March 18, 2025 • 28 mins
Every breath has significance when you're the son of a chiropractor – especially your first one. Dr. Mark Sanna, CEO of Breakthrough Coaching, opens this compelling conversation by sharing how a chiropractic adjustment from his father literally gave him his first breath as a "blue baby" born without oxygen. This profound beginning shaped his lifelong connection to a profession that he now helps others master through his coaching enterprise.
The heart of successful chiropractic practice, Sanna reveals, lies not in clinical skills alone but in the foundational business principles rarely taught in school. "It's not how much you make, it's how much you keep," he emphasizes, sharing how his 30-year discipline of consistently investing 10% of his earnings has created financial freedom through the magic of compounding interest. This wisdom proves especially valuable for new practitioners who possess time – the most powerful wealth-building asset.
Sanna addresses the challenging reality of insurance reimbursements frozen at 20-year-old rates despite rising delivery costs. He advocates for a balanced approach incorporating cash services, where practitioners effectively communicate the value of investing in health. "Your job is to make their health a priority," he explains, highlighting how skilled practitioners help patients recognize that discretionary spending on wellbeing delivers returns no other purchase can match.
The conversation shifts to sustainability practices for busy practitioners, with Sanna offering a counterintuitive insight: "You're either expanding or contracting." He explains that regular environmental changes – whether weekend retreats or seasonal homes – provide the mental expansion necessary to prevent burnout and maintain practice vitality. This perspective challenges the notion that constant presence equals greater success.
Breakthrough Coaching distinguishes itself through integrity, systems-based management, and consultants who've personally implemented these principles. Sanna particularly emphasizes succession planning – helping practitioners create actual value in their practices that translates to retirement security while ensuring continued patient care. For listeners contemplating practice growth or transition, this discussion offers both strategic wisdom and practical next steps toward building a sustainable chiropractic legacy.
Ready to transform your practice with proven systems? Connect with Dr. Sanna at mybreakthrough.com or call 800-723-8423 to discover how coaching can help you achieve your practice goals faster and with greater certainty.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Hi, I'm Dr Arlen Ford , the chairman and co-founder of
Activator Methods International, and today I have with me Dr
Mark Sanna, who is the CEO ofBreakthrough Coaching.
Good morning, mark.
Speaker 2 (00:17):
Good morning, arlen, great to see you.
Speaker 1 (00:19):
Well, we're glad to have you here and you know
you've built an amazingorganization to help
chiropractors in the field and Iwould like to have you give me
a little background.
How did chiropractic find you?
Speaker 2 (00:32):
Well, thanks, arlan, and thanks so much for having me
here on the podcast andallowing me to address your
audience.
My background in chiropracticis I'm a chiropractic kid and my
dad God bless him is 91.
He's in his 61st year as achiropractor, still gives a
(00:55):
great cervical adjustment, whichwas a fantastic thing, and my
history, you know, goes back tothe time before maybe
chiropractic was as accepted asit is today.
And I certainly can remembergetting into scraps on the
playground when people called mydad a quack and I'm like, oh,
(01:18):
he's not a quack and going afterhim.
But the story they tell me andthere's a lot of chiropractors
who will say I owe my entirelife to chiropractic and I
really do.
I was born a blue baby, so nooxygen, and at that time they
would not allow chiropractorsinto the delivery room, right,
(01:41):
probably even the dad wouldn'tgo in the delivery room.
But dad is watching through thewindow and seeing his little
boy not breathing and it came inand actually gave me a
chiropractic adjustment and Ibreathed and that my first
breath on this planet was due toa chiropractic adjustment from
(02:03):
my dad.
Speaker 1 (02:05):
Well, that's pretty dramatic.
It's a dramatic start.
Speaker 2 (02:08):
It's a dramatic start and chiropractic has just been
a part of our lives ever since.
Some people go through thejourney of discovering
chiropractic, for us it wasalways there.
We were kids, we got the mumps.
Dad would wake us up on thehour, adjusting us Morning.
The mumps are gone and we wereall upset because we had to go
(02:29):
to school the next day.
Speaker 1 (02:32):
What's your definition of a successful
chiropractor?
Speaker 2 (02:38):
Well, for me, a successful chiropractor, a
successful person in anybusiness, is somebody who really
has taken a look at what theircore values are and builds their
business, builds their practice, around their values.
You know there are so manycreative ways to be a
chiropractor.
(02:59):
You can be anything frompediatric to geriatric to sports
and in between.
And for me, my core values aretruly my faith, my family, my
personal fitness, my financialfreedom and my ability to have
(03:19):
fun.
No-transcript groundwork of whoam I, why am I going to be in
(03:50):
practice?
And it's not for the money.
I can tell you that that you andI both know.
Parker said it many, many yearsago loving service is my first
technique, right, and if you'rechasing money, you're always
going to be chasing money.
And when you go in there andyou give great loving service,
(04:12):
you have to know the business,and that's part of my story as
well as God bless my dad.
He taught me how to be achiropractor, but he didn't
teach me how to be a businessperson.
So I've been broke and didn'tknow what that's like to go
through that and then toactually learn good business
principles.
But I like a chiropractor whoknows why they're in practice.
(04:36):
It gives you a sense ofcertainty, and I also feel that
there is a certain amount ofsecurity that comes from knowing
that your financial needs aremet, your family's financial
needs are met, and that's fromgiving great service.
Speaker 1 (04:53):
You know you struck on something there, because I'm
around students a lot and,coming out of chiropractic
college, they're quite qualifiedto be a chiropractor but they
don't know step one in business,and so I kind of hear you
saying that you had to learnthat.
What would you say were thecouple of things that you
(05:14):
learned that helped you propelup to the place where you are
today?
