Hey, chiropractors. We're ready for another Modern Chiropractic Marketing Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, content marketing, direct response marketing, and business development, with some of the leading experts in the industry.
Kevin: Hey, docs, welcome to another episode of the Modern Chiropractic Marketing Show. This is your host, Dr. Kevin Christie, and today I've got another interview.
I've been bringing a lot of interviews to you lately and I think we're going to continue that. We'll definitely still do the solo episodes, but just as I get into this, and the podcast is pulling up on three years in April, believe it or not. We're getting a lot of momentum and a lot of great guests. I'm meeting a lot of good people and talking to a lot of good chiropractors, getting a lot of good information from a lot of people.
As that's happening, I'm stumbling upon a great guest and sometimes folks that you don't really expect, and today I'm actually interviewing, not only the wife of a chiropractor, kind of the office manager of the practice. She does coaching. She works with chiropractors. She's really great at systems and she just does so much for the practice—and this is Krista Kippenberger. [01:17.6]
[She] and her husband, Curt, practice together. She's not a chiropractor; he is, and they've just got a very well-run, thriving practice, and they run one of those practices where you can see volume and do it the right way. They’ve got everything from the clinic-gym model going. They do a lot of the SFMA and FMS, just high quality of care with pretty substantial numbers in a very organized and systematized practice, and it's just going very well.
We have a nice interview and we actually talk about two main topics.
- We definitely dive into systems stuff and that's her specialty, and she's the one that's done a lot of the implementing of that into their practice and helping other chiropractors to do some of that also. [02:06.0]
- But then, we also talk about having your situation be that two spouses or significant others are in the same practice, be it one is a chiropractor, one is not, or both are chiropractors. We dive into some of the pros and cons, and nuances of that type of scenario.
So, we’ll have a nice conversation on those two topics. Really, the theme is the systems part of it, but I felt like it was a great time to have that conversation as well, because I get a lot of chiropractors—I know I think I'm coaching three right now that are like that—where it's the husband wife working together in the same practice, whether they're both DCs or one is and one is not. We touch on some of the nuances of that.
Before we dive into that, I want to remind you, we've got a great event coming up. The Motion Palpation Institute is having their Masters Series Sports Summit, and this is going to be everything around the lumbar spine and really diving into that. [03:12.4]
That's March 28 and 29 in Chicago. It's at the National University of Health Sciences there in Lombard, Illinois, and you can sign up for that at www.MPICourses.org. You've got great speakers there. You've got Dr. Mark King, Corey Campbell, and Brett Winchester. We've got David seaman speaking about nutrition. Rich Ulm, Jason Hulme—different last names, Ulm and Hulme—you’ve got both of them.
You’ve just got a great lineup of doctors that are going to be there helping you really just dive into the lumbar spine, and you're going to get everything from palpation, adjusting, some functional assessments and DNS work with Brad. You're going to get some soft tissue. There's also going to be nutrition, obviously, with Dr. Seaman, and then you're also going to get some business and growth, practice growth. [04:02.9]
I went last year. I loved it. I wish I could go this year. Unfortunately, it's too close to the due date. I wish it wasn't close to the due date. I'm not unfortunate that I have a due date. I'm really excited about the baby coming in early mid-April, but I'm kind of giving myself a travel ban after Parker Vegas, so I won't be doing any traveling for a little bit until we have our baby. So, I can't make it this year. I was able to be a part of it and speak there last year and attend. I'll be there next year.
I highly recommend it. Again, that's www.MPICourses.org. You don't want to miss it. You're going to learn a lot of great information, so hope you enjoy that.
Without further ado, here is my interview with Krista.
…
All right, Krista. We've got you on the podcast. I know you and I have talked before and, obviously, I know Curt pretty well. Give us a little bit about yourself, both personally and professionally, and then we'll dive into a couple of exciting topics.
