March 2, 2025 • 37 mins
Welcome to the KC CHIROpulse Podcast.
This week’s topic: Where is Your Chiropractic Focus in 2025?
The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights, and is hosted by Kats Consultants coaches Dr Michael Perusich and Dr Troy Fos. Michael and Troy are both seasoned experts in Chiropractic business development. This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.
In this episode, we discuss:
- Are you focusing on the right things in your practice
- What should and shouldn’t you be focused on
- What are the top areas to drive your practice in 2025
- …and so much more…
In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.
Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and personalized practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.
Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.
DISCLAIMER: The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice, and represents the opinions of the speakers. Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Michael Perusich (00:09):
Doctors, where's your focus in 2025?
Hi everybody.
Welcome to the KC ChiroPulsePodcast brought to you by Kats
Consultants and Chiro HealthUSA.
I'm Dr.
Michael Perusich.
I'm joined with my cohost, Dr.
Troy Fox.
Troy, focus.
Focus man, how do we focus andwhat do we need to focus on?
And you and I've talked aboutthis.
We hear a lot of doctors saythey're losing focus.
(00:31):
They're burning out all thesedifferent things.
What's happening.
What do we need to focus on?
Dr. Troy Fox (00:36):
I think one of it is the world is changing so
rapidly right now.
And maybe you guys have heard ofthis little thing called AI.
Yeah, and the problem is we gota lot of docs that are concerned
that they're falling behindalready that I need to know More
about AI and instead of becominga better doctor.
We'd try to become coders We tryto become you know How do we
(00:56):
figure out how to use an AIagent to do all of our work
Dr. Michael Perusich (00:59):
and it ain't gonna happen right now?
Dr. Troy Fox (01:01):
I think we're way ahead of when that's Actually a
user friendly operation.
You get people on YouTubetelling you they can teach you
how to do it.
There are a lot of courses outthere like course IV and a
couple of others that saythey're going to teach you AI
don't fall into that trap.
Your focus needs to be on yourpractice.
Yes.
Are we moving more towards anautomated practice model?
(01:24):
In the long run, yeah, you'regoing to end up probably being
able to have less staff in yourpractice with more services,
you're going to also be able toprobably have better notes with
less effort, which we all wantto hear that, but you're not
going to create that on yourown.
It's not going to be that easyto do.
And so instead of spinning yourwheels.
(01:46):
I think what we need to focus onis what do we need to be doing
in 2025?
What should our focus bedirected towards?
Dr. Michael Perusich (01:54):
Yeah.
And when it comes to AI, let thetechnology catch up with us.
Yeah, for sure.
All the software companies, allthe EHR producers are working
on.
Bringing AI in the fold is justnot ready yet, at least at the
chiropractic level.
I know some of the hospitalmedical doctors and things are
using it, the technology they'reusing is very advanced.
(02:14):
It's also very expensive.
Yeah, I don't think that'ssomething to focus on yet.
But yeah, it's out there andit's coming.
Dr. Troy Fox (02:22):
Frankly, the stuff that they're using right now,
even at the hospital and dentallevel, I see him using it in
dentistry as well is prettyrudimentary in comparison to
what we're going to see twoyears from now.
Dr. Michael Perusich (02:33):
Sure, absolutely.
And we see doctors losing focuson other things.
We see doctors.
Trying to focus too much onmarketing.
Now that may sound countercounterintuitive.
What I mean is we see a lot ofdoctors focusing too much energy
on who can I pay to do mymarketing for me?
(02:54):
And they wind up jumping intothese groups that actually maybe
doing more detrimental harm tothe practice with their
marketing than you just actuallydoing it.
And here's the great thing.
Google and a lot of the socialmedia platforms are actually
making marketing easier thatthey're opening up the
algorithms more.
Google is really focused on yourGMP, your Google, my business
(03:17):
page.
So just work those things.
If you spend an hour a week, youcould do a lot of great
marketing and not lose focusback on your practice.
Dr. Troy Fox (03:27):
Yeah.
And look at your Google, mybusiness page and look at the
analytics behind it and look andsee what photo, if you don't
have photo photos up on yourbusiness page, oh my gosh, get
them up.
I just looked at a photo.
We have a photo of an infraredsauna.
We have a pretty cool infraredsauna.
It's a larger walk in one.
So it looks like a spa, right?
(03:48):
We've had almost a thousandviews of that one photO.
I'm like, we need to get morelike just literally yesterday,
Kaylee, who works with me andshe does our marketing.
She's younger.
She's the hip, cool person thatcan put my head on the body of a
giraffe in an ad and make itlook cool.
(04:08):
She does some fun stuff.
It's always fun to have youngpeople because they know how to
do stuff that would take me.
A week to figure out she can doit in 15 minutes.
So I just throw stuff her way,but she was talking to me about
that yesterday.
I'm like, Oh my gosh, we need toget more cool photos and videos
on our Google page, because thatreally is becoming the trend.
(04:29):
It's almost like an onlinebusiness card that is
interactive.
And it's cool.
And then people look at yourGoogle reviews on top of that.
If you've got both your money.
Dr. Michael Perusich (04:39):
Yeah.
And if you don't know what yourGoogle, my business page is,
it's that little box that popsup when you put your clinic name
into Google and hit enter, and Idon't mean your clinic name.
com, just put your clinic nameon it.
So a little box that pops up onthe right and you can.
It's got buttons to click onyour website, your hours, your
directions, et cetera.
(04:59):
And it's where all your Googlereviews are.
You need to be working thatpage.
You need to be, you need todate.
Yeah.
And you need to be postingquestions and answering the
questions.
Yes.
You can do that yourself.
Or you can ask people to post aquestion, but make sure that you
answer it.
You need to change your picturesor add to your pictures every
single month.
(05:19):
That is becoming the number onespot where people are going to
find you.
It's a great marketing tool, butyou have to work it.
Dr. Troy Fox (05:27):
And it's free to change all that stuff.
You can just, you look at yourpage when you got an extra hour
or two.
And with, you have that thoughtin mind already, you can ask the
staff, Hey, what, give me acouple of questions that
patients have asked over thelast month over the phone.
You can also, while you're doingthat and you're creating ads
already for Facebook or Tik TOKor whatever you're doing, right.
(05:50):
When you're doing that.
You can either take photos atthe time.
I don't recommend still photos.
I recommend that we're usingsome action footage, right?
Then once we launched like theaction Jackson kind of thing, we
want you to move in and grooveand in your videos, cause stills
don't do as good.
But.
You can pull a still photo fromyour video and use that, or you
(06:13):
can take a photo, before you dothe video, if you've got that in
mind already, you just have aphoto bank of photos that you
just rotate things in and outand add things.
Dr. Michael Perusich (06:22):
Yeah, exactly.
Exactly.
So that's a place where you needto put your focus.
And another place is I seedoctors who've been in practice
for a while realizing.
That maybe some of their statshave slipped just a little bit.
And so their knee jerk reactionis, Oh my gosh, we need more new
patients.
Dr. Troy Fox (06:42):
And they ads on Facebook every day.
They're going to give me like 45new patients and I don't have to
pay anything.
So maybe I should go for thatdeal.
Right?
Dr. Michael Perusich (06:51):
Sure.
Sure.
Yeah.
It's instead of focusing so muchon new patients and we all need
new patients.
Cause if you've been in practicefor a while you have you, you
have people that lead thepractice, they move away, they
passed away, they don't like youanymore, whatever it might be.
So we need to replace those, butthe focus on new patients,
(07:11):
sometimes it's just a littlebent and so we need to be
focusing on things likereactivations.
You've got all these people inyour database.
Why don't we tap into that?
That's an absolute gold mine.
And there's a couple otherthings that I want to talk
about.
We got to take a break.
I'm getting a look.
We got to take a quick break.
to hear word from our sponsors.
(07:32):
So we're talking about where toput your focus in 2025.
We're talking a little bit aboutjust a multitude of things that
you could and should focus on.
So we'll be right back.
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Dr. Michael Perusich (08:50):
All right, everybody.
Welcome back to the KC ChiroPulse podcast brought to you by
Kats consultants and Chirohealth USA.
Troy, we're talking about whereto put your focus in 2025.
And we were just talking about.
the drive for new patients.
And but if you've been inpractice for a while, what about
looking at your database andsaying, Hey, maybe it's time to
(09:11):
reactivate some of thesepatients.
Dr. Troy Fox (09:13):
Anything in house is going to be better because
you guys know you have to siftthrough the wheat and the chaff.
When you start getting likesomebody says, Hey, we're gonna
get you 30 new patients in thedoor.
Maybe two of those patientsStay, pay, and refer, right?
They're going to be thosepatients that actually get
chiropractic and wantchiropractic.
The other 28 are just respondingto an ad and go, Oh, there's a
(09:35):
1995 special and I get a freecar and an adjustment and, what
kind of freak are in a headshape?
I'll shave their heads too.
If
Dr. Michael Perusich (09:43):
you took advantage of the, yeah,
Dr. Troy Fox (09:45):
yeah, I did take advantage of the promotion.
