Last week after teaching a workshop on performing a SWOT Analysis and using it to set Smart Goals, I had a DC tell me that even though he knew about SMART Goals and sets them with full intent, he often didn't keep or reach them. This led us to a discussion on how to achieve goals. We discussed how to track your success or lack there of and make the necessary changes along the way so as to be ultimately successful. Since that conversation I have been thinking that it is not that DC's don't know how to set a goal, but rather that they often don't know how to achieve one that keeps them from being successful.
Let's say that you set a goal of having 120 more new patients this year than last year. That's only 10 more per month. That’s a SMART Goal. It is specific, time bound, measureable, attainable, and reachable. The problem is once you set it, or even as you set it are you setting yourself up to succeed?
The successful DC won’t just set the goal. He will set in place the systems and resources needed to achieve it. He will constantly track and measure the progress of the tasks that are being worked to get the desired results. And most importantly of all, if the systems aren't working completely he will do what is necessary to make the correct changes and find the ways to be successful.
Setting the goal is really the easiest part. The work comes in making it happen.
-David Pritt
Monday, May 3, 2010
Thursday, April 29, 2010
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Friday, January 1, 2010
The Dawn of a New Decade
Though you may turn your life, your career or your business around at any time, the dawn of a new year is a great time to do so. The dawn of a new decade adds frosting on the cake, providing additional psychological boost. As we all move forward in life this year, this decade offers unlimited opportunity for those willing to focus on the fundamentals inherent to success in any business.
Set your calendar for the year. Establish written objectives for each aspect of your life. Some practical categories are personal health, personal spiritual and intellectual growth. On the business side, clear attainable objectives such as a 5% reduction in expenses, and a corresponding increase in production of 5% may fit your organization. These are objectives. However, they do not automatically have a series of action steps clearly defined. In order to achieve these types of objectives, a clear written plan of action steps must be delineated and established. There is an inverse relationship between the time you spend planning, the detail you specify, and how successful you will be in achieving your objectives.
Here also is a daily suggested step by step plan focusing on the fundamentals...Happy 2010.
7 Daily Steps To Success
A solid, efficient organization is the underlying structure essential to creating a customer-centered business. Once the organization and systems are in place, the opportunity for maximum creativity, dynamism and laser beam focus on the person of each customer emerges. In order for daily performance to be optimally successful, each business owner, executive, team leader, and his or her team must be prepared as well as organized. The more prepared the team, the more natural, dynamic, responsive and effective the team will be in providing exceptional, service, in a relaxed, comfortable and enjoyable environment.
To best prepare for the day, I offer the following seven daily steps. I suggest following this list, or one like it that you create that is ideally suited to your platform and goals. Employ these steps every day for a minimum of 6 months to ingrain these success habits. Most successful people develop a routine; this one is time tested and very effective.
- Rise early and “BEAM”
- Breathe. The ancient Samurai culture awakened to the rising Sun, and then exercised their heart and lungs with a series of “power breathing” exercises. The resulting increased oxygen uptake and circulation helped prepare them, as it will you and your physiology, to meet the day fully engaged.
- Express gratitude for all you have currently, and for the gifts and skills with which you have been graced. Be grateful you have the opportunity to leave the world a better place for your efforts.
- Affirm your goals, and what you stand for; review your platform, those things that make you who you are.
- Motivate yourself, and prepare to motivate your team, as well as the people you will meet based upon what you do. Remember to constantly re-dedicate yourself to something bigger than yourself, and strive to help, teach and inspire others to do the same.
- Read for 20-30 minutes each morning. Choose inspiring, thought provocative literature, essays and articles. Commit to life long study, and life long learning. As you read, let the creative juices flow; write down the inspiration and ideas that blossom from what you ingest.
If you are looking for books to read, go to my website for a list of some of the books that have inspired me… http://www.chiropracticementoring.com/recommended_books.php
- Write down your thoughts, plans and ideas; concepts and action steps…but whatever you do, write. It is extremely healthy for your brain. It will keep you sharp. Ideas will germinate and grow into action steps, and an infinite number of opportunities will be formulated from your writing. Consider “mind-mapping” concepts and ideas. Be creative: drawing, sketching, cartooning…let your imagination run wild... The effects of this daily exercise are powerful.