Speaker 2 (05:19):
Yeah.
So for me it was a big learningthat it's not how much you make
, it's how much you keep.
And so when you first startgenerating income and you know,
my dad was first generationAmerican and went through the
(05:40):
depression, and so they neverhad money and never learned how
to manage money but what Ilearned later on is that not
only do you have to have moneyin the bank, there has to be a
level of profitability in thepractice.
Nobody ever talked about profitand it was just okay, great,
(06:02):
open up the envelopes, put themoney in the bank.
If there's money there, we'rehappy.
If there's not, we're not sohappy.
And I didn't learn until laterin life the value of savings.
Tell you, today, 10% of myearnings and this is for at
(06:25):
least the last 30 years has goneinto an investment account and
I've never touched it, never seeit.
And that compounding interestis the key to creating wealth.
And if you're a studentlistening to this, your 10%
(06:47):
might not be as big as my 10% is, but you have the advantage on
me of time.
So as your 10% grows incompounds and compounds, it gets
you into a situation where yourmoney's working for you and
you're not working for yourmoney.
So I wish I had learned thosetwo lessons is like being rich
(07:12):
is no good if you don't have anymoney in the bank and the power
of compounding interest overtime.
I think I wish I had had thatinformation.
You said what would you tellyour younger self?
That would be probably one ofthe lessons I'd write in that
letter.
Speaker 1 (07:28):
Well, you know, I'm a Dave Ramsey fan.
And if you've ever listened toDave Ramsey and that's something
maybe we should stress tostudents is check Dave Ramsey
out, because he's talking aboutbeing debt free and how you have
to have a budget and you haveto live within it, and I see
many young practitioners makingquite good money but they're
(07:51):
spending it all on dumb thingsand I think that's lifestyle
which changes and goes away, andall that kind of thing.
Then all of a sudden they end upwhen they're 55 and they're
saying what am I going to do forretirement if they'd have been
doing what you've been doing for30 years?
You know, it's easy to be amillionaire if you put money
away.
Speaker 2 (08:12):
Absolutely, absolutely.
Speaker 1 (08:14):
What do you think the reimbursement system today is?
It's changing and I'd like tohear a little bit about what
your thoughts are on theinsurance reimbursement.
Speaker 2 (08:25):
Well, that's a great question.
My dad has a quote.
He says, mark, I spoke, Ipracticed before there was
insurance reimbursement, whenthey had insurance reimbursement
and when they took it away.
And so there is no doubt in mymind that insurance
(08:45):
reimbursement, when you look atthe reality of today, is
declining for chiropractors.
There are many chiropractorswho are being paid on fee
schedules that are literally 20years old, that there has not
been an increase in theirreimbursement rate for 20 years.
And now it costs you a heck ofa lot more to deliver an
adjustment today than it does 20years ago.
(09:08):
I can tell you.
You know, when we look atinflation and overhead and cost
of staff and all of that, thereshould be commensurate increases
in reimbursement.
But there's not.
And so today you absolutely andI'm not saying step out of
(09:28):
insurance.
Insurance has a purpose, but youmust, must, must be able to
embrace cash services with apatient.
You have to be able to delivervalue, communicate value in a
way that the patient is willingto pay their discretionary
income for their health.
So your job is to make theirhealth a priority.
(09:51):
You know, you ask people what'sthe most important thing in
life, right?
Not money, it's health.
If you don't have your healthdoesn't matter how much money
you have, and so knowing thatyou are delivering a service
that can improve the quality ofpeople's lives, their longevity,
their ability to stay mobileand autonomous in their older
(10:13):
years, that's a big darn deal.
The third-party payer systemhas not caught on to that.
It's for sick care.
Chiropractors, we do health care, and so being able to deliver a
service and charge a fair pricefor it and be paid cash is
essential.
That's not to say that, as thechiropractic profession, we're
(10:39):
not working very diligentlybehind the scenes to make sure
that some of the terriblereimbursement practices
literally abusive reimbursementpractices for chiropractors, are
not being addressed.
We are addressing them.
We have legislation climbing upCapitol Hill again for a
Medicare Modernization Act,which hopefully we're going to
(11:01):
have this time come around andbe able to have our patients be
reimbursed for their exam.
Imagine we have to do an examto be paid.
We don't even get paid for ourexam for Medicare to be paid.
We don't even get paid for ourexam for Medicare.
So having fair reimbursement,having fair access to
(11:27):
chiropractic care, those arethings that are absolutely at
the top of the minds of theleaders of the profession today.
Speaker 1 (11:31):
You know, having a practice that's cash has been a
lot of the ways a lot of peoplehave gone.
I've got several people in ouractivator club our instructors
and so forth that have justswitched to cash.
It was a bit difficult in thebeginning, but it turned out in
the end to be the way to go andthey wouldn't go any other way.
(11:51):
And so what do you think of acash practice?
Speaker 2 (11:54):
Yeah, I often say you know, when you address an
audience and I ask them raiseyour hands, who are the guys who
, or gals, have gone all cashand those will be the one who
raise their hand.
I said well, you didn't have toraise your hand because you're
the ones who are smiling.
Exactly, it truly is.
The third party payment systemthat we're involved with is
(12:18):
really a square peg in a roundhole.
We're not meant to fit in thathole and, that being said, the
pioneers who've gone before us,the people like my dad and
yourself who fought the battlesto be able to have us recognized
in the health care system thatthere is a cultural authority
(12:39):
that comes from having insurancereimbursement there.
It's not easy to start apractice from scratch completely
as cash, but certainly there isa point in your career that you
will reach when you should nolonger be beholden to insurance
reimbursement.
That you've built a practice, afollowing of patients who will
(13:05):
come and pay the money for theservice that you've given.