Liked it so much.
I started offering it topatients, but so when you get
those kind of patients in,that's a lot of work.
And we've talked in otherpodcasts and we will in the
future as well about how much itcosts.
To run and develop a new patientto the point of where they
become profitable We're notgoing to talk about that today
But what I am going to say isit's a lot quicker to get to
(10:06):
profitability And you have a lothigher retention when you are
using in house referrals whetherthat be a proxy And if you don't
know what a proxy is just aquick version is hey, mike I
hear that your daughter, youknow is playing soccer now And
we haven't really seen her inthe office.
Who's she using for achiropractor?
(10:27):
And Mike's, oh, she doesn't havea chiropractor.
We need to get her in here andhave her checked out.
I'll have the front office stafftake care of that when you go up
front.
And, it's really easy to dothat.
The dialogue is different forevery person.
That was just one littleexample.
In house, we can also startraiding our database, like you
said, and look at reacts.
There are people that havedropped out of care and we do we
(10:50):
do some interesting reacts andit's amazing.
Whenever we send out that react,we do it drips.
We don't do like the wholedatabase at once.
We pick sections.
Sure.
When we do it, it's amazing.
Every time we get people thatare like, Oh my gosh, yes, I'd
love to schedule it.
Cause we do it in the form of atext message.
And when they get it, they go,Oh my gosh, yeah, I want a
(11:11):
schedule.
And they come in and they go, Ohmy gosh, it's been how many
months since I saw you?
Yeah.
Dr. Michael Perusich (11:16):
And they're shocked.
Dr. Troy Fox (11:17):
I got busy and forgot.
And
Dr. Michael Perusich (11:19):
and that's what happens to a lot of them.
Dr. Troy Fox (11:21):
And then it's Hey, so what do you want now to care?
I always ask when somebody hasbeen gone for a while, is there
something you didn't like aboutthe care?
Oh no, I loved it.
I just got busy.
Okay.
So are we ready to get back on amaintenance or wellness
schedule?
Absolutely.
And a lot of times there may bea little bit of work to get
there.
Hey, it's been four months.
You're definitely veryrestricted to your lumbar spine.
(11:41):
And that was the initial problemyou came in with.
I'm going to see you one time aweek for a couple of weeks
before we move you back out tothat.
Maybe if they've been gone forjust a few months,
Dr. Michael Perusich (11:49):
right?
So yeah.
So that's a great one to focuson here.
Here's another one.
Why do you think some places areso some businesses are so
popular take Starbucks, forexample, and I know we use
Starbucks is as an example allthe time, but it's a great
example of what I'm about tosay.
(12:10):
They're so popular, not becausethey have the cheapest cup of
coffee.
They have the best coffee houseexperience, and that's why
people go there.
The story, somebody walks intoyour practice with a Starbucks.
You immediately want to ask whatflavor did you get?
And Hey, by the way, did youthink about getting me one?
Because everybody gets excitedabout it.
(12:30):
Yeah, and we want to be able tohave that kind of experience for
our patients.
We want them to get excitedabout coming to see us.
We want them to be looking at uslike we're cheers where
everybody knows your name kindof thing.
And if we can focus on creatingthat great patient experience,
(12:51):
guess what?
We're going to do a couple ofthings.
We're going to build up ourretention because people are
going to stay.
More, they're going to want tocome more often.
That's a good thing.
And what else are they going todo?
They're going to refer peoplein.
Yeah, because it's a cool placeto go.
So I think that's a great placeto focus on in 2025.
Dr. Troy Fox (13:12):
And if you're not doing that, think of these
numbers.
We already, as chiropractors,have a higher satisfaction
rating than medicine when itcomes to spinal problems, like
back problems.
Dr. Michael Perusich (13:22):
And you were talking about a study or an
article or something.
You read the other day.
You were talking about this theother day
Dr. Troy Fox (13:28):
where
Dr. Michael Perusich (13:29):
Our patient satisfaction is just
through the roof compared toother providers.
Dr. Troy Fox (13:33):
So if you have that office that doesn't have
that, that, that patientexperience, that's great.
My concern for you is as you'refalling behind, even the other
chiropractors in your area, youshould at least be on par with
them, meaning that you shouldhave a great customer experience
or a great patient experiencewhen they come through the door.
The beauty that we do have, andI'll give everybody cute kudos
(13:55):
that's listening to this.
We don't have a dissatisfactionrating.
Unfortunately, in medicine,there is a dissatisfaction
rating.
We are dissatisfaction ratingsat zero.
It's either, hey, we're superthrilled with you or we're not
like over the top.
We're just neutral, but we'renot negative about the
chiropractic care that wereceive.
But sometimes with medicine, andI get it because there are some
(14:17):
pretty intrusive treatments inmedicine that people wish they
hadn't have done sometimes.
And so I would say overall, oursatisfaction rating is good, but
if you're not up there, Myconcern is, again, that there's
five chiropractors in your town,and four of them have a great
customer or patient experiencewhen they walk through the door.
(14:39):
And you don't.
It's like going to, it's likegoing to a coffee shop.
And you walk in the door, andit's dirty, and it's dingy, and
it's not very pretty in there,and they don't really have, I
can't get a macchiato, oramericano, or cappuccino, or all
those names.
I don't, most of them, I don'tknow what they mean.
All I can get is a black cup ofcoffee, and they don't even have
(15:01):
real cream.
They just have the shaker thingwith the powder in it.
How many of you would want a cupof coffee from there?
Not many because we've been, wehave been conditioned that when
you go to a coffee house, it'sgoing to be a bohemian, cool,
hipster atmosphere, right?
And you're going to be able toget names of copies, coffees
that you don't even know whatthey are.
Dr. Michael Perusich (15:21):
You don't even know what you're getting.
Dr. Troy Fox (15:23):
And you hear people say, I'm going to half
calf, double tap calf with thetwist, a lemon macchiato half,
what is a
Dr. Michael Perusich (15:31):
macchiato?
Dr. Troy Fox (15:32):
I have no idea.
I really don't.
I do Americano cause I know it'swater and coffee.
And yeah, it's, amen brothers.
That's what I do too.
I understand that one, but wehave been conditioned that we
enjoy that we go in and we thinkit's super cool to go someplace.
Starbucks coined it when theystarted coming out with sizes on
their drinks that I didn'tunderstand.
(15:52):
A tall, it's like a small,right.
And then you get a
Dr. Michael Perusich (15:55):
small, then there's a grande, which is
not a large.
And I think I heard the otherday that they've got another new
size and it's some okay.
Yato style name.
Dr. Troy Fox (16:05):
So we got all this crazy things.
So if you're not up with otherchiropractors from a standpoint
of creating this experience,look around, go sit in your
waiting room.
This is a, this is homework foryou in 2025 to be focused, go
sit in your waiting room andlook 360 degrees.
And if you're able to do it.
While staff is in the building,hear what the sounds are coming
(16:29):
from the front desk.
What does it sound like, smellfeel like?
I've always been a big fan ofwhat it looks like when you walk
through the door.
And if you guys have heard me inpast, for the past 200 podcasts,
I have talked about if I walkinto your office and there's
dust on the plants, I am notexcited about your office.
Number one, what does it looklike?
(16:51):
Number two, what are the soundsthat I'm hearing?
And number three, what do Ismell?
Yeah.
You don't have to cook freshcinnamon rolls every day for it
to smell good in your office.
A diffuser is cool.
Dr. Michael Perusich (17:02):
Cinnamon rolls on a Macchiato.
Dr. Troy Fox (17:04):
Or what was the smell that we had in new Orleans
at the Ritz?
What was that a banana bread,
Dr. Michael Perusich (17:10):
banana bread
Dr. Troy Fox (17:11):
bathroom at this hotel in the, in new Orleans
smelled like banana bread.
Somebody came out and said, yougot to go in and smell the
bathroom.
And I was like, I don't want todo that.
Dr. Michael Perusich (17:24):
No, you really want to do it, but you
have to
Dr. Troy Fox (17:26):
smelled like warm banana bread or out of the oven.
And it was such a.
Wild experience that I like hadto stand in there and think
about that for a minute You cando simple things like a
diffuser.
How about sounds should youhave?
Like crazy wild slash metal,Ozzy
Dr. Michael Perusich (17:46):
osbourne
Dr. Troy Fox (17:46):
Some ozzy osbourne playing in your office or Is it
more relaxing to have a spasound or maybe some jazz music?
Maybe you listen to the localChristian radio station, which
is usually not going to be musicthat is going to have a negative
theme.
Those are the kind of thingsthat we're talking about when we
walk into the office.
So sit in your office, lookaround, are the baseboards all
(18:08):
scraped up?
Are the, I was sat in mydentist's office the other day,
and the first thing that Inoticed was all the arms on the
chairs were all scraped up.
It's time for new furniture.
And they run a busy office, andI get it.
You're going to get wear andtear in your waiting room.
