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: All right, welcome to another episode of the modern chiropractic marketing show. This is your host, Dr. Kevin Christie and today's episode is actually an interview that Josh Satterlee and I did of each other at the same time we were in Vegas. We were there for Parker Vegas and it really was a great trip. I had an awesome time. I met with a lot of different people, had some dinner with folks that I had never thought I would had, had a lot of good connections, a lot of good meetings. My, my presentation went good. I was speaking Thursday morning at 8:30 AM and I didn't know how that would be because that's the first morning of it and I know some people get in that day, but it went really good. We had a filled room, big room and I thought it just overall went good. It was nice to get it out of the way. [01:06.5]
Last year was a Saturday morning, so I had to kind of wait a couple of days and dwell on it. But this was great. I was able to get it done. And then from there just meet with a lot of good people and it was a great time. But during that trip Josh and I decided to have a interview. We were talking about a topic that's kind of come up quite a bit in the evidence informed crowd and a lot of the docs that are doing physical therapy exercises, personal training, rehab, whatever you want to call it. And obviously Josh does a lot with the clinic gym hybrid and he wanted to dispel a little bit of a myth of, you know, not, not outsourcing it right and doing all the work yourself and doing all the exercises yourself and spending 30 45 60 minutes with a patient and getting reimbursed much less than you should and so we dive into that conversation. I thought it was fun. I thought we touched on a few things and as always, having Josh on the podcast is always a learning experience for me and myself. [02:06.3]
He's got great stories, great analogies, and you'll hear a few of them in this interview. So here is the interview that will be on my podcast and his podcast. So not really, either of us interviewing each other. It’s just a conversation. I hope you enjoy it and I hope you, I hope to see a Parker Vegas next year. I'll be there. I think it's February 18th and 20th, so it's a little bit later than the last couple of years, but I'm gonna make it part of my yearly trip barring any other conflicts. So I hope to see you there next year.
All right, welcome to the show, Josh. And I'm really excited to have you here. We're in Vegas together hanging out and this is kind of a dual episode. It'll be on your podcast. We'll be online, but at the topic is really in your wheelhouse. So I think I might be asking a little bit more of the question. So before we do that, what's new with you?
Josh: Oh man. What's new? Oh, we're out here in Vegas. We're at the Parker seminar. And you know, it's funny like thinking about back to a year ago, being here, a lot of things were just new, like your CSA. [03:05.8]
We just had lunch with our friend John Morrison, who basically kind of launched a chiropractors little more than a year ago, but the Parker seminar was kind of that big thing. Man, since then I've had a spoken a bunch, got a bunch of new members in our program. It sounds like you have some, a lot of new members in your program. Started a business with my wife. I didn't think of anything else, man. It’s just
Kevin: Quite a bit.
Josh: Yeah. Oh, teaching a bunch. So there's just a bunch going on. I can't keep track of it all.
Kevin: You mentioned you're leaving tonight for LA. What course is that?
Josh: Teaching the SFMA and the selective functional movement assessment down in LAX.
Kevin: Perfect. Nice.
Kevin: So what I wanted to chat about today, obviously we're in Vegas, we're having a lot of conversations, but one of the things that we've talked about with the clinic gym, hybrid, and then some of the situations we see in the profession where a lot of chiropractors are having a hard time making a business out of doing what they really want to do. And in this particular chiropractor that we're going to talk about right now, not a person, but just a type of chiropractor wants to do a good amount of rehab or strength or fitness, whatever you want to call it, but they want to have that in their practice. [04:17.5]
But what they tend to fall into is they're spending a lot of time themselves personally doing that and the reimbursement just isn't there. And that's causing a whole slew of problems. Are you seeing that happen quite a bit?
Josh: All the time. I mean, every week I'm on the phone with somebody and I'll hear this story of, and I don't want to start out thinking that this is that these people are bad. I think their intentions are absolutely their great intentions, which is, Hey, I want to integrate. Let me dissect the language. I want to integrate active care. So that could be exercise, rehab, whatever. I want to integrate that. I see its promise. I see what it does for people. I'm really excited. I love to share it with people and so I spent, you know they, they say I spent a lot of time doing it and then in the same conversation they say, I just can't seem to get enough new patients. I can't seem to make enough money. The expenses are really high and that's a very common occurrence in my world. And I think with just a few tweaks, those people aren't too far from success, but I think the perspective certainly needs to be different. [05:19.4]
Kevin: Yeah. I've seen a couple of chiropractors I've talked to, it's probably more than that, but where they're busy, like they're, they're technically almost maxed out, but that number is low. It's like I'm only able to see eight people in a day because they're spending so much time with that person and they're not getting the reimbursement or charging enough to do it. And they're good intentioned. But this, this vicious cycle of, okay, you're busy. So you can't really add a whole lot more people to your schedule. You're not paying yourself as much as you want. You can't afford to hire someone because you're not even paying yourself as much.