- Study your schedule. Every day you should leave your business with a copy of your exact schedule for the next day. If you are a realtor, dentist, physician, chiropractor, attorney or accountant, with regularly scheduled clients or patients, you have a detailed list of names to study. Your schedule should include any phone calls you need to make, any other pertinent reminders relevant to client, patient or customer, care as well as inter-business communication from your team. You must study your schedule. What is important to each person you will see? What was your conversation with them the last time you met? What about them could you explore more deeply in order to help them understand the relationship between their current situation, condition or life, and your service? How can you exceed their expectations?
In addition, you must look at and apply the concept of “6 degrees of separation” to your schedule. Who knows whom? You must note the interconnectedness of each and every person on your schedule. You must know whom you are meeting, treating or advising, as well as who they know in order to maximize the opportunity to help more people with your business or practice. Referrals are not automatic you must create the opportunity for them.
- Focus on your plan, your goals, and your agenda. Do not imitate others, nor allow yourself to be distracted by the actions, successes or failures of others. Do not attempt to live out anyone else’s agenda, system or plan. Be sure you constantly assess and re-assess in order that you can optimize your function in your business or practice. Focus intently on the tasks at hand for the day. Put all the energy, intensity and passion into your day it deserves.
- Be humble and yet always acknowledge your successes. Never take anyone, or your own skills or current level of success for granted. Repeat step 1b above…often. Constantly acknowledge your wins, and yet keep raising your own standards a little bit each day. Strive to improve your spiritual, intellectual, emotional, familial, and physical self every day.
- Arrive prepared. Physically, emotionally, mentally and in a spirit of focus and dedication to a cause bigger than yourself. Be fully present in mind and body to serve the public. Lead them and teach them in a way they can understand. Be respectful and fully embrace the spirit of helping your fellow citizens with your skills and talents.
Start implementing this routine immediately. Repeat daily: the effects are cumulative and success will be yours. Enjoy.
Saturday, June 27, 2009
An Open Letter to Our President
As we enter into this critical time of debate regarding the future of health care in our country, we must all participate. Every voice counts, if it is heard that is. Take a few moments to send a letter to the White House, and to your local representatives in the Senate and House of Representatives. Though I am optimistic about the contributions chiropractic will make in the future, regardless the outcome of the legislative compromises ahead, I believe we should help to frame the debate. We have as a profession contributed greatly to the health and welfare of our fellow citizens since 1895. I know we will continue to do so. However, we must have a voice in the national debate to have maximum impact at this juncture.
June 2, 2009
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Dear Mr. President:
I am a second-generation chiropractor. I grew up personally witnessing the incredible benefits of chiropractic care in our community. My father the late Dr. Richard Heun practiced in Napa, California for nearly 40 years. In that time, thousands of people suffering from all sorts of physical ailments sought and received help from my father. This patient-centered approach to hands on health care inspired me to pursue a career in chiropractic as well.
I practiced in Pinole, CA for twenty years. My focus was on sports and spinal rehabilitation. I developed a multi-disciplinary clinic, incorporating the latest rehabilitation techniques with a team of professionals from other disciplines. We had great success in helping many patients regain their function and strength, to return to productivity, and to enjoy their lives again.
I have retired from practice, and now mentor chiropractors with the objective of developing clinical excellence, and mastering a patient-centered approach to practice success. I teach seminars and workshops, and counsel doctors throughout our great country, and in the UK, Australia and Japan. The profession is alive and well all over the world.
As you begin to implement your plans for health care reform, please remember the value my profession provides the public. We are the largest drugless healing art. We as a profession represent the third largest block of physicians in the USA. We provide a primary portal of entry in health care, the role of the “family physician” in many small communities. We are all well trained, and can integrate as part of a health care team, dedicated to helping our fellow citizens from a conservative health care perspective. For many ailments affecting the human frame and muscular system, we offer the least invasive, safest, and least costly solution available.
Dr. Scott J. Heun
Thursday, May 14, 2009
Medicare or Medi-Scare?
This excerpt was sent to me today in an email. It originated from Dr. Leonard from the Wisconsin Chiropractic Association.
Subject: Will Medicare Fire Chiropractic Based on OIG Finding?
Will Medicare Fire Chiropractic?
Attached is a copy of a report issued by the Office of Inspector General (OIG) on payments made to chiropractors for Medicare services. The audit’s findings were as follows:
Medicare inappropriately paid $178 million for chiropractic claims in 2006, representing 47 percent of claims meeting our study criteria.
Efforts to stop payments for maintenance therapy have been largely ineffective.
Claims data lack initial visit dates for treatment episodes, hindering the identification of maintenance therapy.