But if you haven't been in yourwaiting room in a while, go out
and look, because you know what,as a patient.
I sat in the chair and I noticedthose things.
(18:29):
I noticed that the floor isdirty.
I noticed everything about it.
It's like walking into a hotelroom.
Do you notice if they didn'tclean the room and the sheets
are laying on the bed andthere's debris on the floor,
you'd notice that.
Dr. Michael Perusich (18:40):
So we used to every day we would go out and
we would test.
Every single chair in thewaiting area.
And when I say test, we wouldmake sure that it wasn't getting
weak, falling apart, loose,needed to be tightened up.
Make sure that the the cloth orthe vinyl, depending on the
chair was in good shape anddidn't need to be repaired.
(19:02):
And if there was a problem, wewould yank that chair out.
And we had a couple of extrasthat we'd put in its place until
that one got fixed back up.
Yeah.
We all, and this drives me nuts.
Okay.
You go into a chiropracticclinic and they've got every
single chiropractic.
poster that you could possiblyfind.
(19:24):
Some are framed, some aren't,some are dog eared and turning
yellow.
Yeah.
Some are thumbtacked to the wallor taped to the wall, even
better.
Some have nice glass frames,some don't, and it's just this
hodgepodge of.
Stuff and it looks like a fleamarket and if that's your
practice, I'm, sorry I don'tmean to offend you but that's
(19:47):
one of those things you need tolook at It doesn't cost that
much to go to a hobby lobby orsomeplace like that And get
those put together black frameswith a piece of glass And make
them look nice
Dr. Troy Fox (19:59):
Yeah,
Dr. Michael Perusich (19:59):
it doesn't cost that much.
Dr. Troy Fox (20:00):
You know what's right next to that?
The tv that's on and it saysthis channel is not available.
Now I've never seen that in achiropractic office, I'll be
honest about that, but I'vewalked into like bar and grill
where you're getting ready towatch a game and they have seven
tvs and one of them's working.
It's it seems a little chintzyokay, so
Dr. Michael Perusich (20:18):
So I go to my dentist's office.
This is another thing drives menuts.
And they have soap operasplaying on the TV in the waiting
room.
What, why are we doing that?
Dr. Troy Fox (20:28):
Now do something like a Chiro TV where it rolls
across stuff for you.
I use Chiro TV, so it's not ashameless plug for him.
It's just what I use.
I like TV out there.
Or you can do your own.
I know you guys put togetherlike a memory stick.
I just haven't had time to doit, but you guys had a memory
stick that rolled through, youcan just do a rolling slide show
(20:50):
on your TV as well.
If you don't want to spend the20 or 30 bucks a month Option.
The other option is that youdon't have a TV at all.
If you're not going to put upthere, because honestly having
an off or this channel notavailable, just looks tacky.
It looks like you're lookinglike you're in an office.
It's about to go, that's aboutto get closed permanently.
Dr. Michael Perusich (21:11):
Yeah.
Make, just make sure you updatethings.
And when it comes to yourposters, move them around once
in a while.
It's funny when you move themaround, people think you got new
ones.
Dr. Troy Fox (21:19):
And replace your light bulbs,
Dr. Michael Perusich (21:21):
replace your light
Dr. Troy Fox (21:22):
bulbs.
Yeah, it's a lot of simple stuffwhen it could sell a lot of
these action items of focus, orI get that you're focused when
you're in your adjusting room,if there's a new scuff on the
wall, cause you spend nine hoursa day in there,
Dr. Michael Perusich (21:35):
right?
But you got to look at the wholeplan.
Dr. Troy Fox (21:38):
Have you gone to the waiting room lately?
And a lot of times your staffhadn't either because they're
busy behind the front desk.
So as the doctor, you're theleader.
So unless you've appointedsomebody on your staff, because
a lot of times during staffmeetings, maybe I'll say, Hey,
it's your week to check thewaiting room and we literally
check it every day, we're outthere with a sweeper in the
morning, making sure that ifthere's a spot or two especially
(22:01):
when it's.
It's been icy out and stuff andpeople are dragging rock salt
and junk in your office.
Sure And we live in a farmingcommunity people bring dirt and
stuff into which is not a bigdeal And you know what?
They probably don't even noticeit That's probably one.
They don't really notice a wholelot, but I do
Dr. Michael Perusich (22:18):
Yeah, we had some pig farmers that would
leave their boots outside at thefront door, which is kind and
courteous, but yeah, we had thevacuum out twice a day, just
making sure the place was clean.
And one of my staff was incharge of making sure the
physical plant was put togetherand looked well.
But I always check to, it didn'tmean
Dr. Troy Fox (22:37):
I had a manager at Dylan's grocery store.
When I was a kid, when I was inhigh school, I worked at Dylan's
and I remember that's
Dr. Michael Perusich (22:45):
funny.
I did too.
Dr. Troy Fox (22:46):
Yeah.
I'm working in the store and I'ma high school kid and I've got
one, I've got my tie on, but myshirt's unbuttoned and the tie
is hanging down about an inch.
And I remember him walking inand pointing at me and he goes,
we don't do that at Dylan's.
We do that at Bogart's.
That's number one.
So Bogart's was the othergrocery store in town and they
weren't nearly as cool asDylan's.
You were the cool kid if youworked at Dylan's.
(23:08):
It was a treat.
And that was the creme de lacreme.
The other one was he walked inone day and it'd been raining
outside and you know how peoplewalk mud and everything into the
stores and it gets dirteverywhere.
And we're trying to keep up.
Spot mopping.
We can't get the big machine outand run it.
The one that, that cleans thefloor.
So we're spot mopping as quicklyas we can.
(23:30):
It wasn't perfect.
And this gentleman that was ourmanager and I have great respect
for him.
Wonderful guy.
He walks in the door and helooks at me and I was the lead
guy.
I was a senior in high school atthe time.
And I was in charge of everybodythat was there.
And he goes, have we even spotmop today?
He goes, this looks like effingBogarts.
(23:52):
And so again, that the boat, soagain, we made a reference to
somebody else, but our focusmaybe wasn't quite where it
should have been.
Cause you know what?
We were able to actually getthat store a lot cleaner after
he said something.
Dr. Michael Perusich (24:06):
Yep.
Dr. Troy Fox (24:07):
Maybe we weren't as focused.
We should have been.
So those are two things you canlook at marketing and physical
plant are two big ones, I think.
Dr. Michael Perusich (24:15):
And we're not speaking about Bogart's by
the way.
Dr. Troy Fox (24:17):
No, it was just, it was a competition thing at
the time.
I don't want Bogart's becauseBogart's where I lived at had
the best fried chicken ever, butthere you go.
Dr. Michael Perusich (24:27):
So you made me think of something and
that's your team and that's agreat place to focus on in 2025
is team development.
And so think about your staff,people.
On their jobs, they like to haveopportunities for professional
development.
That's one of the things thatkeeps people that keeps creates
employee retention.
(24:48):
And so this is a great thing tospend time on and think about it
as they grow.
Don't you grow too?
Sure you do.
As they become less focused onjust doing tasks, they become
more focused on being yoursuccess partner.
And isn't that a great thing?
So now they're helping driverevenue, they're watching for
treatment opportunities, andreally helping to build patient
(25:10):
relationships.
Dr. Troy Fox (25:12):
If they see your vision, they become more, more
involved in it.
And quite frankly, even thoughit was a harsh reality for me
that day at working at Dylan's,I saw Bob's vision, the manager
at that point.
And you know what?
From there on out, I didn'tdisappoint the man because I saw
his vision for what that storeshould look like.
We should be the same way.
And I think our staff wants toshare in that vision.
(25:33):
So from a focus standpoint, wecan get a lot of help from our
staff.
You're right.
Staff development is huge.
Dr. Michael Perusich (25:40):
Yes.
And I'm telling you, a welltrained, developed staff will
help grow your practice quickerthan you can ever imagine.
Dr. Troy Fox (25:47):
Yeah, absolutely.
So it's so fun when you have awell oiled machine and some of
you've gotten to work with awell oiled machine and seeing
the opposite side.
Some of you had to weed out thefolks that aren't part of the
well oiled machine becausethey'll, the wheat separates
from the chaff pretty quick.
When you got people that arehighly motivated and then you
got some that aren't they willout themselves pretty quickly
(26:10):
and unfortunately it's painfulfor them.
Because they're not a part ofthat vision.
They're just, they're collectinga paycheck.
And so you may have some staffshake up as you really get
involved, but it's better foryour practice in the long run.
Dr. Michael Perusich (26:24):
Yeah, exactly.
So we need to take another breakhere real quick, but we're
talking about things to focus onin 2025.
And I think we probably have onemore jewel to give you.
So don't go away.
We'll be right back.
Kats Consultants (26:38):
Kats Chiropractic Consultants your
partner in chiropractic success.
We are dedicated with one on oneguidance to bring you all your
practice management needs.
Let's supercharge your practice.
Give us a call today.
Dr. Michael Perusich (27:05):
All right.
Welcome back to the KCChiroPulse podcast.