Kevin: And they seem like they can't get out of that.
Josh: Right. And then your phones aren't getting, you're not able to get back to the people that have come in. You're not able to develop anything new because you're working sunup to sundown. You're super tired and yet, yeah, I mean, during those hours you're charged up, you care. It's awesome. But I would agree, like you can't seem to get out in front of themselves. [06:13.0]
Kevin: And, and you've mentioned this many times, I think you were one of the first ones to start talking about it, was the idea of maximizing your license.
Kevin: And again, I don't want to, I don't want to devalue how doing rehab or any type of fitness, let's just call it exercise for them for the moment. I don't want to devalue that cause it's obviously we know how important that is for the patient. I know a lot of chiropractors value their skillset in actually delivering that to the patient base. So I'm not here, you know to discount that at all. But when you talk about maximizing the chiropractor's license, what does that look like in this type of condition or set setting?
Josh: Yeah, well I, when I say that, you know, I talk about this story, I've told a bunch on stage, but I'll, I'll tell it here because I think it's important for people to hear it. I call it the Coinstar story. You ever seen a Coinstar machine?
Kevin: Yeah I use it.
Kevin: I do. [07:03.0]
Josh: Yeah. So these machines, green machines in front of like supermarkets, whatnot, you dump all your change in there, counts it and says, Oh Hey, you know, you don't, you dumped in $121 and then typically take like 8% of it, if you want cash, maybe 10% of it. So out of that 120, let's just say they take $12 and and then they give you the receipt, you go up to the check stand, they'd give you the cash, right? So one, 120, what did I say? 121 minus 12 under $9, right? Well, that business wanted to grow and so this was years ago, but the founders of the business, like how can we grow? How can we grow? And somebody said, Hey, I know, let's, let's give gift cards. So you put on $121, you get $121 worth of gift card because gift cards operate with like this 20%.
Josh: Non-Use. Yeah. So they're like willing to give you the full amount. All right? So that goes on. They see some bump in revenue and then you know, the, the company is like, Hey, we want to grow, we want to grow. And everybody was focused on how can we machines, you know, count better, how can we have less maintenance? And they hire consultant, Hey, how can we grow this thing? [08:07.0]
And you know, they had like, they had contracts with like Walmart, CVS, Walgreens, all these places. So it wasn't like, I mean anywhere where there was a lot of foot traffic they had, they had one of their machines, right? It's not like you could not going to put them in public parks for God's sakes, but they hadn't damned her everywhere. So then the consultant comes in and looks at the machines and he's like, show me how you make them. Okay, we show you this. Show me how maintenance happens. You know, what are you going to do? We hire an armored truck and the buckets of coins are really heavy, blah blah.
So you have to hire these strong people, look, kind of showing him all the problems, right? And then all right, show me where they are. So they go to like a Walgreen's. Okay, it's right here. We have this little lease for whatever it is, 16 square feet. You know, we do the power this way and we pay for the maintenance this way. And you know, all this stuff. So it's going on and on, the consultant leaves and he's gone for like three days and the CEO is kind of like worried when there's consultants gone for three days. It means there's no way to improve this business. [08:59.0]
I think it is important because a lot of chiropractors get there, right? They're like, Hey, we tweaked everything we could. We’ve reduced the heating bill, we’ve reduced, you know how many pencils we buy, all that stuff. Do online charting, read all this stuff and it's like you get scared, you get nervous.
So the, going back to the story of the consultant comes back after three days and he's excited and he tells the CEO like, Hey man, assemble some of the board. I've got great news and the consultants, like, what, what do you mean? Like, he's like, you guys don't even know what you got here. And I got great news. We're going to blow this thing up. So he'll get the whole board together and the consultant says, listen, you know, what's the most valuable piece of this, of this business? And and there was like, Oh, it's our machines. You know, the proprietary coin counting technology and we count faster and more accurate than anybody else. Wrong. It's our relationship with the gift card companies. Wrong and he's gone through and finally he stepped back. It was the most valuable thing in this entire business is that you dummies somehow negotiated the greatest 16 square foot lease at the front of every major retailer in the world. [10:02.6]
All you got to do is stop thinking about coins and start thinking about what else can you put into 16 square feet. And so after a while, that same company came up with a much more viable product called Redbox. And you know, I mean, when Redbox was hot, it's kind of faded away now Netflix. But when it was hot man, I mean, you know, as I say, like I saw one outside of McDonald's, you never leave McDonald's on a Friday, you know, you've got happy meals for the kids and you're like, Oh shoot, I should really count my coins real quick. What? You're leaving McDonald's on a Friday night and let me grab a couple of movies for the weekend. You know, and people were just burned through these things. We're making like I don't remember 50 times more than the Coinstar was for the company. [10:45.7]
And I think as chiropractors when you're asked me to maximize our license, we kind of get stuck in the idea of like, Oh only I can provide this great healthcare service to my patients. Only I understand these things, only I can treat them, only I can rehab them, only I can stretch them, Only I can do soft tissue. All these things that we think are only I, and I want to say dude, the most valuable thing of your entire business is not the weight's, it’s not, it's the fact that under your umbrella that DC license you can hire people to do a ton of shit.
