insurance starts running out. This is Chen. Yen, and your host today for your ChiroSecure shows a six and seven figure practice make-over mentor at introvertedvisionary.com And let’s talk about this. The reason this topic has come up is because I was talking to a few chiropractors the other week and I had asked them, well, what, what do you usually say to people when w w what are some of the most frustrating things you hear from, from potential patients as it, when it comes to, uh, is it, they can’t afford it, or what are some things that they say to you that, that, that is really frustrating. And one, one chiropractor said, well, they tell me that insurer says run out. And so, um, you know, basically they’re not rescheduling the appointment.

And I asked, well, what, what do you actually say to them? So I got a few answers and some of them were to the extent of saying, I understand, and we’ll come back when, when basically like when you can. And one very important thing. Um, as I heard that chiropractor say that I thought to myself, we need to, as chiropractors as healthcare professionals, we need to hold the space for patients to holding the space. Meaning that if, if not, you, who will be the ones to tell patients what is really going to be most beneficial for the health, instead of them perhaps coming from a place of not understanding where you’re much. So let’s talk a little bit about this. I can talk about how can you actually answer that kind of, uh, a concern a patient might have that keeps them from coming back. We’ll talk about that first. And then let’s talk about what can be done before that point, so that people don’t end up saying that to you as much anyway, because chances are, if they’re saying that to you at that point in time, there’s a part of them that doesn’t value the care. So this is what you can actually say to a patient who, who says, well, my, my insurance is running out. So I think, I don’t think I can come back anymore.

You can just say, I understand, but it’s up to you. Oh, well not, but it’s up to you, but you can say, I understand, and it’s up, you, we will pay for what we prioritize to be important. We will pay for what we prioritize to be important. If you don’t have your health, you don’t have anything. And that’s all you need to say because, and, you know, it’s interesting because as I said, set this to two, one of the chiropractors, actually, I was talking to more than one car, but I was pointing this out too, to one of the chiropractors who had said that told me how he, he typically has responded in the past. He said, you know what? That is true, because I do actually see people tell me that, and then they drive off in their Mercedes or, um, and so, or, or do, you know, have their nails perfectly done and all this, right?

So the truth is we will pay for what we prioritize to be important. And in those moments, if a patient is, it doesn’t seem like they’re going to move forward with it. Just be honest with them about saying something like that or saying something directly relevant to their health and why you feel like they need the care. And from a place of what you feel like is best for that person’s health. And when you come from that place, then you won’t need to worry about whether you’re being too pushy or anything like that. You’re just, you’re really looking after the good for your patient. Now, when it comes to, what can you say so that it, uh, and like this right now, if, if you find this helpful, by the way, so now if you end up having people say that to you more often than not, it could also be because they, they don’t really have evaluated up to this point.

They don’t see why, or maybe they have valued it, but then they don’t think they need continued care because they think they’re at a pretty good place. Have you ever had people who who feel better and then they, then they drop off because they don’t think they need it anymore, but you recognize that people feeling better. Isn’t always the end point of optimal health. And yet they’re their, um, goal may not be at optimal health because they didn’t even realize that that could what that really means and how that could really be possible. They just came to, because they thought I could get out of pain or they want to get wanted to get out of pain out of pain. And that’s that. So part of it is about how you’re educating them from when they’re sitting and care to every visit. What are you saying that continues to educate them about how the continued visits will continue to help them?

One very simple tip also is have you ever had people who have come to you for one thing, but they never realized you could help them with other things? Has that ever happened to you before? Go ahead and type in the chat? Yes. If you, if this has happened to you before, and so that can happen and it’s because people don’t even put the two, two together, even if they feel like you’re an amazing doctor and I’ve really helped them, they might not even realize you could help them with other things. And so it’s helpful to, to, um, at the beginning of each visit, or if they’re coming in twice a week, then you could just do this maybe once a week, um, have them fill out a very short, very, very short progress form. It just has a couple of questions on it. One of them says, what are your thoughts, top three most frustrating health issues right now.

So what, that’s one of the questions on there. And then that way, um, they’ll get a chance to let you know, what’s, what’s currently most pressing for them. And then you could help them with that or talk about how you’re helping them, uh, with that. And then at the end of the visit, you could say this time we worked on this and next time we’re getting, we’re going to work on that. So that way there’s always context to what you’re doing in, in future visits. And there’s a purpose for it. People understand it. And, and they always understand because you’re always reminding them that you’re always educating them about it. I’ve gotten asked the question of, well, do I really need to do that? Because I already asked the patient anyway. Well, have you ever been to a doctor before and you meant to ask your doctor something, but you ended up forgetting completely.

It’s happened to the best of us. I know he’s happened to, to me before, too, and I’m a clinician as well, right? So, uh, it can happen to the best of us, including your patients. So by giving them a moment to reflect on their progress, which is why it’s a progress form assessment form, it’s very short. One has just a couple of questions, and this is only one of them. Then this can help them have a moment to reflect on, on where they’re at with things. And, and I, and then you also get to see this too. And the things that you never thought you could help him with, it might end up showing up on here, and then you can also look at it and discuss it with the patient. So with that, thank you for being here today on the show and for more six and seven figure practice, make-over tips that you can use in your practice right away, go to introvertedvisionary.com. And if you’re at a plateau in your practice, and you would like your, your practice to grow faster, we’ve helped many chiropractors. We’ve helped grow from know newer in practice to getting their first patients to also ushering our claimants into seven figures in a three to four year timeframe, the integrated way. So go to introvertvisionary.com and look forward to helping you grow faster and help more people to wake up the planet till next time


Empowering Women in Chiropractic – Clinical Communication – What’s Changed?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  We suggest you watch the video while reading the transcript.

Hello and welcome to today’s show growth without risk. My name is Dr. Janice Hughes, and I just love to say thanks to ChiroSecure for including me and engaging me as one of the hosts today. I’d love to have a conversation about almost what sounds like a bit of an oxymoron, clinical communication. And I say that because typically we don’t really clinically think about how we’re communicating or whether we’re being heard or understood by other people. So it’s interesting because as practitioners, we spend a lot of times on the science and understanding the technical parts or how to describe to a patient what’s going on clinically putting them on clinical care plans. But we don’t tend to spend very much time thinking about how we’re actually communicating that. Now I’m not going to be able to in one show today, break down every aspect or every piece, kind of the history behind communication, and then how we change it or how we get more impact.

But I’d love to give you a little bit of an overview today. And I know I’ve been having more questions related to this by a lot of practitioners, a lot of really tough conversations are happening in the world, these states. So the thing I’d like you to understand all of us grow up and we’re kind of taught something called the golden rule. And if you think about it, I always laugh. A lot of even little kids shows Disney shows really there’s characters that talk a lot about if you don’t have anything nice to say, don’t say anything at all. And there’s another piece of the golden rule where a lot of times people will say, we’ll say and do unto others as you would have them say or do to you. And what I want to share with you is that I think that that golden rule for communication is actually just simply wrong, because what tends to happen is if you or I communicate the way we hear the way we understand, we’re only going to appeal to a certain style or a certain percentage of the population.