We're talking about things tofocus on in your practice, in
your chiropractic clinic in2025.
We've talked about a lot ofgreat things.
We've talked aboutreactivations.
We've talked about new patients.
We've talked about several greatthings, staff development, but
what we haven't talked about yetis profitability focused on
(27:28):
profitability in 2025.
And you know when you when wetalk about
Dr. Troy Fox (27:35):
hold on you didn't say new patients I didn't say
profitability instead of newcapability.
All right, explain to me why Icare more about profitability
and less about new patients.
And I know some of you've heardthis and it's a broken record.
I don't care.
You know what you
Dr. Michael Perusich (27:52):
need
Dr. Troy Fox (27:52):
to hear it more often.
Cause I'm tired of going tostate conventions and hearing
you guys ask how many newpatients did you see last month?
I saw 45 and I charged every oneof them a dollar a visit,
including The exam.
Okay.
How profitable am I?
All right.
So
Dr. Michael Perusich (28:08):
hit it.
Yeah.
If you've walked up to me at aconvention before and told me
how many new patients you'reasking you you're seeing, you've
heard my response.
I don't really care.
No.
Cause it's superfluous.
Yeah.
We have to focus onprofitability and here's why new
patients are not profitable.
I don't care what you say, but.
The average chiropractor shouldbe billing out about 400 to 500
(28:32):
an hour.
And there's no way you'recharging 500 for that hour long
new patient exam.
Plus think about the marketing,the staff time, your time to
process a new patient.
They're just not profitable.
And if you're losing them in bythe third or fourth visit, which
the typical dropout point is daythree.
(28:54):
You've actually lost money onthat patient.
So we have to focus on thepatients who want to stay, pay,
refer, and believe in what wedo.
Dr. Troy Fox (29:00):
So here's an easy way to do this.
So just so you can see how muchmoney you're losing in the
short.
So we won't even include staffinto this.
Let's just put marketing costsin there.
Marketing cost total.
Yeah.
Yeah.
Divide that by the number of newpatients that you received.
(29:22):
And then you can parse outexactly what it costs you per
patient.
Now you can do it more than amonth.
I'm not saying it should be justa month, but we know for the
year, really, and trending, isit costing us more or less with
the marketing we're doing,because if we're trending to
where it's costing us more perpatient, I need to look at
marketing and to determine isthere a better avenue or have
(29:42):
trends changed, but I'm going tolook at it from a month and a
year.
And sometimes quarterly as well.
But I want to know what did itcost me.
Okay, now what did that newpatient came in and they paid
29.
99 for that new patient special.
And then they came in and theypaid 45 for an adjustment and
they paid 25 for a therapy andthey came in day one.
(30:06):
They got their exam.
They got maybe a couple x rays.
They came in day two, day three,and they dropped out of care.
And so I'm at about 200 now, andI have to look and see, okay,
what did I pay for marketing?
And then you go ahead and throwon top of there, all right,
there's probably a littlebuilding cost.
There's a little bit of staffcost and all that.
(30:27):
And you're lucky if you brokeeven at that point.
And most of the time, lucky.
And most of the time you didn't.
And I see some of you guysspending thousands on marketing
every month.
It's crazy to keep generating.
You don't have to do thatbecause you still want to get 50
new patients a month into yourpractice.
You are spending so much moneyand spending your wheels and
(30:50):
losing those patients so early.
Wouldn't it be better if you hada better method to, or a better
mousetrap?
In other words, a better methodto get people to understand,
stay, pay, and refer becausethey get chiropractic rather
than the constant turnoverwheel.
And that's where we run into theproblem.
And so our focus doesn't need tobe as much on new patients.
(31:10):
Do we need new patients?
Sure.
Do we need 50 a month?
Dr. Michael Perusich (31:15):
Probably not.
Yeah.
And here's the other side ofprofitability too.
We see this all the time.
Doctors are setting their feestrategy randomly and oftentimes
based on what other doctors intown are doing.
That's wrong.
You have to have a fee strategythat matches your ability to
(31:36):
promote your practice andmatches the level of service
that you give.
And there's one more componentto it.
It has to create profit.
That's a novel idea, creatingprofit.
And far too often we seedoctors, they don't even know
what their profitability rateis.
And we, you've got to know that.
So that's where you got to throwthat business hat on.
(31:58):
This is where a good coach comesin handy to help drive your
profitability in the rightdirection.
Dr. Troy Fox (32:03):
Yeah, don't tell me when I talk to you that you
think the guy down the street ischarging 43 for an adjustment
and so you're afraid you can'traise your fees this year past
40 because you want to staybelow your competition down the
street.
That's not how you set fees.
That's a reason.
You're telling me that you usethermography on every patient
(32:25):
that you use a very extensiveexam on every patient and the
guy down the streets doing a twominute exam and telling people
to lay down on the table.
You're not even comparing applesto apples.
So quit comparing yourself toothers.
Dr. Michael Perusich (32:38):
No, just look at ways to become better,
create a better experience.
But.
You've got to look, you've gotto peel the layers back and
you've got to look at thatprofitability.
I was talking to a doctor theother day and not a client of
ours, but we threw some quickcalculations, figured out he's
losing 30 cents every time apatient walks in the door.
(33:03):
Again, race to the bottom.
Why?
And, part of it was he hadn'traised his fees in years.
And part of it was he didn'tknow that his fees were below
his reimbursement level and, awhole bunch of things.
So you've got to really makesure that you're digging in from
a business standpoint andunderstanding the true
profitability, true profit pointof your practice.
Dr. Troy Fox (33:24):
That's the same guy that's at the state
convention telling me that hesaw 45 new patients probably was
and it's like I'm fortunatebecause I get that you're trying
to show me how successful youare.
You don't have to show me howsuccessful you are, that we're
doing awesome in practice and wedon't need a literal, a tsunami
of new patients.
Think about that.
(33:45):
You need a tsunami of newpatients every month.
just to make yourself feelbetter.
And I've been there.
Trust me, we speak fromexperience because you and I
were to practice were taughtthat really on up front.
It was get as many new patientsin the door as you can.
That's what everybody wasteaching you back then.
(34:06):
Truth of the matter was welearned very early on that was
and you and I both learned atthe same time.
There was a month when you and Ihad An event that we ended up
with more than a hundred newpatients in a month.
That's a lot.
Dr. Michael Perusich (34:23):
It was, it
Dr. Troy Fox (34:24):
was the moment we both had the light bulb click on
and we went, what are we doinghere?
We are, there's people comingout of the woodwork.
We couldn't even see the peoplethat we had as new patients and
service our patientseffectively.
Dr. Michael Perusich (34:40):
I couldn't remember who they were.
Yeah.
Yeah, it was horrible.
Dr. Troy Fox (34:45):
It was horrible.
And that was the, that was wherewe finally realized, what new
patient numbers don't matterbecause you can bring in 100 new
patients and lose 96 of them.
And it's as good as having maybe2 new patients because you lost
so much money on the other 90some, right?
We figured out early on thatthere's a formula and that
(35:06):
formula is not new patientformula.
And so that's why we tell you,you don't need to focus on it.
You need new patients in yourpractice.
Yes, but do you need as many asyou think you do?
Probably not.
So
Dr. Michael Perusich (35:18):
no, there's a capacity point and you
have to
Dr. Troy Fox (35:20):
know what that is.
Our focus should be on betterservice for our patients, not on
new patients.
Dr. Michael Perusich (35:25):
Exactly.
And these are all things that.
Having a good business coachbehind you and guiding you and
giving you that oversight andreally help you monitoring
things is such a greatinvestment in your
profitability, your success,your future, and the value of
your practice.
At some point, most of you outthere probably want to sell your
(35:46):
practice and use that as part ofyour retirement nest egg, right?
But far too often, we seepractices become worthless
because you haven't done allthese things and your focus is
in the wrong direction.
Go to KatsConsultants.
com, check out what we're doingto help clients, help doctors
out there, drive their practicesto be truly profitable.
(36:06):
And guess what?
They're also fun.
So we're unfortunately trainedthat bigger is better and
bigger.
I'm here to tell you is notalways better.
So I'll take profitability overbigger any day.
Dr. Troy Fox (36:21):
And if you think the tidbits you get from this
podcast are phenomenal andyou're like, what more could
they possibly give me from acoaching standpoint?
Very individualized, verypersonalized.
And we get into the weeds andwhat's going on in your
practice.
So that's where the differenceis.
We can give you generalizationslike we're given, and this is
all great information, but whatdo you specifically need?
And that's why getting into theweeds and finding out what's
(36:44):
going on in your practice andanalyzing your numbers allows us
to create huge change in yourpractice.
Because we are very personalizedand specialized from that
standpoint, rather than justgiving you general information,
which is really good, but soyou're listening to this today
going, man, there's some changesI can make in my practice.
Absolutely.
We can take even further.
And it's more,
Dr. Michael Perusich (37:05):
and one would be great when you're that
successful, we can go out andshare a macchiato together.