Chiropractors often do not comply with the Manual documentation requirements.
88% of the reviewed claims had inappropriate payments for “maintenance therapy”, 26% for undocumented care, and 6% for miscoded care. 20% of the claims had multiple errors. Separate from the undocumented claims counted as errors, 83 % of chiropractic claims failed to meet one or more of the documentation requirements.
In the past, when reports regarding the chiropractic profession have been required by Congress, the reports were inexcusably delayed. This report seems to have been issued at a time calculated to do maximum damage to the chiropractic profession – in the middle of the debate over health care reform.
If the chiropractic profession does not immediately and aggressively respond to the conclusions of this report, every one of our competitors will point to this report as an excuse to disregard the chiropractic profession as decisions are made on the benefits to be included or the reforms that are to be made in the health care reform bill.
We believe the report has a critical flaw in that its definition of “maintenance therapy” is discriminatory and it is nearly impossible to apply to a particular case via a review of chiropractic documentation.
The Medicare policy manual defines “maintenance therapy” as follows:
Maintenance therapy is defined as a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition. When further clinical improvement cannot reasonably be expected from continuous ongoing care, and the chiropractic treatment becomes supportive rather than corrective in nature, the treatment is then considered maintenance therapy. For information on how to indicate on a claim a treatment is or is not maintenance, see §240.1.3.
Discrimination
First, it is critical to note that Medicare has a different standard for chiropractors than it does for medical providers. Medicare routinely pays for the medical treatment of symptomatic chronic conditions including heart disease, rheumatoid arthritis, diabetes, macular degeneration, allergies, and many others. On the other hand, Medicare states that chiropractic adjustments “performed to maintain or prevent deterioration of a chronic condition” are maintenance therapy. For Medicare patients, medical treatment that keeps a chronic or degenerative condition from worsening is accepted; but it is a violation of the law for chiropractors to provide the same standard of care to their patients.
Definition of maintenance care
When a Medicare patient presents with another episode of a chronic condition, their chiropractor cannot know whether it is a new problem or an exacerbation of a previous problem until he/she examines the patient (which Medicare will not pay for). At this point, if the chiropractor determines the pain is due to an exacerbation of a previous problem, they are supposed to guess, based on the current deterioration of the patient’s spine, whether or not this treatment plan will fully resolve the problem because if it merely prevents deterioration of the condition to the point where, for instance, it might require expensive surgery, a chiropractor violates the law by providing care.
The chiropractic profession has never challenged this absurd definition of maintenance therapy. It appears to have been written by an individual without specialized knowledge of the needs of the elderly with regard to their spinal problems. The overwhelming percentage of Medicare patients who seek care from chiropractors are suffering from chronic conditions. If a chiropractor is able to document that acute symptomtology is present, these patients should not be viewed by Medicare to be receiving maintenance therapy.
Other problems
The OIG report also found that 26% of the audited claims had inappropriate payments for undocumented care. Clearly there should be no payment for chiropractic services when a chiropractor fails to document their clinical interaction with the patient. However, the basis for these determinations was opinions of reviewers hired by OIG.
OIG stated they “worked with the medical review contractor to select chiropractors with previous experience in reviewing chiropractic services provided to Medicare beneficiaries to serve as medical reviewers for this study”. The chiropractic profession is all too familiar with the bias of chiropractic reviewers who skew their opinion to retain their employment relationship. Without an unbiased review of the credentials of those performing this “review” work, the chiropractic profession should insist that an unbiased third party with impeccable credentials confirm the accuracy of these “reviews”.
Because time is of the essence, the response of the profession to this report needs to be widely disseminated to members of Congress and the Obama administration before our competitors seek to destroy our credibility in the negotiations over national health care reform.
Regards,
Russ Leonard
Executive Director
Wisconsin Chiropractic Assn
(608) 256-7023 Ph
(608) 256-7123 Fax
Subject: Will Medicare Fire Chiropractic Based on OIG Finding?
Will Medicare Fire Chiropractic?
Attached is a copy of a report issued by the Office of Inspector General (OIG) on payments made to chiropractors for Medicare services. The audit’s findings were as follows:
Medicare inappropriately paid $178 million for chiropractic claims in 2006, representing 47 percent of claims meeting our study criteria.
Efforts to stop payments for maintenance therapy have been largely ineffective.
Claims data lack initial visit dates for treatment episodes, hindering the identification of maintenance therapy.