Kevin: And you and you have the space to do it. And I know,
Kevin: I know last year you showed it here at Parker where you showed it stage, you know, it was like the size of the stage could be a rehab area and it's not a big stage to where you could do it. So the size.
Josh: I wasn't in the main room with like.
Kevin: You were….you were
Josh: It was a thousand square foot stage. Yeah I was in a side room.
Josh: And it was small. Yeah you're right. It was like 20 by 10 or something
Kevin: And it was cool you demonstrated that and so it kind of what you're saying is that you maximize a license, you add things below it, you obviously hire it, but then you have the space to it to handle it and you can maximize not only your license but also the space. And it's a similar analogy to what you're just talking about. [11:58.2]
Josh: But I mean like if we go back to all the things that get done at your office as far as patient treatment, cause I know you have a very active population and you're going after that weekend, Warrior athlete and those are the perfect markets. So if we, like right now, today you are here and this is a day your practices would normally be open. Am I right?
Kevin: It's open. Yeah. That’s right
Josh: If we look at all the services rendered today,
Josh: And if we just looked at those as like a, you know, just to CPT CPT Codes, what are the ones that absolutely require Kevin Christie to be there? And if you go down the list, I think there's only two. Adjust, so strength coaches, personal trainers, they can adjust. And then the other one is exam, like you can examine, diagnose, they can maybe assess or screen but they can't really diagnose. And that diagnosis, you know, leads to recommendation, which some people might call a sales cycle, you know, but a diagnostic recommendation, it's like you have this disease, here's your prescription, works really good. [12:53.9]
That's the aspect that you need to do to maximize that. But then the follow-up, the, the stretching, muscle work, exercise, rehab, all that stuff, start thinking about who can do that. That doesn't need to get paid as well.
Josh: You know
Kevin: It's true. And it's one of those things I think we inherently, like you mentioned, we think we have to do everything or we're the best at it. But if you do, if you can do a really good job of teaching these exercises to patients who are usually motor morons, right? I would guarantee you could teach it to someone who has a little bit of a background in it like exercise size or a fitness trainer, whoever. So you just take those same skills you have in teaching every different patient the same stuff, and you teach it and train someone to do it for you. And then from there, I want to ask you this, and I don't think it's a delicate conversation, but the psychology behind it, if your patients see you as the fitness and rehab person, like you're doing all of that, do you think they also struggle to bridge that gap to say, that's my doctor also? Or is that a reasonable thing to question. [13:53.9]
Josh: Yeah and all the time, all the time. Because people, I think de-value themselves in a big way. There are people out there that will argue this point all day long. All right. But I'm just gonna tell you some observations outside of chiropractic that I've seen. Number one, a really smart marketer share this. And I've shared this a thousand times with our client's, but you ever been to Costco?
Kevin: Oh yeah.
Josh: Okay. Inside Costco, there's always an optometrist. Do you look at Costco as a healthcare facility…like no. I looked at Costco as a convenient place to shop and has high quality products. That's right. And inside there there's this other service optometry. You started in a gym, right?
Josh: Yeah, so they had a chiropractor, a very skilled chiropractor in there, but when you were renting from the gym for whatever human psychology reasons.
Kevin: It was hard.
Josh: The gym was not perceived to be the, the highest of expertise, right?
Kevin: Yeah. [14:52.8]
Josh: So for some reason when the flip side, the flip happens where the chiropractor owns those things. Now the perception is, okay, this is a different level of service. This is a different level of, of offering and you don't want to end up as the optometrist inside the Costco. You want to be the clinic that makes these diagnoses and recommendations that also can be solved by exercise.
Kevin: Yeah, I agree with that. It's, I had that happen a few times. You know, I've got an ice practice now and all of that and it's set up the way I want it to be. But yeah, I started in a gym and then the other thing that used to happen is I had a corporate location right down the street. We were a mile away.
Kevin: And everything was the same except we happen to be a chiropractor in a corporation, which didn't give us, it didn't position as well in there as like the experts are like, it's kinda like the optometrist or the veterinarian in the dog store that’s..
Josh: Sure. Yeah.
Kevin: And so it was the same type of thing, to where you know, I, we had our practice right on the street where we were in our own building and we did things right away and we were considered, you know, in a lot of ways the extra in a community and people would pay high cash rates. [15:59.3]
Then the same psychology or the difference in psychology inside of the corporation. They didn't even want to pay their insurance deductible or their copay. They just looked at us as like, Oh, some chiropractor off the street cause they put inside here.
