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How was your 2011? Did you hit all your goals?

Did you learn any lessons along the way?

Because my year started off kind of crazy (see #1 below), I put off setting any specific goals. By the end of the year, I could see that 2011 hadn’t been much of an improvement over my 2010 goals.

That’s the whole point of setting goals, so that you have something to aim at. So by January 2nd of this year, I already had all my goals listed out on paper. No messing around this year.

While on the business side of things my year was about like the one before, 2011 was still a great year! It was very busy, especially on the family side of things. Looking back over the year, I realize that many of these events taught me (or reminded me if I’d already learned them) that running a business is really about something bigger than just the business.
Lesson #1. Children are a blessing.
On January 3, 2011, very early in the morning (3 AM) we were blessed with a new son, Camden Elijah Beck. It’s hard to imagine he was just a tiny little tike, because now he walks around my office hitting things with a toy hammer and trying to unplug all the wires on my computer.

#2. Set a goal for your family and work hard for it.
Autumn and I have been married for 13 years, and we’ve moved 12 times! After moving to the Texas hill country in the beginning of 2009, we had been renting a smaller house in town until we became familiar with the area.

But as our family grew, we knew it was time to look at buying a home, hopefully with some room for the kids to roam. In May we moved into what my wife calls her “dream home”: something large enough for living, homeschooling and me to have a nice home office!

Here’s a view from the front (before the worst drought in Texas history completely wiped out everything green):

#3. Take time to make memories with your family.
A few years ago, I realized my family and I were not taking enough vacations. So we started an annual beach trip to the gulf coast. This year was much nicer without the threat of oil washing up on the beach, as it had been in 2010 with the Gulf oil spill fiasco.

We also decided to try out the Houston Space Center. While the Center was the kid’s favorite, my favorite part was taking a tour of the NASA research facilities. It’s amazing to see the humanoid robots and spider bots that are being built and testing right in front of us.

Here we are on the dunes of Surfside Beach.

These are the lessons and events that marked by 2011 year. (Let me know yours in the comments below).

Also, here’s a neat video showing some major events searched for on Google in 2011. (Notice how fast Google is becoming a major news source? Expect more from me on this blog showing you how to get the most out of Google in 2012!)

It’s often said that to have success in your practice, you’ve got to focus on “a big hairy goal” or see the “big picture” or get “the big idea”.

This is true enough, but not precise enough.

You see, once you have that big picture, then it’s time to get to work. And inevitably as you focus on accomplishing that big picture day by day, you realize there are tons of tiny little steps!

There’s marketing, exams, paperwork, treatment notes, billing, etc., etc. The carpet sure looks dirty and the toilet isn’t perfectly clean either. And who’s going to change that light bulb that’s been out in the closet for 5 weeks?

“No worries, don’t sweat the small stuff” you tell yourself.

But then you begin to realize that big picture isn’t really materializing. And that big hairy goal is looking so hairy you’ve forgotten why you wanted to accomplish it in the first place.

What’s the solution?

I recommend you be more concerned about the details of your business. Someone’s got to sweat the small stuff. It does matter what you wear to your office. (If it didn’t matter you would wear your pajamas.) Patients do care if your breath smells like rotten garlic after lunch.

And you’ve got to make sure your staff understands your high standard of excellence in keeping your office efficient and clean. Nothing turns a patient off more than a dirty, smelly and unorganized office. Does your office smell like greasy fast food after lunch? Is Mary’s perfume at the front desk enough to knock your next patient out?

But here’s the key to “sweating the small stuff”…

You should only be “sweating” about a specific topic only once. As the owner, it is your job to make sure it gets done. Either by you or by someone else.

Make a list of everything you do in your business each month. Then ask yourself what you are good at and what you like to do. You might even give each task a rating of 1 to 5, 1 being something you absolutely love and 5 being something you hate to do.

Then start with the 5′s and ask yourself who else could do those. For example:

Need light bulb change? That’s Carol’s job to take care of. (Make a note to put that on her to do list and regularly check it.)
Billing? Outsource it or hire someone part time in-office.
Marketing? Get a done-for-me marketing program that works (highly recommended: The Ultimate Chiropractic Ads).

Check out my More Tools page to see other examples.

Now once you’ve taken as much off your plate as you can, you should have plenty of time to focus on what really matters. Plus, your office will look, smell and be more efficient as a result.

