March 16, 2025 • 25 mins
Welcome to the KC CHIROpulse Podcast.
This week’s topic: Are you taking control of what is walking into your Chiropractic Clinic?
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 Fox. 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:
- Why you need to use your doctor skills in practice
- Why building doctor authority can make your practice explode
- How being the doctor can build long-term trusted patient relationships
- Why you are doing patients a favor by recommending the care you believe they need
- Simple tips to use doctor authority to grow your practice
- …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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KC CHIROpulse Podcast. Helping Chiropractors keep their pulse on success. Thanks for listening.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Michael Perusich (00:09):
Doctors.
Are you taking control of what'swalking into your office?
Hi, everybody.
Welcome to the KC ChiroPulsepodcast brought to you by Kats
Consultants and Chiro HealthUSA.
I'm Dr.
Michael Perusich.
And of course I've got my friendand co host here, Dr.
Troy Fox.
Troy, all these things that walkinto our practices.
(00:30):
Are we paying attention?
Are we taking control or are wejust laying over and doing what
the patient thinks we should do?
Dr. Troy Fox (00:39):
Okay.
So I got overrode on the titleof this folks, because I was
going to ask if you're all abunch of wusses and needed our
help but I'm going to tell you alittle story that we're going to
talk this over.
So this happened to me in mypractice just yesterday, before
we recorded this patient walksinto my practice has a rib out
(01:00):
of place, need said rib poppedback in place.
comes in, sits down.
I look through their intake.
They've got three, no less.
Three autoimmune diseaseprocesses going on.
Drink 10 plus drinks a day.
Smokes not heavily, but smokes.
All right.
Not the healthiest ofindividuals.
(01:21):
50 year old female.
Also on birth control.
We'll just throw that one inthere.
That reminds you of takingboards, right?
50 year old female, overweighton birth control.
She was slightly overweightsmoker.
All right.
And she's got three.
Yeah.
And she's got three autoimmunedisease problems.
So she walks in, sits down.
I come in.
How are you doing?
(01:41):
I'm Dr.
Fox.
Nice to meet you.
I've taken a look at yourintake, and the first thing I'd
really like to start with istalk about some of the
autoimmune processes you havegoing on, how long they've been
going, and she sticks her handstraight out in front of her and
puts it in my face and basicallysays, I'm not here for you to
look at my other problems.
I want you to pop my rib back inplace.
(02:04):
And I said, you know what, I puta doctor in front of my name for
a reason.
I'm not a chiropractictechnician.
I'm a doctor of chiropractic andyour comorbidities are numerous.
And we need to talk throughthese because they tie directly
into your condition.
And I pretty much got after itwith her and she said, all
(02:24):
right, I'm listening.
And we went through with thething.
The other thing that I couldhave said is, hey, if you're not
interested in talking about thisjust may be the wrong office for
you because we're very thoroughwhen we work with patients.
And if you don't want to divulgeinformation about this, even
though you've already written iton your intake, we can find
another office for you to go to.
I'll find you a pop and goclinic.
Dr. Michael Perusich (02:46):
So that's called doctor authority and you
got to have that authority withpeople.
And you and I both could come upwith a whole catalog of these
kind of patients that havewalked into our practices.
I remember one, one Patient camein one time.
I hadn't seen her in six monthsand she comes barging in a
little more.
She's a gruff lady, but a littlemore gruff than usual, agitated
(03:09):
and says, I'm having a headache.
I need to get adjusted.
And I said, I haven't seen youin six months.
We're doing an exam.
And she said, I don't want to doan exam.
She wound up leaving.
Out us doing any kind oftreatment and I found out the
next day she had a stroke thatnight.
Yeah.
So I wonder why she was havingthat headache, right?
Yeah.
So if I did just laid her downon the table and, adjusted her
(03:29):
neck to help her with herheadache.
I'm using air quotes.
If you're just listening, WouldI have caused a stroke?
Probably not.
But if she was already havingone and that's why she was
having the headache, who'd havegotten blamed?
So you got all this stuffwalking into your practice.
You got to be paying attention.
You got to use your authority.
And it's two things.
Are you uncovering conditionsthat could be contraindicated to
(03:55):
an adjustment like a stroke.
Are you uncovering things thatpatients really need to have
addressed?
Because your job is to providethem with the best care plan,
not just a care plan.
Dr. Troy Fox (04:09):
Yeah.
In my case, we ended upreferring to a naturopath for
some of the care and talkingabout why chiropractic care
would take longer because yourhealing patterns are very slow
right now with all theautoimmune and the inflammatory
processes.
So that's very good.
I will tell you it never pays tohave the passenger grab the
wheel when you're driving thecar.
(04:29):
That's a good way to put it.
And that's what patients do.
They try to grab the wheel andhere's why.
I'm sorry guys.
As a group, we're not as wellrespected as we should be.
People don't walk into asurgeon's office and tell them
how to do a surgery.
People don't walk into theirgeneral practitioner's office.
They do more than they used to.
Sometimes they get after themnow and they're like, why are
(04:52):
you not telling me?
Why did you not tell me that Ineeded to take CoQ10 if I'm
taking a statin drug?
I've had patients do that totheir medical doctors after I've
told them.
It's a non starter for me.
If you don't want to take CoQ10,I don't want to work with you.
Yeah.
And they're like, what?
And I'm like, yeah, cause I haveno idea.
Some of the aches and pains youhave are basically because your
heart's not squeezing it at therate it should.
(05:14):
So sometimes I do non starteritems and they'll go back, but
they will go sometimes to GP.
That never used to happen.
