December 2004

Up and down, on the way up

by Dr. CJ Mertz

One of the hardest lessons for motivated and driven chiropractors to learn, is that the practice must go up and down in the process of real growth. The key is, knowing what dictates "unhealthy ups" and "healthy downs." Once you understand this law and apply it consistently, your practice is capable of experiencing multiple levels of growth.

No one likes to see their practice drop, even though every practice will experience a downward trend. Those DCs who break through will ultimately know what to do when it happens. At the same time, a practice seldom builds unless it sustains back‑to‑back‑to‑back growth ‑‑ three strong weeks in a row. By the second week, however, excitement can turn into anxiousness, and the streak comes to an end.

Chiropractors love to adjust! When the number of people to adjust starts to slip, emotions can range anywhere from frustration to boredom. On the other hand, if there are more people waiting to get adjusted than there time allotted, emotions can flare from anxiety to emotional shutdown. As weird as it sounds, managing the up can be as difficult as managing the down.

If it were easy for practices to grow and keep growing, everyone would be doing it. In reality less that 15% of chiropractors in practice will ever reach 300 adjustments per week. This isn't because of a lack of desire, but a lack of strategy and leadership skills. You should be spending at least 90 minutes per week off camera, perfecting your growth strategies. Anything less than that and chances are high you'll get stuck in the "up and down, Bermuda triangle."

There are many articles you can read about practice building or tools to employ that may help you reach your goals. But if you can't manage "up and down," you won't reach the next level of practice growth.

A classic example of unhealthy up is flooding your practice with a lot of free or greatly discounted services for your patients. Initially, the energy of the new growth is stimulation. Inevitably, the lack of fair exchange to effort put forth pops the bubble and the practice slides back.

Another example of an unhealthy up is simply adding frequency to your existing patient base. Once again, the volume feels great early on, but the law of fair exchange always takes over. Fortunately, there are incredible strategies to building real growth beyond your existing patient base that assist you in not "giving" your care away.

Jack Welsh, previous CEO of GE built it to become the number one company in the world. Of the four core objectives he attributed to the conglomerate's great success, one key was that he let go of the bottom 10% of his employees every year and any subsidiary not number one or number two in its category would be sold off. This is a classic example of forcing a "healthy down."

As you're reading this, I'll bet there are a handful of patients who really don't fit in your practice. They buck your system, your team doesn't look forward to their badgering and you spend more time worrying about, talking about and thinking about the few difficult patients than all your patients who are raving fans.

A healthy garden is a well‑pruned garden. There's something magical about using your leadership skills to make the tough decisions and release a patient who's being completely irresponsible with his or her care. For every weed that's pulled in the garden, four flowers are able to bloom.

Sometimes the only way up is through a short term down. You'll be happier, your team will be ecstatic and the new chemistry always creates a vacuum for brand new growth. A healthy practice grows up and down on the way up. Healthy ups come from back‑to‑back‑to‑back weeks of growth. Healthy downs are forced by making the tough decisions to prune your garden and maintain the highest integrity within your practice.

The more you understand the up and down paradox, the less emotional you become about the results inside your practice. One good week needs to be backed up by another good week in order for it to really make a difference. Getting overly excited about one good week is a sign of an amateur understanding of the up and down paradox. Becoming nervous, tense or frustrated with a down week only sets the tone for a repeat.

Building a big practice requires faith, confidence and belief in chiropractic and the needs of the many who so desperately want what you have to offer. You must be able to look beyond the current week and past couple of weeks and keep your eye on where you it is you want to go. And, in the process, don't be afraid to ask for help. Learning to do right things right, is an investment that pays off a hundredfold in your future.

(Dr. CJ Mertz is president of the International Chiropractors Association, executive director of ChiroUSA, and founder and head coach of the prestigious Waiting List Practice [WLP] chiropractic training organization. For information on WLP coaching services and products, call Kate Golle at 877-TEAM‑WLP.)