Ultimately chiropractically acupuncture, whatever practitioner is listening, I would like you to have more impact because people really hear you and understanding, you know, understand what you’re trying to share with them. So one of the things that I like, I teach it a lot at some of the chiropractic universities. I’ve taught it in management groups. And a lot of it is just a learning or an understanding of something called the four quadrants of communication. And the best way I can describe it is there’s a number of layers or filters related to how we communicate. Now at the top, you can almost think about it like a big funnel like this. You know, we’re at the top of the funnel is things like, are you auditory, visual or kinesthetic in chiropractic? As we know a lot is the touch the feel. So there’s going to be a little bit of that kinesthetic nature within us, but it’s really do you hear and learn that way?

Do you see and learn? You know, do you have people talking at you showing you describing things? Like what kind of style do you learn? And that’s obviously at the top of the filter, if we go a little deeper, that’s where you start to get things like your belief systems, your habits, your patterns, you know, belief systems have a lot to do with how we communicate deeper than that is something called the four quadrant personality style. And there’s a pretty simple little questionnaire or assessment tool that I use so that people can better understand their own style. And we’re actually going to put up on the screen for you a number where you can text thanks to ChiroSecure. Instead of you having to communicate with me individually, this little assessment tool is available directly through ChiroSecure. So if you text this number on the screen, 4 8 0 5 0 0 6 5 7 4, you’ll actually be able to get this little assessment tool that you can do yourself.

Now, when I do this in a classroom, or when I do this with a lot of people, I always say, don’t take very long to do this. It’s a, self-assessment, it’s a little bit of an assessment tool where you just kind of want to go and trust yourself. And you’re going to self score yourself in several different areas. Then what ends up happening is you get a score and you get two different numbers for the score that you then plot on a graph. And I’m happy if you have questions by all means. Just reach out to me either in the stream of comments related to this, um, presentation, or just reach out to me individually as well. I’m happy to help you see where you fit on this piece of paper or this tool, the best way I can describe it right now while you’re listening is it’s like you’re taking a simple piece of paper and you’re splitting it into four quadrants.

Now, the quadrants there’s the driver, the expressive, the amiable and the analytical. And those are what we call our four quadrant personalities. Now this is an assessment tool taught originally by a management company, a business management company, nothing to do with chiropractic, but applying it to chiropractic allows me to help you think in terms of how do you communicate to a patient? How do you communicate to your team? I know I see a lot in all the Facebook groups and streams, frustrations about hiring frustrations, about training frustrations, about communication with staff in particular, a lot of it comes down to if we better understood them, we could help teach them in a way that they understood. Now it’s tough because a lot of times it’s easier to just speak and, and talk and educate in the style that we’ve grown up with. But like I said, you’re only then going to appeal to a certain part of the population.

So whether that’s with patients and, or your staff, a lot of times, if we’re not careful, we find that things just fall really flat. Now I’m not going to break down every one of the styles right now, other than to say and share that on the next couple of times that I’m hosting, I will go a little more deeply into how this impacts us clinically related to patients that let me give you an idea of why I think this kind of clinical approach or thinking through communication is so important. Some of you are naturally stronger communicators than others. Again, a little bit about your personality comes into play. I also find that in many cases, a lot of women have more intuitively been able to pick up someone else’s style, and then you can almost mimic or, or pattern the other person’s style. That gets us to a certain point.

I, for example, in clinical practice was quite good, quite intuitive and strong with understanding someone’s style. But I still was finding that, you know, in that way of communicating about chiropractic, I fell back to my regular style. I’m a driver personality. I am pretty short, quick. You know, I tease a lot of people as I teach you this, you know, pattern of communication, that in some ways, if I was your patient, as an example, as a driver, I would expect a lot. I’d expect you to be on time. I would expect to be able to come in, not have to sit and wait in the clinic have really quick instant answers. I would want to know really how this thing called chiropractic impacts me directly. And how am I going to get the most results? How am I going to get the biggest bang for my buck?

So I’m a driver. And what I found is I was all too often, really succinctly, quickly, almost very directly speaking to patients. And in many cases I was completely overwhelming patients because the perfect example is one of the other, your style’s called amiable. Okay. I always tease that these are some of the nicest, kindest people. They are more withdrawn. They are more people oriented as a driver. I’m more job oriented and amiable. Amiable is more people oriented and amiable patient for me as a driver, you know, doctor, I was just, all matter of fact, let’s get down to business. Didn’t want to chit-chat, but some of the amiables actually need to feel, you feel like they’re in relationship with you as a chiropractor. Now we can learn tools. So that, that doesn’t take a lot of time, but I had to learn that myself as a practitioner so that I could have those amiable patients better hear or understand me.

Now, some of you listening would say, wait a minute, I’ve got so many other things on my plate. Why would I spend time learning this? Well, just as an example, the way that the four quadrants percentage wise in the population splits out is it’s about 20% of the population are drivers. About 20% of the population are expressives about 20% of the population. And these are general. Statistics are analytical that you can see that that leaves about 40% of the population that are amiable. So any of us that are the other styles, if you’re a more expressive chiropractor, you really want the animals to be able to better hear you and understand you and better will be being able and willing, I guess I should say, to accept your recommendations. So the styles are not only about how we even have them understand chiropractic it’s about their willingness to then schedule appointments, understand a care plan, communicate with you effectively within the clinic.

You know, you hear a lot about how do we train people to, you know, come in and talk to us on a regular visit. Some personalities are going to be really willing to come in, lie down, face down on the table, have you palpate them and then update, get other styles. They, they need different things. I just want to share with you today and instill why it’s worth taking, taking a look at how you can become a better communicator. Now, a bunch of different groups and organizations out there that are brilliant with teaching some of the initial visit to report a findings. What to say, how to say it, if you can add on top of that, the filter of how you just communicate in general, it’s going to help all those things that you do have far more impact. Now, I also want you to know this has a lot of impact throughout your entire life.

Let me give you an example of why it’s also important to learn, you know, raising our kids. Many of you will know that each of our kids tends to be a different style. So just as an example, as a more driver personality, when my, I have three sons and when the two youngest, my middle and youngest were still in elementary school, I was taking my middle son for regular vision therapy. On top of him being adjusted. He had some visual field changes and we needed to go for some vision therapy. Well, I would typically in the beginning finished consulting, finished my job. Kids would have just come in the house. I be ready to pack them into the vehicle to take him for his appointments. But you notice that I was doing it in my style. And what I would find is that I would come out say, okay, get your shoes.

Let’s get in the car. And my youngest son would be right there with me in the car. And there would be no sign of my middle son who was the one that the appointments were for. I would walk back into the house and he would basically be in a meltdown on the stairs crying. And for me, it’s like, what? Like I said, get your stuff, get in the car. But what he heard was my tone of voice. And he would think that I was mad at him. So it was up to me to say, do I want to go through that struggle every time, three times a week for appointments? Or was there a different way I could handle that. So as a driver, I had to think through how do I not talk my language? How to, uh, how do I better communicate for him?

So it was little tools. Like I was better not letting them get in the house and get his shoes off because he’s an amiable anymore wanting to hang out after school as a young man play video games. So I would do things like the bus drop the kids off only, literally less than a block from my house, but could I be in the vehicle? And could I be over there to pick him up already? Could I have his favorite snack in the vehicle, all of those things to ease okay. Or better understand his style so that we could ultimately get him to his appointments. So, likewise, let’s think about how that applies in our clinics. You can imagine really training your team. Different styles have different skill sets, have different ways of operating that are incredibly powerful. Like I, on a couple of the next sessions, all break down a couple of the patterns related to the different styles.