Josh: So over, I live kind of off, you know, not every, every perceives that everybody in Vegas lives on the strip. We don't actually have, we kind of live off the strip. So I live about half an hour from the strip and there is a fairly nice casino and everything over over by us and they have a spa. And in that spa you can get a massage. Massage, I think it's like 120 an hour. Literally across the street. I'm saying you could walk there in 30 seconds, literally across the street from that, is a place where you can get an hour long massage for $60. So what's the difference? You know.
Kevin: Perceived value, right?
Josh: That's right.
Kevin: Yup. [16:44.2]
Josh: And so along those lines, and this is probably where we get some hate mail, but all this, so I was just, I just took the family to Disneyland at Christmas. Right. And I think Disney, some people love them, hate them, but man, you cannot fault them for operations. Right. They're stellar operators. And they definitely get the biggest value out of everything they do. Hell no. You know, they'll take a $1 corn dog and sell it to you for eight bucks. Right? Like, but why is that? Because everything is clean because everything is organized because every everybody's wearing the right outfit. They're all wearing name tags, they're all doing everything. And you know, we're waiting in a line and I see a guy who's like an electrician, he's fixing something I see that has a name tag and they're all this kind of oval.
But I notice it doesn't say like, it doesn't look like the name tag or anything. I go, Hey man, those were the name tag and he's, he's dressed fairly nice. And he goes, Oh actually I'm a contractor. I'm, I'm just fixing this a Wi-Fi system. Oh really? I go, they still make you wear a name tag and he's smiling. He's like everybody, everybody wears a name tag. Like that is so ingrained in their thing. Right. And I think that's right because they want everybody to be perceived with value. If you come into their organization, you're perceived with that. [17:51.2]
I'm looking at what he's wearing. He's not wearing anything that identifies his company. He's wearing like a black polo and tan pants, you know, and it's like I have a feeling Disney said, Hey, there's one brand promoted in here and it's the Disney brand. If you're from, you know, Joe's electric electrical. And it happened in here. But when I go back to this perceived value, sorry I'm kind of rambling. One of the things that drives me nuts when people play the role of trainer practor
Kevin: I like that
Josh: Is that they also kind of start… like what would I say?….Like merging towards, they get lazy about how they dress and what they wear and everything and you know, and they're, they're treating patients at their highest, their busiest clinic times in like running shoes and sweats and like a a nice, you know, workout tee shirt. And I know this debate has gone on online, but I'd say like, find me the company that's kicking ass that doesn't make their employees worse..a nice uniform. Show me that there's no company I can think of where they went super casual and still maintain high profits. And if you don't want high profits, cool, wear whatever you want. [18:56.3]
But if there's this trend where every single company, you know, we're in Vegas, every single casino makes their employees wear a certain outfit that they've paid a lot of money and have designed. What they don't do is be like, Hey Kevin, I know you're dealing black checks. I would do it. Feel free to wherever, whatever you want. You know, don't even sweat it. I mean you want to wear a tee shirt and running shoes, go for it.
Kevin: Oh. No it's a big part of it. You know? And I think we're not saying you can't do exercises with patients and things like that, but we're just, you got to understand that it's not even about money in a sense of like having all the cars and having all the nice stuff. It's about making a livable wage and then being able to scale it to where you can't have a front desk person; you can have an associate at some point. You can have some freedom of time. You don't want to be our age in your forties and still having to do that to where you can't hire anybody because you've, you've built this system the wrong way.
Kevin: And only
Josh: If that truck will never go out of first gear. Like you can work as hard as you want man. [19:53.8]
Josh: And you know, it's funny, I remember I had a buddy who played football in college and he went to the NFL for two years and unfortunately kind of never really just couldn't make it. Right.
Kevin: Like 80% of the NFL, they don't realize.
Josh: Yeah, you work with some NFL guys, you
Kevin: Most people don't realize it's not all a Patrick Mahomes, right.
Josh: Yeah. But I remember this story, he told me that I think unfortunately in the world of evidence-based active care chiropractic, sometimes we get caught in this trap. And here's, here's what my buddy told me. I said, what was it like being in the NFL? He goes, Oh man, he's all you ever watch like a highlights on, on college Saturday, college football Saturday. And you watch some kid just break loose. And I mean, he's just leaving. Nobody can catch him. I mean, he's gaining ground every step he takes. I'm like, yeah man, I've seen. Then he goes, imagine 11 guys like that on one side of the field and then on our side of the field we got another 11 and he's like, you know, I went there thinking, man, I was the fastest guy in my college and, and my perspective leaving the NFL is my college didn't produce fast enough guys. [20:52.1]
Josh: You know, he's like,
Josh: I was just never faster and yet I was the fastest in my college. And I think our perception of what success is in a chiropractic world, unfortunately sometimes we need to refocus that lens.
Josh: Or you don't want to be the most profitable practice running out of a tiny gym, 10 by 10 square feet. You need to step back and go, let's, let's adjust this lens. So if we go to here to Parker, right, you got all, all sorts of different practices.