Regardless of what anyone says, success really is in the details. Yes, have a big goal. That’s not difficult. Lot’s of people have goals.

It’s the getting things done part, the accomplishing of multiple tasks all at once, that is the hard part. This is why most people never accomplish their goals.

Details matter. The whole world is full of details.

Just check out this video and stand amazed at the details of God’s creation (it’s full HD so you can full screen it and enjoy it.).

It is very likely that everything you’ve been taught about what motivates people is wrong. In this video you’ll see why giving a bonus to your staff based on money alone is not motivating them. In addition I recommend you ask how these concepts can be used to motivate yourself to achieve your goals this year.

I can attest that the 2 motivations Pink gives at the end of the video have worked tremendously well for my productivity.

To learn more, check out Danial Pink’s book Drive: The Surprising Truth About What Motivates Us

Last week we looked at three big marketing strategies you should be be doing this year to build your practice. (To read that post, click here.) Today, let us look at four more marketing methods you would be very wise to use in 2011 for your biggest year yet.

#4. Have Your Staff Do “Focused” Spinal Screenings

This recommendation may come as a shock to some of my readers, as I have often times said spinal screenings are a waste of time for most doctors. And I still tell my clients and customers that. For the doctor, it is not a good use of your time to go and spend 4 hours standing at the front of a business, chasing people with a clipboard in hand. I’ve done enough of these types of screenings in my lifetime and 95% of them were a complete waste.

But there are three reasons you should do spinal screenings: (1) you’re new in practice, (2) you’re about to go out of business and need new patients ASAP, or (3) you can have someone else do it for you at a big event. It’s this third one that I recommend you focus on in 2011. A big event would be a huge festival that your town holds once per year, or a large business that let’s your staff come in to screen (like Walmart, Costco, etc.). Notice I said “your staff”, and not you as the doctor. If you want to streamline this process for your staff, and find out how chiropractors are still getting into Walmart to do screenings, I recommend you get Dr. Smith’s Spinal Screening Program.

#5. Email Marketing With Current and Inactive Patients

It’s amazing that many chiropractors still don’t ask for their patient’s email address. It’s as simple as including it on the intake form for all new patients. The reason this is so important in your marketing strategy is that we’re all human, which means we forget things. Patient’s forget appointments unless reminded. And this is especially true of patients who’s treatment plan does not require them to come in often (maintenance or wellness patients, etc.) How much revenue is lost in your practice every week simply because people forgot about their appointments?

The simple solution is to set up a system with your staff to email patients about their appointments. Or society is becoming more and more an email/internet society, replacing the telephone. My dentist emails me a remind before each appointment, which makes a huge difference when I’m extremely busy and likely to forget. Now I don’t recommend this for all patients, but you should make a list of the ones who need to be reminded most. Also, something similar can be done for inactive patients. You can compile an email letter that offers inactive patients to return to care. If your list is set up right, with a click of a button your email can go out to thousands of inactive patients at once. This strategy can really have an affect on your practice in the long run.

#6. Get More PI Patients

As health insurance becomes more difficult to work with in 2011, many chiropractors will turn to seeing more car accident cases. Unfortunately, most chiropractors still think PI marketing is all about using outdated attorney-schmoozing techniques to get new PI patients. While it’s true a few chiropractors do this, its by no means necessary to for having a successful PI practice.

There are much better ways to get new patients from attorneys, as well as MDs, ER rooms, body shops, existing patients, Facebook, and more. This does not mean you must become a 100% PI mill practice. But you should take another look at PI, as the return is much higher because you actually get paid a fair value for your care, if it’s done right. See This PI Marketing program for all the new marketing strategies you can use.

#7. Use Direct Mail

Direct mail has long been a tested and proven marketing method in businesses worldwide. But when the recent recession hit, so many companies pulled out of direct mail marketing that the USPS took a huge hit. And unfortunately many chiropractors did the same. Of course cutting back on your direct mail campaign doesn’t make sense if all your competition has done the same. Like newspaper ads, now is the best time to use direct mail, since others are cutting back or convinced it doesn’t work.

What type of direct mail? I would not suggest fancy postcards. Long copy letters and postcards work best, but they must be written well and not sound sleazy or cheap. Also, list selection is important when it comes to direct mail. Getting a good list from a list broker can increase your return on investment drastically. We’ll look closer at direct mail in a future blog post.