But thinking in terms of, if you take a simple piece of paper and split that into four, what I want you to know is that the top right hand quadrant is where the drivers sit. The bottom right hand is where the expressives are. The bottom left is the amiable. And the top left is the analytical, a couple of really general patterns to this learning. This clinical approach to communication is that the two personalities above that middle line, along the horizon, above the mid point across the page are the drivers and the analyticals. Both of those personalities are more bottom line production, detail job. First people second, the two below the horizon are the opposite. They’re more people first job, second. So you can see right away. If you have someone on your team, if you’re an analytical and you have someone on the team, that’s an amiable or an expressive what’s tending to happen is sometimes between patients you’ll come out to try to teach them something or share something you’ll be fairly detailed oriented, or you’ll say, here’s what needs to happen.

And for them being more people oriented, it can come across to sharp. It can come across. Like you’re not considering their emotions, their feelings, you know, whether they have time to address that right then or not. So it’s almost like the top part of the page. And the bottom part of the page are those opposite styles. Now, likewise, you can divide these four quadrants. If you think about the vertical line down the page, the two on the right hand side, have some tendencies that are different than the two on the left. So the driver on the top and the expressive on the bottom, right, are very different. They’re much more open. They’re willing to emote. They’re willing to say things, tell you like it is talk about it. The two on the left are much more withdrawn or closed. Doesn’t mean they won’t communicate. It does.

It’s just not that they are super forthright right? At the very beginning of the communication. So I wanted to give you just a few general ideas about these patterns or habits related to communication. So again, we’ll put up and we’ll also post the way that you can get this assessment tool. Because what I want you to understand is this is a way to look at your skill in communicating so that your team and ultimately every one of your patients better hears you and understands what you’re sharing with them. It allows you to be a little cleaner, clearer, and ultimately get the results that I know you all want. You want people to be well-educated. You want them to be well-educated about health and wellbeing. That’s, what’s so critical for us in private practice. It’s also, what’s so needed in the world right now. Let’s face it.

It’s a time in the world of a lot of miscommunication. We have a lot of people, health choices being dictated fears, driving health choices. So ultimately that’s backing people up a lot into their own style. If we don’t think more clinically about how to communicate, we’re going to miss sharing our important messages with people. So I’m excited on our next session. I’ll break down those styles a little bit more and how some of those patients show up in the clinic, how we can more effectively communicate related to even just the initial visit, even welcoming them into our clinic. And then a few tools say for the report of findings as well. So I just wanted to share that whole idea about the four quadrants with you. Please know that next week on our show growth without risk, you’re going to have the host Dr. Sherry McAllister. So please stay tuned for that as well. Again, I’d like to take the opportunity to say thank you to ChiroSecure for allowing me to be one of the regular hosts of the show. I appreciate you, please. Don’t hesitate to reach out, to ask more about why or how it will benefit you to be a little more clinical thinking about the way that you share your message of health and wellbeing. Thanks and have a wonderful day



Empowering Women in Chiropractic – LIST YOUR PRACTICE or SELL YOUR PRACTICE?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  We suggest you watch the video while reading the transcript.

Hey everybody. Welcome. I am Dr. Randi, Ross CEO of Premier Practice Consultants. And I’d like to welcome you to our show today. Uh, let’s first give a big shout out to ChiroSecure for sponsoring and hosting. These shows, you know, it gives you such great information every week. Go to their website, amazing team. There’ll be happy to help you with anything that you need. All right, well, we’re going to go ahead and jump right in here. We don’t want to waste any time. Uh, so today we’re to list your practice or do you want to sell your practice? And this is a conversation I have probably almost daily, if not two, three times a week. And it’s two very different concepts. Um, and often when people are thinking about selling their practice, you know, we have to determine, you know, kind of which half of their brain they’re working this with.

Uh, so do you think that you have any idea what your practice is worth? Do you think it’s worth what you gross? Do you think it’s worth two times gross? Do you think it’s worth two times net? Do you think it’s gross and equipment, do you think it’s gross and equipment and plus plus plus plus plus, or maybe a one of those, the things your practice is priceless? You know, it’s, it’s very interesting to think about this and, uh, you know, a lot of people really don’t put a lot of thought into this until they’re winding down or maybe they’re relocating, like a lot of people are doing today. So, uh, often we have a lot of misinformation and we’ve been given kind of the wrong, uh, guidelines as to which, you know, is the right way to think about this. The first thing that anyone should do, if you really thinking about considering selling your practice, and this might be something you’re thinking about, you know, maybe I want to retire in two years or three years or five years.

If you’re thinking in that kind of timeframe, you want to start this practice, you know, most places are anywhere from 12, 18, 24 plus months to sell depending upon a lot of different variables. So if this is something that you can see yourself getting into that timeframe, you really want to start in. The first place to start is to get an objective, proper practice valuation. So this really is not, you know, your, your colleague that practices down the road. Um, it’s not even other people that might be part of your professional team, because there’s some very specific variables that goes into determining what your practice is worth. And the other thing that’s important to note is our profession is different than others. So words what chiropractic practices sell for and possibly what a dental or a multidisciplinary medical practice Salesforce is very different. So if you don’t have someone that specializes in understanding the chiropractic profession, you might actually get misguided and you might actually be misinformed.

So when we talk about, this is a question I get all the time. So when I finally determine what my practice is worth, should I actually start a whole bunch higher so that I have room to negotiate. I don’t really live by that concept. I think that if your practice is properly priced, you have a proper valuation and you have the documentation to substantiate where that value came from. Not just, you know, kind of out of thin air, whether that, you know, tax returns and P and L’s and certain stats that you know, many of you keep that, especially if you work with, with different coaches, um, you know, w what’s the value of your equipment, the depreciated value, not what it costs when you bought it. So I’m not big from the school of, well, you know, my practice you’re telling me my practice is worth $300,000.

So let’s start at three 50. So I have room to negotiate. I don’t really think that that works. If someone’s gonna offer you less than your practice is worth as their way of presenting an offering terms, that’s going to happen. Whether, you know, you start high or not, they’re going to be looking at the data that substantiates what the actual value of the practices. And actually often when you try and use this strategy, it doesn’t always work because then people think you have an overinflated opinion of the actual, what I call market, ready value of your practices. So you’re going to be a little more difficult to work with. So you can actually scare away certain people that could be potential viable buyers. So keep that in mind, you know, remember you’re not in the real estate market when we’re doing this, and this is really important.

We all know that in many places right now real estate is, you know, over the moon. You know, I live in Southeast Florida and property values have gone up 20, 30% just in the last 18 months in certain developments. This is not that. So if you’re trying to equate it to, well, you know, I priced my, my home a little bit higher. So there was room to negotiate. This, this is not that strategy. Your home is going to be a different selling model than your business. Your business is going to be worth. It’s going to be based. The value of your business is going to be based on certain elements that are going to go into determining, uh, you know, what someone is willing to pay for your practice. So go through a few of these, just see, kind of get an idea of how you should start thinking about this.

