For most Chiropractors the completion of this “if only” sentence is quite predictable. Can you hear the strident voices shouting in unison, “If only. . . I had more new patients?” It is a striking contradiction that a profession that espouses the benefits of an inside-out approach to health is addicted to an outside –in philosophy when it comes to growing a business. We routinely take the path of least resistance looking for the quick fix event and shun the hard work of building through process.

It is a fact that all businesses need to promote their services to potential customers if they are to succeed. As small business owners we must do the same. How you promote your business determines whether or not you build a flash in the pan practice or a solid profitable self sustaining business.

While everyone can benefit form Chiropractic care, the brutal fact is that unless you are a non- profit organization (by design that is) you have a limited market. Now before you judge that statement consider what constitutes a viable Chiropractic patient. First they must be aware of their need and made aware that your services could help solve their problem. Second, they must be willing to do something about it and accept your solution. And third they must have the ability to follow through with care. The word I chose is limited, not limiting. The fact is that there is an ample supply of patients who fit these criteria.

When most Chiropractors think of marketing they think advertising. The two are quite different.


Advertising is the promotion through public announcements on Facebook, radio, television, and the internet of something in order to attract interest to it. The game of buying patients is costly, risky, and less profitable. Most importantly it requires more selling on your part. Advertising, by its nature, adds more steps in the decision making process. Purchasing a series of Chiropractic care is nothing like buying a vitamin or paying for a massage because Chiropractic is a high impact and risky venture for people. The decision process is already demanding, so more steps equals more stress. You will have to make the potential patient aware and then eager to buy. More selling is needed because you have to create urgency and attempt to convince them to buy your Chiropractic solution and your brand of Chiropractic. It’s inefficient and requires a huge personal energy expenditure that eventually leads to burnout.

“Marketing is an Attitude not a Department” – Phil Wexler


Marketing, on the other hand, is the business activity of presenting products or services to potential customers in such a way as to make them eager to buy. Marketing is everything you do to attract and retain patients. It is how your business is perceived by your staff, your patients, your bank, your accountant, your attorney, your church and, of course, your business advisors/coaches. Marketing creates referrals. Everyone agrees that a referral practice is the ultimate goal. These patients are already interested and therefore aware and eager for a solution. A recent Chiropractic survey asked the question, “Where do most of your new patients come from?” 68.4 % of those surveyed answered, “from existing patient referrals.” Why then are we so obsessed with spending most of our time, energy and money outside looking in?

Chiropractors will buy just about anything and they line up with credit cards in hand for the next “killer gimmick.” Do they work? Yes and No. Yes, a flush of new patients come in. No, because 90 days later the numbers are pretty much the same and you need the next “fix” because nothing has changed in the way you do business. Well, that’s not entirely true, your image may have been tarnished by the type of promotional event, rushed exams, rushed reports, overburdened staff, system break downs, and lengthy office visits for the “regulars.”

If the foundational work is skipped and systems are anemic the results are always the same; an influx of new patient euphoria that dulls your logic while your inside voice screams “Finally, I am on my way,” sadly followed by the cold gray reality of a practice plateau. Foundational work is so critical. The Chiropractor who is a skilled entrepreneur never abdicates the responsibility for growing his/her business to others. He/She embraces the leadership challenge of marketing without resentment or hesitation.

Join us next week as we continue this conversation and dive further into how you can improve your marketing ability!



Imagine how simple it would be to report your findings if all of your new patients came with a USB port. Then all you would have to do is stick in a flash drive and transfer your findings along with the appropriate studies validating your recommendations. Well that day may come but not fast enough to make a difference in your practice right now. If you want more new patients you must take your good patient communication skills and make them great.

The Problem

The problem with most Report of Findings is that they don’t work. They fail to get results for the patient. Allow me to repeat that statement, They fail to get results for the patient. Most reports do not cultivate trust, deliver meaning or move the patient to follow through. Reports too often leave the patient dazed and confused and a confused mind always says no. This has real consequences for both you and your patients. The patient misses the opportunity to get the care they want and you lose the opportunity to serve!

You probably think (hope) that getting a patient to accept your recommendations is pretty straight forward. You gather the history, do the appropriate exams, formulate a plan and boom they start care. And of course the most famous bromide of them all, “They stay, pay and refer.” Too often reports are heavy on facts and light on human touch. Data-dumping does not get the results the patient needs. A doctor-centered report of findings focuses on what the doctor needs to say. A patient-centered approach focuses on what the patient needs to hear, it “relates” to the patient.