That's true.
All right, everybody.
Thanks for tuning in this week.
You guys are great.
You are the reason why ourpodcast has grown so much over
the last couple of years, somake sure you subscribe, share,
comment all those great thingsthat so we know you're out
(37:28):
there.
So we appreciate all of you.
And from all of us here at Katsconsultants, we'll see you next
time.
See ya.
Doctors, where's your focus in 2025?
Hi everybody.
Welcome to the KC ChiroPulsePodcast brought to you by Kats
Consultants and Chiro HealthUSA.
I'm Dr.
Michael Perusich.
I'm joined with my cohost, Dr.
Troy Fox.
Troy, focus.
Focus man, how do we focus andwhat do we need to focus on?
And you and I've talked aboutthis.
We hear a lot of doctors saythey're losing focus.
(00:31):
They're burning out all thesedifferent things.
What's happening.
What do we need to focus on?
Dr. Troy Fox (00:36):
I think one of it is the world is changing so
rapidly right now.
And maybe you guys have heard ofthis little thing called AI.
Yeah, and the problem is we gota lot of docs that are concerned
that they're falling behindalready that I need to know More
about AI and instead of becominga better doctor.
We'd try to become coders We tryto become you know How do we
(00:56):
figure out how to use an AIagent to do all of our work
Dr. Michael Perusich (00:59):
and it ain't gonna happen right now?
Dr. Troy Fox (01:01):
I think we're way ahead of when that's Actually a
user friendly operation.
You get people on YouTubetelling you they can teach you
how to do it.
There are a lot of courses outthere like course IV and a
couple of others that saythey're going to teach you AI
don't fall into that trap.
Your focus needs to be on yourpractice.
Yes.
Are we moving more towards anautomated practice model?
(01:24):
In the long run, yeah, you'regoing to end up probably being
able to have less staff in yourpractice with more services,
you're going to also be able toprobably have better notes with
less effort, which we all wantto hear that, but you're not
going to create that on yourown.
It's not going to be that easyto do.
And so instead of spinning yourwheels.
(01:46):
I think what we need to focus onis what do we need to be doing
in 2025?
What should our focus bedirected towards?
Dr. Michael Perusich (01:54):
Yeah.
And when it comes to AI, let thetechnology catch up with us.
Yeah, for sure.
All the software companies, allthe EHR producers are working
on.
Bringing AI in the fold is justnot ready yet, at least at the
chiropractic level.
I know some of the hospitalmedical doctors and things are
using it, the technology they'reusing is very advanced.
(02:14):
It's also very expensive.
Yeah, I don't think that'ssomething to focus on yet.
But yeah, it's out there andit's coming.
Dr. Troy Fox (02:22):
Frankly, the stuff that they're using right now,
even at the hospital and dentallevel, I see him using it in
dentistry as well is prettyrudimentary in comparison to
what we're going to see twoyears from now.
Dr. Michael Perusich (02:33):
Sure, absolutely.
And we see doctors losing focuson other things.
We see doctors.
Trying to focus too much onmarketing.
Now that may sound countercounterintuitive.
What I mean is we see a lot ofdoctors focusing too much energy
on who can I pay to do mymarketing for me?
(02:54):
And they wind up jumping intothese groups that actually maybe
doing more detrimental harm tothe practice with their
marketing than you just actuallydoing it.
And here's the great thing.
Google and a lot of the socialmedia platforms are actually
making marketing easier thatthey're opening up the
algorithms more.
Google is really focused on yourGMP, your Google, my business
(03:17):
page.
So just work those things.
If you spend an hour a week, youcould do a lot of great
marketing and not lose focusback on your practice.
Dr. Troy Fox (03:27):
Yeah.
And look at your Google, mybusiness page and look at the
analytics behind it and look andsee what photo, if you don't
have photo photos up on yourbusiness page, oh my gosh, get
them up.
I just looked at a photo.
We have a photo of an infraredsauna.
We have a pretty cool infraredsauna.
It's a larger walk in one.
So it looks like a spa, right?
(03:48):
We've had almost a thousandviews of that one photO.
I'm like, we need to get morelike just literally yesterday,
Kaylee, who works with me andshe does our marketing.
She's younger.
She's the hip, cool person thatcan put my head on the body of a
giraffe in an ad and make itlook cool.
(04:08):
She does some fun stuff.
It's always fun to have youngpeople because they know how to
do stuff that would take me.
A week to figure out she can doit in 15 minutes.
So I just throw stuff her way,but she was talking to me about
that yesterday.
I'm like, Oh my gosh, we need toget more cool photos and videos
on our Google page, because thatreally is becoming the trend.
(04:29):
It's almost like an onlinebusiness card that is
interactive.
And it's cool.
And then people look at yourGoogle reviews on top of that.
If you've got both your money.
Dr. Michael Perusich (04:39):
Yeah.
And if you don't know what yourGoogle, my business page is,
it's that little box that popsup when you put your clinic name
into Google and hit enter, and Idon't mean your clinic name.
com, just put your clinic nameon it.
So a little box that pops up onthe right and you can.
It's got buttons to click onyour website, your hours, your
directions, et cetera.
(04:59):
And it's where all your Googlereviews are.
You need to be working thatpage.
You need to be, you need todate.
Yeah.
And you need to be postingquestions and answering the
questions.
Yes.
You can do that yourself.
Or you can ask people to post aquestion, but make sure that you
answer it.
You need to change your picturesor add to your pictures every
single month.
(05:19):
That is becoming the number onespot where people are going to
find you.
It's a great marketing tool, butyou have to work it.
Dr. Troy Fox (05:27):
And it's free to change all that stuff.
You can just, you look at yourpage when you got an extra hour
or two.
And with, you have that thoughtin mind already, you can ask the
staff, Hey, what, give me acouple of questions that
patients have asked over thelast month over the phone.
You can also, while you're doingthat and you're creating ads
already for Facebook or Tik TOKor whatever you're doing, right.
(05:50):
When you're doing that.
You can either take photos atthe time.
I don't recommend still photos.
I recommend that we're usingsome action footage, right?
Then once we launched like theaction Jackson kind of thing, we
want you to move in and grooveand in your videos, cause stills
don't do as good.
But.
You can pull a still photo fromyour video and use that, or you
(06:13):
can take a photo, before you dothe video, if you've got that in
mind already, you just have aphoto bank of photos that you
just rotate things in and outand add things.
Dr. Michael Perusich (06:22):
Yeah, exactly.
Exactly.
So that's a place where you needto put your focus.
And another place is I seedoctors who've been in practice
for a while realizing.
That maybe some of their statshave slipped just a little bit.
And so their knee jerk reactionis, Oh my gosh, we need more new
patients.
Dr. Troy Fox (06:42):
And they ads on Facebook every day.
They're going to give me like 45new patients and I don't have to
pay anything.
So maybe I should go for thatdeal.
Right?
Dr. Michael Perusich (06:51):
Sure.
Sure.
Yeah.
It's instead of focusing so muchon new patients and we all need
new patients.
Cause if you've been in practicefor a while you have you, you
have people that lead thepractice, they move away, they
passed away, they don't like youanymore, whatever it might be.
So we need to replace those, butthe focus on new patients,
(07:11):
sometimes it's just a littlebent and so we need to be
focusing on things likereactivations.
You've got all these people inyour database.
Why don't we tap into that?
That's an absolute gold mine.
And there's a couple otherthings that I want to talk
about.
We got to take a break.
I'm getting a look.
We got to take a quick break.
to hear word from our sponsors.
(07:32):
So we're talking about where toput your focus in 2025.
We're talking a little bit aboutjust a multitude of things that
you could and should focus on.
So we'll be right back.
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Dr. Michael Perusich (08:50):
All right, everybody.
Welcome back to the KC ChiroPulse podcast brought to you by
Kats consultants and Chirohealth USA.
Troy, we're talking about whereto put your focus in 2025.
And we were just talking about.
the drive for new patients.
And but if you've been inpractice for a while, what about
looking at your database andsaying, Hey, maybe it's time to
(09:11):
reactivate some of thesepatients.
Dr. Troy Fox (09:13):
Anything in house is going to be better because
you guys know you have to siftthrough the wheat and the chaff.
When you start getting likesomebody says, Hey, we're gonna
get you 30 new patients in thedoor.
Maybe two of those patientsStay, pay, and refer, right?
They're going to be thosepatients that actually get
chiropractic and wantchiropractic.
The other 28 are just respondingto an ad and go, Oh, there's a
(09:35):
1995 special and I get a freecar and an adjustment and, what
kind of freak are in a headshape?
I'll shave their heads too.
If
Dr. Michael Perusich (09:43):
you took advantage of the, yeah,
Dr. Troy Fox (09:45):
yeah, I did take advantage of the promotion.
Liked it so much.
I started offering it topatients, but so when you get
those kind of patients in,that's a lot of work.
And we've talked in otherpodcasts and we will in the
future as well about how much itcosts.