So when a buyer looks at your practice, they’re going to look at a number of things. You know, first when we talk about the math portion of it, they’re going to look like they’re going to look at what is the business grossing, um, you know, uh, is a business grossing $300,000, 500,000. Maybe it’s only grossing a hundred thousand dollars, you know, and that’s okay. That’s what the reality of your situation is. And then they want to know the profit. So these are two very different things. Um, and one of the most important things that people struggle with that I work with when we’re, when we’re trying to determine, or, or a buyer is trying to determine what the actual value and what I’m willing to pay for your practices is someone coming up with what we call clean overhead, clean overhead is what it costs to run your business.

Now, we all know as small business owners, legally, we’re allowed to write a whole bunch of stuff off, um, that really pertained to us personally, and that’s fine, you know, everybody does it. Uh, but what you really need to understand is a lot of those things that are illegal write-offs, um, are not going to be passed through expenses. And they’re not going to be an expense that if I come and buy your practice tomorrow and start on Monday, I’m not going to have those expenses. So that’s a really important way to determine what your profit is, because in theory, think, just follow me on this, because it’s so simple. It sounds almost too simple. If you take what you gross, and then you take what your real expenses are and you subtract them, that’s technically what your profit should be. Now, I know that’s not going to be the reflected net on your taxes.

We’re not talking about that because if someone understands what the profit of your practices, it’s going to be easier for them to determine is this something that they want to purchase and acquire? And if so, what are they willing to pay for it? If you have trouble showing someone what the true profit is in your business, you’re going to struggle with selling. And even as from a broker’s perspective, we struggle with helping people with that sometimes because not everyone is really organized and efficient. And sometimes even when we go through either their taxes or their P and L’s to help them get, uh, this, you know, accurate overhead number, there’s things just lumped together in these giant categories. And then you have to kind of sift through there, give you one insurance. Well, insurance is, you know, $15,000 a year. Well, is that your car insurance in there?

Is it health insurance for you and your family, nothing to do with employees. Um, is there, you know, your life insurance in there or your, uh, um, you know, your interests like, so those are things that would not pass through to a buyer. Those are things that, you know, maybe they have their own health insurance somewhere else. Their spouse works for a big company. They don’t need that. Um, maybe they’re not, I mean, it sounds crazy, but maybe they’re not interested in having liability. So those are just, you know, a few examples, another big one that I see that people forget to, um, when they’re selling their practice, what we call add back in is, you know, your travel, your entertainment, your conferences of your CE credit thing, all those things. And you have to go through this with a fine tooth comb to get the accurate number, but I can tell you makes a huge difference in determining what a buyer will pay for your practice, K your equipment.

Um, you know, typically, you know, we have people, do we call depreciated equipment list? Well, that’s anything more than five years is worth about half of what you paid for it. Yes, there were a couple of exceptions, but for the most part, that’s a general rule. A lot of people get stuck on their equipment is worth really more than it is. Uh, so remember, it’s not what you paid for it 10 years ago. It’s not even what your insurance broker has. It, uh, you know, priced at for replacement in the event. You know, God forbid you had a fire or something like that. That’s not the value of your equipment location. This is such a hard thing sometimes for people to understand. So, like I mentioned before I live in Southeast Florida, well, practices in Florida are really going as long as they’re properly priced for that top dollar.

Why? Because I think something like 150,000 people, you know, a week are moving here. Well, that creates a lot of growth and that creates a lot of demand for something. So location of exactly where in the country it is right now, especially is playing a huge part in what someone’s willing to pay for your practice, uh, because like anything else, um, you know, from the Northeast, people are migrating south to Florida, Georgia, the Carolinas, they’re not migrating north. There are exceptions to that when someone has family members or something that they want to get close to again. And most of the people from the west, you know, from, uh, from Washington state, from California are mostly going, you know, Arizona’s, uh, Texas, some Kentucky, things like that. They don’t seem to be coming as far east as, as you know, the coast over here. So that’s one kind of component of location.

The other component of location is exactly where is your practice? Is it on a main road? Is it on a secondary road? Is it on a tertiary road? Is it in like an industrial park, which you might have a beautiful office, but someone might think that that’s not super beneficial. So the location you chose for your practice could actually be a part of the equation for someone determining what they’re going to pay for your practice. Uh, the decor, you know, is your practice. Up-to-date aesthetically and modern. We actually discussed this a few weeks ago, or have you been in practice for 30 years? And you basically have the same carpeting, the same color, the same waiting room chairs, the same, you know, receptionist counter, because people frown on that a lot because they walk in and instantly they see, I have to spend $20,000 to update this practice.

This is not aesthetically what I would be comfortable with. So that’s one thing you have to consider your math might all work. The InTASC stick for a very successful business, but if someone walks in and see something old and outdated, there are some people, not everyone, they can’t see beyond that. So keep that in mind, if you’re preparing to sell within the next few years, your staff, you know, are you staffed rockstars? Are they staying? Um, you know, how, what kind of training do they have? These are all things that have value. Obviously your stats, everyone wants to know how many new patients do you have, how many total office visits, what was your billing? What was your collections? These are things that everyone is going to want to see. So make sure you’re keeping good records on that. And what is your payer profile?

Um, so obviously if you’re a hundred percent cash, never an issue, I’d never had a buyer say to me, my practice has too much cash. I’m not interested in it. Um, but some people might have practices that are higher pie. That’s just the type of payer profile they have, which is fine. But some people would not be interested in purchasing that. Some people might have a large amount of Medicare and for some people that’s not something that’s attracted to them. So you’re these, all these things that we just listed, you know, your payer profile, your stats, the core, your equipment, what is your actual profit, all, you know, uh, combined go into someone determining and evaluating, what am I doing willing to pay for this practice for someone sometimes what they’re willing to pay for the practice has absolutely nothing to do with what we determined it’s worth.

You know, the old saying something’s only worth what someone’s willing to pay for it. So always keep that in mind. And now we’re going to talk about it. All right. She have a buyer you’ve agreed on a price. You’ve agreed on the terms. Fantastic. Now that buyer has to go to a bank. So if we properly priced your practice, not a practice that, you know, we substantiated is worth $300,000 on, on the market. And you said, Nope, I want, I want 400,000 starting at 400. That let’s even say you’ve got a buyer, which that’s unlikely. We’re just kind of having a scenario here that person’s going to go to a bed. And the bank’s going to look at the same math and, and incorporated elements that, that we use to create a market report valuation for your practice. And they’re going to go, what are you talking about?

We’re not funding this practice of $400,000. We even care if the buyer wants to pay that we’re going to do 80% of $300,000. So just saying, you want more, again, this isn’t like real estate, your house is worth 300. You got to buy for 400. Guess what? That personal come up with the other hundred thousand dollars cash doesn’t work that way here. So don’t even think that, you know, even right, if you have all these elements together, the, the math has to work for the bank. Remember they’re always mitigating their risk. That’s all they care about a bank. When it comes to funding, are they mitigating their risk? And is there profit in this to fund this business? They can’t mitigate their risk if their information in their reports and how they do their own, you know, how they determine the value is way more than it’s actually worth someone Desi for it.