That's a great point, and so Ithink every chiropractor should
be thinking of okay, when do Imeet that point where I no
longer have to take these things?
Insurances that are four visits, five visits with
pre-authorization and a stack ofpaperwork, but I can go in and
(13:26):
enjoy my patients and enjoydelivering my care and my
adjustments, you know having asuccessful practice is fun, but
it can also be stressful.
Speaker 1 (13:38):
I remember being, you know, in Minnesota for 25 years
and having a big, big practice,and it was fun as could be, but
by the end of the week you werelooking for something you know
to relax with.
What do you do to help peoplewith that kind of problem?
Speaker 2 (13:57):
What do you do to help people with that kind of
problem?
Well, I tell you the one thing,and I'm sure you know, arlen,
that when you're managing anoffice of that size, you can't
do it alone.
You've got to have great peoplearound you.
You have to know how todelegate, you have to know what
you do well and stay in yourwheelhouse.
You must keep the big pictureof the business.
(14:20):
You've got to watch your bottomline, but you don't have to
micromanage everything.
If you're going to have areally successful practice, you
need folks to take care of allof the myriad of things that you
don't even think about.
My goodness, just HR alonetoday, where people quit my text
.
Or things that you don't eventhink about.
My goodness, just HR alonetoday where people quit my text,
(14:40):
or they ghost you.
Or people say you know, listenwhen we practice.
Never have a staff member calland say I'm taking a personal
day.
What do you mean?
A personal day?
Speaker 1 (14:53):
Well, you got a hundred people coming.
Speaker 2 (14:55):
Yes, personal day.
Well, you got a hundred peoplecoming.
Yes, exactly.
So I think have a great team,pay them well, pay them as much
as you can possibly pay them.
And the reason is you want themto stay.
You don't want them looking atother things, you don't want
them driving Uber.
You want them to say this isthe best job on the planet.
(15:16):
I love Doc, I want to be here.
I think that's really key.
So, number one have greatpeople around you.
The other thing is understand.
You know you say you got tosharpen the saw means you got to
recharge your batteries and youcannot be a healer, you cannot
be a business person, you can'tbe an executive or an
entrepreneur if you don't takedowntime to recharge your
(15:40):
batteries.
And literally that means youknow staycation is fine, but
change your environment.
Go out of town, even if it'sfor a drive, and meet new people
, have new experiences, andyou're going to come back into
that practice energized andrevitalized.
I've spoken to some docs whohaven't taken a scheduled
(16:03):
vacation in 20 years.
That is just not the way tostay healthy and balanced in
life, right.
Speaker 1 (16:11):
No, you're really onto something here.
I've had a theory for years andI've never talked much about it
.
But ever since I becamesuccessful this is 30 years ago
I always had a retreat.
And I remember in my Minnesotapractice I had a lake house 38
miles from the practice.
(16:32):
I would leave on Friday nightand I wouldn't come back till
Monday morning.
It took me exactly 41 minutesto get there, but when I drove
across the bridge I knew I wasin a different country, a
different feeling.
I relaxed and I started to tellstudents to this day I have a
summer home in Phoenix.
(16:52):
Somebody said how do yousurvive the summers?
I said in the White Mountains,home in Phoenix.
Somebody said how do yousurvive the summers?
I said in the White Mountains.
You know, it's the break thatreally helps us continue along.
You know life in practice.
Speaker 2 (17:04):
You know, arlen, I have a saying you're either
expanding or you're contracting.
And if you're in the practicethink about a boxer in the
corner of the ring and they'regetting hit, and they're getting
hit, and they're getting hiteventually you start hiding in
your corner and that's kind ofwhat it's like.
If you're in practice andyou're getting the hit, and
you're getting the hit andyou're getting the hit, you
(17:24):
start to contract inward.
Getting out of that environmentallows you to expand your
mindset, expand your vision.
Right, move your body and be innature.
Right.
Being in nature is tremendouslyexpansive, right.
Being stuck in four walls in anoffice all day long, that's not
(17:48):
tremendously expansive.
So, you know, do a little pulsecheck.
If you're listening, am Iexpanding or am I contracting?
And if I feel like I'm incontraction phase, take a day,
take a couple of days and getout and change your environment.
Speaker 1 (18:06):
Now, what makes breakthrough coaching different?
You know there's several ofthem out there.
However, I've kind of noticedmaybe you can confirm this
there's not as many out there inthe coaching business as there
used to be.
It's only the ones left thatare really good at it that are
left.
Am I correct in thatobservation?
Speaker 2 (18:25):
Yes, yes, it's a really interesting profession.
You know, I was very, veryfortunate to grow up and always
have coaches, because my dadalways had coaches and we came
up with some great, greatmentors.
The vision early that having acoach is a really important
(18:53):
thing in business and life andhaving somebody having an
outside perspective on mypractice that I'm so inside of
was really, really important tome.
I think what's happened is thatthe pace of change is
accelerated.
Yes, the pace of change isaccelerated and right now, with
(19:16):
AI and all of the beautifulchanges that are coming from
that, it's harder and harder forthe practicing doc who's in
there delivering adjustmentsevery day, to keep up with all
of the changes, and whether it'schanges in reimbursement or
changes in marketing I mean,marketing has transformed with
AI.
What you can do now in yourpractice with AI would have cost
(19:36):
you thirty, forty thousanddollars to have somebody do what
an AI assistant could do foryou now online, right.
So I think what has keptBreakthrough Coaching on the
forefront number one is ourintegrity that we don't go in
any gray zones.
We stay straight all of thetime.
(19:56):
We know that value is the mostimportant thing and having
certainty in your procedures.
We also know that systems arewhat makes success.