But people will readily comeinto their chiropractor and let
them know how much BS that examis they're getting ready to do
is, even though they're gettingready to have a stroke or an
aneurysm how our prices are toohigh or whatever.
(05:34):
I haven't heard that in a while,but you hear people, if you get
involved in pricing while you'rein the adjustment room, you're
going to have people dicker overprice in the adjustment room.
I just laugh at them.
I go, I don't know what theprices are.
I don't know.
I don't know.
I don't set it.
I just work here.
They're like, isn't your name onthe outside?
And I go, yeah, I go, you seethose girls up front.
(05:55):
They don't let me be in charge.
I just work here.
So I get the pricing thing outof the way, but we get
questioned a lot.
And we also get the questionthat everybody hates.
What exercises should I do?
My first response, 90 percent ofpeople that asked me that
question will never lift afinger to do one exercise.
It seems a little, it seems alittle counterintuitive at this
(06:17):
point to give you exercises.
I say that and the reason I doit is because I'm going to use
my authority at that point.
And if they say, I'll do themgreat because the program that
we have, I will custom build youa program.
It will send to your email oryour phone and it's going to
track your progress and send itback to me.
That's 25 a week.
(06:37):
And that's the only time I everreally get involved in finances
to let them know, I'm going totrack you and you're going to
pay for it.
Dr. Michael Perusich (06:44):
You got to stay out of that conversation.
We got to take a quick break,but we'll be right back.
We're talking about not lettingpatients take the wheel.
I love that.
We'll be right back.
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We understand the financialpressures families are under,
whether they're insured, onMedicare, or paying out of
(07:16):
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(07:36):
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So why wait?
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Because when you put yourpatients first, everyone wins.
Dr. Michael Perusich (08:01):
All right, everybody.
Welcome back to the KCChiroPulse podcast.
We're talking about takingcontrol of your patients and
their care.
And guiding them for what theyneed, not just necessarily what
they want, because sometimes ifwe just do what they want, we
might be causing more harm.
We might not be giving them theopportunity to respect what we
(08:25):
do in the right way, and again,we can come up with all kinds of
conditions, but.
I remember another patient thatcame in and he was having a
little back pain and he'd beento several other doctors,
medical doctors.
He'd been to the hospital, hebeen to several other
chiropractors and hissymptomatology just seemed
weird.
And he had some comorbiditieslike being overweight.
(08:47):
And he was in his earlyseventies and.
Low back pain, what do you dowhen you got comorbidities and
you've got red flags, you take xrays.
So I took x rays of the guy, hehad this huge abdominal
aneurysm, huge.
So I called the surgeon down thestreet and said, I've got a huge
abdominal aneurysm here.
(09:08):
He said, send him right on over.
I'll take a quick peek, send thefilms with him.
Great.
It was back when we actually didplain film.
It, I'm telling you, it was sobad that.
When I got home that night, thesurgeon lived in my
neighborhood.
He came by, knocked on my door,said, Hey, you got a beer in the
fridge.
We need to talk for a minute.
He had scheduled this guy forsurgery.
(09:29):
First thing the next morning.
It was so bad, but had, I juststarted adjusting the guy and
that aneurysm would have blownwhose fault is that it's my
fault.
Not only from a medical legalstandpoint, but I didn't do the
right thing for the patient.
(09:50):
So we have to use our diagnosticcapabilities.
We have to use our intuition.
We have to be the doctor and wehave to use our authority.
To lead patients to what theyreally need.
And if patients don't want toaccept that, maybe you need to
consider not accepting them intocare.
Dr. Troy Fox (10:08):
That's a tough decision to make.
And I know sometimes when you'renewer in practice, it's really
hard to do.
You don't have extra.
Yeah, you got extra time at thatpoint.
Make sure that you're doing allthe right things.
Make sure that your procedurefor that patient matches what
you know to be the correct thingto do early, and you'll still
follow it 30 years later.
(10:28):
Because here I am 30 years in,and I'm as about as abrupt with
people as I've ever been.
Because I don't put up withthat.
And here's why I don't, I'm not,I am a hundred percent, almost a
thousand percent, here's what Iworry about.
And folks, you should worryabout this too.
And I know you guys got thissituation.
One, I worry about my wife.
(10:51):
I worry about my kids.
I worry about my legacy.
Is it worth one adjustment thatI didn't do the right thing?
No.
I worry about my staff and theirfamilies who depend on me and
trust me to do the right thingand have such faith in my
abilities as a doctor that theyunwaveringly defend me out in
the public.
(11:12):
How about I do something that isunconscionable, something that
you cannot defend.
I roll a patient into sideposture with a monster abdominal
aorta.
When they've got all thesymptoms, they tell me they've
got tearing pain.
I even write it in my notes.
He has tearing pain in theabdominal region.
(11:32):
And then I go in and I do themillion dollar roll.
You guys, some of the older guysknow what the million dollar
roll is.
I do the million dollar roll.
And guess what?
It costs me my career.
It costs me.
My livelihood, it cost myreputation and my legacy done
because I didn't shoot x rays.
Dr. Michael Perusich (11:51):
I'm going to put that whole concept really
in really simple terms.
Who do you think is going torefer the most patients to you?
The patient that you did a greatjob, but maybe never treated,
but pointed out some healthconditions that they really
needed to get under control andyou referred them out or patient
that you weren't thorough with.
You didn't use your doctorauthority and you hurt them.
(12:14):
Who's going to refer you morepatients?
It's not real hard to figure outthat guy that had the abdominal
aneurysm that I mentionedearlier.
He referred me like 20 patients.
I never treated the guy.
I just diagnosed him andreferred him, but he was so
thankful that he referred allkinds of people, all of his
friends.