They’re not going to do that. They’ve just lost their risk. So, you know, it becomes to a bank about math. What’s the strength of the practice, you know, in other words, does it have good cashflow? Um, what’s its history, is it making money? Are you declining or are you increasing? You know, we can talk about COVID the COVID year, another time. I don’t want to get into that here, but just kind of, you know, usually they’re taking a three year average. That’s typically what they’re looking at. You know, what kind of documentation is there to, to provide them, to substantiate some of this information? You know, a lot of times people just have really crappy documentation. And then when a bank asks for information, you, you kind of don’t have anything to back it up that instantly for a bank, that’s a red flag. If you’re not organized and efficient and can’t give them what they ask for as obnoxious as they might be, that is a little bit of a red flag for them.

So something else to keep in mind to be organized efficient, and be prepared to share the documentation that substantiates the value of your practice. And what’s the buyer’s strength. That’s really important too. It’s it’s, it is based on your business that they’re technically buying for this person. Um, but the buyer has to have some strength too. And there is a lot of variables that can go into that. Um, you know, one of the things people think, well, if someone’s a, you know, a new doctor or just out of school, that they don’t qualify for anything, well, that’s actually not always true. There are other strengths that they can have that the right funder knows how to work with or manipulate. If we want to use that word that makes them look like a good risk to a bank. Um, and obviously there’s a lot of other variables when a buyer, yes, they look at your credit score.

They look at your debt to income ratio. If you’re not right out of school, um, you know, they’re going to look at other things, obviously, if you had any kind of, you know, bankruptcy or ill financial dealings of that nature, uh, that will come into play with that. So what you think your practice is worth and what a bank might be willing to pay for it, even if a buyer does, might be two different things. So what we want to offer here is if anyone’s interested in figuring out and finding out what is your practice actually worth? Okay, we’re offering 25% of evaluations through the month of August. Just go to our website, premier practice consultants.com on the homepage and see this little blue button that says client intake form, fill it out. It’s about five, six questions. And at the bottom, there’s a code just put in August, 2021.

And I will know that you came to us from this ChiroSecure event. Well, that’s going to wrap it up for me today. Hope you learned something, make sure you log on next week. Dr. Nathalie Beauchamp will be here. And she always has such amazing information on all different kinds of practice growth and your staff. And I mean, her, her list of accomplishments and information is just endless. Well, I’m Dr. Randy Ross, again, CEO, premier practice consultants, visit our website. See how we can help you like to thank ChiroSecure again for having me. And I hope you guys have a fantastic day.

Join us each week as we bring you the best in business growth, practice management, social media, marketing, networking leadership, and lots more. If it’s about women in practice and business, you’ll hear it here. We hope you enjoy this week’s Facebook live event. Please like us on Facebook comment and share. We look forward to seeing all of you next week for another episode of empowering women in chiropractic. Now go ahead and hit the share button and tell your friends and colleagues about the show. Thank you for watching. Have a beautiful day. This has been a ChiroSecure production.


Empowering Women in Chiropractic – Cultural Competence 101 for the Chiropractor Part 3

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  We suggest you watch the video while reading the transcript.

Hello? This is Dr. Charmaine Herman again with Agave Upper Cervical Health Center for another episode or part of cultural competence, 1 0 1 for the chiropractor. Thank you for joining me again today. We’re going to go ahead and start talking about cultural competence again and just keep, we’ll keep adding to the knowledge that we gained before. So let’s go ahead and get started. I have a slide show ready for you. So again, this is part three. If you haven’t seen part two in part one, please go back and watch them. So let’s go ahead and move forward into part three. For those who don’t know me again, I’m Dr. Charmaine Herman. I am a native New Yorker originally from the islands. I currently teach at Life University and I practice in Alpharetta, Georgia. I’m an upper cervical specific doctor of chiropractic, and I have some training in cultural competence and I do cultural competence training at Life University. So I’m bringing this knowledge to you as well.

So our goals today are to define what cultural competence is. We’ve been talking about cultural competence last week. We had a discussion last time we had a discussion. We’ll talk a little bit more about what culture is, and then also get into defining what cultural competence is. In addition to that, we’re going to discuss how cultural competence is seen in healthcare or for us chiropractic care. What are some of the benefits of cultural competence? So let’s define cultural competence. Now, last time we discussed what culture actually is now, culture is the whole person. When your patients walk in the door, they are one mass of their culture. So there are foods that they eat, the clothes that they wear the hell, the holidays that they celebrate, the language that they speak. That’s part of who they are. That’s part of their culture. We, as doctors of chiropractic, we also have our own individual cultures, but culture is the whole person.

We talked last time also about the hidden aspects of color, such as how people define modesty or how people define space or how people define what’s time, whether time is quality or quantity. I know sometimes we couldn’t. We’re concerned about patients that don’t show up on time, but certain cultures see time as a quality and not a quantity, not how much time being there on time, but spending more quality time with family members and friends is more important than being at our offices at three o’clock on the dot. So there’s a challenge with seeing the different cultures and how they interpret time. This is the way how they determine model determined or interpret modesty or how they interpret their communication style. Some people are more of a boast. Some people are very silent in their communication. So all of us have our own distinct cultures and that’s what makes us individuals, and that’s what makes it so important that we, as doctors of chiropractic understand the cultures of our patient, because that also dictates their behavior and even their compliance to care.

So other people have talked about cultural competence, the CDC defines cultural competence as the integration and transformation of knowledge about individuals and groups of people in specific standards into specific standards, policies, practices, attitudes, use to use them, sorry, inappropriate cultural settings to increase the quality of services, thereby producing better outcomes. So the theories is talking about better outcomes. Once we can understand the importance of our patients and their culture to the entire care process. So that’s one thing. So let’s move on to the next definition of cultural competence. And this is from the office of minority health, um, also for the, his, the health and human services office. So it says a set of congruent behaviors, attitudes, and policies that come together in a system agency or among professionals too, that enable effective work in cross-cultural situations just by defining the whole word of competence.

Competence itself means that it implies the capability. I’m sorry that having the capacity to function effectively as an individual or an, and as an organization with the context of cultural beliefs, behaviors, and needs that are presented by the consumers and their communities. So we’re talking about cultural competence in the vein of service, how we serve our communities, how we serve our patients. So in healthcare, cultural competence is a, just a little bit different. When we talk about chiropractic care of a healthcare professionals, it is understanding the importance of social and cultural influences on patient’s health, beliefs, and behavior, considering how these factors interact at multiple levels with how we deliver our care to our patients. So understanding our patient’s cultures helps us to do better as far as delivering our services to our patients.

So there are a lot of benefits that have been documented for cultural competence as far as better patient outcomes. So doctors of chiropractic who understand their patient’s culture are able to work with them in the confines of their culture. So they understand that maybe that they’re more modest than their culture. So when I adjust, I’m going to make sure that they have more of a recovery of their, of their more modest in some cultures, if it’s a female patient of male doctor cannot adjust her. So you have a female chiropractor on staff to adjust those types of patients who have that cultural separation as far as how they can be adjusted. So we also see that get better outcomes. We also improve the health, um, health disparities into communities where you’re dealing with poor social economics, communities, health disparities are something that are very common, but by working with the patient, understanding their social economic issues, even in your pricing and how you see patients, and even in your conversation with them, by them coming to your office, you’re helping that entire community and you get better outcomes, improve patient centered care.