Krista: Sure. So I'm Krista Kippenberger. I am the wife of Dr. Curt Kippenberger, and 10 years ago we opened Focus on Health chiropractic and have done it together ever since, and I still am very involved in the practice. Personally, I am a mother. I am very involved in our community and, yeah, I guess that's it. [05:21.7]
Kevin: That's a lot. It's a lot more than the 30 seconds it takes to say it, right?
Krista: It is. It is a lot.
Kevin: We're going to touch on two main things today and we’ll just go around from that. But one of the things I wanted to jump right out of the gates with was, obviously, you're the wife of a chiropractor and that's a common theme.
I think we could kind of talk about it in two ways. One is the chiropractor. One is not, but really does a lot of the office work and oversees things, and smooth community outreach and all that. And then, it also ties into the same bucket in a lot of ways. You'll get the husband, wife, or spousal partnership that is a both chiropractors. [06:09.0]
Krista: Yes.
Kevin: And so, we can see it both ways. I think we can just touch on your dynamic and [enable] the folks out there that are both chiropractors in the same practice to extrapolate it out.
But let's touch on that a little bit. What are some of the things that you see? Opened up the practice together 10 years ago. Let's start there. What's your role in the practice?
Krista: I was everything at first. We could not afford to hire anyone at first, and so, I was front desk. I was the biller. I was his chiropractic technician. I was the rehab therapist. I was everything that he needed me to be, as far as helping in the office. As we got bigger and we were able to hire on some people, I started giving some of those jobs away. [07:04.5]
First was that rehab position where I didn't love touching people—that made me not a chiropractor—and so, I gave that one away really quickly. Then, obviously, I am not very good at billing either, and so, I started giving that one away. As I just started giving the jobs that I didn't love and Curt said, “The jobs you don't like, you give away.” I was like, I know, exactly. Shouldn't that be your position, to find people who are stronger than you to put in those positions, so that you can really do what you are good at?
And what I'm really good at is I'm a people person who needs to be out in the community as our face and as marketing, and it's funny that when I'm out in the community, people will say, Aren't you the doctor? or they'll come in with their new patient appointment and they'll say, Oh, I was expecting Krista and Curt will say, Uh, well, she's not the doctor and … [08:05.0]
Kevin: That's funny, and yeah, you're probably like you can come and introduce yourself, and do a little bit of the communication and then maybe transfer from there.
Krista: Yes, exactly. He's like, You probably don't want her in here treating you. I’m like, Yeah …
Kevin: She doesn’t like to touch people.
Krista: That’s right, yeah. Don't tell them that part of it, but, yeah, that's totally.
Kevin: So, I’ve gotten to know you two and your practice over the past year, which has been fun, and you guys have a very involved practice, very busy, very well-developed. I think one of the things that you guys have done well has been systems. Can you touch on your role in helping develop the systems in the practice?
Krista: Yeah, I feel like that is one of my strengths. I love to look at things kind of 3,000, 30,000 feet up. What does it look [like]? What’s not working? And let's get it going in a way that we can. [09:00.4]
I love that Curt and I are very different personalities. He is a very detailed person and needs things just right, and I'm a very, what we call High-D, a dreamer. I can see things in the future. And so, that keeps us very much balanced where he can say, You didn't think about this, and I can say, Oh, you need this system for that, and so, we balanced each other very well.
So, he'll say something in a meeting like, Okay, we need this to get insurance on file for patients to check out. Then how do you do that? And that's where I'm like, Okay, so front desk, you have to get a form, or then they can fill out their credit card information. They can have a signature on file and then they can leave. And those are the details that I'm good at. It’s putting something like that into place.
Kevin: That's perfect, and it seems like you guys are functioning and your unique abilities like Strategic Coach would talk about. [10:02.2]
They're actually interesting, too. I'm not sure if you're familiar with them, but that's the coaching group that I've been a part of for six years, and they have a similar situation where Dan Sullivan is, let's call it, the talent, in a sense where the company was built around his knowledge and skill set. So, obviously, the practice exists because Curt is a chiropractor, not to discount your involvement with it, but obviously you’ve got to have a chiropractor to have a chiropractic practice. So, there's that.