We also know that systems arewhat makes success, and if
you're baking the cake freshevery day, you might forget
something in the recipe, but ifyou're working a recipe and
(20:17):
you're working a successfulpractice, knowing those systems
are really key.
And so we've had literally 30years of refining systems in
thousands of chiropracticpractices.
So it gives you a nationalvision.
Trends move nationally.
I think what's also different iswe're not a mom and pop shop.
(20:37):
We have a team of consultantsthat were all Breakthrough
Coaching members first.
So remember, in the beginning Isaid I was a client of the
company.
I don't know if I told you thatI was first a client of
Breakthrough Coaching, hiredthem to manage the practice and
then I bought the company andthat's how I got involved with
Breakthrough Coaching.
(20:58):
And so I followed that with allof our consultants.
They've all been successful,brought their practice over the
million-dollar mark and have anaptitude to coach, and so that's
been one of our secrets isyou're coached by somebody who's
been in your seat, not 20 yearsago, 30 years ago, but right
(21:20):
now, and knows what's happeningin your region and in your area
to keep your practice growing,keep it moving, keep it on the
cutting edge.
Speaker 1 (21:28):
Who is the ideal client for you?
Speaker 2 (21:33):
For me, the ideal client has been out of practice
5, 15 years.
They are interested in growingtheir practice, maybe taking
their practice to the next level.
One of our specialties is wehave the number one program for
multidisciplinary practices.
So bringing a nursepractitioner or a PA into your
(21:55):
practice, but doing it smart,doing it in a stepwise fashion.
You do it wrong, you can sinkthe ship.
You do it right, it's abeautiful way.
Collaborative care is abeautiful way to deliver service
.
So I like to work with folkswho want to be coached, who want
to grow their practice and whoare also interested in their
(22:16):
exit strategy.
So that's kind of the unspokenconversation in chiropractic is
what's my plan?
And a lot of docs.
Their plan is to work till theydrop dead and I want to make
sure that they have a successfulplan for succession in the
practice, a successful plan forsale of that practice eventually
(22:37):
, and I like to say you don'tever have to retire.
You just don't have to own yourpractice.
You could work in it, buthaving an exit strategy is
really key and I love workingwith docs toward that end.
Speaker 1 (22:50):
I think that's a huge , huge thing, because I remember
one time some of my friends whowere getting up in age came to
me and said what do you think mypractice is worth?
And I said nothing.
And they said what do you mean?
Nothing, I'm doing 100 people aweek or whatever it was.
And I said it's not worthanything until you can have it
turned over to somebody that canactually carry it on.
(23:12):
And they said well, how do I dothat?
And I said there are plenty ofpeople out there.
Just be careful who you go toto get a succession plan going.
And I remember a couple of myfriends good friends that
retired and they're making thesame amount of money per year
for 10 years.
They were 65 when they retired.
(23:33):
They're making the same amountof money for 10 years.
That's how they sold theirpractice.
Now, if you're out therelistening to this, you know you
can call Mark and he can tellyou how that goes, because
there's contracts, there's alldifferent kinds of things to
help you take a good practice.
You don't want to leave iteither, because you want your
people taken care of.
(23:53):
And so in the activator world,you know, we now have, oh, 2,000
proficiency-rated doctors andyou can go to an activator
practitioner around the world.
That only took 15 years.
You know people want a quicksuccess around the world.
That only took 15 years.
You know people want a quicksuccess.
But what we're trying to do isis say, we want you to be able
to get a standardized adjustmentwherever you are.
(24:14):
And so this is why there's sucha good well, we're having our
doctors look for young kidscoming out of school because
they know the technique, so thenthey can teach them the
business and that kind of thing.
So, uh, how do they get a holdof you, mark?
Because you've been generouswith your time here, I want them
to know how they can get a holdof an expert, and so tell us
(24:36):
how we contact you.
Speaker 2 (24:39):
Well, thanks, arlen.
You can find me online atmybreakthroughcom and you want
to spell out the wordbreakthrough
M-Y-B-R-E-A-K-T-H-R-O-U-G-Hcom.
You can give me a ring at800-723-8423.
(25:01):
It's 1-800-7-advice the wordadvice and a good thing about
having.
So there's not a lot of ArlenFours in the world.
There's not a lot of MarkSantas either.
So if you Google Mark Santa,you're going to find me and
you'll find my LinkedIn profileand on all the social media.
So that's kind of having aninteresting name also makes it
(25:25):
kind of easy to be found.
Speaker 1 (25:27):
Well, you know.
There's one last question I had.
I know a lot of people thatpractice, manage and things like
that, and one of my friendssaid you know, 80% of people
don't want to be successful.
He said so we only help the 20%that do.
And I wonder does that make anysense to you that those numbers
you know what?
Speaker 2 (25:49):
We are an interesting profession.
We are a profession of veryindependent thinkers, and so we
don't often join our stateassociations or join our
national organizations, becausewe think we can do it on our own
.
And you can only coach somebodywho wants to be coached.
(26:12):
I've learned that over mycareer and so that it may be
right that it may be that 20%who understands yeah, I can do
this on my own, but I can do itfaster, better, smarter.
Having somebody who's alreadybeen there take me along the way
, you know.
(26:32):
I like to say if you want tomake a million bucks, don't ask
your buddy, who's making $80,000a year how do I make a million
bucks, because he'll tell youhow.
And you want to have somebodywho's already been there, been
in your shoes, gone through whatyou're going to, and then can
share their life experienceswith you, and that makes the
(26:55):
journey so much less rocky, itmakes the climb smoother and it
makes it happen quicker for you.
Speaker 1 (27:03):
Do you also take new kids out of school?
Speaker 2 (27:06):
We do.