(12:34):
And he also
Dr. Troy Fox (12:36):
saw you as an RD, right?
He saw you as a real doctorbecause you did real doctor.
S.
H.
I.
T.
Sorry, but it's true.
You really did real there.
We do.
You really did real doctorstuff.
You were a gangster, right?
(12:57):
And you did what you weresupposed to do rather than
pulling the meat thing that Isee a lot of people do.
And you don't assert yourself.
You don't use doctor authority.
And you don't work your way outof the situation.
All you do is make yourself lookthe fool and they tell their
friends, Hey, you can go intothis guy and he'll just pop your
back one time, or she'll popyour back one time and then let
(13:17):
you do whatever you want.
They like it.
Heck yeah.
The press off of that isincredible.
Oh, yeah, this is the doctorthat let us do whatever we want
to do
Dr. Michael Perusich (13:26):
right.
Dr. Troy Fox (13:27):
The long term on that is horrible terrible,
horrible for your practice,longevity and bad for your
patients.
Dr. Michael Perusich (13:34):
I remember another patient he and his
construction crew were workingon a really tall three story
barn.
So if you live in the dairyworld.
You see these big three storybarns all the time.
So they're working on the roofof this three story barn.
He decides to slide off andlands on his back from three
stories up, just flat on hisback.
(13:57):
They call the office.
We're bringing him in.
He needs an adjustment.
Now, common sense, everybody,right?
He just slid off a three storyrough.
So we tell him, no, go to theemergency room.
Guess where they showed up.
They showed up in my parkinglot.
He really wants to see youfirst.
He really wants to see if youcan do anything first.
(14:19):
I walk out to this van.
They opened the back doors ofthe van.
They've got this guy laying onhis back on a piece of plywood.
And I just looked at him and Isaid, okay, you just slid off a
three story roof and you can'tfeel your legs and the pain in
your back is starting tosubside.
Go to the emergency room.
(14:39):
Okay, doc.
I will.
I just didn't want to go unlessyou actually saw me, so I don't
know if he really thought I wasgoing to adjust him and make
everything go away or if he justwanted to make sure he got my
physical opinion, but that's thekind of order you've got to
have.
Yeah.
Dr. Troy Fox (14:54):
Is that too much doctor authority right there
where the guy shows up on apiece of plywood in the back of
a van?
Dr. Michael Perusich (15:01):
It's a true story.
You got to hear Morissette tellit.
It's even funnier.
Dr. Troy Fox (15:04):
Here's the deal.
If you did this up right, nextthing you know, when you make it
into a feature film, you gotBrad Pitt laying in the back of
the van, the plywood, and youget to be George Clooney.
He George has a little more hairthan you.
But he could come out becausehe's played doctors before.
So we'll let him do it.
He comes out to the that isserious authority right there,
but you know what that isserious loyalty to the fact that
(15:25):
you've always given goodinformation That's why and you
develop that over time.
I can tell you folks, I tookover the practice.
I'm in two years ago and didpatients trust me?
Not a bit.
Sure.
When I walked in, I was theoutsider.
I didn't live in this town.
I didn't know what I was talkingabout.
Two years later, I got peoplecoming to me.
(15:45):
Hey, before I go to my medicaldoctor, when you hear that, you
know that you've got authorityat that point.
You know that you're headed inthe right direction and you're
going to win every time withthat attitude
Dr. Michael Perusich (15:57):
every time.
And you guys out there, you hearus talk about this all the time.
You got to build trustedrelationships.
It's not just relationships.
It's not just trust.
It's trusted relationships andyou do it.
By being, what'd you call it?
An RD, a real doctor by usingyour diagnostic skills.
I firmly believe that us aschiropractors, we have some of
(16:21):
the best diagnostic skills whenit comes to the musculoskeletal
system.
We need to use that.
We need to show people that wereally know what we're doing.
And when you do, you build thatdoctor authority people, but
here's the best part of it.
Okay.
I'm going to, this is a practicebuilding tip.
Okay.
Hang on, we've got to take abreak.
(16:42):
We're going to do the practicebuilding to when we come back.
So we're talking about takingcontrol of a patient cases, not
letting patients grab the wheel.
So hang in there.
We'll be right back.
Kats Consultants (16:53):
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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 (17:20):
All right, everybody.
Welcome back to the KCChiroPulse podcast.
I almost forgot where we are.
Welcome back to the KCChiroPulse podcast.
We're talking about buildingyour doctor authority.
And making sure that you'remanaging case as well.
And here's my practice tip.
When you do a thorough history,a thorough evaluation, and you
(17:42):
really put on your diagnosticthinking cap, and you start
thinking real broad and realdeep.
Here's the cool thing about it.
You're going to come up with atreatment plan that is pretty
significant.
You're going to come up with awhole lot of reasons to be able
to treat that patient for quitea while.
(18:03):
I'm not saying you're doing thatbecause you're just trying to
drive revenue.
I'm saying you're doing thatbecause you've uncovered a lot
of health issues that thepatient really needs not only
help with, but they need to beaware of, and you're going to
become their health advisortheir, real health doctor, R.
H.
D.
(18:24):
There you go.
And you're going to become thattrusted partner in their health
journey, their chiropracticjourney.
And they're not only gonnaunderstand what you do, but that
those are the patients who staypaid, believe in what you do.
Those are the ones who referother people in.
Those are the ones who refereverybody they know.
Those are the ones who almost onbended knee will do whatever you
(18:47):
tell them to do because theytrust that you're telling them
the right thing.
And the practice building partof that is not the revenue
generation as much as it is, youdon't have to see, you don't
have to generate new patientsafter that.
They just show up at the door.
It's crazy.