The super-successful practice will implement all seven of these strategies. Which of these 7 will you implement this year?

Have you set up your marketing plan for this year yet?

If you haven’t, what are you waiting for? Set your goals high and plan now for a breakthrough year. Big numbers are possible with the right tools. Just a few weeks ago a client told me he had received 300 extra new patients from using my newspaper ads in 2010. What would 300 more new patients do for your practice, and more importantly your lifestyle?

Here are my recommendations regarding the marketing strategies you should be focusing on for 2011.

1. Finally Do Online Marketing Right.

Chiropractic internet marketing is the strangest thing. It’s the one strategy everyone knows they should be doing, as its getting bigger and bigger every day. It’s also one of the lowest forms of marketing you can do for your practice.

But here’s the strange part: most chiropractors are dragging their feet on doing anything. I’ve seen people spend hours “marketing” on Facebook and Twitter, while their website can hardly be found on Google. Every day you wait to do it right, someone else comes along in your town and figures it out. Being ranked #1 on Google is like being king of hill, and the longer a competitor stays king of the hill the harder it is to knock them off.

So here’s what you need to do right now. Make sure your website shows up on Google’s top 5 for your area for the major keywords that patients would type in; chiropractor, back pain, headaches, decompression, etc. If you’re not there, that’s the first thing to work on. Once you’re set up at least in the top 10, add some condition specific landing pages to your website and buy some qualified traffic from Adwords to send to your site. (See my explanation in more detail in this webinar.)

You may choose to put in the time to do this or hire someone else to do it for you. If you hire someone else, please make sure they (1) know chiropractic, (2) can write marketing copy and (3) actually understand how Google works. Very few web designers understand chiropractic enough to present it to the public. And most web designers are more gifted in the technical skills of programming than in writing. This produces a beautiful site with moving spines and award-winning graphics, but wouldn’t convince your mom to come in as a patient.

Also they must understand what Google likes (hint: it’s called a WordPress site layout). Any high school kid can build a website for you. But there is very little chance it will ever make the coveted top 10 on Google. And if you, your wife, and the aforementioned high school kid are the only ones to every see your website…it’s pointless.

#2. Ignore the ‘Death of Newspapers’ Mantra

When I wrote my first newspaper ad for my practice, someone told me it was pointless since newspaper didn’t work any more. The ad brought in 17 decompression patients at the cost of $800. In 2009 my Ultimate Chiropractic Ads brought in a conservative estimate of $20 million dollars for chiropractors in the U.S. (I haven’t estimated 2010 yet, but it has to be about 5 times that based on the numbers of doctors who bought them.)

Here’s the point…

Ignore the gloomy predictions and focus on your practice now. Will newspapers disappear? Maybe they will someday. Who knows. But the question you need to ask yourself is this: “Is there a newspaper in my town?” If the answer is yes, you should be advertising there. When there no longer is a newspaper in your area, then you can join with the naysayers and proclaim that newspapers are dead. Until then, use them for all they’re worth.

Here are the best producing ads according to feedback in 2010:

• Spinal decompression
• Neuropathy (crazy numbers are being reported for these ads)
• Back pain/sciatica
• Fibromyalgia
• Migraine headaches

You can see the commonality between the above…they all are condition specific ads. In 2011, you’ll need to get even better at showing prospects how you can help them with their specific problems.

#3. Get Into Local Businesses

This year, setting up events in local businesses will bring you many more new patients. While this method has been around for decades, the same old techniques don’t work today. New tactics have been tested to educate and schedule new patient appointments from these events. One method that is working very well is using the Teacher Appreciation Program to check teachers in local schools. If you have a massage therapist on staff, they will be very useful in making connections with local businesses.

Where should you go?

The list is endless. Schools, malls, gyms, banks, Costco and even Walmart. (Yes,Walmart is possible. Look for more on this unique strategy in a few days.) Many of these places, like Costco, will have some type of community health event already planned each year.

I’ve got 4 more strategies you must use in 2011, but this blog post is getting a bit long already. Look for the final 4 next week, one of which you will be shocked I’m actually endorsing!

Use this list to and check off what you need to do.Get out a calendar and pencil in dates that ads will run, changes to be made, etc. Let’s make 2011 your best year yet.