We have a new practitionerprogram that starts them at a
very, very low fee to get theminto the program.
It's still individual.
We do one-on-one live coaching,so we are a coaching company.
We put on beautiful seminars.
We have an amazing website withgreat resources, but we are a
(27:28):
coaching company and so weabsolutely love to work with
students.
I have a call this afternoonwith a gal who's just getting
started in Birmingham, alabama,so shout out.
Speaker 1 (27:40):
Oh, there you go.
Well, dr Mark Sanna, the CEO ofBreakthrough Coaching, thank
you for your time and wisdom,and I hope your students are
listening and some doctors outthere that are getting ready to
retire, and I hope we've been ofvalue to you.
Thank you much, mark.
Speaker 2 (27:56):
Thank you, arlen, thank you so much.
Hi, I'm Dr Arlen Ford , the chairman and co-founder of
Activator Methods International, and today I have with me Dr
Mark Sanna, who is the CEO ofBreakthrough Coaching.
Good morning, mark.
Speaker 2 (00:17):
Good morning, arlen, great to see you.
Speaker 1 (00:19):
Well, we're glad to have you here and you know
you've built an amazingorganization to help
chiropractors in the field and Iwould like to have you give me
a little background.
How did chiropractic find you?
Speaker 2 (00:32):
Well, thanks, arlan, and thanks so much for having me
here on the podcast andallowing me to address your
audience.
My background in chiropracticis I'm a chiropractic kid and my
dad God bless him is 91.
He's in his 61st year as achiropractor, still gives a
(00:55):
great cervical adjustment, whichwas a fantastic thing, and my
history, you know, goes back tothe time before maybe
chiropractic was as accepted asit is today.
And I certainly can remembergetting into scraps on the
playground when people called mydad a quack and I'm like, oh,
(01:18):
he's not a quack and going afterhim.
But the story they tell me andthere's a lot of chiropractors
who will say I owe my entirelife to chiropractic and I
really do.
I was born a blue baby, so nooxygen, and at that time they
would not allow chiropractorsinto the delivery room, right,
(01:41):
probably even the dad wouldn'tgo in the delivery room.
But dad is watching through thewindow and seeing his little
boy not breathing and it came inand actually gave me a
chiropractic adjustment and Ibreathed and that my first
breath on this planet was due toa chiropractic adjustment from
(02:03):
my dad.
Speaker 1 (02:05):
Well, that's pretty dramatic.
It's a dramatic start.
Speaker 2 (02:08):
It's a dramatic start and chiropractic has just been
a part of our lives ever since.
Some people go through thejourney of discovering
chiropractic, for us it wasalways there.
We were kids, we got the mumps.
Dad would wake us up on thehour, adjusting us Morning.
The mumps are gone and we wereall upset because we had to go
(02:29):
to school the next day.
Speaker 1 (02:32):
What's your definition of a successful
chiropractor?
Speaker 2 (02:38):
Well, for me, a successful chiropractor, a
successful person in anybusiness, is somebody who really
has taken a look at what theircore values are and builds their
business, builds their practice, around their values.
You know there are so manycreative ways to be a
chiropractor.
(02:59):
You can be anything frompediatric to geriatric to sports
and in between.
And for me, my core values aretruly my faith, my family, my
personal fitness, my financialfreedom and my ability to have
(03:19):
fun.
No-transcript groundwork of whoam I, why am I going to be in
(03:50):
practice?
And it's not for the money.
I can tell you that that you andI both know.
Parker said it many, many yearsago loving service is my first
technique, right, and if you'rechasing money, you're always
going to be chasing money.
And when you go in there andyou give great loving service,
(04:12):
you have to know the business,and that's part of my story as
well as God bless my dad.
He taught me how to be achiropractor, but he didn't
teach me how to be a businessperson.
So I've been broke and didn'tknow what that's like to go
through that and then toactually learn good business
principles.
But I like a chiropractor whoknows why they're in practice.
(04:36):
It gives you a sense ofcertainty, and I also feel that
there is a certain amount ofsecurity that comes from knowing
that your financial needs aremet, your family's financial
needs are met, and that's fromgiving great service.
Speaker 1 (04:53):
You know you struck on something there, because I'm
around students a lot and,coming out of chiropractic
college, they're quite qualifiedto be a chiropractor but they
don't know step one in business,and so I kind of hear you
saying that you had to learnthat.
What would you say were thecouple of things that you
(05:14):
learned that helped you propelup to the place where you are
today?
Speaker 2 (05:19):
Yeah.
So for me it was a big learningthat it's not how much you make
, it's how much you keep.
And so when you first startgenerating income and you know,
my dad was first generationAmerican and went through the
(05:40):
depression, and so they neverhad money and never learned how
to manage money but what Ilearned later on is that not
only do you have to have moneyin the bank, there has to be a
level of profitability in thepractice.
Nobody ever talked about profitand it was just okay, great,
(06:02):
open up the envelopes, put themoney in the bank.
If there's money there, we'rehappy.
If there's not, we're not sohappy.
And I didn't learn until laterin life the value of savings.
Tell you, today, 10% of myearnings and this is for at
(06:25):
least the last 30 years has goneinto an investment account and
I've never touched it, never seeit.
And that compounding interestis the key to creating wealth.
And if you're a studentlistening to this, your 10%
(06:47):
might not be as big as my 10% is, but you have the advantage on
me of time.
So as your 10% grows incompounds and compounds, it gets
you into a situation where yourmoney's working for you and
you're not working for yourmoney.
So I wish I had learned thosetwo lessons is like being rich
(07:12):
is no good if you don't have anymoney in the bank and the power
of compounding interest overtime.
I think I wish I had had thatinformation.