That’s something that we’re, we’re w we get a lot of great compliments that chiropractors have great patient-centered care because we talk more to our patients. We have more conversations with our patients, but they feel better about talking to us when we’re more in tune with who they are and their cultural needs and their cultural beliefs. So that’s also important, and we want to improve our patient satisfaction. And again, we do well in patient satisfaction, but being culturally competent will help us even do better by understanding again, their social and their cultural needs as they’re in our offices, the things that they need, even if, as a mother that needs someone to watch your children in order to come to your office, I’ve known some chiropractors to actually offer, um, help with finding daycare for their patients. So they can actually come in to many of them have the children come with them, but some people are afraid to bring their children, or they’re in a situation where they can’t bring their children.

So that’s where we see a lot of chiropractors now doing the mobile chiropractic, going to the patient’s home to actually take care of them and the rest of the family. So they don’t have to bring them out, especially with COVID and coming through a pandemic, many people are leery about leaving their homes. So just by changing certain things, understanding the culture that your patients, who they are and what they’re experiencing can help increase the benefits of chiropractic care as well. So let’s move on now, based upon our census for 2050, it is estimated that the United States population is going to change drastically. So many of our minority populations are actually being considered as emerging majority communities. For example, our Latino, Hispanic community is going to grow to 24% of the population African-Americans with beads at 12%. And even our Caucasian white population is going to decrease from over 50 to just about at 50, 51%.

So we’re looking at a lot of changes occurring in our, in our world and our society in the United States of America. That’s going to change the, um, the dynamics of our community. The demographics are going to change. So we’re going to see more people hopefully of color in our practices because we’re getting more numbers. They’re increasing. We want to get them into chiropractic care. That’s part of our chiropractic mission, bringing the world, taking chiropractic to the world. So everyone in our communities are part of that world. So as doctors of chiropractic, we have to think about that when we’re setting our strategies for seeing our communities, what do we do? How do we reach more people for chiropractic?

So cultural competence is not just a term used in chiropractic or used by the, by the CDC or the office of mint office of health, minority health. There’s so many other areas where cultural competence is not just a buzzword, but it’s actually being incorporated into policies and practices, even in places such as the police department in business. It’s a very big thing because with now that we’re zooming and doing all that other stuff we can do now in niche people across the seas and have a total global economy, cultural competence is a big part of that global economy, understanding how to work on the cross cultural boundaries, dealing with, and working with people from other cultures. So cultural competence is becoming more and more important again, as I said, in our first episode, when I was working for the department of health many years ago, cultural competence became important to reaching people who lived in the mountain areas who had challenges, who, who, who had a challenge because they were burning rubber.

And now the federal government told us they couldn’t burn rubber on their property. So that caused a lot of contention between the state agency and the citizens, because we didn’t understand their culture. We didn’t understand that they’d been there for hundreds of years and telling them that they now cannot burn rubber. Was this totally against all of their understanding as far as their, their home, their community, their property. So we had to retrain culturally to be cultural competent, so we can actually understand the communities that we were working with on a public safety, public health issue. So we want to make sure we were able to do that. So cultural competence again, is going to becoming more and more important as we look at not just healthcare, but even in our, um, our police academies. They’re talking about that in the military. They’re talking about that. So cultural competence is becoming more and more part of our society. So we, as chiropractors should also be prepared to be culturally competent as work when we work with our patients.

So when, okay, cultural competence, I’m going to get more into this topic in our next coming episodes, but I’m going to talk about how important cultural competence is in our policies. We, when we set up our policies in our offices, our, our manuals, our SOP, our training, how that should be an important part of our training. Um, and in addition to that, things such as our attitudes, as doctors of chiropractic, you know, we can take a negative attitude, say, well, why should I care? You know, all I care about is there a spine? Cause that’s what we’re talking about. Just adjusting the spine, that’s all we do. But remember that spine didn’t just roll in by itself. It was attached to a person. So actually understanding the cultures of the people that we work with and, and meeting their needs. Their cultural needs is very, a big part of being, um, culturally competent and to actually give better care to our patients.

In addition to that policies, attitudes, um, things that documents in our office can be changed to assist our, our communities suppose you’re working in the community where there are mostly, um, Hispanic individuals. Do you have any of your income in income in intake forms in Spanish? It’s great to have someone at the front desk that speaks Spanish, but what about your intake forms? Your documents can that, can they read that? Because just because a person speaks a different language doesn’t mean that they’re illiterate. Um, in most cases they can read their own language. So changing, having forms that are more, um, that are translated into the languages of the patients that you serve in your community, say if you’re in a German community or you serve a, an Asian community, how are your intake forms? Do they meet that? What about pictures in your office?

Do they show patients that they are wanted? They are a big part of your community that you want to serve them, their pictures, their pictures represented in your office. So those are the little things that can make your office a little bit more culturally competent as far as just changing a few things in your policies. So we’ll get more into cultural competence. And I plan to do that in our upcoming episodes, talking about how to become culturally competent. So I can talk about this all day, but what do I do? How do I get there? Um, and can I get just culturally competent, overnight, or there’s some steps that I need to take. So that’s what we’re going to do when we have our upcoming sessions are going to talk about how do I start to become culturally competent? What can I, as adoptive chiropractic do to become more culturally competent.

We’re also going to talk about issues such as understandings bias. We all have biases. Some are conscious, some are subconscious, but what are our biases? What are they, how do we identify them? How do we understand them? A big part of being culturally competent is understanding our own biases and being able to put those aside so we can work with people and be fair and, and our judgements and things like that when we’re working with people. So we talk about culturally competent, culturally competent. There’s so much more to that. I’m just giving you guys just the tip of the iceberg. So in upcoming episodes, we’re going to talk more about that. So again, the next episode, we’re going to talk about how to become culturally competent and also how to identify some of these biases, both subconscious and unconscious that we have even as doctors of chiropractic. So that’s all I have for today. It’s been always a pleasure to come and talk to you even just for a few minutes. Thank you so much for your time. Thank you so much for ChiroSecure for giving me time to talk about this important topic. You all have a great day. And again, this is Dr. Charmaine Herman. I look forward to talking to you again soon. Take care.

Empowering Women in Chiropractic – Put Your Oxygen Mask On First

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. We suggest you watch the video while reading the transcript.

Hello, and welcome to Empowering Women in Chiropractic. I’m your host, Dr. Cathy. And today, we’re going to talk about putting your oxygen mask on first, perhaps you’ve been on a plane and you’ve heard the flight attendants tell you if the air mask drop from the department above, be sure to put chores on first, before trying to help other people. Well, you know what? That lesson should apply to every aspect in life, because the reality is, if you don’t take care of yourself, you’re less capable of taking care of everybody else. And if you don’t put your needs first, you become less capable of taking care of everybody else’s needs. So let’s talk about the top five mistakes that women chiropractors make and how you can start to correct them. Now, listen, number one is not putting your healthcare needs first. Not making yourself the top of your priority.

And ladies I’ve been there. I know you’ve been there. We’ve all done it. We’ve got babies. We’ve got practices. We’ve got little kids who are growing up to be big. Kids are growing up to be preteens who are soon going to be teens. I get how it’s so easy to put everybody else’s needs first, but guess what? If you’re not taking care of yourself and making your health a priority, you become less and less capable of doing all the things that you’re able to do. Now, if you’ve listened to this show before, and I know that you have, and I thank you so much for joining us every week, right here with Kyra secure, then you know that I love to talk about sharpening your ax and sharpening your ax means if you’ve been out in the woods, chopping wood and chopping wood and chopping wood, eventually you start to get tired and your ax gets dull.