Josh: I would want to say like, Hey, let's take, divide this room into the top 50 earners and the bottom 50 earners and then say in that top 50 earners, what is the amount per hour that really makes a chiropractic practice successful in the fact that you can be here on a Friday, your clinic is open.
Josh: Thursday yeah, you're still, you're still making money. You're still, you know, like the bills are getting paid and you're not even there. So if we look at that, what is it? And I think that if we refocus our lens, and I hate, I think you got to stick around $300 an hour and you got to be able to do that for 30 straight hours a week.
Kevin: Yeah [21:53.0]
Josh: And every doctor that comes in there has got to be able to produce 30 hours at $300. Now, not that specific, doctor doesn't have to do that, but you have to have a system that produces that.
Kevin: Exactly. Like, you're not going to take home $300 an hour as a doctor in a sense of your take home pay. But the clinic needs to be producing that so there's enough meat on the bone to actually start to build a real practice and grow out of it. And that was the one thing that for me I, and this is my recommendation, if you are in a gym or you are doing a lot of it, I was there in 2007 that's how I started. And then I rented a room out of an orthopedic office. I was there but I was doing enough to where there was enough meat on the bone and saving a knowing that I had to get out of there. Cause if I didn't get out of there I was going to be stuck there for a long time. And so I did it and I use it as a springboard. So maybe that's where you're at right now, but just know that you have to get your systems in place to be able to bring in enough money that $300 an hour as a clinic to where you can have a team around you and it doesn't have to be 10 employees, but one to three team members can really help you grow and catapult into the next level of revenue. And then in some more freedom. [22:58.3]
Josh: But I talked to people probably every month and I would say that I hear about like I treat two people an hour.
Josh: Sometimes one, but let's say two people an hour. And I say, okay, what do you charge? And they're like, Oh, somewhere between 45 and $60. And that $120 or $100 mark an hour or whatever maybe there's a couple of places in the country where the cost of living is so low that that'll work, but ain't going to work in most places. And it doesn't allow you to improve your product. Like you, you have sure you talk to these chiros that are great, practicing, they're great at adjusting, they're great at patient communication, they're great at exams, they are great at all that, but they're flat broke and they are no longer great people to be around to their husbands, wives, kids, patients.
And it's heartbreaking right.
Kevin: Yeah, it eats at you and you end up losing the love of what you're doing. And then it just becomes this..
Kevin: Definitely a problem. [23:51.6]
Josh: And, and I had a guy on my podcast one time a Anthony Renna and he's, you know, one of the top trainers in the nation. I mean, like he's been around, he's seen it all. And and one thing he said is that just stuck with me. He's like, you gotta be careful about undercharging your early clients. Cause in personal training, there's this idea like, Oh, well everybody's charging 60, so I'll charge 50. And it's like; people aren't price shopping at that hard dude. Don't worry about it, you know? But, but what he said is, because the problem is when you fill up at that rate, you begin to despise your clients because for 40 bucks an hour, stupid Kevin Christie's making me wake up at 4:30 I'm going to be here by 5:00 to run him through his thing and then he's going off to work. He's not in pain. It's like, you haven't, you built this cage dude. You said 40 bucks to Kevin, you know like, and he's like, yeah, just make sure you're not doing it in a rate where you're going to be angry with that person or increase your rates. [24:46.9]
And he said, the biggest thing is increase your rates till you're uncomfortable saying it. And he's like, you go from 40 bucks and say, Hey Kevin, a future training is going to be $100. He said the greatest thing that can happen is that person says, okay, as now you've got to step up. Now you've got to perform as a hundred dollars trainer would, which is a whole lot different than a $40 trainer would.
Kevin: And I think Chiropractors fall into the money side of it and also the time side of it, it's like they starting out early in a spend too much time with them and they can't get away from that. Right? Like when they get busy, they don't have the time to see them much and person gets upset. So even if you're starting out, figure out how much you want to personally spend with that person and do that. And then cluster book don't just say, Oh, I've got an hour to spend with two patients. I'll just do that because I have the time. [25:32.5]
Josh: And clinically I'll tell you what man, you reduce that time. You've got to get better. I mean, I'm sure you've seen this thing. You and I kind of trained different parts of the country, but around the same time about A.R.T. And did you have those early on? Were you seeing people like 20-30 minutes straight of A.R.T? I mean, my thumbs were killing me
Josh: And I'm thinking, Oh, I'm so awesome. And then you know, when I realized this aint gonna work and we reduced down to a 15 minute visit, it's not your own lesson. You're getting better because you're like, what are the one or two things I need to work on that'll make this person better?
Josh: If I work your head to toe? It's like, I don't know what worked, hell you don't know what worked.
Kevin: And you could say that about exercise too, right? Like you don't necessarily have to go over six exercises with the person. There might be two or three that are actually going to help them get more bang for your buck and then go from there. Right?