To run and develop a new patientto the point of where they
become profitable We're notgoing to talk about that today
But what I am going to say isit's a lot quicker to get to
(10:06):
profitability And you have a lothigher retention when you are
using in house referrals whetherthat be a proxy And if you don't
know what a proxy is just aquick version is hey, mike I
hear that your daughter, youknow is playing soccer now And
we haven't really seen her inthe office.
Who's she using for achiropractor?
(10:27):
And Mike's, oh, she doesn't havea chiropractor.
We need to get her in here andhave her checked out.
I'll have the front office stafftake care of that when you go up
front.
And, it's really easy to dothat.
The dialogue is different forevery person.
That was just one littleexample.
In house, we can also startraiding our database, like you
said, and look at reacts.
There are people that havedropped out of care and we do we
(10:50):
do some interesting reacts andit's amazing.
Whenever we send out that react,we do it drips.
We don't do like the wholedatabase at once.
We pick sections.
Sure.
When we do it, it's amazing.
Every time we get people thatare like, Oh my gosh, yes, I'd
love to schedule it.
Cause we do it in the form of atext message.
And when they get it, they go,Oh my gosh, yeah, I want a
(11:11):
schedule.
And they come in and they go, Ohmy gosh, it's been how many
months since I saw you?
Yeah.
Dr. Michael Perusich (11:16):
And they're shocked.
Dr. Troy Fox (11:17):
I got busy and forgot.
And
Dr. Michael Perusich (11:19):
and that's what happens to a lot of them.
Dr. Troy Fox (11:21):
And then it's Hey, so what do you want now to care?
I always ask when somebody hasbeen gone for a while, is there
something you didn't like aboutthe care?
Oh no, I loved it.
I just got busy.
Okay.
So are we ready to get back on amaintenance or wellness
schedule?
Absolutely.
And a lot of times there may bea little bit of work to get
there.
Hey, it's been four months.
You're definitely veryrestricted to your lumbar spine.
(11:41):
And that was the initial problemyou came in with.
I'm going to see you one time aweek for a couple of weeks
before we move you back out tothat.
Maybe if they've been gone forjust a few months,
Dr. Michael Perusich (11:49):
right?
So yeah.
So that's a great one to focuson here.
Here's another one.
Why do you think some places areso some businesses are so
popular take Starbucks, forexample, and I know we use
Starbucks is as an example allthe time, but it's a great
example of what I'm about tosay.
(12:10):
They're so popular, not becausethey have the cheapest cup of
coffee.
They have the best coffee houseexperience, and that's why
people go there.
The story, somebody walks intoyour practice with a Starbucks.
You immediately want to ask whatflavor did you get?
And Hey, by the way, did youthink about getting me one?
Because everybody gets excitedabout it.
(12:30):
Yeah, and we want to be able tohave that kind of experience for
our patients.
We want them to get excitedabout coming to see us.
We want them to be looking at uslike we're cheers where
everybody knows your name kindof thing.
And if we can focus on creatingthat great patient experience,
(12:51):
guess what?
We're going to do a couple ofthings.
We're going to build up ourretention because people are
going to stay.
More, they're going to want tocome more often.
That's a good thing.
And what else are they going todo?
They're going to refer peoplein.
Yeah, because it's a cool placeto go.
So I think that's a great placeto focus on in 2025.
Dr. Troy Fox (13:12):
And if you're not doing that, think of these
numbers.
We already, as chiropractors,have a higher satisfaction
rating than medicine when itcomes to spinal problems, like
back problems.
Dr. Michael Perusich (13:22):
And you were talking about a study or an
article or something.
You read the other day.
You were talking about this theother day
Dr. Troy Fox (13:28):
where
Dr. Michael Perusich (13:29):
Our patient satisfaction is just
through the roof compared toother providers.
Dr. Troy Fox (13:33):
So if you have that office that doesn't have
that, that, that patientexperience, that's great.
My concern for you is as you'refalling behind, even the other
chiropractors in your area, youshould at least be on par with
them, meaning that you shouldhave a great customer experience
or a great patient experiencewhen they come through the door.
The beauty that we do have, andI'll give everybody cute kudos
(13:55):
that's listening to this.
We don't have a dissatisfactionrating.
Unfortunately, in medicine,there is a dissatisfaction
rating.
We are dissatisfaction ratingsat zero.
It's either, hey, we're superthrilled with you or we're not
like over the top.
We're just neutral, but we'renot negative about the
chiropractic care that wereceive.
But sometimes with medicine, andI get it because there are some
(14:17):
pretty intrusive treatments inmedicine that people wish they
hadn't have done sometimes.
And so I would say overall, oursatisfaction rating is good, but
if you're not up there, Myconcern is, again, that there's
five chiropractors in your town,and four of them have a great
customer or patient experiencewhen they walk through the door.
(14:39):
And you don't.
It's like going to, it's likegoing to a coffee shop.
And you walk in the door, andit's dirty, and it's dingy, and
it's not very pretty in there,and they don't really have, I
can't get a macchiato, oramericano, or cappuccino, or all
those names.
I don't, most of them, I don'tknow what they mean.
All I can get is a black cup ofcoffee, and they don't even have
(15:01):
real cream.
They just have the shaker thingwith the powder in it.
How many of you would want a cupof coffee from there?
Not many because we've been, wehave been conditioned that when
you go to a coffee house, it'sgoing to be a bohemian, cool,
hipster atmosphere, right?
And you're going to be able toget names of copies, coffees
that you don't even know whatthey are.
Dr. Michael Perusich (15:21):
You don't even know what you're getting.
Dr. Troy Fox (15:23):
And you hear people say, I'm going to half
calf, double tap calf with thetwist, a lemon macchiato half,
what is a
Dr. Michael Perusich (15:31):
macchiato?
Dr. Troy Fox (15:32):
I have no idea.
I really don't.
I do Americano cause I know it'swater and coffee.
And yeah, it's, amen brothers.
That's what I do too.
I understand that one, but wehave been conditioned that we
enjoy that we go in and we thinkit's super cool to go someplace.
Starbucks coined it when theystarted coming out with sizes on
their drinks that I didn'tunderstand.
(15:52):
A tall, it's like a small,right.
And then you get a
Dr. Michael Perusich (15:55):
small, then there's a grande, which is
not a large.
And I think I heard the otherday that they've got another new
size and it's some okay.
Yato style name.
Dr. Troy Fox (16:05):
So we got all this crazy things.
So if you're not up with otherchiropractors from a standpoint
of creating this experience,look around, go sit in your
waiting room.
This is a, this is homework foryou in 2025 to be focused, go
sit in your waiting room andlook 360 degrees.
And if you're able to do it.
While staff is in the building,hear what the sounds are coming
(16:29):
from the front desk.
What does it sound like, smellfeel like?
I've always been a big fan ofwhat it looks like when you walk
through the door.
And if you guys have heard me inpast, for the past 200 podcasts,
I have talked about if I walkinto your office and there's
dust on the plants, I am notexcited about your office.
Number one, what does it looklike?
(16:51):
Number two, what are the soundsthat I'm hearing?
And number three, what do Ismell?
Yeah.
You don't have to cook freshcinnamon rolls every day for it
to smell good in your office.
A diffuser is cool.
Dr. Michael Perusich (17:02):
Cinnamon rolls on a Macchiato.
Dr. Troy Fox (17:04):
Or what was the smell that we had in new Orleans
at the Ritz?
What was that a banana bread,
Dr. Michael Perusich (17:10):
banana bread
Dr. Troy Fox (17:11):
bathroom at this hotel in the, in new Orleans
smelled like banana bread.
Somebody came out and said, yougot to go in and smell the
bathroom.
And I was like, I don't want todo that.
Dr. Michael Perusich (17:24):
No, you really want to do it, but you
have to
Dr. Troy Fox (17:26):
smelled like warm banana bread or out of the oven.
And it was such a.
Wild experience that I like hadto stand in there and think
about that for a minute You cando simple things like a
diffuser.
How about sounds should youhave?
Like crazy wild slash metal,Ozzy
Dr. Michael Perusich (17:46):
osbourne
Dr. Troy Fox (17:46):
Some ozzy osbourne playing in your office or Is it
more relaxing to have a spasound or maybe some jazz music?
Maybe you listen to the localChristian radio station, which
is usually not going to be musicthat is going to have a negative
theme.
Those are the kind of thingsthat we're talking about when we
walk into the office.
So sit in your office, lookaround, are the baseboards all
(18:08):
scraped up?
Are the, I was sat in mydentist's office the other day,
and the first thing that Inoticed was all the arms on the
chairs were all scraped up.
It's time for new furniture.
And they run a busy office, andI get it.
You're going to get wear andtear in your waiting room.
But if you haven't been in yourwaiting room in a while, go out
and look, because you know what,as a patient.
I sat in the chair and I noticedthose things.
(18:29):
I noticed that the floor isdirty.
I noticed everything about it.
It's like walking into a hotelroom.
Do you notice if they didn'tclean the room and the sheets
are laying on the bed andthere's debris on the floor,
you'd notice that.