Chiropractors often do not comply with the Manual documentation requirements.
88% of the reviewed claims had inappropriate payments for “maintenance therapy”, 26% for undocumented care, and 6% for miscoded care. 20% of the claims had multiple errors. Separate from the undocumented claims counted as errors, 83 % of chiropractic claims failed to meet one or more of the documentation requirements.
In the past, when reports regarding the chiropractic profession have been required by Congress, the reports were inexcusably delayed. This report seems to have been issued at a time calculated to do maximum damage to the chiropractic profession – in the middle of the debate over health care reform.
If the chiropractic profession does not immediately and aggressively respond to the conclusions of this report, every one of our competitors will point to this report as an excuse to disregard the chiropractic profession as decisions are made on the benefits to be included or the reforms that are to be made in the health care reform bill.
We believe the report has a critical flaw in that its definition of “maintenance therapy” is discriminatory and it is nearly impossible to apply to a particular case via a review of chiropractic documentation.
The Medicare policy manual defines “maintenance therapy” as follows:
Maintenance therapy is defined as a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition. When further clinical improvement cannot reasonably be expected from continuous ongoing care, and the chiropractic treatment becomes supportive rather than corrective in nature, the treatment is then considered maintenance therapy. For information on how to indicate on a claim a treatment is or is not maintenance, see §240.1.3.
Discrimination
First, it is critical to note that Medicare has a different standard for chiropractors than it does for medical providers. Medicare routinely pays for the medical treatment of symptomatic chronic conditions including heart disease, rheumatoid arthritis, diabetes, macular degeneration, allergies, and many others. On the other hand, Medicare states that chiropractic adjustments “performed to maintain or prevent deterioration of a chronic condition” are maintenance therapy. For Medicare patients, medical treatment that keeps a chronic or degenerative condition from worsening is accepted; but it is a violation of the law for chiropractors to provide the same standard of care to their patients.
Definition of maintenance care
When a Medicare patient presents with another episode of a chronic condition, their chiropractor cannot know whether it is a new problem or an exacerbation of a previous problem until he/she examines the patient (which Medicare will not pay for). At this point, if the chiropractor determines the pain is due to an exacerbation of a previous problem, they are supposed to guess, based on the current deterioration of the patient’s spine, whether or not this treatment plan will fully resolve the problem because if it merely prevents deterioration of the condition to the point where, for instance, it might require expensive surgery, a chiropractor violates the law by providing care.
The chiropractic profession has never challenged this absurd definition of maintenance therapy. It appears to have been written by an individual without specialized knowledge of the needs of the elderly with regard to their spinal problems. The overwhelming percentage of Medicare patients who seek care from chiropractors are suffering from chronic conditions. If a chiropractor is able to document that acute symptomtology is present, these patients should not be viewed by Medicare to be receiving maintenance therapy.
Other problems
The OIG report also found that 26% of the audited claims had inappropriate payments for undocumented care. Clearly there should be no payment for chiropractic services when a chiropractor fails to document their clinical interaction with the patient. However, the basis for these determinations was opinions of reviewers hired by OIG.
OIG stated they “worked with the medical review contractor to select chiropractors with previous experience in reviewing chiropractic services provided to Medicare beneficiaries to serve as medical reviewers for this study”. The chiropractic profession is all too familiar with the bias of chiropractic reviewers who skew their opinion to retain their employment relationship. Without an unbiased review of the credentials of those performing this “review” work, the chiropractic profession should insist that an unbiased third party with impeccable credentials confirm the accuracy of these “reviews”.
Because time is of the essence, the response of the profession to this report needs to be widely disseminated to members of Congress and the Obama administration before our competitors seek to destroy our credibility in the negotiations over national health care reform.
Regards,
Russ Leonard
Executive Director
Wisconsin Chiropractic Assn
(608) 256-7023 Ph
(608) 256-7123 Fax
Friday, May 8, 2009
Praise and Recognition
According to a survey published in USA Today, the way employees want to be acknowledged for their work may be different than our knee jerk reaction as to how they want to be recognized.
Take this "quiz".
Rank the following items in the order you think employees prefer.
Additional time off.
Cash bonuses.
Seminars or Training.
Verbal recognition.
A personal card or note.
What was your first choice? How about your second? If you chose the one most people choose, cold hard cash, you would be...
incorrect. In fact the 42% of those surveyed preferred verbal acknowledgement over additional pay! Cash bonuses came in at 19%. Followed by additional time off at 9%, seminars and training at 7% and cards and notes at 6%.