And then, Dan Sullivan’s wife really runs the business component, the systems component, and really makes sure that they actually have a sustainable business around it, because like we're finding in a lot of chiropractic practices, unfortunately, just because you are a chiropractor and you have the license doesn't mean you're able to run a business around it.
Krista: That’s right.
Kevin: And that's what it seems like is happening with you. Not to say that Curt wouldn't have a business without you, but he's already mentioned to me many times how valuable you are and actually turning it into a thriving business that allows him to function in his unique abilities as a chiropractor. [11:13.6]
Krista: And that's exactly what I was going to say. They went to school to be a chiropractor, to be a doctor. Let them do what they're good at, again, use their strengths. I feel like as much as he wants to be in the know of what's happening up front, he also doesn't want to be in the know. He just wants to know that things are going well. Patients are getting taken care of and systems are in place. That's what he wants to know.
And I don't think that a chiropractor can do both with being an office manager and being a doctor, because it lends themselves to the employee being kind of confused like, Can I talk to you now about vacation? and Curt is like, Are you kidding me? I'm treating patients. No, I cannot deal with either office drama or office vacations, or something like that. [12:02.6]
Kevin: Definitely. That’s one of the things that I try to get chiropractors to understand. They're not always going to have a situation necessarily where their significant other can run the other side of the practice, but we need to get our business functioning to the point where there is some profit to where they can reinvest in somebody that could fill those types of roles to allow them to function in their skill set, and that's one of the obvious benefits of maybe having a partner that can definitely do that for you.
I want you to spotlight some of the other positives of a scenario where it's two significant others in the same practice, whether one is a chiropractor and one's not, or both are. What are some of the positives in this scenario?
Krista: That you're both kind of working for the same goal and that you can make goals together. I think that that is one of the benefits of our relationship, and how we have fun sometimes is in dreaming about what focus on health could be, vision-casting about what focusing on health can be, and that's one of the benefits. [13:11.6]
I also think another benefit is we never run out of things to talk about.
Kevin: Sure, which could also go into the con category we'll talk about in a minute, right?
Krista: Right. We have never had a problem where we're like, Just stop talking about it. We're very, very passionate. It was our first baby, and so, we'll talk about our first baby before we'll even talk about our kids sometimes, just because that's what interests us.
I think that, also, we grow so much every year of trying to be the best versions of ourselves like, Okay, so that wasn't a very good management decision. How can we go up from there? What leadership can we learn from that? What lessons can we learn? And so, it just continues to keep growing us, which if you're in a marriage for a while, it can get boring, and that is not us. [14:08.2]
Kevin: That’s good. Perfect.
Krista: Constantly, yes.
Kevin: Yeah, the communication is great and having someone. I think another benefit would be that you have ownership mentality, right
Krista: Right.
Kevin: And that's the thing. It’s like you can get an office manager and, hopefully, you get someone that's batteries-included and has an ownership mentality. But the ultimate and ownership mentality is when it's yours, right?
Krista: Yes, and there are so many times I say that when I'm talking to people. I'm like, Okay, let me like put on my owner's hat as well and tell you this.
Kevin: Yeah, for sure, because that's what it is. It's your practice. It's his practice. It's yours together. And being able to have that mentality in a partner is really helpful in growing anything.
Then, let’s go to the flip side of the coin, right? What are some of the potential things that couples need to worry about or just look out for in these types of scenarios? [15:08.2]
Krista: Sure. I think, as we first started the business, when we were kind of waiting for our business to get bigger and busier, we were on top of each other basically at the front desk. He would come up and hang out, and I'd be like, Get out of my hair. Are you kidding me?
And so, we were not a great fit to work together, and I'll tell people that a lot. We could not work together if it was just him and I still. I love that we have other employees that can lend an ear to when one of us needs to vent. Maybe Curt isn't that person I need to vent to. I need to vent to my office manager or someone else outside of the practice, because he and I, at first, did not jive well. I came from a teaching aspect and he came from selling bikes at Walt's Fitness, and so, we just had a very different mentality of how business should go and that was kind of hard at first. [16:09.5]
Kevin: That makes sense. That can definitely be a challenge, I'm sure. Anything else we should look out for?