You said what would you tellyour younger self?
That would be probably one ofthe lessons I'd write in that
letter.
Speaker 1 (07:28):
Well, you know, I'm a Dave Ramsey fan.
And if you've ever listened toDave Ramsey and that's something
maybe we should stress tostudents is check Dave Ramsey
out, because he's talking aboutbeing debt free and how you have
to have a budget and you haveto live within it, and I see
many young practitioners makingquite good money but they're
(07:51):
spending it all on dumb thingsand I think that's lifestyle
which changes and goes away, andall that kind of thing.
Then all of a sudden they end upwhen they're 55 and they're
saying what am I going to do forretirement if they'd have been
doing what you've been doing for30 years?
You know, it's easy to be amillionaire if you put money
away.
Speaker 2 (08:12):
Absolutely, absolutely.
Speaker 1 (08:14):
What do you think the reimbursement system today is?
It's changing and I'd like tohear a little bit about what
your thoughts are on theinsurance reimbursement.
Speaker 2 (08:25):
Well, that's a great question.
My dad has a quote.
He says, mark, I spoke, Ipracticed before there was
insurance reimbursement, whenthey had insurance reimbursement
and when they took it away.
And so there is no doubt in mymind that insurance
(08:45):
reimbursement, when you look atthe reality of today, is
declining for chiropractors.
There are many chiropractorswho are being paid on fee
schedules that are literally 20years old, that there has not
been an increase in theirreimbursement rate for 20 years.
And now it costs you a heck ofa lot more to deliver an
adjustment today than it does 20years ago.
(09:08):
I can tell you.
You know, when we look atinflation and overhead and cost
of staff and all of that, thereshould be commensurate increases
in reimbursement.
But there's not.
And so today you absolutely andI'm not saying step out of
(09:28):
insurance.
Insurance has a purpose, but youmust, must, must be able to
embrace cash services with apatient.
You have to be able to delivervalue, communicate value in a
way that the patient is willingto pay their discretionary
income for their health.
So your job is to make theirhealth a priority.
(09:51):
You know, you ask people what'sthe most important thing in
life, right?
Not money, it's health.
If you don't have your healthdoesn't matter how much money
you have, and so knowing thatyou are delivering a service
that can improve the quality ofpeople's lives, their longevity,
their ability to stay mobileand autonomous in their older
(10:13):
years, that's a big darn deal.
The third-party payer systemhas not caught on to that.
It's for sick care.
Chiropractors, we do health care, and so being able to deliver a
service and charge a fair pricefor it and be paid cash is
essential.
That's not to say that, as thechiropractic profession, we're
(10:39):
not working very diligentlybehind the scenes to make sure
that some of the terriblereimbursement practices
literally abusive reimbursementpractices for chiropractors, are
not being addressed.
We are addressing them.
We have legislation climbing upCapitol Hill again for a
Medicare Modernization Act,which hopefully we're going to
(11:01):
have this time come around andbe able to have our patients be
reimbursed for their exam.
Imagine we have to do an examto be paid.
We don't even get paid for ourexam for Medicare to be paid.
We don't even get paid for ourexam for Medicare.
So having fair reimbursement,having fair access to
(11:27):
chiropractic care, those arethings that are absolutely at
the top of the minds of theleaders of the profession today.
Speaker 1 (11:31):
You know, having a practice that's cash has been a
lot of the ways a lot of peoplehave gone.
I've got several people in ouractivator club our instructors
and so forth that have justswitched to cash.
It was a bit difficult in thebeginning, but it turned out in
the end to be the way to go andthey wouldn't go any other way.
(11:51):
And so what do you think of acash practice?
Speaker 2 (11:54):
Yeah, I often say you know, when you address an
audience and I ask them raiseyour hands, who are the guys who
, or gals, have gone all cashand those will be the one who
raise their hand.
I said well, you didn't have toraise your hand because you're
the ones who are smiling.
Exactly, it truly is.
The third party payment systemthat we're involved with is
(12:18):
really a square peg in a roundhole.
We're not meant to fit in thathole and, that being said, the
pioneers who've gone before us,the people like my dad and
yourself who fought the battlesto be able to have us recognized
in the health care system thatthere is a cultural authority
(12:39):
that comes from having insurancereimbursement there.
It's not easy to start apractice from scratch completely
as cash, but certainly there isa point in your career that you
will reach when you should nolonger be beholden to insurance
reimbursement.
That you've built a practice, afollowing of patients who will
(13:05):
come and pay the money for theservice that you've given.
That's a great point, and so Ithink every chiropractor should
be thinking of okay, when do Imeet that point where I no
longer have to take these things?
Insurances that are four visits, five visits with
pre-authorization and a stack ofpaperwork, but I can go in and
(13:26):
enjoy my patients and enjoydelivering my care and my
adjustments, you know having asuccessful practice is fun, but
it can also be stressful.
Speaker 1 (13:38):
I remember being, you know, in Minnesota for 25 years
and having a big, big practice,and it was fun as could be, but
by the end of the week you werelooking for something you know
to relax with.
What do you do to help peoplewith that kind of problem?
Speaker 2 (13:57):
What do you do to help people with that kind of
problem?
Well, I tell you the one thing,and I'm sure you know, arlen,
that when you're managing anoffice of that size, you can't
do it alone.
You've got to have great peoplearound you.
You have to know how todelegate, you have to know what
you do well and stay in yourwheelhouse.
You must keep the big pictureof the business.
(14:20):
You've got to watch your bottomline, but you don't have to
micromanage everything.
If you're going to have areally successful practice, you
need folks to take care of allof the myriad of things that you
don't even think about.
My goodness, just HR alonetoday, where people quit my text
.