No matter where you are at in life or your practice, there is hope. While we can’t sit on our haunches and “believe” success into our practice, we can be inspired by others, which should cause us to then take action.

This guy is making the best of what he has. Are you?

What are your business goals for 2010? You are going to write down some goals, right?

I recommend you spend a couple of hours over the next few days giving thought to your goals. Once you’ve determined very specific goals, write or type them out on a sheet of paper.

Do not just write down the number of visits you want to see each week. Too many chiropractors are still hung up on the “I want to see 300 a week. I want to see 500 a week.” (If you’re still in this mindset, you must read my previous post The High Volume Lie, which had quite a few comments.)

Here are the goals I would recommend you have, in order of significance…

1. Gross income and net income.

Contrary to what some politicians believe, paying taxes and hiring employees isn’t your main purpose in business. Profit is the reason you started a business in the first place. If you just wanted to just adjust patients, you could work for someone else. You opened your own practice to make a good income and life for yourself and your family. Reaching this goal will determine who well you accomplish the next 4 goals.

#2. Number of New Patients Per Month

You might be wondering why this isn’t #1? Simple really. If you aren’t taking home an income to feed your family, it doesn’t matter how many new patients you have. Back in my “dumb days”, I had plenty of new patients, but gave away so much care my family struggled to make it. (Read about my dumb days inside the Ultimate Chiropractic Ads site.) To find out how to increase your new patients monthly, look at my last couple of blog posts, where I make some predictions of what’s going to happen in 2010.

#3. Average Dollars Collected Per Visit

This is one many chiropractors neglect. It doesn’t matter if you see 300 a week if you’re average collection per visit is only $10. This number is really telling about your practice. It will give you an overall picture of how well your doing with adding additional services plus how well your staff is doing with collections. To figure the REAL number for last year, divide total collections by the number of patient visits. (To figure the FAKE number in case the real number scares you, look at your “recommended care plan sheets” and divide the cost by the recommended visits.)

#4. Case Value Average

This is the average value each new patient case will generate in your office. (Figured by dividing your total monthly or yearly collections by the number of new patients you saw in that period.) The higher this is, the more likely you are getting paid for what you do and giving the patient quality care. Above $2000 is good, below $1000 means you’re going to be in trouble if you hit a slow month of new patients. Hint: You don’t raise this number by recommending care the patient doesn’t need, but by adding additional products to your practice that the patient does need or want. Examples: massage, rehab, decompression, and supplements.

#5. Number of Visits Per Month

Here we finally get to many chiropractor’s favorite question, “How many you seeing a week doc?” Weekly is okay, but I think setting goals for the month is better. Weeks can go up and down depending on holidays, vacations, etc. This number is important, but not nearly as important as the above 4.

These are the five must-have goals. You can have others of course, and should.

I recommend using The One Page Business Plan by Jim Horan for getting it easily mapped out.

I got this book last year and it is by far the best book on business plans. Don’t think you only need a business plan when you start up a new practice. This book helps you lay out a real vision, mission, and attainable goals.

It’s a step-by-step easy to follow workbook and CD-Rom. (After being completely misled by an early chiropractic coach about the terms “vision” and “mission”, this book helped to finally clear this up.)

The good news is that it helps you produce a concise business plan (hence the name of the book) which you can refer back to easily. I printed it out and kept it on or by my desk all year.

Then, throughout the year as you consider new strategies for your practice, you can ask yourself, “Does this new addition to my practice fit my vision and my mission?” or “Will this new marketing tool help me reach my objectives?”

By doing this, it will help you to stay on track. You’ll be able to look at it quickly and get a reference point for where you are headed.

In addition to having my business goals on the One Page Business Plan, I have an additional paper where I write my personal goals. This includes family vacations I plan to take, the number of books I plan to read, spiritual goals, marital goals, etc.

Get started now with your goals. By next week you’ll want to hit the ground running with accomplishing those goals.

(Today’s blog post is by Chris Burfield, founder of Chiropractic Secret Society, a free social networking site for chiropractors to share ideas. Chris also owns and operates a chiropractic office in Texas, which grosses over 500K annually.)

Is your office streamlined?  …or is it chaos at times?  Are you delegating low priority things to your staff?  …or are you trying to be a Super Man or Wonder Woman and do it all yourself?