(19:07):
I 20 years just about I didn'teven advertise for new patients.
We built that trusted authorityin our community.
Dr. Troy Fox (19:18):
Yeah.
I'm going on two years the
Dr. Michael Perusich (19:19):
same thing.
Dr. Troy Fox (19:20):
Yeah.
I'm going on two years of notadvertising and I took over a
new practice and I haven'tadvertised.
I, the best way to put yourselfin that position is to figure
out how to be influential enoughto create doctor authority.
Yep, know when to say no andyou'll get referrals from your
existing patients because theytrust you Like they've never
(19:42):
seen any chiropractor act likethis before my patients tell me
you act like no chiropractorthat we've ever met before like
you're like Yeah, like it's yourway or the highway.
You're very staunch about it.
And you also will lay out whyevery time.
Dr. Michael Perusich (19:57):
Yeah.
I'm going to, I'm going to givea, I'm going to give a shout out
real quick to one of our Katsconsultants members.
They have an associate doctorwho's pretty fresh out of
school.
And I want to give a littleshout out to her because she was
telling me the other day when wewere on a phone call.
That she had a new patient comein, she was having cervical
(20:18):
thoracic pain.
She'd had a little fall, she'dbeen a couple other places, and
it just, it was getting worse.
She does a very thorough exam,she does tuning fork over C7,
hurts, she does x rays.
Clay shovelers fracture.
She's six weeks in practice, butshe didn't let her desire to
(20:44):
have a patient to adjust,override her good diagnostic
abilities and taking good careof the patient didn't go into
care.
The patient went to anorthopedist for further
evaluation and maybe care.
But that's the kind of patientthat yeah.
Is going to refer a ton ofpeople back to that brand new
doctor.
So she's already building rightout of the gate.
(21:06):
She's building that doctorauthority.
She's creating that sense in thecommunity that she knows what
she's doing and that she's areal doctor.
Dr. Troy Fox (21:17):
Yeah, that's amazing.
And I'll tell you what, we needmore of that, not less of that.
Yeah.
And I, I'm going to, I'm goingto step on some toes here when
we don't do proper exams and wejust say, lay down on the table
and then call me when you needme.
You're not a real doctor.
Sorry.
You're a chiropractic technicianat that point in the patient's
(21:37):
eyes.
I'm not saying you're not a realdoctor because I know you are.
I know you are.
I went to school with you.
I've met you out on the street.
You're a real doctor with realskills.
You're just not using them.
And unfortunately, sometimesthat gets you, in a bad
situation with the patient inthe legal system.
Sometimes it just gets you in abad situation because you're not
(21:58):
looked at with any respectwhatsoever.
I still remember there was a docin a small town in Kansas and my
cousin used to go to him.
And this guy was, he was amarshmallow.
He didn't do exams.
He just lay you down on thetable.
He was old time chiropractor.
People liked him because hedidn't cost much.
(22:19):
You could just walk in there.
You could even get him, as mycousin said, to forego his lunch
hour to adjust him.
Not because my cousin was busyall morning, but because he
wanted to get adjusted at 1230.
Because it was convenient forhim.
So this guy would bend overbackwards and my cousin would go
see him like twice a year.
And I was like, Oh, howdisgusting is that?
(22:44):
And if he knew that's whatreally happened, would it have
stopped him?
That's my question.
Would it have stopped him fromdoing that?
Dr. Michael Perusich (22:50):
So I think we need to do a podcast.
I got a great topic.
He just made me think of this onthe PRN mindset.
Oh yeah.
Cause you just brought that up,being part of a good doctor is
giving patients recommendations.
And in my mind, when you tell apatient come back, when you need
me, you're telling the patientone of two things, either I just
(23:12):
quit you.
Or you don't have a spine for alittle while, come back when it
returns.
Yeah,
Dr. Troy Fox (23:21):
we should talk about that.
Peering mindset is, you and Iboth, we've had so many
discussions about that.
It's somebody you've heard us.
And if we sound like a brokenrecord guess what?
We're going to continue to soundlike a broken record.
We want you to be, as I saidearlier, what did I say?
Dr. Michael Perusich (23:37):
Be a gangster.
Dr. Troy Fox (23:38):
And that's what we're doing
Dr. Michael Perusich (23:39):
for our clients is we're helping them be
gangster.
Chiropractors truly helpingthem.
We're helping them build theirdoctor authority, their
community engagement, most ofall their profitability in their
practice.
So if you're having trouble withprofitability for whatever
reason, give us a call, go toour website, jump on one of our
(24:02):
calendars.
Let's talk about your practice.
We do that for free.
And I know sometimes it soundslike we, we really get on our
soap box about something orreally hard headed about
something.
We're very passionate aboutchiropractic and we believe
that.
Every chiropractor not only hasthe ability, but also the skill
to be.
(24:22):
Not only a great doctor, but avery profitable doctor as well.
And you deserve that.
Uber successful.
It's
Dr. Troy Fox (24:30):
not just money.
When we say that you'reprofitable, I'm talking about
you're profiting in yourpersonal life, your family, your
practice, your spiritual life,all the above.
We care about all of it.
Not just one class.
Dr. Michael Perusich (24:43):
And you said it earlier, it's really all
about your legacy.
Yeah.
A hundred percent.
All right, everybody.
Thanks for tuning in to the KCChiroPulse podcast.
Be sure to subscribe, share thiswith everybody.
If you have some ideas for apodcast, send them to us, email
it to Troy atkatsconsultants.Com.
Go check out our website, Kats,consultants.
(25:04):
com.
We got all kinds of freedownloads on there.
Most of all, we appreciate youtuning in every single week.
We'll see you next time.
See you later.