Or things that you don't eventhink about.
My goodness, just HR alonetoday where people quit my text,
(14:40):
or they ghost you.
Or people say you know, listenwhen we practice.
Never have a staff member calland say I'm taking a personal
day.
What do you mean?
A personal day?
Speaker 1 (14:53):
Well, you got a hundred people coming.
Speaker 2 (14:55):
Yes, personal day.
Well, you got a hundred peoplecoming.
Yes, exactly.
So I think have a great team,pay them well, pay them as much
as you can possibly pay them.
And the reason is you want themto stay.
You don't want them looking atother things, you don't want
them driving Uber.
You want them to say this isthe best job on the planet.
(15:16):
I love Doc, I want to be here.
I think that's really key.
So, number one have greatpeople around you.
The other thing is understand.
You know you say you got tosharpen the saw means you got to
recharge your batteries and youcannot be a healer, you cannot
be a business person, you can'tbe an executive or an
entrepreneur if you don't takedowntime to recharge your
(15:40):
batteries.
And literally that means youknow staycation is fine, but
change your environment.
Go out of town, even if it'sfor a drive, and meet new people
, have new experiences, andyou're going to come back into
that practice energized andrevitalized.
I've spoken to some docs whohaven't taken a scheduled
(16:03):
vacation in 20 years.
That is just not the way tostay healthy and balanced in
life, right.
Speaker 1 (16:11):
No, you're really onto something here.
I've had a theory for years andI've never talked much about it
.
But ever since I becamesuccessful this is 30 years ago
I always had a retreat.
And I remember in my Minnesotapractice I had a lake house 38
miles from the practice.
(16:32):
I would leave on Friday nightand I wouldn't come back till
Monday morning.
It took me exactly 41 minutesto get there, but when I drove
across the bridge I knew I wasin a different country, a
different feeling.
I relaxed and I started to tellstudents to this day I have a
summer home in Phoenix.
(16:52):
Somebody said how do yousurvive the summers?
I said in the White Mountains,home in Phoenix.
Somebody said how do yousurvive the summers?
I said in the White Mountains.
You know, it's the break thatreally helps us continue along.
You know life in practice.
Speaker 2 (17:04):
You know, arlen, I have a saying you're either
expanding or you're contracting.
And if you're in the practicethink about a boxer in the
corner of the ring and they'regetting hit, and they're getting
hit, and they're getting hiteventually you start hiding in
your corner and that's kind ofwhat it's like.
If you're in practice andyou're getting the hit, and
you're getting the hit andyou're getting the hit, you
(17:24):
start to contract inward.
Getting out of that environmentallows you to expand your
mindset, expand your vision.
Right, move your body and be innature.
Right.
Being in nature is tremendouslyexpansive, right.
Being stuck in four walls in anoffice all day long, that's not
(17:48):
tremendously expansive.
So, you know, do a little pulsecheck.
If you're listening, am Iexpanding or am I contracting?
And if I feel like I'm incontraction phase, take a day,
take a couple of days and getout and change your environment.
Speaker 1 (18:06):
Now, what makes breakthrough coaching different?
You know there's several ofthem out there.
However, I've kind of noticedmaybe you can confirm this
there's not as many out there inthe coaching business as there
used to be.
It's only the ones left thatare really good at it that are
left.
Am I correct in thatobservation?
Speaker 2 (18:25):
Yes, yes, it's a really interesting profession.
You know, I was very, veryfortunate to grow up and always
have coaches, because my dadalways had coaches and we came
up with some great, greatmentors.
The vision early that having acoach is a really important
(18:53):
thing in business and life andhaving somebody having an
outside perspective on mypractice that I'm so inside of
was really, really important tome.
I think what's happened is thatthe pace of change is
accelerated.
Yes, the pace of change isaccelerated and right now, with
(19:16):
AI and all of the beautifulchanges that are coming from
that, it's harder and harder forthe practicing doc who's in
there delivering adjustmentsevery day, to keep up with all
of the changes, and whether it'schanges in reimbursement or
changes in marketing I mean,marketing has transformed with
AI.
What you can do now in yourpractice with AI would have cost
(19:36):
you thirty, forty thousanddollars to have somebody do what
an AI assistant could do foryou now online, right.
So I think what has keptBreakthrough Coaching on the
forefront number one is ourintegrity that we don't go in
any gray zones.
We stay straight all of thetime.
(19:56):
We know that value is the mostimportant thing and having
certainty in your procedures.
We also know that systems arewhat makes success.
We also know that systems arewhat makes success, and if
you're baking the cake freshevery day, you might forget
something in the recipe, but ifyou're working a recipe and
(20:17):
you're working a successfulpractice, knowing those systems
are really key.
And so we've had literally 30years of refining systems in
thousands of chiropracticpractices.
So it gives you a nationalvision.
Trends move nationally.
I think what's also different iswe're not a mom and pop shop.
(20:37):
We have a team of consultantsthat were all Breakthrough
Coaching members first.
So remember, in the beginning Isaid I was a client of the
company.
I don't know if I told you thatI was first a client of
Breakthrough Coaching, hiredthem to manage the practice and
then I bought the company andthat's how I got involved with
Breakthrough Coaching.
(20:58):
And so I followed that with allof our consultants.
They've all been successful,brought their practice over the
million-dollar mark and have anaptitude to coach, and so that's
been one of our secrets isyou're coached by somebody who's
been in your seat, not 20 yearsago, 30 years ago, but right
(21:20):
now, and knows what's happeningin your region and in your area
to keep your practice growing,keep it moving, keep it on the
cutting edge.
Speaker 1 (21:28):
Who is the ideal client for you?
Speaker 2 (21:33):
For me, the ideal client has been out of practice
5, 15 years.