The reason I ask is because a company cannot grow beyond the ability to streamline and delegate.

What that means is, every job position, if it wants to go to a more effective and efficient state, has to streamline what it is doing in the most efficient pathway it can be done in.

You must delegate low priority things, so you can focus higher priority things.

Think about this for a minute.  What is going to make you more money, answering telephones and scheduling patients which is a $12 an hour job or Adjusting 15 patients in an hour which can be a $1000 + and hour job?

Anytime you do something that is lower priority in your office, you bring your office down.

Your office will IMPLODE and not EXPLODE!!

It is important to delegate lower priority things in your business so you can focus on those things which are higher priority and make you the most money.

Another thing that I require everyone on my Team do, is write down the 7 top priority things they can do in a day to help fulfill our Mission.

By doing this, we can see which things actually help to grow the office. We then take those common priorities and streamline them in a way that we can achieve those things more effectively and efficiently.

It is essential, in order to grow the organization to keep going toward greater efficiency and greater effectiveness.

If you do not make yourself duplicatable, then you hold yourself and your practice down.  It is essential to duplicate and create the delegation process or your practice will not grow. …plain and simple!

Which months are the best to advertise in? Is December or January really a waste of money?

Everyone has an opinion about when to market and when to be a scrooge with your marketing dollars. But there are certain months I have discovered are great to advertise in.

Let’s look at a few conditions…

For auto accident ads, you want to advertise during the times of the year when the weather has an effect. It’s been shown that during icy periods, rain, or fog, more people will get into accidents. This doesn’t mean you can’t run a PI ad during good weather, but after bad weather is best.

If you live in warmer climates, then you would want to run ads that affect people who are more active like golf, etc. Contrary to popular belief, patients do see chiropractors in the summer and you should be marketing then.

It’s much smarter to run ads and keep your marketing up during the summer, than it is to listen to consultants telling you to take the summer off from advertising.

Does the consultant to take off all summer from his marketing to chiropractors?

There is a period of time where you should curtail your marketing, but it’s a short period of time at the end of the year. That’s means the last two weeks of December you should not have a new ad coming out.

Not because people are spending more money at this time, the money is low, and all that fluff.

It’s simply because people are less likely to be considering their health during this time, based on their travel schedule and the things that they have going on. Readership in most newspapers drop during this time too.

No matter what any consultant or colleague says, that’s the only two weeks you should not consider having a live ad in the paper. (That right, all other Holiday weeks are great.)

I would definitely recommend having an ad the first week of December though!

January is typically a decent month only because a lot of people will be considering their health and their new year?s resolutions then. I don?t find January to be the best month, in my experience, but it certainly is a good month for marketing.

Funny story on January.

One consultant I had said that I should market hard in January, because that’s when everyone is “thinking about their health”.  Another consultant I had later said “no, absolutely don’t spend any money on advertising in January, because that’s when everyone’s deductibles start over!”

Who’s right?

Who cares! What month do you not want new patients to come in?

Really, every month is a good month for marketing, even December.

Don’t get the idea because I said don’t advertise in the last two weeks of December you should take the whole month off.

A lot of chiropractors make the mistake of saying…

“I’m going to take December off from marketing. And nope, can’t market in June and July because kids are out of school. November? Well shucks, there’s Thanksgiving, so I better not spend money there. April has Easter weekend, May memorial day weekend, and September has labor day weekend so I can’t market in those months either…..”

You get the picture. Don’t be like this fool who always has an excuse why they aren’t marketing their practice. That mentality is going to hurt your practice.

I’ve known doctors who’ve done these stupid things and have struggled just to keep the doors open. All because they put their marketing on halt for awhile. They thought their referrals would keep them going through these “non-advertising months”.

But where do most referrals come from? They mostly come from new patients or newer patient who’ve started care in the last month.

With all that said, there are some months that have proven to work better for me and my coaching clients.

The best months I’ve found to market were in the middle of the spring and fall (March and April, October and November). I can’t say for certain why that is. I have certain theories, but it doesn’t really matter. The fact is that’s when I’ve found my ads have the best response.

This does not mean that you should only run your chiropractic ads during these months!

It only means you should have more ads running than the normal during these times. November has always been a very good month for me, even with the Thanksgiving holiday in the U.S.