Doctors.
Are you taking control of what'swalking into your office?
Hi, everybody.
Welcome to the KC ChiroPulsepodcast brought to you by Kats
Consultants and Chiro HealthUSA.
I'm Dr.
Michael Perusich.
And of course I've got my friendand co host here, Dr.
Troy Fox.
Troy, all these things that walkinto our practices.
(00:30):
Are we paying attention?
Are we taking control or are wejust laying over and doing what
the patient thinks we should do?
Dr. Troy Fox (00:39):
Okay.
So I got overrode on the titleof this folks, because I was
going to ask if you're all abunch of wusses and needed our
help but I'm going to tell you alittle story that we're going to
talk this over.
So this happened to me in mypractice just yesterday, before
we recorded this patient walksinto my practice has a rib out
(01:00):
of place, need said rib poppedback in place.
comes in, sits down.
I look through their intake.
They've got three, no less.
Three autoimmune diseaseprocesses going on.
Drink 10 plus drinks a day.
Smokes not heavily, but smokes.
All right.
Not the healthiest ofindividuals.
(01:21):
50 year old female.
Also on birth control.
We'll just throw that one inthere.
That reminds you of takingboards, right?
50 year old female, overweighton birth control.
She was slightly overweightsmoker.
All right.
And she's got three.
Yeah.
And she's got three autoimmunedisease problems.
So she walks in, sits down.
I come in.
How are you doing?
(01:41):
I'm Dr.
Fox.
Nice to meet you.
I've taken a look at yourintake, and the first thing I'd
really like to start with istalk about some of the
autoimmune processes you havegoing on, how long they've been
going, and she sticks her handstraight out in front of her and
puts it in my face and basicallysays, I'm not here for you to
look at my other problems.
I want you to pop my rib back inplace.
(02:04):
And I said, you know what, I puta doctor in front of my name for
a reason.
I'm not a chiropractictechnician.
I'm a doctor of chiropractic andyour comorbidities are numerous.
And we need to talk throughthese because they tie directly
into your condition.
And I pretty much got after itwith her and she said, all
(02:24):
right, I'm listening.
And we went through with thething.
The other thing that I couldhave said is, hey, if you're not
interested in talking about thisjust may be the wrong office for
you because we're very thoroughwhen we work with patients.
And if you don't want to divulgeinformation about this, even
though you've already written iton your intake, we can find
another office for you to go to.
I'll find you a pop and goclinic.
Dr. Michael Perusich (02:46):
So that's called doctor authority and you
got to have that authority withpeople.
And you and I both could come upwith a whole catalog of these
kind of patients that havewalked into our practices.
I remember one, one Patient camein one time.
I hadn't seen her in six monthsand she comes barging in a
little more.
She's a gruff lady, but a littlemore gruff than usual, agitated
(03:09):
and says, I'm having a headache.
I need to get adjusted.
And I said, I haven't seen youin six months.
We're doing an exam.
And she said, I don't want to doan exam.
She wound up leaving.
Out us doing any kind oftreatment and I found out the
next day she had a stroke thatnight.
Yeah.
So I wonder why she was havingthat headache, right?
Yeah.
So if I did just laid her downon the table and, adjusted her
(03:29):
neck to help her with herheadache.
I'm using air quotes.
If you're just listening, WouldI have caused a stroke?
Probably not.
But if she was already havingone and that's why she was
having the headache, who'd havegotten blamed?
So you got all this stuffwalking into your practice.
You got to be paying attention.
You got to use your authority.
And it's two things.
Are you uncovering conditionsthat could be contraindicated to
(03:55):
an adjustment like a stroke.
Are you uncovering things thatpatients really need to have
addressed?
Because your job is to providethem with the best care plan,
not just a care plan.
Dr. Troy Fox (04:09):
Yeah.
In my case, we ended upreferring to a naturopath for
some of the care and talkingabout why chiropractic care
would take longer because yourhealing patterns are very slow
right now with all theautoimmune and the inflammatory
processes.
So that's very good.
I will tell you it never pays tohave the passenger grab the
wheel when you're driving thecar.
(04:29):
That's a good way to put it.
And that's what patients do.
They try to grab the wheel andhere's why.
I'm sorry guys.
As a group, we're not as wellrespected as we should be.
People don't walk into asurgeon's office and tell them
how to do a surgery.
People don't walk into theirgeneral practitioner's office.
They do more than they used to.
Sometimes they get after themnow and they're like, why are
(04:52):
you not telling me?
Why did you not tell me that Ineeded to take CoQ10 if I'm
taking a statin drug?
I've had patients do that totheir medical doctors after I've
told them.
It's a non starter for me.
If you don't want to take CoQ10,I don't want to work with you.
Yeah.
And they're like, what?
And I'm like, yeah, cause I haveno idea.
Some of the aches and pains youhave are basically because your
heart's not squeezing it at therate it should.
(05:14):
So sometimes I do non starteritems and they'll go back, but
they will go sometimes to GP.
That never used to happen.
But people will readily comeinto their chiropractor and let
them know how much BS that examis they're getting ready to do
is, even though they're gettingready to have a stroke or an
aneurysm how our prices are toohigh or whatever.
(05:34):
I haven't heard that in a while,but you hear people, if you get
involved in pricing while you'rein the adjustment room, you're
going to have people dicker overprice in the adjustment room.
I just laugh at them.
I go, I don't know what theprices are.
I don't know.
I don't know.
I don't set it.
I just work here.
They're like, isn't your name onthe outside?
And I go, yeah, I go, you seethose girls up front.
(05:55):
They don't let me be in charge.
I just work here.
So I get the pricing thing outof the way, but we get
questioned a lot.