They are interested in growingtheir practice, maybe taking
their practice to the next level.
One of our specialties is wehave the number one program for
multidisciplinary practices.
So bringing a nursepractitioner or a PA into your
(21:55):
practice, but doing it smart,doing it in a stepwise fashion.
You do it wrong, you can sinkthe ship.
You do it right, it's abeautiful way.
Collaborative care is abeautiful way to deliver service
.
So I like to work with folkswho want to be coached, who want
to grow their practice and whoare also interested in their
(22:16):
exit strategy.
So that's kind of the unspokenconversation in chiropractic is
what's my plan?
And a lot of docs.
Their plan is to work till theydrop dead and I want to make
sure that they have a successfulplan for succession in the
practice, a successful plan forsale of that practice eventually
(22:37):
, and I like to say you don'tever have to retire.
You just don't have to own yourpractice.
You could work in it, buthaving an exit strategy is
really key and I love workingwith docs toward that end.
Speaker 1 (22:50):
I think that's a huge , huge thing, because I remember
one time some of my friends whowere getting up in age came to
me and said what do you think mypractice is worth?
And I said nothing.
And they said what do you mean?
Nothing, I'm doing 100 people aweek or whatever it was.
And I said it's not worthanything until you can have it
turned over to somebody that canactually carry it on.
(23:12):
And they said well, how do I dothat?
And I said there are plenty ofpeople out there.
Just be careful who you go toto get a succession plan going.
And I remember a couple of myfriends good friends that
retired and they're making thesame amount of money per year
for 10 years.
They were 65 when they retired.
(23:33):
They're making the same amountof money for 10 years.
That's how they sold theirpractice.
Now, if you're out therelistening to this, you know you
can call Mark and he can tellyou how that goes, because
there's contracts, there's alldifferent kinds of things to
help you take a good practice.
You don't want to leave iteither, because you want your
people taken care of.
(23:53):
And so in the activator world,you know, we now have, oh, 2,000
proficiency-rated doctors andyou can go to an activator
practitioner around the world.
That only took 15 years.
You know people want a quicksuccess around the world.
That only took 15 years.
You know people want a quicksuccess.
But what we're trying to do isis say, we want you to be able
to get a standardized adjustmentwherever you are.
(24:14):
And so this is why there's sucha good well, we're having our
doctors look for young kidscoming out of school because
they know the technique, so thenthey can teach them the
business and that kind of thing.
So, uh, how do they get a holdof you, mark?
Because you've been generouswith your time here, I want them
to know how they can get a holdof an expert, and so tell us
(24:36):
how we contact you.
Speaker 2 (24:39):
Well, thanks, arlen.
You can find me online atmybreakthroughcom and you want
to spell out the wordbreakthrough
M-Y-B-R-E-A-K-T-H-R-O-U-G-Hcom.
You can give me a ring at800-723-8423.
(25:01):
It's 1-800-7-advice the wordadvice and a good thing about
having.
So there's not a lot of ArlenFours in the world.
There's not a lot of MarkSantas either.
So if you Google Mark Santa,you're going to find me and
you'll find my LinkedIn profileand on all the social media.
So that's kind of having aninteresting name also makes it
(25:25):
kind of easy to be found.
Speaker 1 (25:27):
Well, you know.
There's one last question I had.
I know a lot of people thatpractice, manage and things like
that, and one of my friendssaid you know, 80% of people
don't want to be successful.
He said so we only help the 20%that do.
And I wonder does that make anysense to you that those numbers
you know what?
Speaker 2 (25:49):
We are an interesting profession.
We are a profession of veryindependent thinkers, and so we
don't often join our stateassociations or join our
national organizations, becausewe think we can do it on our own
.
And you can only coach somebodywho wants to be coached.
(26:12):
I've learned that over mycareer and so that it may be
right that it may be that 20%who understands yeah, I can do
this on my own, but I can do itfaster, better, smarter.
Having somebody who's alreadybeen there take me along the way
, you know.
(26:32):
I like to say if you want tomake a million bucks, don't ask
your buddy, who's making $80,000a year how do I make a million
bucks, because he'll tell youhow.
And you want to have somebodywho's already been there, been
in your shoes, gone through whatyou're going to, and then can
share their life experienceswith you, and that makes the
(26:55):
journey so much less rocky, itmakes the climb smoother and it
makes it happen quicker for you.
Speaker 1 (27:03):
Do you also take new kids out of school?
Speaker 2 (27:06):
We do.
We have a new practitionerprogram that starts them at a
very, very low fee to get theminto the program.
It's still individual.
We do one-on-one live coaching,so we are a coaching company.
We put on beautiful seminars.
We have an amazing website withgreat resources, but we are a
(27:28):
coaching company and so weabsolutely love to work with
students.
I have a call this afternoonwith a gal who's just getting
started in Birmingham, alabama,so shout out.
Speaker 1 (27:40):
Oh, there you go.
Well, dr Mark Sanna, the CEO ofBreakthrough Coaching, thank
you for your time and wisdom,and I hope your students are
listening and some doctors outthere that are getting ready to
retire, and I hope we've been ofvalue to you.
Thank you much, mark.
Speaker 2 (27:56):
Thank you, arlen, thank you so much.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Intentionally Disturbing
Join me on this podcast as I navigate the murky waters of human behavior, current events, and personal anecdotes through in-depth interviews with incredible people—all served with a generous helping of sarcasm and satire. After years as a forensic and clinical psychologist, I offer a unique interview style and a low tolerance for bullshit, quickly steering conversations toward depth and darkness. I honor the seriousness while also appreciating wit. I’m your guide through the twisted labyrinth of the human psyche, armed with dark humor and biting wit.