Krista: I think, again, going back to knowing each other's strengths and the skills that they have, that one another has, I can't do everything in this practice and I don't pretend to. I very much respect that Curt has opinions on things that I don't really know about, and so, I'll be able to step back and say, Okay, you handle this issue because that's you, and he can say the same with me like, You handle that because that's more your skill set.
And so, just knowing each other's background of skills, whether you're taking a disc profile or an enneagram, or whatever one you want to take, knowing that personality, it also helps me bring him problems. [17:03.0]
He is not a person where when he walks right in the door, I should say, Hey, guess what happened today? He needs 20 minutes like, Hey, I need to warm up and then I'll start talking to you first, and I've just had 30 micro conversations today. I don't need you here as well.
So, yeah, knowing that I bring a problem to him and give him time to think about it, and not say, I have to have the answer right now, that's just his personality. He has to gather information before he can give me an answer.
Kevin: That makes sense and I think I can speak to another potential thing that our audience needs to look out for, or it's just a reality of it, whether it's good or bad, but if you've got a significant other that's working for the practice, obviously, that's some payroll that your practice is going to take on versus maybe the other opportunity would be if the spouse was working for another business, making an income. [18:01.5]
So, you may determine that both parties need to have an income. Now you've got to make sure that the practice can actually sustain that, and it's not one of those scenarios where you're just providing your significant other with a job that the company really can't afford, but you're doing it anyway, just for obvious reasons.
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Krista: Right, and we did that first starting out as well. We didn't really know what a bank loan looked like, and should we have paid ourselves so much and know that was not the right answer. We should have paid as little as we could to have kept money in the practice, but that's I think another [issue]. Entrepreneurs taking money out of their practice too soon is also another subject and conversation.
Kevin: For sure, but I guess the benefit, too, is that with the hard work and the two people with the ownership mentality, and really getting on the same page is that you really can expedite the process of success, I would say, or practice success. But I guess that also takes a level of honesty and communication, right? If one person is not holding up their end of the bargain, you’ve got to be able to call them on their B.S., right?
Krista: Yeah, for sure, and that can be difficult. Even with employees, calling them on that. You're now the employee. You are now the boss. And so, calling me out maybe was probably hard for him, to say, Uh, not exactly how I want you to do it. [20:13.1]
Kevin: Yeah, I get it. Perfect. That's great information. I want to segue into the second topic, and before we do, I just want to make sure the audience knows that you do coaching and you can touch on that as much or as little as you'd like as we transition to the next topic. This is something that you have a skill set in. This isn't just us talking in theory. You do this and help out other people, so that's great.
And it's a topic that your practice has done very successfully and I've talked to some other chiropractors that have done it very successfully, but I've also talked to very many chiropractors that have not been able to do this, and it's really that it creates a real roadblock if you can't make this transition, but it’s the topic of having rehab—corrective exercise, exercise, whatever you want to call it—in our practice, but getting to the point where you can delegate it out to somebody else that's going to do it and not the doctor per se. [21:16.2]
Because what I'm finding, and I know you’ve talked a lot of chiropractors where, they're spending too much time doing the exercises, not getting paid enough. I'm not against chiropractors doing the rehab as long as they have an exit strategy out of it and/or they're getting paid very well to do it, because otherwise you're spending a lot of time for not enough money, whereas someone else could do that and do it well, as long as, like you mentioned earlier, we have the systems in place.
Let's dive into that topic, and I'll let you go from here and then we'll just converse on it, okay?
Krista: Sure. I really think—and not just touching back on why would a doctor not want to hire a rehab tech, and I'm talking about if you can afford it—there are some doctors who may not trust that a rehab tech would do it exactly how they would want it. [22:11.8]
I think that we have gotten to a point where we hire people with a background of exercise fizz, personal training, some type of movement-based program that really makes them interested in wanting to learn physical therapy assistant, wanting to learn the different exercises to be able to teach the patient.