And we also get the questionthat everybody hates.
What exercises should I do?
My first response, 90 percent ofpeople that asked me that
question will never lift afinger to do one exercise.
It seems a little, it seems alittle counterintuitive at this
(06:17):
point to give you exercises.
I say that and the reason I doit is because I'm going to use
my authority at that point.
And if they say, I'll do themgreat because the program that
we have, I will custom build youa program.
It will send to your email oryour phone and it's going to
track your progress and send itback to me.
That's 25 a week.
(06:37):
And that's the only time I everreally get involved in finances
to let them know, I'm going totrack you and you're going to
pay for it.
Dr. Michael Perusich (06:44):
You got to stay out of that conversation.
We got to take a quick break,but we'll be right back.
We're talking about not lettingpatients take the wheel.
I love that.
We'll be right back.
ChiroHealth USA (06:54):
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That's where ChiroHealth USAsteps in, the solution for your
practice.
We understand the financialpressures families are under,
whether they're insured, onMedicare, or paying out of
(07:16):
pocket for treatment.
By offering discounts on care,you can ensure that your
patients can still afford thetreatment they need.
And at Chiro Health USA, we'recommitted to making sure no
family has to sacrifice theirhealth due to financial
hardship.
We'll work with you to create agame plan that keeps your
waiting room full and yourpractice thriving.
And here's the best part.
(07:36):
Offering affordable care notonly benefits your patients, but
also positively impacts yourbottom line.
So why wait?
Join Chiro Health USA today andjoin the ranks of the most
successful practices.
Because when you put yourpatients first, everyone wins.
Dr. Michael Perusich (08:01):
All right, everybody.
Welcome back to the KCChiroPulse podcast.
We're talking about takingcontrol of your patients and
their care.
And guiding them for what theyneed, not just necessarily what
they want, because sometimes ifwe just do what they want, we
might be causing more harm.
We might not be giving them theopportunity to respect what we
(08:25):
do in the right way, and again,we can come up with all kinds of
conditions, but.
I remember another patient thatcame in and he was having a
little back pain and he'd beento several other doctors,
medical doctors.
He'd been to the hospital, hebeen to several other
chiropractors and hissymptomatology just seemed
weird.
And he had some comorbiditieslike being overweight.
(08:47):
And he was in his earlyseventies and.
Low back pain, what do you dowhen you got comorbidities and
you've got red flags, you take xrays.
So I took x rays of the guy, hehad this huge abdominal
aneurysm, huge.
So I called the surgeon down thestreet and said, I've got a huge
abdominal aneurysm here.
(09:08):
He said, send him right on over.
I'll take a quick peek, send thefilms with him.
Great.
It was back when we actually didplain film.
It, I'm telling you, it was sobad that.
When I got home that night, thesurgeon lived in my
neighborhood.
He came by, knocked on my door,said, Hey, you got a beer in the
fridge.
We need to talk for a minute.
He had scheduled this guy forsurgery.
(09:29):
First thing the next morning.
It was so bad, but had, I juststarted adjusting the guy and
that aneurysm would have blownwhose fault is that it's my
fault.
Not only from a medical legalstandpoint, but I didn't do the
right thing for the patient.
(09:50):
So we have to use our diagnosticcapabilities.
We have to use our intuition.
We have to be the doctor and wehave to use our authority.
To lead patients to what theyreally need.
And if patients don't want toaccept that, maybe you need to
consider not accepting them intocare.
Dr. Troy Fox (10:08):
That's a tough decision to make.
And I know sometimes when you'renewer in practice, it's really
hard to do.
You don't have extra.
Yeah, you got extra time at thatpoint.
Make sure that you're doing allthe right things.
Make sure that your procedurefor that patient matches what
you know to be the correct thingto do early, and you'll still
follow it 30 years later.
(10:28):
Because here I am 30 years in,and I'm as about as abrupt with
people as I've ever been.
Because I don't put up withthat.
And here's why I don't, I'm not,I am a hundred percent, almost a
thousand percent, here's what Iworry about.
And folks, you should worryabout this too.
And I know you guys got thissituation.
One, I worry about my wife.
(10:51):
I worry about my kids.
I worry about my legacy.
Is it worth one adjustment thatI didn't do the right thing?
No.
I worry about my staff and theirfamilies who depend on me and
trust me to do the right thingand have such faith in my
abilities as a doctor that theyunwaveringly defend me out in
the public.
(11:12):
How about I do something that isunconscionable, something that
you cannot defend.
I roll a patient into sideposture with a monster abdominal
aorta.
When they've got all thesymptoms, they tell me they've
got tearing pain.
I even write it in my notes.
He has tearing pain in theabdominal region.
(11:32):
And then I go in and I do themillion dollar roll.
You guys, some of the older guysknow what the million dollar
roll is.
I do the million dollar roll.
And guess what?
It costs me my career.
It costs me.
My livelihood, it cost myreputation and my legacy done
because I didn't shoot x rays.
Dr. Michael Perusich (11:51):
I'm going to put that whole concept really
in really simple terms.
Who do you think is going torefer the most patients to you?
The patient that you did a greatjob, but maybe never treated,
but pointed out some healthconditions that they really
needed to get under control andyou referred them out or patient
that you weren't thorough with.
You didn't use your doctorauthority and you hurt them.
(12:14):
Who's going to refer you morepatients?
It's not real hard to figure outthat guy that had the abdominal
aneurysm that I mentionedearlier.
He referred me like 20 patients.
I never treated the guy.
I just diagnosed him andreferred him, but he was so
thankful that he referred allkinds of people, all of his
friends.