Dr. Michael Perusich (18:40):
So we used to every day we would go out and
we would test.
Every single chair in thewaiting area.
And when I say test, we wouldmake sure that it wasn't getting
weak, falling apart, loose,needed to be tightened up.
Make sure that the the cloth orthe vinyl, depending on the
chair was in good shape anddidn't need to be repaired.
(19:02):
And if there was a problem, wewould yank that chair out.
And we had a couple of extrasthat we'd put in its place until
that one got fixed back up.
Yeah.
We all, and this drives me nuts.
Okay.
You go into a chiropracticclinic and they've got every
single chiropractic.
poster that you could possiblyfind.
(19:24):
Some are framed, some aren't,some are dog eared and turning
yellow.
Yeah.
Some are thumbtacked to the wallor taped to the wall, even
better.
Some have nice glass frames,some don't, and it's just this
hodgepodge of.
Stuff and it looks like a fleamarket and if that's your
practice, I'm, sorry I don'tmean to offend you but that's
(19:47):
one of those things you need tolook at It doesn't cost that
much to go to a hobby lobby orsomeplace like that And get
those put together black frameswith a piece of glass And make
them look nice
Dr. Troy Fox (19:59):
Yeah,
Dr. Michael Perusich (19:59):
it doesn't cost that much.
Dr. Troy Fox (20:00):
You know what's right next to that?
The tv that's on and it saysthis channel is not available.
Now I've never seen that in achiropractic office, I'll be
honest about that, but I'vewalked into like bar and grill
where you're getting ready towatch a game and they have seven
tvs and one of them's working.
It's it seems a little chintzyokay, so
Dr. Michael Perusich (20:18):
So I go to my dentist's office.
This is another thing drives menuts.
And they have soap operasplaying on the TV in the waiting
room.
What, why are we doing that?
Dr. Troy Fox (20:28):
Now do something like a Chiro TV where it rolls
across stuff for you.
I use Chiro TV, so it's not ashameless plug for him.
It's just what I use.
I like TV out there.
Or you can do your own.
I know you guys put togetherlike a memory stick.
I just haven't had time to doit, but you guys had a memory
stick that rolled through, youcan just do a rolling slide show
(20:50):
on your TV as well.
If you don't want to spend the20 or 30 bucks a month Option.
The other option is that youdon't have a TV at all.
If you're not going to put upthere, because honestly having
an off or this channel notavailable, just looks tacky.
It looks like you're lookinglike you're in an office.
It's about to go, that's aboutto get closed permanently.
Dr. Michael Perusich (21:11):
Yeah.
Make, just make sure you updatethings.
And when it comes to yourposters, move them around once
in a while.
It's funny when you move themaround, people think you got new
ones.
Dr. Troy Fox (21:19):
And replace your light bulbs,
Dr. Michael Perusich (21:21):
replace your light
Dr. Troy Fox (21:22):
bulbs.
Yeah, it's a lot of simple stuffwhen it could sell a lot of
these action items of focus, orI get that you're focused when
you're in your adjusting room,if there's a new scuff on the
wall, cause you spend nine hoursa day in there,
Dr. Michael Perusich (21:35):
right?
But you got to look at the wholeplan.
Dr. Troy Fox (21:38):
Have you gone to the waiting room lately?
And a lot of times your staffhadn't either because they're
busy behind the front desk.
So as the doctor, you're theleader.
So unless you've appointedsomebody on your staff, because
a lot of times during staffmeetings, maybe I'll say, Hey,
it's your week to check thewaiting room and we literally
check it every day, we're outthere with a sweeper in the
morning, making sure that ifthere's a spot or two especially
(22:01):
when it's.
It's been icy out and stuff andpeople are dragging rock salt
and junk in your office.
Sure And we live in a farmingcommunity people bring dirt and
stuff into which is not a bigdeal And you know what?
They probably don't even noticeit That's probably one.
They don't really notice a wholelot, but I do
Dr. Michael Perusich (22:18):
Yeah, we had some pig farmers that would
leave their boots outside at thefront door, which is kind and
courteous, but yeah, we had thevacuum out twice a day, just
making sure the place was clean.
And one of my staff was incharge of making sure the
physical plant was put togetherand looked well.
But I always check to, it didn'tmean
Dr. Troy Fox (22:37):
I had a manager at Dylan's grocery store.
When I was a kid, when I was inhigh school, I worked at Dylan's
and I remember that's
Dr. Michael Perusich (22:45):
funny.
I did too.
Dr. Troy Fox (22:46):
Yeah.
I'm working in the store and I'ma high school kid and I've got
one, I've got my tie on, but myshirt's unbuttoned and the tie
is hanging down about an inch.
And I remember him walking inand pointing at me and he goes,
we don't do that at Dylan's.
We do that at Bogart's.
That's number one.
So Bogart's was the othergrocery store in town and they
weren't nearly as cool asDylan's.
You were the cool kid if youworked at Dylan's.
(23:08):
It was a treat.
And that was the creme de lacreme.
The other one was he walked inone day and it'd been raining
outside and you know how peoplewalk mud and everything into the
stores and it gets dirteverywhere.
And we're trying to keep up.
Spot mopping.
We can't get the big machine outand run it.
The one that, that cleans thefloor.
So we're spot mopping as quicklyas we can.
(23:30):
It wasn't perfect.
And this gentleman that was ourmanager and I have great respect
for him.
Wonderful guy.
He walks in the door and helooks at me and I was the lead
guy.
I was a senior in high school atthe time.
And I was in charge of everybodythat was there.
And he goes, have we even spotmop today?
He goes, this looks like effingBogarts.
(23:52):
And so again, that the boat, soagain, we made a reference to
somebody else, but our focusmaybe wasn't quite where it
should have been.
Cause you know what?
We were able to actually getthat store a lot cleaner after
he said something.
Dr. Michael Perusich (24:06):
Yep.
Dr. Troy Fox (24:07):
Maybe we weren't as focused.
We should have been.
So those are two things you canlook at marketing and physical
plant are two big ones, I think.
Dr. Michael Perusich (24:15):
And we're not speaking about Bogart's by
the way.
Dr. Troy Fox (24:17):
No, it was just, it was a competition thing at
the time.
I don't want Bogart's becauseBogart's where I lived at had
the best fried chicken ever, butthere you go.
Dr. Michael Perusich (24:27):
So you made me think of something and
that's your team and that's agreat place to focus on in 2025
is team development.
And so think about your staff,people.
On their jobs, they like to haveopportunities for professional
development.
That's one of the things thatkeeps people that keeps creates
employee retention.
(24:48):
And so this is a great thing tospend time on and think about it
as they grow.
Don't you grow too?
Sure you do.
As they become less focused onjust doing tasks, they become
more focused on being yoursuccess partner.
And isn't that a great thing?
So now they're helping driverevenue, they're watching for
treatment opportunities, andreally helping to build patient
(25:10):
relationships.
Dr. Troy Fox (25:12):
If they see your vision, they become more, more
involved in it.
And quite frankly, even thoughit was a harsh reality for me
that day at working at Dylan's,I saw Bob's vision, the manager
at that point.
And you know what?
From there on out, I didn'tdisappoint the man because I saw
his vision for what that storeshould look like.
We should be the same way.
And I think our staff wants toshare in that vision.
(25:33):
So from a focus standpoint, wecan get a lot of help from our
staff.
You're right.
Staff development is huge.
Dr. Michael Perusich (25:40):
Yes.
And I'm telling you, a welltrained, developed staff will
help grow your practice quickerthan you can ever imagine.
Dr. Troy Fox (25:47):
Yeah, absolutely.
So it's so fun when you have awell oiled machine and some of
you've gotten to work with awell oiled machine and seeing
the opposite side.
Some of you had to weed out thefolks that aren't part of the
well oiled machine becausethey'll, the wheat separates
from the chaff pretty quick.
When you got people that arehighly motivated and then you
got some that aren't they willout themselves pretty quickly
(26:10):
and unfortunately it's painfulfor them.
Because they're not a part ofthat vision.
They're just, they're collectinga paycheck.
And so you may have some staffshake up as you really get
involved, but it's better foryour practice in the long run.
Dr. Michael Perusich (26:24):
Yeah, exactly.
So we need to take another breakhere real quick, but we're
talking about things to focus onin 2025.
And I think we probably have onemore jewel to give you.
So don't go away.
We'll be right back.
Kats Consultants (26:38):
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partner in chiropractic success.
We are dedicated with one on oneguidance to bring you all your
practice management needs.
Let's supercharge your practice.
Give us a call today.
Dr. Michael Perusich (27:05):
All right.
Welcome back to the KCChiroPulse podcast.
We're talking about things tofocus on in your practice, in
your chiropractic clinic in2025.
We've talked about a lot ofgreat things.
We've talked aboutreactivations.
We've talked about new patients.
We've talked about several greatthings, staff development, but
what we haven't talked about yetis profitability focused on
(27:28):
profitability in 2025.