Josh: Absolutely. Absolutely. And I like, I, I again, I don't want to discourage people out there. Like, it's great if you come from a, I mean, I just talked to Kat who had like seven years of strength and conditioning background. I think he coached it a like a D2 university, super knowledgeable, super great. And I was excited and he's like, yeah, so I'm going to, I'm going to do some strength and conditioning and I'm going to do some coaching in my office, I was like, no, you're not. [26:41.1]
But you gotta have that perceived value. So one thing that could happen is if you're absolutely like, Hey man, my batteries get charged from working with people in strength conditioning. I want to do it. Yeah, I'm totally down with that, but let's set it up that that is the absolute highest level service offered at your gym. So you can train with Joe Schmoe for, let's just say in our small group session, 40 bucks a session, there's six of you. You can train one on one with our high end trainer here for 150 bucks. If you want to work with Dr Christie and he only does a class twice a week, he has to approve you into it. There's only six spots, but instead of $40 an hour, that one $75 more.
Josh: Make yourself ultra-exclusive. The only thing that happens is you make more money.
Kevin: I like it
Josh: It’s like people are going to say yes and their perception is going to be this is a higher end coaching class, you know.
Kevin: I like it. It's a good idea. It's a, it's a value thing. And then a question I have for you is if someone's finding themselves in this cycle, they can't get out of it. They know they want to, what would be some of the steps for them to actually, okay, I'm not, there's not enough meat on the bone. I'm not charging enough. I'm spending too much time. I can't hire anybody. What would be some of the ideas that they could start to implement to get out of that cycle? [27:53.2]
Josh: So it's tough because there's a lot of combinations that kind of get us there. And I was just with my son doing matched pairs, he's like 10 match pairs, like 56 times one is56, 28 times two is 56.
Josh: You know, 14 times four like you keep going down that. So match pairs. So there's the time and the money, right? I think the easiest way is whatever you're charging now I'd encourage you cut your time in half. So if you're charging 60 bucks for half an hour, cut it to 15 minutes and keep charging 60 bucks, you just doubled your potential revenue. Now, are there going to be bumps along the way? Absolutely. People are going to be like, well, they're, it's going to feel quick to them because they might've gotten into the kind of social hour mentality, which by the way, every older doctor told me about when I was young,
Kevin: I still do
Josh: I don't understand. I don't have enough patients and it's like one of those things. Yeah, they were right. Yeah. Just cut your time in half and and challenge yourself to cut your time and half through more efficient treatments. Don’t; don't just say, Oh, I'm going to spend 15 minutes. Be like, no, I'm going to get the same results in just less time. It means you got to be fricking accurate with your diagnosis, accurate with your treatment and quit messing around with shit that just doesn't serve you. [28:59.4]
Kevin: Yeah. I had a chiropractor want to do decrease the time, but then lower his cost a little bit. Not, he still would've made more money, but I was like, you know what, just keep it,
Kevin: Keep the price lower. I mean you could, it's a, it's an idea. But I was like...
Josh: That one thing you just reminded me. I did recommend that to somebody because they were struggling with insurance reimbursements. And I said like if you're charging, say this is a 60 bucks an hour for two people, so half hour sessions, you're going to get 120 an hour the most you'll ever make.
I said maybe reduce it to 45 and then go 15 minutes or 50 minute sessions. So now we're going 180. Right? So we just bumped up by 50% in the hour. But the reason we did that is because that $45 cash right now looks a lot like my copay. So if my insurance doesn't work, like there's parenting there
Kevin: No one loses much. [29:50.5]
Kevin: Everybody's situation's a little bit different for sure.
Josh: But but yeah, I think like 15 minutes, if you get it down to 10 minutes, you know, like and then doesn't mean like you, you can always invest, have a, a long front end visit.
Josh: And you know, like guys like say Troy Van Biezen, I mean the guys working with some incredible athletes. I think his intakes like two hours long.
Josh: But I guarantee you he isn’t spending that much, he's not spending an hour with everybody. He doesn't have the time. He's so popular.
Kevin: Well, so that's part of it. Like I know he's not doing a whole lot in private practice now. He's traveling all over the PGA tour with these guys. And I think what ends up happening is that's very sexy. And we see that and we see the Gray Cooks and the Greg Roses and the Troy Van Biezens, and it's sexy. We would love to have that situation. But they, they apply that type of time and model to a low reimbursement. I don't know what Troy Van Biezen makes, but I know it's not a little.
Josh: And I don't think Rickie Fowler's arguing about his copay. [30:47.6]
Kevin: Exactly. Rickie Fowler's not arguing about his copay and Jordan Spieth and all that. And obviously Greg Rose and Gray Cook, we all know that. So they're, they're getting compensated. So if you find yourself in a way where you can position yourself as the expert and you can command 150 $200 a session, which some are doing. I know there's a couple of people that I know that are.
Kevin: That are rehab heavy, but they're commanding a lot of money for it, then that's fine.