(12:34):
And he also
Dr. Troy Fox (12:36):
saw you as an RD, right?
He saw you as a real doctorbecause you did real doctor.
S.
H.
I.
T.
Sorry, but it's true.
You really did real there.
We do.
You really did real doctorstuff.
You were a gangster, right?
(12:57):
And you did what you weresupposed to do rather than
pulling the meat thing that Isee a lot of people do.
And you don't assert yourself.
You don't use doctor authority.
And you don't work your way outof the situation.
All you do is make yourself lookthe fool and they tell their
friends, Hey, you can go intothis guy and he'll just pop your
back one time, or she'll popyour back one time and then let
(13:17):
you do whatever you want.
They like it.
Heck yeah.
The press off of that isincredible.
Oh, yeah, this is the doctorthat let us do whatever we want
to do
Dr. Michael Perusich (13:26):
right.
Dr. Troy Fox (13:27):
The long term on that is horrible terrible,
horrible for your practice,longevity and bad for your
patients.
Dr. Michael Perusich (13:34):
I remember another patient he and his
construction crew were workingon a really tall three story
barn.
So if you live in the dairyworld.
You see these big three storybarns all the time.
So they're working on the roofof this three story barn.
He decides to slide off andlands on his back from three
stories up, just flat on hisback.
(13:57):
They call the office.
We're bringing him in.
He needs an adjustment.
Now, common sense, everybody,right?
He just slid off a three storyrough.
So we tell him, no, go to theemergency room.
Guess where they showed up.
They showed up in my parkinglot.
He really wants to see youfirst.
He really wants to see if youcan do anything first.
(14:19):
I walk out to this van.
They opened the back doors ofthe van.
They've got this guy laying onhis back on a piece of plywood.
And I just looked at him and Isaid, okay, you just slid off a
three story roof and you can'tfeel your legs and the pain in
your back is starting tosubside.
Go to the emergency room.
(14:39):
Okay, doc.
I will.
I just didn't want to go unlessyou actually saw me, so I don't
know if he really thought I wasgoing to adjust him and make
everything go away or if he justwanted to make sure he got my
physical opinion, but that's thekind of order you've got to
have.
Yeah.
Dr. Troy Fox (14:54):
Is that too much doctor authority right there
where the guy shows up on apiece of plywood in the back of
a van?
Dr. Michael Perusich (15:01):
It's a true story.
You got to hear Morissette tellit.
It's even funnier.
Dr. Troy Fox (15:04):
Here's the deal.
If you did this up right, nextthing you know, when you make it
into a feature film, you gotBrad Pitt laying in the back of
the van, the plywood, and youget to be George Clooney.
He George has a little more hairthan you.
But he could come out becausehe's played doctors before.
So we'll let him do it.
He comes out to the that isserious authority right there,
but you know what that isserious loyalty to the fact that
(15:25):
you've always given goodinformation That's why and you
develop that over time.
I can tell you folks, I tookover the practice.
I'm in two years ago and didpatients trust me?
Not a bit.
Sure.
When I walked in, I was theoutsider.
I didn't live in this town.
I didn't know what I was talkingabout.
Two years later, I got peoplecoming to me.
(15:45):
Hey, before I go to my medicaldoctor, when you hear that, you
know that you've got authorityat that point.
You know that you're headed inthe right direction and you're
going to win every time withthat attitude
Dr. Michael Perusich (15:57):
every time.
And you guys out there, you hearus talk about this all the time.
You got to build trustedrelationships.
It's not just relationships.
It's not just trust.
It's trusted relationships andyou do it.
By being, what'd you call it?
An RD, a real doctor by usingyour diagnostic skills.
I firmly believe that us aschiropractors, we have some of
(16:21):
the best diagnostic skills whenit comes to the musculoskeletal
system.
We need to use that.
We need to show people that wereally know what we're doing.
And when you do, you build thatdoctor authority people, but
here's the best part of it.
Okay.
I'm going to, this is a practicebuilding tip.
Okay.
Hang on, we've got to take abreak.
(16:42):
We're going to do the practicebuilding to when we come back.
So we're talking about takingcontrol of a patient cases, not
letting patients grab the wheel.
So hang in there.
We'll be right back.
Kats Consultants (16:53):
Kat's 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 (17:20):
All right, everybody.
Welcome back to the KCChiroPulse podcast.
I almost forgot where we are.
Welcome back to the KCChiroPulse podcast.
We're talking about buildingyour doctor authority.
And making sure that you'remanaging case as well.
And here's my practice tip.
When you do a thorough history,a thorough evaluation, and you
(17:42):
really put on your diagnosticthinking cap, and you start
thinking real broad and realdeep.
Here's the cool thing about it.
You're going to come up with atreatment plan that is pretty
significant.
You're going to come up with awhole lot of reasons to be able
to treat that patient for quitea while.
(18:03):
I'm not saying you're doing thatbecause you're just trying to
drive revenue.
I'm saying you're doing thatbecause you've uncovered a lot
of health issues that thepatient really needs not only
help with, but they need to beaware of, and you're going to
become their health advisortheir, real health doctor, R.
H.
D.
(18:24):
There you go.
And you're going to become thattrusted partner in their health
journey, their chiropracticjourney.
And they're not only gonnaunderstand what you do, but that
those are the patients who staypaid, believe in what you do.
Those are the ones who referother people in.
Those are the ones who refereverybody they know.
Those are the ones who almost onbended knee will do whatever you
(18:47):
tell them to do because theytrust that you're telling them
the right thing.
And the practice building partof that is not the revenue
generation as much as it is, youdon't have to see, you don't
have to generate new patientsafter that.
They just show up at the door.
It's crazy.