So, I think if you have a rehab mind first, we can train that moving forward, as a doctor might think, How could I train someone from the ground up? You don't necessarily have to. Get someone maybe with a little bit of experience who can help in that way.
Kevin: That's what we did, and this is something that not everyone is going to have the opportunity to do, but we have a local university that's around us that has an exercise science, exercise physiology program, and they actually have to do a 400-hour internship. [23:12.4]
And so, [there are] one or two ways you can look at. We're part of the internship program and you could get a part of that where you have about three a year, [which was] what I was doing and I still do that. One of them was really good and I needed a rehab tech, so I hired her. She's still with me to this day. It's been a couple of years that she's been on board and that's been our kind of source for that potential employee.
Krista: That's good. And then, you can even try them out before you hire them, and get their personality and get how good they do with the patients like, Do they take care of people? and all of that.
Kevin: Yeah, and we just put together a good training program for it. For a little bit, yeah, like you said, I use it definitely as kind of a talent acquisition, but also as a long job interview. If the person was not necessarily good enough to hire, but they were good at the internship, we train them well enough where they could do a lot of that as we oversaw it. And then, once I did find that good one, I was able to cherry-pick them and hire them. [24:10.2]
Krista: I also think a rehab tech can see things that maybe the doctor not necessarily has missed, but when you're getting in a different personality with that patient, they may share something with the rehab tech that they forgot to share with the doctor, or the rehab tech would say, I noticed this, that they were favoring this ankle. Did you notice that?
And so, when we do our grand rounds and that comes out like, Oh, we're taking really good care of people and noticing from different perspectives, it's not just one provider doing it all.
Kevin: Absolutely. Perfect. What was the hardest transition when you did go from not having a person to having one? Was it the systems and training or …?
Krista: Again, first off, we hired someone with a background of massage therapy, and so, she had that kind of movement background. But, yeah, it was like, What do we want her to do? Do we just want her to put people on a stim? Do we just [want that only]? [25:14.6]
That was like, No, she can do more than that. How much more can she do? And maybe that might be too much, or is she spending too much time with the patient and this running the doctor behind?
Yeah, so making that role really was difficult, to find out that roadmap for the day. They're the ones who control the schedule. They're the ones who are telling the doctor where to go like, You're in this room next and don't forget that they're having some pain in their chest, and blah, blah, blah.
Kevin: Perfect. You guys do the FMS and SFMA stuff, right?
Krista: Yes.
Kevin: How has it been as far as the training on that? Do you have a pretty well-developed training program for preceptors that you have and potential new rehab techs? [26:09.0]
Krista: Yes, so we have that in-house, that manual where [they're] able to look at and read over. We have all of the exercises that the doctors want them to treat on video, so that they can take them home, and listen to them and look at them, so that they can teach when they come back.
So, yeah, and it's still developing. I don't pretend that it's perfect. It's still always growing and we're always learning from the next tech that we hire like, We need to include that in the system to make it even better for the patients’ satisfaction.
Kevin: Let me ask you another question. Do you think there's a trust issue that some chiropractors have with delegating that out of their practice?
Krista: I definitely think, yes, I do.
Kevin: And then, how did you guys overcome that?
Krista: I think a lot of that was bouncing ideas off of each other. I always call myself like that, that patient who doesn't, I'm your patient. I'm your demographic. And if I don't understand why we're doing something one way, then you need to explain it to me. [27:18.9]
And so, I think that that's how the rehab system and tech came about. It was like, Oh, well, why? And I just kept asking why. Why? Why do we do it that way? Why can't she do this and could she do this? I was actually the first one who suggested we get a rehab tech because I was the front desk and I was sick of making up time for him like, Okay, he's five minutes behind.
Why is he five minutes behind?
It's because he's doing the rehab and that's what he would constantly tell me like, I got stuck in doing all of the rehab, and I’m like, We need to hire that out, and he said yes. And have had an associate before who has had some trust issues with the rehab technician. They would rather do it. [28:04.0]
And so I think especially in the state of Missouri where the doctor doesn't get paid well to do that, it's just more business sense and I guess that's what I bring to the [practice].