But this is not a hard and fast rule. I only mention it to you so you can test it. One year July was my biggest ever months when it comes to collections and new patients.

Can you guess the two most important numbers to track for a chiropractic practice?

“How many ya seeing doc?” If you you’ve been to some of the hyped up chiropractic seminars, you might think it’s the number of weekly patient visits. After all, you’ve probably been asked this question more times than you’d like to hear.

What does the number of visits per week really tell you about anyone’s practice? It doesn’t tell you how many of those visits are free or discounted. It doesn’t tell you the doctors overhead. For all we know, he could be seeing 300 per week and barely paying the bills. Some gurus even teach that the question “how many you seeing?” actually should be answered with how many patient visits you “see in your head”. Which means make up any answer you want.

“How many new patients you seeing?” New patients are a very important number to track, but the number you see per month doesn’t always tell the whole story. If someone does a spinal screening and gets 30 new patients in for a free exam, is this equal to 30 referred new patients who paid full price? No. Therefore, the importance of new patient totals can vary depending on the quality.

“What are you collecting?” Indeed, the monthly amount collected is a critical number to know for your practice. One that many chiropractors would do good to focus on more. But still, what does this tell you about the “health” of someone’s practice. If someone collects $100,000 a month, you may think he’s a very wealthy doctor. But what you don’t know is that he spent $110,000 to make that $100k. What collections don’t take into account is the overhead a practice has: the rent, payroll, marketing costs, leases, taxes, etc.

“Okay, so what are the two most important numbers? Just tell me already!”

The #1 most important number to know for your practice is the net profit for your practice. Also referred to as the “profit margin”. Simply take the total amount collected and subtract your expenses (doctor’s salary is not counted as expense for this exercise.) Now what % of your gross collections each month is your net profit?

It doesn’t matter if you had 100 new patients last month…or see 1000′s of visits per week…or collected $236,000 last month…if you’re net profit sucks. How many slow months can you make it through with only a 10% or 20% profit margin?

Now granted, you may not want to tell everyone this magic number. But if someone was to ask you, you better know it to the penny for last month…even if you don’t say it out loud. I’ve consulted with too many chiropractors who tell me “we’ll, I think it’s about 50%”. I reply “you think?” Then they give me some excuse about their bookkeeper or account not doing the books yet. Look, we’re not talking about taxes or anything to do with the IRS. We are talking about the actual amount of money that goes into your pocket each month. If you don’t know this number, you’re truly flying blind.

The second most important number is your return on investment for your marketing or ROI for short.Your marketing ROI is just a measure of the profit margin on your marketing dollars. So if you spend $1 on marketing and get back $5, this is good. If you get back $10 or $15 this is excellent.If you aren’t tracking your ROI, you can’t say for certain how well an advertisement performed. Simply measuring the number of new patients that came in from an advertisement is not adequate in comparing ads either.

Let’s look at some actual case studies. Here’s part of an email I received a couple of weeks ago…

Dr.Beck, we put the ‘sciatic don’t live it’ insert on Monday to 2 zipcodes that went to 6,000 readers, we got 3 patients ,all over 80 years old, who all paid. we took in $4,500, which was a 18:1 return. I want to crawl, walk, then run , as I tested the waters, with your ad’s. So far we are pleased, and will put out same ad to more zip codes to a different area next week. Pleased to say each of our 80+ year old NP’s ,noticed improvement with chiropractic and are happier citizens and telling friends. Thanks for the blessings.

Based on the above case study, did this doctor do well or not? You could be  thinking “only 3 new patients, that sucks big time!” Or you could say “gosh Dr. Beck, $4500 isn’t that great. I mean that barely pays for my salary!”

But we are missing an important peice of this case study. How much did he actually spend to get that $4500 in his bank account? Here’s the part I left out…

…for a cost of only $250 for the ad…

Wow! For a cost of only $250, he made back $4500. That’s an 18 to 1 return…for every $1 spent he made back $18. Realize he said “will put out same ad to more zip codes to a different area next week.” He can now roll this out to other zipcodes and bring in quite a bit more than his salary. But if he was only tracking the number of new patients that came in — which was only 3 — he may throw in the towel and decide to never run another ad.

Always measure your marketing ROI. Measure it for each ad you run and the monthly total of all your marketing.