And you know when you when wetalk about
Dr. Troy Fox (27:35):
hold on you didn't say new patients I didn't say
profitability instead of newcapability.
All right, explain to me why Icare more about profitability
and less about new patients.
And I know some of you've heardthis and it's a broken record.
I don't care.
You know what you
Dr. Michael Perusich (27:52):
need
Dr. Troy Fox (27:52):
to hear it more often.
Cause I'm tired of going tostate conventions and hearing
you guys ask how many newpatients did you see last month?
I saw 45 and I charged every oneof them a dollar a visit,
including The exam.
Okay.
How profitable am I?
All right.
So
Dr. Michael Perusich (28:08):
hit it.
Yeah.
If you've walked up to me at aconvention before and told me
how many new patients you'reasking you you're seeing, you've
heard my response.
I don't really care.
No.
Cause it's superfluous.
Yeah.
We have to focus onprofitability and here's why new
patients are not profitable.
I don't care what you say, but.
The average chiropractor shouldbe billing out about 400 to 500
(28:32):
an hour.
And there's no way you'recharging 500 for that hour long
new patient exam.
Plus think about the marketing,the staff time, your time to
process a new patient.
They're just not profitable.
And if you're losing them in bythe third or fourth visit, which
the typical dropout point is daythree.
(28:54):
You've actually lost money onthat patient.
So we have to focus on thepatients who want to stay, pay,
refer, and believe in what wedo.
Dr. Troy Fox (29:00):
So here's an easy way to do this.
So just so you can see how muchmoney you're losing in the
short.
So we won't even include staffinto this.
Let's just put marketing costsin there.
Marketing cost total.
Yeah.
Yeah.
Divide that by the number of newpatients that you received.
(29:22):
And then you can parse outexactly what it costs you per
patient.
Now you can do it more than amonth.
I'm not saying it should be justa month, but we know for the
year, really, and trending, isit costing us more or less with
the marketing we're doing,because if we're trending to
where it's costing us more perpatient, I need to look at
marketing and to determine isthere a better avenue or have
(29:42):
trends changed, but I'm going tolook at it from a month and a
year.
And sometimes quarterly as well.
But I want to know what did itcost me.
Okay, now what did that newpatient came in and they paid
29.
99 for that new patient special.
And then they came in and theypaid 45 for an adjustment and
they paid 25 for a therapy andthey came in day one.
(30:06):
They got their exam.
They got maybe a couple x rays.
They came in day two, day three,and they dropped out of care.
And so I'm at about 200 now, andI have to look and see, okay,
what did I pay for marketing?
And then you go ahead and throwon top of there, all right,
there's probably a littlebuilding cost.
There's a little bit of staffcost and all that.
(30:27):
And you're lucky if you brokeeven at that point.
And most of the time, lucky.
And most of the time you didn't.
And I see some of you guysspending thousands on marketing
every month.
It's crazy to keep generating.
You don't have to do thatbecause you still want to get 50
new patients a month into yourpractice.
You are spending so much moneyand spending your wheels and
(30:50):
losing those patients so early.
Wouldn't it be better if you hada better method to, or a better
mousetrap?
In other words, a better methodto get people to understand,
stay, pay, and refer becausethey get chiropractic rather
than the constant turnoverwheel.
And that's where we run into theproblem.
And so our focus doesn't need tobe as much on new patients.
(31:10):
Do we need new patients?
Sure.
Do we need 50 a month?
Dr. Michael Perusich (31:15):
Probably not.
Yeah.
And here's the other side ofprofitability too.
We see this all the time.
Doctors are setting their feestrategy randomly and oftentimes
based on what other doctors intown are doing.
That's wrong.
You have to have a fee strategythat matches your ability to
(31:36):
promote your practice andmatches the level of service
that you give.
And there's one more componentto it.
It has to create profit.
That's a novel idea, creatingprofit.
And far too often we seedoctors, they don't even know
what their profitability rateis.
And we, you've got to know that.
So that's where you got to throwthat business hat on.
(31:58):
This is where a good coach comesin handy to help drive your
profitability in the rightdirection.
Dr. Troy Fox (32:03):
Yeah, don't tell me when I talk to you that you
think the guy down the street ischarging 43 for an adjustment
and so you're afraid you can'traise your fees this year past
40 because you want to staybelow your competition down the
street.
That's not how you set fees.
That's a reason.
You're telling me that you usethermography on every patient
(32:25):
that you use a very extensiveexam on every patient and the
guy down the streets doing a twominute exam and telling people
to lay down on the table.
You're not even comparing applesto apples.
So quit comparing yourself toothers.
Dr. Michael Perusich (32:38):
No, just look at ways to become better,
create a better experience.
But.
You've got to look, you've gotto peel the layers back and
you've got to look at thatprofitability.
I was talking to a doctor theother day and not a client of
ours, but we threw some quickcalculations, figured out he's
losing 30 cents every time apatient walks in the door.
(33:03):
Again, race to the bottom.
Why?
And, part of it was he hadn'traised his fees in years.
And part of it was he didn'tknow that his fees were below
his reimbursement level and, awhole bunch of things.
So you've got to really makesure that you're digging in from
a business standpoint andunderstanding the true
profitability, true profit pointof your practice.
Dr. Troy Fox (33:24):
That's the same guy that's at the state
convention telling me that hesaw 45 new patients probably was
and it's like I'm fortunatebecause I get that you're trying
to show me how successful youare.
You don't have to show me howsuccessful you are, that we're
doing awesome in practice and wedon't need a literal, a tsunami
of new patients.
Think about that.
(33:45):
You need a tsunami of newpatients every month.
just to make yourself feelbetter.
And I've been there.
Trust me, we speak fromexperience because you and I
were to practice were taughtthat really on up front.
It was get as many new patientsin the door as you can.
That's what everybody wasteaching you back then.
(34:06):
Truth of the matter was welearned very early on that was
and you and I both learned atthe same time.
There was a month when you and Ihad An event that we ended up
with more than a hundred newpatients in a month.
That's a lot.
Dr. Michael Perusich (34:23):
It was, it
Dr. Troy Fox (34:24):
was the moment we both had the light bulb click on
and we went, what are we doinghere?
We are, there's people comingout of the woodwork.
We couldn't even see the peoplethat we had as new patients and
service our patientseffectively.
Dr. Michael Perusich (34:40):
I couldn't remember who they were.
Yeah.
Yeah, it was horrible.
Dr. Troy Fox (34:45):
It was horrible.
And that was the, that was wherewe finally realized, what new
patient numbers don't matterbecause you can bring in 100 new
patients and lose 96 of them.
And it's as good as having maybe2 new patients because you lost
so much money on the other 90some, right?
We figured out early on thatthere's a formula and that
(35:06):
formula is not new patientformula.
And so that's why we tell you,you don't need to focus on it.
You need new patients in yourpractice.
Yes, but do you need as many asyou think you do?
Probably not.
So
Dr. Michael Perusich (35:18):
no, there's a capacity point and you
have to
Dr. Troy Fox (35:20):
know what that is.
Our focus should be on betterservice for our patients, not on
new patients.
Dr. Michael Perusich (35:25):
Exactly.
And these are all things that.
Having a good business coachbehind you and guiding you and
giving you that oversight andreally help you monitoring
things is such a greatinvestment in your
profitability, your success,your future, and the value of
your practice.
At some point, most of you outthere probably want to sell your
(35:46):
practice and use that as part ofyour retirement nest egg, right?
But far too often, we seepractices become worthless
because you haven't done allthese things and your focus is
in the wrong direction.
Go to KatsConsultants.
com, check out what we're doingto help clients, help doctors
out there, drive their practicesto be truly profitable.
(36:06):
And guess what?
They're also fun.
So we're unfortunately trainedthat bigger is better and
bigger.
I'm here to tell you is notalways better.
So I'll take profitability overbigger any day.
Dr. Troy Fox (36:21):
And if you think the tidbits you get from this
podcast are phenomenal andyou're like, what more could
they possibly give me from acoaching standpoint?
Very individualized, verypersonalized.
And we get into the weeds andwhat's going on in your
practice.
So that's where the differenceis.
We can give you generalizationslike we're given, and this is
all great information, but whatdo you specifically need?
And that's why getting into theweeds and finding out what's
(36:44):
going on in your practice andanalyzing your numbers allows us
to create huge change in yourpractice.
Because we are very personalizedand specialized from that
standpoint, rather than justgiving you general information,
which is really good, but soyou're listening to this today
going, man, there's some changesI can make in my practice.
Absolutely.
We can take even further.
And it's more,
Dr. Michael Perusich (37:05):
and one would be great when you're that
successful, we can go out andshare a macchiato together.
That's true.
All right, everybody.
Thanks for tuning in this week.
You guys are great.
You are the reason why ourpodcast has grown so much over
the last couple of years, somake sure you subscribe, share,
comment all those great thingsthat so we know you're out
(37:28):
there.
So we appreciate all of you.
And from all of us here at Katsconsultants, we'll see you next
time.
See ya.
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