And most people, most entrepreneurs, most women chiropractors that I talked to, we don’t take the time to rest and sharpen our ax because in our mind, there are so many things that need to get done that we can’t stop. We can’t take a break. We certainly can’t rest. We just have to keep going because the list will just keep getting longer and longer. And if you have ever been in that situation, you know what I’m talking about, where the list just seems like you can never get it all done. And then there’s more on it the next day. So if you’ve been in that situation and you’re chopping wood and you’re chopping wood and you’re chopping wood, and the ax is getting dull and you’re getting tired, you’re actually going to have to work twice as hard to get half the results. This is a hard one ladies, but you’ve got to stop.

You’ve got to take arrest and you have to sharpen that act so that when you come back to it, you’re way more effective. You’re way more energized. Your ax is true, or your blade is sharper and your results are way greater than they would have been had you not taken arrest. So one of the things that I made a priority in my life is that Christmas new year’s every year I shut the practice down and I make that a time to recharge up here. I’ve got to be in the sun toes in the sand, right drink in my hand, because I have to reconnect to what makes me feel alive so that I can get back in January and serve when the people need it the most, because that’s when they’ve all created their new year’s resolutions. But the one year that I didn’t do that the whole next year suffered because I didn’t make my health and myself a priority.

So I know that there’s mornings where you’re going to be up all night, because you’ve been nursing or changing diapers or changing sheets. And who knows what else? And then those days you might feel like I just can’t go to the gym, or I just can’t make a healthy meal, or I just can’t get motivated to dance around the house. But you know what? Those are the days that it’s most important when we’re serving and serving and giving and giving and loving and loving and doing, and doing for everybody else. Those are the days that we really have to stop, make ourselves a priority. I recently stopped homeschooling my kids, which I’d done for seven years and let them let them start in going to public school. And the first Tuesday that I didn’t have to run around with my hair on fire and stressed out and trying to get it all done.

I really didn’t know what to do with myself. And so my staff has jokingly relabeled my Tuesdays as to me Tuesdays, because that’s the day that I give to me. That’s the day that I do things for me. That’s the day that I make all of the crazy wild experiences that I want just for me a priority. And I’m going to urge you to do that for yourself because when you make yourself and your health a priority, you have more energy, you’ve got more vitality. You feel better, you’re functioning better. You look better when you look at yourself in the mirror, which makes you want to do more. And don’t discount the fact that looking good makes you feel better about yourself. And I’m not talking about Barbie doll. I’m talking about when you’re able to make the time to put yourself together, you’re going to feel so much better.

So number one, I think of the top five mistakes that most women Chiros, chiropractors make is not making your health a priority. If you’re not doing that right now, then think about the five aspects of health. And most of us have talked to patients for years about the five aspects of health. And I call these the dream lifestyle that’s D for diet or for rest E for exercise, a for attitude and, and for mental impulse. And that should be the base. It’s a big triangle. And I want you to make these things a priority in your life daily exercise. You’ve got to move your body quality nutrition, making sure that you are eating good foods that grow to fuel your body so that you can go out and serve others. And making sure that you get that positive mental attitude so that you can get through your day, minimize your stress, have a good quality restful night of sleep, and then make sure that you yourself are getting adjusted.

And that brings me to the second one. And the second mistake that most women make is that improper posture during their adjustments. So when you’re delivering the M for your other patients, right, that foundation of that triangle, when you’re delivering your adjustments, not using proper posture is going to set you up for a lifetime of discomfort. Eventually dis-ease eventually crazy symptoms, pain things that may prevent you from being able to practice. So think about how you’re doing your cervical adjusting. Are you rounding your spine and hunching over to bend down to patients? Do you need to use a stool or do you need to elevate your table for the cervical adjustments? Or could you just get down into a really good, really powerful, effective squat position? Me personally, I like to get down and squat because I want to use the muscles and I want to get down there low.

And I want to keep my spine in a great position while I’m putting their spine in a great position. So think about the techniques that you’re using. If you’re doing side posture and you’re using your wrist in some weird abnormal position that I know you were taught in school, but maybe isn’t the most effective way for women to adjust. Then rethink your adjusting position, because I don’t want you in this weird position. That’s going to blow out your shoulders, blow out your elbow, blow out your wrist puts you in pain and eventually shorten your career. I want you to use a position that utilizes the body of your patient, utilizes their size, their mass, their body, to get them into a better position so that you could do minimal stress on your body. And when you learn how to start adjusting in ways that protect you guess what?

You can adjust bigger patients, you can adjust more patients. You can adjust for more years and you can continue to function for a long time. One of the things I’ve always said to my female students and the female doctors that I’m very privileged to mentor is that you are going to adjust patients that are twice your size every day for the rest of your life. Now, whether you practice with a spouse or a male partner, or, you know, some male chiropractors, the majority of them are not adjusting patients that are twice their size because they’re typically bigger than we are. And so when they’re adjusting big patients, they may be equal size. They may be a little bit bigger, but for women chiropractors, the majority of our patients may be twice our size. So we’re not using our body properly and using better ergonomics and using our joints in a way that’s going to protect them and maintain them for the long haul, rather than putting our bodies in a position that’s going to injure us.

Then we’re setting ourselves up for a shorter career, greater levels of pain, more discomfort, possible disability. And we don’t want to do that. So that brings me to number three. And that is, you’ve probably seen people do it. Hopefully you have it. That is trying to muscle through an adjustment. And if you know what I mean by that, that’s where you’re trying to force an adjustment. And you’re trying to push all your muscle to try to get something to go rather than lining it up and letting it go with these. I use the example of a child trying to bang the square peg into the square hole. And for women, if we line that square peg up into that square hole, it goes every time the adjustment slips through every time the bone can go back into its position. Every time if you’re using proper line of drive, you don’t have to use a lot of force line of drive speed, not too much force that bone is going to go where it needs to go every time into its natural set point.

However, if you’re that big bully of a kid and you’re trying to take the square peg and put it into the round hole, it’s not going to fit unless you bang the living daylights out of it and try to force it in. You’ve had an adjustment like that. I know you have, I have to. And that’s the person who doesn’t use line of drive. Doesn’t use proper speed, uses a lot of force. It hurts your body’s going to guard, or the patient’s body is going to guard. And they’re going to muscle that adjustment in which isn’t necessarily going to give the patient the relief that they’re seeking. And it’s definitely not going to be a positive impact on their nervous system. It’s going to be an, an insult on their nervous system. So don’t try to muscle that bone and get really specific with the adjustment that you’re delivering.

Get really specific on your line of dry. If you haven’t worked on your line of driving, you just taken it for granted. And you’ve noticed that lately upper thoracics are getting harder to move lower thoracics. You’re, you’re having challenges with some of your patients, cervical. Sometimes they’re not going, it’s probably your line of drive. And if you, if you want that BJ picture, that, that great, great picture where he shows the line of drive of every segment and you don’t have it, or you can’t find it, just reach out to me and I’ll send it to you because I think it’s a great teaching tool. And what I do is use straws with my students and aplastic spine to show them those lines of drive. Because if you get that right, the bone goes and you don’t have to muscle your adjustment and muscling the adjustment.