Josh: There's a dude in a Florida, I don't want to mention his name, but I think he's like, Hey man, you can come in, you can book as many hours you want, but every hour is 450 or something like that.
Josh: And he's booked up. And so actually this is a great thing from your perspective. So you said you have to have that expertise and I would agree.
Josh: It's hard for those young doctors to have that confidence to go like, Hey, I'm, I'm to look you in the eye and say I'm going to charge you 250 an hour, or whatever it is. But what are maybe your top two ways people can establish their expertise?
Kevin: Well, I talked about it today. And in my talk, I think when you get really confident in your communication skills; I think that's a big part of it. You know, it's like being bold and knowledgeable and really communicating well. [31:51.2]
And so if you're struggling to do that work on it, communication is a learned skill. There are going to be some charismatic people that are born that way and great speakers and all that, but you can get better at communicating. So I think that's a big one. And go ahead.
Josh: No, I was going to say the NFL rookie campus full of talented guys that didn't want to work at it. Right.
Josh: And then you get the Jerry Rices who were just, okay, Emmett Smith just, okay. Never known as the fastest guy out there, but God dang it. Did they work on their craft?
Kevin: Exactly. Or it's even like today we heard David Goggins speak as far as, you know, he's the Navy seal and everything like that. And there was a guy who admitted he's not intellectually the smartest, he was 297 pounds at one point. But his mind is wired in a different way to where he drove past that. And he became who he is now. And so with communication you can get better at it and it's not as daunting as you think. So that's one I would say two is, is really good content marketing and getting out there and educating the community and being consistent with it and showing your expertise. [32:53.8]
And especially if you do it on video and those types of things, people have this perceived value like we talked about earlier. It's like if you're on video and you're communicating well and you're showing stuff, they're going to put you in a higher regard and they're going to, you're going to be able to really drive your position into a better standpoint. And then you just have to, you have to bring the goods too, like; you can't charge $250 an hour if you saw clinically. So that's table stakes. Like you gotta be good clinically. And if you layer on those other two things, I think you're doing well.
Josh: Yeah. And you know, going along that the video stuff, I know a lot of people are out, they're intimidated, they're scared as hell. And I just read this great little write up about this guy who's, so he's a college professor, is teaching a photography class and so he divided the room in half and he said half the room is going to be graded on the quantity of your pictures that you take. And an A is a hundred pictures, B is a 90 C is 80 D is 70 and below. [33:51.6]
And then the other half of the room you're going to be graded on one picture. Just one. Right? And so you just, when the class ends is bring in your a hundred or bring in your one. And so he said the thing that was interesting to him as an instructor, he's like, we sat through the same lessons, the same class, everything. So the people that shot one picture were horrible. They thought they were good. He said, but you could see in the people that did a hundred, they did a bunch of repetitions. They took some risks, was lighting, with set with a, you know, a contrast. They shot in low light, highlight all this stuff. They were playing around, they were having the reps, right. And he said their, their 10 best pictures would beat any of the people that took one picture. And I think when you're talking about video content marketing, like so many people are like, well, I don't know what to say. I don't know this. Who cares? Dude, just do a crappy version and just, it's okay. And just say, that's the worst video I'm ever going to shoot my life. You know what? The next one's going to be better, but there's no way you can get to a point where you're pumping out just amazing content. [34:52.1]
If you're not taking the reps, you know, it's just, there's nothing. I mean, you played baseball, there's nothing you do one time that you're great at. You're first up at bat sucks, it's horrible, but your hundredth is pretty good.
Kevin: And I think that applies to everything you're talking about. And it's just about driving forward with that and having the repetition and getting better at it. I know I tried to continue to improve on it. I learn every time I do it. And so.
Josh: And then you, you, you start with your iPhone and then you're like, Hey man, I've done a, you know, look at our friend Jeff Langmaid.
Josh: I mean how many cameras is that guy gone through? Probably 20 but you know what? He's on every single camera. It probably shot a hundred great videos.
Kevin: He's a good example of someone who does it consistently.
Josh: Yeah and keeps upgrading his, what he knows the style and when he shoots and then lighting and the camera lands and all that stuff and you go, Oh wow. Is that how it needs to start? Hell no. Jeff started with some crappy setup, you know, and he's incredible. And I mean, now he hires a guy to edit and I'm sure early on it was like he was editing on his laptop and an, you know, upstairs in his, in his house like we all do and that, that's okay. [35:57.5]
Kevin: Yeah. So you just got to plug forward with it. And then I start laying a game plan for getting out of this cycle and starting to position yourself as the expert, maximize your license, delegate out the exercises. There's a lot of good people out there that can do it. If you can teach it to patients, I know you can teach it to someone to do it in your office and you'll still provide the same quality of care. Like I'm confident and what our patients get. They may only get 10 minutes of me, but they're getting a 30 to 40 minute visit and they're getting good rehab, they're getting good soft tissue and they're getting good manipulation so it can be done. Any last words on on that? I think, I think we really covered it pretty well.