The moral of the story is, to verbally praise your team, when it is deserved of course, is the best way to give them what they want. In so doing, you will build the team morale, and drive success in your practice.
Take this "quiz".
Rank the following items in the order you think employees prefer.
Additional time off.
Cash bonuses.
Seminars or Training.
Verbal recognition.
A personal card or note.
What was your first choice? How about your second? If you chose the one most people choose, cold hard cash, you would be...
incorrect. In fact the 42% of those surveyed preferred verbal acknowledgement over additional pay! Cash bonuses came in at 19%. Followed by additional time off at 9%, seminars and training at 7% and cards and notes at 6%.
The moral of the story is, to verbally praise your team, when it is deserved of course, is the best way to give them what they want. In so doing, you will build the team morale, and drive success in your practice.
Friday, March 6, 2009
Implement the No Whining Rule...
Dr. Scott J. Heun
If you want to improve the quality of your service, and grow your practice based upon referral, you must have a cohesive, dynamic and communicative team. This team must be involved in the organization, must be responsive to the needs of each person you serve, moreover contribute on a regular basis to improving the efficiency and quality of the service the practice provides the public. A regular interplay of ideas is required. However, whining is not allowed.
I instituted the "no whining rule" in my practice years ago. It solved a plethora of issues, and resulted in a much more dynamic and patient-centered team.
Here's how it works.
Every team member has an email account to be used specifically for inter-office communication. Be sure to amend your office policy to insure a secure and safe use of email from your organization. Be specific as to your rules and regulations. (If you do not have an office policy in place, write me at info@chiropracticementoring.com and in the RE: line write I need ChiroHire and Made-To-Fit.)
Each team member is instructed that whenever they make an observation of something that is problematic, they are to compose an email describing the issue in detail, and send this to the CEO (Chiropractic Executive Officer) and the team.
Here is what changes an observation from a whine, to a constructive and organization improving opportunity. Any observations must be accompanied by a proposed solution to the issue at hand, as described and noted from the perspective of the resident expert at that post...the observer noting the problem!
The CEO then assesses the impact of the problem, considers the proposed solution, and elects to adopt the recommendation, modify it, seek advice from the team, and then implement or reject the recommendation accordingly.
A printed copy of the observation and recommendation is kept in the team members personnel folder. Credit for contributions to the success of the practice organization and or growth of the practice directly or indirectly, deserve to be rewarded.
Every practice should be responsive to the marketplace, dynamic and intensely focused on customer service through ever improving efficiency. This simple solution applied, and acted upon provides the means to constantly improve your practice, with the ultimate result being improved service, as well as an improved bottom line.
If you want to improve the quality of your service, and grow your practice based upon referral, you must have a cohesive, dynamic and communicative team. This team must be involved in the organization, must be responsive to the needs of each person you serve, moreover contribute on a regular basis to improving the efficiency and quality of the service the practice provides the public. A regular interplay of ideas is required. However, whining is not allowed.
I instituted the "no whining rule" in my practice years ago. It solved a plethora of issues, and resulted in a much more dynamic and patient-centered team.
Here's how it works.
Every team member has an email account to be used specifically for inter-office communication. Be sure to amend your office policy to insure a secure and safe use of email from your organization. Be specific as to your rules and regulations. (If you do not have an office policy in place, write me at info@chiropracticementoring.com and in the RE: line write I need ChiroHire and Made-To-Fit.)
Each team member is instructed that whenever they make an observation of something that is problematic, they are to compose an email describing the issue in detail, and send this to the CEO (Chiropractic Executive Officer) and the team.
Here is what changes an observation from a whine, to a constructive and organization improving opportunity. Any observations must be accompanied by a proposed solution to the issue at hand, as described and noted from the perspective of the resident expert at that post...the observer noting the problem!
The CEO then assesses the impact of the problem, considers the proposed solution, and elects to adopt the recommendation, modify it, seek advice from the team, and then implement or reject the recommendation accordingly.
A printed copy of the observation and recommendation is kept in the team members personnel folder. Credit for contributions to the success of the practice organization and or growth of the practice directly or indirectly, deserve to be rewarded.
Every practice should be responsive to the marketplace, dynamic and intensely focused on customer service through ever improving efficiency. This simple solution applied, and acted upon provides the means to constantly improve your practice, with the ultimate result being improved service, as well as an improved bottom line.
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