If you’re a hundred and a hundred and fifty, a hundred eighty two hundred pound woman trying to move at two hundred and fifty two hundred eighty three hundred pound patient muscling, it is going to set you up for failure in the long haul. It’s not going to make you stronger necessarily. It’s going to make you overuse muscles and joints and set you up for failure. So I love for you to get more specific on your line of drive and do you use proper body positioning for yourselves so that you can deliver a great, great adjustment now, number four, on the top five mistakes that so many of us make is saying, yes, when you should say, no, it’s taking on too many objects or opportunities or charitable events or voluntary events. When in reality, you should be saying no or delegating tasks for many, many years. I okay. Everything in the office and by oversaw, I should actually say I did everything in the office.

I know you’re there or have been because we’ve all gone through that phase where every single thing that went on, we assume that if it needed to, to be done, it needed to be done, right, right. If it needed to be done right, then we needed to do it. And there’s a time period where you do need to do it because you need to create your own systems and policies and procedures in your office. So you need a hand and in that, but you also need to hand it off. And when you hand it off, it might be a little bit scary because now you have to wonder, are they going to do it exactly the way I want it done? And if not, then I’m just going to have to do it anyway. So it’s double the work. So I might as well just do it.

But the longer you hold onto that mindset, the longer you will continue to do, do everything and not delegate to the people that you’ve brought in as part of that, your team to help you out so that you could focus on what you need. You do best and allow other people to learn, learn how to do things to the standard you want them done so that they can do those things the best. Right? And delegating can seem hard for a lot of, a lot of people, a lot of driven people, a lot of type a leaders. We still want to do it, even though we want to lead other people, we want to do it because we want to make sure it’s done, right. But let me tell you something, the minute you learn to let go and delegate to other people, you freed yourself up to do the more important things or the more meaningful things or the things that really make your heart sing.

So learn how to let go. And, and one of the exercises that I’ve shown a lot of my students is grip as hard as you can, whether that’s the steering wheel or a pen or a water bottle or a book or whatever it is that you’re holding onto the checkbook or the billing software disc or whatever it is that you’re holding onto. So hard grip it so hard to the point where you start to tremble and then learn how to let go. And that freeing feeling is just amazing. It’s kind of like, do you remember being a child and standing in a doorway where you’d kind of like push your arms against the doorway as hard as you could, and you’d count to 30 and then you’d walk out of the doorway and your arms would just effortlessly float up. That’s the feeling when you learn how to say no or delegate tasks to other people, it is freeing.

It is releasing all that tension and that stress and that effort and that hard work that you’re doing that you may not need to do because the minute you need to learn to let go, there’s a saying, let go or get dragged. And sometimes when we hold on to every single task in our office and we don’t let go, and we don’t delegate, we get dragged down by the paperwork or by the, the insurance or by the billing or by the things that we don’t want to do. Maybe that’s exams. Maybe you want to hire an exam doctor, but learn to delegate the things that are not top on your priority and allow someone else to do those for you so that you can accelerate and do the things that you want to do to grow your practice and improve your quality of life. That brings us to number five and number five, ladies, I want to tell you, I’ve been there.

I’ve worked with women who’ve been there and that is not investing for your future and not developing a practice that is worth selling. And what that means is you look at what’s in front of you today. You look at the bills today, you look at what you want to pay off today. You look at what you want to have financially or materialistically in your life today. And you forget to look at 5, 10, 25 years down the line, and you may not be setting your practice up as one that somebody would want to come in and buy, because if it’s completely based on your personality and it’s not based on any kind of systems, or it’s not established in the community where somebody would say, well, that would be a valuable business to own. If it’s just based on what you like. And that’s good, I’m okay with that.

But it’s not based on how do I grow this practice for the long haul so that it becomes a saleable practice. Then you’re not setting yourself up with a retirement or an exit strategy. So maybe that means working toward eventually owning your own building. Maybe that means working toward eventually bringing in other associates that or independent contractors that can help establish the practice, or maybe it just means bringing in people that can keep the practice running while you go off on vacations or go take care of family issues or go take care of personal desires, but something that sets the practice up where you are not dependent on bending over the table every day, every just to be able to afford your lifestyle. So set yourselves up in such a way that you can step back and breathe or take a little time away from the practice or minimize your hours, or be able to go and travel and do the things that you love, or spend time with your family set yourselves up in a way that allows you to live an extraordinary life.

And if you’re not already investing in yourself, then take a little bit of money. It may not be a lot in the beginning, but take a little bit and put it away. And the more regularly you do that, just a little bit, all the time is way better than throwing one big chunk. Once in a blue moon, just a little bit, learn how to invest in yourself, seek out people who can teach you how to do the things that you don’t know so that you can really, and truly produce the life that you really want. Because reality is if we put our oxygen masks on first, if we make ourselves and our needs a priority, we’re more willing to make other people a priority when we feel fulfilled. And I’m talking about self fulfilled. When we feel fulfilled in our role, as women, as leaders, as doctors, as mothers, or spouses or daughters, or aunts or nieces, whatever roles that we fulfill, when we feel truly valued in those roles, then we feel a desire to go out and serve other people.

And we feel more on fire for life, more energized to go out and share the abundance that we’re so blessed with. So make sure that you’re making yourself a priority and make sure that you care for yourself so that you can and do want to care for others. Now, I’m going to give you three quick tips, because I want you to have a self care routine that really works for you. And those three quick tips are when you start your day, start your day with something that matters to you, it may be yoga. It may be cardio. It may be meditation. It may be reading. It may be gratitude. It may be just going in the shower and singing out loud with the music going and the water going. And nobody coming in, whatever makes you feel alive. Start your day with that every day, make it a non-negotiable make sure first and foremost, you start your day in a way that honors you second tip mid day, stop.

What you’re doing. Find time to reach out to someone, speak to someone, compliment someone, share something of value with someone, motivate, inspire, educate, or empower someone else. Because if you make that a daily habit in the middle of your day, guess what it refreshes that for you. It reinforces that for you, and it keeps you in that mindset. And my third tip, cause you only need three tips to get through the day, morning, noon, and night. And my third tip is end the day in a way that honors you, whether that’s cardio, whether that’s relaxation, whether that’s sitting outside under the stars and just gazing out at the universe and dreaming about all the possibility and potential, whether that’s raising a glass to the sunset or dancing away in the late night hours with your kids, like I love to do. And the music’s blasting all over the kitchen, whatever it is that honors you to celebrate the day you just had because every day is a cause for celebration.

Trust me yesterday, I turned 50 and fabulous and I am so excited and on fire and invigorated for everything that the world, the holes that I’m going to go out and grab. And I want you to feel the same way. I want you to enjoy your career change lives and make a positive impact on your community and all that. You are blessed to speak, to touch and reach in your lifetime and be able to do it with the grace, the strength, the power, the health, the energy, the vitality, and the vibrancy to go on and face every single day. Like it is a party and a celebration that you have been invited to every day. So ladies go make this a fabulous day, go celebrate life. And I thank you so much for joining us. And I look forward to seeing you the next time that I get to host this wonderful show, empowering women in chiropractic, and we’ll see you next time.

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