(19:07):
I 20 years just about I didn'teven advertise for new patients.
We built that trusted authorityin our community.
Dr. Troy Fox (19:18):
Yeah.
I'm going on two years the
Dr. Michael Perusich (19:19):
same thing.
Dr. Troy Fox (19:20):
Yeah.
I'm going on two years of notadvertising and I took over a
new practice and I haven'tadvertised.
I, the best way to put yourselfin that position is to figure
out how to be influential enoughto create doctor authority.
Yep, know when to say no andyou'll get referrals from your
existing patients because theytrust you Like they've never
(19:42):
seen any chiropractor act likethis before my patients tell me
you act like no chiropractorthat we've ever met before like
you're like Yeah, like it's yourway or the highway.
You're very staunch about it.
And you also will lay out whyevery time.
Dr. Michael Perusich (19:57):
Yeah.
I'm going to, I'm going to givea, I'm going to give a shout out
real quick to one of our Katsconsultants members.
They have an associate doctorwho's pretty fresh out of
school.
And I want to give a littleshout out to her because she was
telling me the other day when wewere on a phone call.
That she had a new patient comein, she was having cervical
(20:18):
thoracic pain.
She'd had a little fall, she'dbeen a couple other places, and
it just, it was getting worse.
She does a very thorough exam,she does tuning fork over C7,
hurts, she does x rays.
Clay shovelers fracture.
She's six weeks in practice, butshe didn't let her desire to
(20:44):
have a patient to adjust,override her good diagnostic
abilities and taking good careof the patient didn't go into
care.
The patient went to anorthopedist for further
evaluation and maybe care.
But that's the kind of patientthat yeah.
Is going to refer a ton ofpeople back to that brand new
doctor.
So she's already building rightout of the gate.
(21:06):
She's building that doctorauthority.
She's creating that sense in thecommunity that she knows what
she's doing and that she's areal doctor.
Dr. Troy Fox (21:17):
Yeah, that's amazing.
And I'll tell you what, we needmore of that, not less of that.
Yeah.
And I, I'm going to, I'm goingto step on some toes here when
we don't do proper exams and wejust say, lay down on the table
and then call me when you needme.
You're not a real doctor.
Sorry.
You're a chiropractic technicianat that point in the patient's
(21:37):
eyes.
I'm not saying you're not a realdoctor because I know you are.
I know you are.
I went to school with you.
I've met you out on the street.
You're a real doctor with realskills.
You're just not using them.
And unfortunately, sometimesthat gets you, in a bad
situation with the patient inthe legal system.
Sometimes it just gets you in abad situation because you're not
(21:58):
looked at with any respectwhatsoever.
I still remember there was a docin a small town in Kansas and my
cousin used to go to him.
And this guy was, he was amarshmallow.
He didn't do exams.
He just lay you down on thetable.
He was old time chiropractor.
People liked him because hedidn't cost much.
(22:19):
You could just walk in there.
You could even get him, as mycousin said, to forego his lunch
hour to adjust him.
Not because my cousin was busyall morning, but because he
wanted to get adjusted at 1230.
Because it was convenient forhim.
So this guy would bend overbackwards and my cousin would go
see him like twice a year.
And I was like, Oh, howdisgusting is that?
(22:44):
And if he knew that's whatreally happened, would it have
stopped him?
That's my question.
Would it have stopped him fromdoing that?
Dr. Michael Perusich (22:50):
So I think we need to do a podcast.
I got a great topic.
He just made me think of this onthe PRN mindset.
Oh yeah.
Cause you just brought that up,being part of a good doctor is
giving patients recommendations.
And in my mind, when you tell apatient come back, when you need
me, you're telling the patientone of two things, either I just
(23:12):
quit you.
Or you don't have a spine for alittle while, come back when it
returns.
Yeah,
Dr. Troy Fox (23:21):
we should talk about that.
Peering mindset is, you and Iboth, we've had so many
discussions about that.
It's somebody you've heard us.
And if we sound like a brokenrecord guess what?
We're going to continue to soundlike a broken record.
We want you to be, as I saidearlier, what did I say?
Dr. Michael Perusich (23:37):
Be a gangster.
Dr. Troy Fox (23:38):
And that's what we're doing
Dr. Michael Perusich (23:39):
for our clients is we're helping them be
gangster.
Chiropractors truly helpingthem.
We're helping them build theirdoctor authority, their
community engagement, most ofall their profitability in their
practice.
So if you're having trouble withprofitability for whatever
reason, give us a call, go toour website, jump on one of our
(24:02):
calendars.
Let's talk about your practice.
We do that for free.
And I know sometimes it soundslike we, we really get on our
soap box about something orreally hard headed about
something.
We're very passionate aboutchiropractic and we believe
that.
Every chiropractor not only hasthe ability, but also the skill
to be.
(24:22):
Not only a great doctor, but avery profitable doctor as well.
And you deserve that.
Uber successful.
It's
Dr. Troy Fox (24:30):
not just money.
When we say that you'reprofitable, I'm talking about
you're profiting in yourpersonal life, your family, your
practice, your spiritual life,all the above.
We care about all of it.
Not just one class.
Dr. Michael Perusich (24:43):
And you said it earlier, it's really all
about your legacy.
Yeah.
A hundred percent.
All right, everybody.
Thanks for tuning in to the KCChiroPulse podcast.
Be sure to subscribe, share thiswith everybody.
If you have some ideas for apodcast, send them to us, email
it to Troy atkatsconsultants.Com.
Go check out our website, Kats,consultants.
(25:04):
com.
We got all kinds of freedownloads on there.
Most of all, we appreciate youtuning in every single week.
We'll see you next time.
See you later.
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