You know, one thing that I'm kind of pursuing and just share this thought with you then.
Josh: I went to a seminar recently and not a seminar, workshop. They kept saying, and it was people trying to optimize your office operations, right? [36:49.0]
Josh: So there's a lot of like you're a fan of Zapier or Zapier, so it was a bunch of people using Zapier and this and that and, but the room is mostly attorneys for whatever reason, is mostly attorneys. Only half of them had an office that most of them worked remotely or rented little space. Right. And then probably 75% of them had a phone answering service that answered the phone instead of them having hiring a staff member. And I was like, why is that? And like, Oh it just, it's too expensive and the, you know, the phone service can offer coverage more, you know, more widely.
And I left that thing going man, do we just, are we just stuck in this like perspective of how an office quote unquote needs to be because that's how the guy that taught you, Kevin did it and then you taught me. So I did it and then I hired an associate tot him and then he hires associates on him and it's like, Oh that's the traditional way of doing it. And here at Parker and a bunch of things, like there are some things on expo that I'm looking at going, man, you guys are dinosaurs. You don't know it but you're going extinct. And on the flip side, what is the office of the future? Like, what will you need to do as a professional and you know, is there an app that could do it? Is there an app that can fill a role? [37:57.7]
Is there a technology that can reduce? Here's a, here's a thought I had from something. What if every single patient, when they walked in on day one already had their new patient paperwork done? 100% of your patients know how fast could they see the doctor on day one.
Kevin: Yup. That'd be good.
Josh: I mean 5 minutes,
Kevin: Our system does it and they can do it from remotely and I'd say we get 75% of the doing. It really helps out. We'd love to get the other 25% but the two things in our practice that have streamlined is that, which cuts out 75% of the paperwork and then the online scheduling. And so it reduces my phone calls quite a bit, so it frees up our front to do.
Kevin: So you got to definitely implement those systems.
Josh: I just think like what are those things step back from your practice? What are you assuming has to be in your practice that doesn't
Kevin: That doesn't.
Josh: You know, like I used to say it takes a 400 square feet to have one of these gyms and chip gleam or our mutual buddies link. I ain't got born or square feet. So I'm telling you right now it takes 200 because he had 200 you know, and I'm like, shit, you can actually do it in 200 then I had a client come along and she has 100 I think 68 square feet
Kevin: And she did it [38:58.8]
Josh: With a pole in the middle. Like a structural beam.
Josh: She's doing it. And she has three trainers by the way. She's hired three trainers to run those classes, so she doesn't have to. And I'm like, man, you guys are great at like stepping back going, I don't need to do this.
What do I need to do? You know? And what is it that you need to do or I need to do on our practices and what can truly change if we don't just say, well that's how it's always been.
Kevin: Yeah. And so I want to wrap this up with just one quick thing. It's the sinking fund idea. I didn't come up with it. It's a Dave Ramsey thing. But if you are having a hard time hiring that person financially and your cash flow, I don't want you to kill your cash flow and I don't want that. But you can start seeing, you'll maybe I could tuck away $4,000 in this next year.
Kevin: That I could have that will release, give me a few months of of on, of onboarding this new person and have that money set aside so you don't do it. So if you're starting to concern about getting out of that cycle financially, that would be one of my recommendations for it.
Josh: I love it, dude. I love it. [39:57.4]
Josh: I got one for you little as we wrap up here; I’d recommend the book, ‘Atomic habits’.
Kevin: Great book.
Josh: And I think if you want to be that superstar, just start with those little tiny habits and, and I don't know what it is. You know, so when we're talking about like reducing the time you spend with a patient, maybe you know, he talks about those micro habits, but maybe the success is, you know, measuring how many of these I have treatment done under 10 minutes, you know, or going to chess clock, slap it down and it starts counting down or whatever and see how many you can score consecutively. And, and I don't, I think we're at a point where I've never been more excited as I always say, I've never been more excited to be a chiropractor and I've never been more excited about how to set up an office as the technologies and everything that's available today.
Kevin: Yup and I just think we need to, to adjust to the times, right?
Kevin: Like insurance isn't going to reimburse for this unfortunately a lot of times. So we need to build systems around it. There are plenty of chiropractors that are doing it. Try to learn from them, learn from you
Kevin: And you'll be fine. [40:56.5]
Josh: Yeah. Awesome dude. Well, Hey, it's been a pleasure man. Thanks for having me.
Kevin: Thanks for your time.
Thanks for tuning in today. Please be sure to check our redesigned website at www.ModernChiropracticMarketing.com. Stay up-to-date with our blog, where content is regularly added by Kevin and guest contributors. You can also access our library of podcast episodes there. Go to www.ModernChiropracticMarketing.com and subscribe to the podcast today. [41:20.9]
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