Kevin: Yeah, I can say that in the state of Florida with health insurance, if you're in network and you do the exercise, you have to spend at least eight minutes. It's a 15-minute unit, but you'd spend at least eight minutes, and then I think we get reimbursed $17 and change for that unit.
Krista: That’s right.
Kevin: But then, I know a lot of chiropractors that are spending more like 25–30 minutes. You could probably build two units at that point, and so, you could get to the 30-something, but, again, that's still not a great hourly rate for what you're doing.
And then, in Florida we're capped with ASH with three I think, two of the four ASH. The other one is not, but it's capped at 40, so you're getting capped. Anyway, you're not really getting that second unit, so it just becomes quite a problem. [29:02.5]
I do find a lot of chiropractors where what's happening, too, is that they are getting [a lot of training, whereas] the chiropractors in the past were not getting heavily trained in rehab. Now they are. There are so many. I can name now 10 different types, whether it's McKenzie or SFMA, or obviously you've got a lot of the other types of rehab courses out there, and McGill, and there is just so much training involved in it, DNS and a lot of great stuff.
And so, they are getting highly trained in the rehab component with it, so they feel like it's there thing to do, which is fine. I'm not saying you can't, but getting the trust to delegate it out to somebody and put a system around it to do it, they're not making that leap and they end up not having any way of getting out from underneath that. It really just leaves a hard scenario becoming profitable to ever hire someone. It just becomes this vicious cycle. [30:04.3]
Krista: I agree and I think that that is where my coaching helps. I can help give you that time to put that in place. I think a lot of doctors are like, How in the heck am I supposed to train but also work full time? It's just easier for me to do it, and I think that's a lot of our mentality. I'll just do it without having to tell someone else how to do it, but if we can get a system in place that you are comfortable with and then someone can learn that system, then we can give that away. I'm not just saying give it away and let's see what happens. Let's see if they can teach. Let’s have a system in place first that they can then learn it and they can show you, and they can be checked off in a system that that they've mastered it, and then we can go on.
Kevin: Yeah, tell us a little bit about that. What are you doing for other chiropractors and other practices? What's the name of your company? How can they contact you? Let's get all the nice information about that stuff. [31:03.2]
Krista: Sure. We have started Ignite Consulting. I have started Ignite Consulting and it's really helping. It came from a point where I just noticed I was coaching in my own business, so I was coaching my office manager from being from a desk to now being a leader. I feel like that is one place that I can go. Also, I was coaching a lot of our associates, and so how do we learn? How do we learn the systems in our practice?
I was able to walk them through that, and then hold them accountable with numbers whereas they might not know where to find that, and I can say, Hey, you had so many new patients last week and how many visits you’ve had, but let's maybe check the system. Maybe it didn't work out well in one of these ways.
So, yeah, it really has just evolved from what I've done in my own practice over the 10 years that I want to be helpful and inspiring to new docs coming in and not really knowing like, What's the next step? Is it hiring a rehab person or should I hire an office manager? Which would be more beneficial for me? [32:10.8]
Kevin: Perfect. That makes a lot of sense. And so, how could they get ahold of you to touch base on this? Because I think it's something that's fully needed. I know you and I have talked about it. I definitely love what you're doing and it's a unique offering in the marketplace where a lot of chiropractors, especially ones that have a similar type of practice as yours, as mine, how they could really benefit from that. So, how could they reach out to you?
Krista: Sure. I have a Facebook page, Ignite Consulting, and you can book a first free consultation, see if it would be right for you and if we fit together, where I just really take a look at what's going on in your business and be able to say, Okay, here's what I see I can help with and then go from there.
Kevin: Perfect. That sounds great. I want to thank you very much for your time. I really appreciate it, and I know you and I will be diving into this type of stuff even further, and we'll have you on again in the near future. [33:04.6]
Krista: I love it. Thanks, Kevin, for having me.
Kevin: My pleasure.
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