Stop reporting your findings and start “Relating Your Findings” using the following three steps.

  1. Personalize the report
  2. Give the patient your best recommendation
  3. Make the decision process easy
Personalize every report.

Begin your presentation with, “As I understand it, the most important thing for you right now is to be able to_____.” Never use dogmatic platitudes like “You need to come for the rest of your life,” or weak avoidance tactics like “If you’re not better after five adjustments then chiropractic won’t work for you.” Both are cookie cutter one size fits all positions.

Make your best recommendation your only recommendation.

Interpret the examination findings then stand firmly upon your clinical opinion, best available evidence and experience to date. This is your point of view; you are the expert. Is it always right? Of course not, but it is the best you can do with what you know right now. Changing your recommendation during the report when you sense resistance is not patient-centered. It is, in fact, doctor-centered and fear driven behavior. Too often the fear of being criticized, or the need to make everyone happy makes us people pleasers not patient leaders.

Make the decision process easy

You must make the decision process easy. Address the patient’s problem in the context of how it is limiting their life. Make the cause of their symptoms tangible. Instead of saying misalignments are caused by toxins, thoughts and trauma, tell them exactly what you think. As an example you could say, “Spinal misalignments can occur as a result of accumulated stress and injuries. In your case I suspect ____.”        And make the care plan simple. As an example, “In order to get the results we are both looking for you will need a concentrated course of care over the next ____”

The reality is that patient non-compliance is a source of frustration for all health care providers. Yet chiropractors need to be better because our margin for error is a whole lot less. People always pay for services they value and value the services they pay for. And in today’s stingy economy, chiropractic care needs to be affordable and valued. You can take charge of your practice but only if you take responsibility for your role in patient non-compliance.


Things will go wrong, they always do. Can you handle distractions or setbacks without folding like a lawn chair? To get to the next level you will need exceptional mental agility and decisiveness.

Decisiveness is the ability to make decisions quickly, firmly and clearly.

I watched another ‘aha’ interview with the great Tiger Woods. He told the journalist that his father taught him how to discipline his mind and stay focused on the next shot regardless the circumstance. Apparently his dad would harass him while preparing and making his swing. He made loud noises, dropped clubs, and got in his face, anything to knock him out of the zone. Tiger’s living legacy is proof that mental training pays off.

Flat out Wrong!

Many of your decisions will be flat out wrong. So what! Successful people are faith driven, they know that eventually they will hit on the things that work. Accuracy comes with practice. Extraordinary performances in your career demand rigorous training and a Zen –like resolve. The discipline to separate what you want now, from what you want to have eventually keeps your mind’s eye in the moment where you can have the greatest impact.

Fear driven behavior leads to panic and paralysis. Choices made in this emotional climate are short-term fixes that attract long-term suffering. And even more devastating is the emotional lockdown, indecision. Indecisiveness builds plaques of self doubt and eventually clogs the arteries of creativity.

Thoughts alone do not move the universe but your thoughts move you to speak, to act and to be attracted to resources and opportunities that will get you to the next step in your career. While it is clear that we do not have control over the thoughts that pop into our head; we can take charge once we are aware of them. We choose to feed or starve them. That’s power.

Simple Questions

When deciding on a course of action whether it is hiring a staff, a coach, or attending a seminar. Ask yourself the following profoundly simple questions and then act:

  • Is my dream worth the effort?
  • Does it really make a difference one way or another with the people in my life? (My spouse, my family, my staff and our patients)
  • Is this a part of my problem or a piece of the solution?
  • Will doing this move me closer or further away from my longer term goal?

Now hear this. Evidence from every success story I know about can be summarized by the following statement.

If you are not willing to put your personal savings and time into your dream, you really don’t want what you say you do.


“Your arrows do not carry,” observed the Master, “because they do not reach far enough spiritually”
Eugene Herrigel – Zen and the Art of Archery

We all get frustrated when we fail to hit our personal targets. As an example, let’s suppose that last January you set a goal of earning $100,000 more this year. And now after spending the last 9 months climbing and striving to reach that goal you find yourself only achieving half that goal. What follows is a loss of momentum. A few self-limiting beliefs got reinforced. The result is a drop in energy and vigor. Thus, when you reinstate the goal for the next year you are already operating at a personal energy deficit.

You can imagine what will happen the next year, and the year after that if you continually fail to hit your targets. Perhaps right here, right now, you are feeling the effects of the frustration of falling short of those goal year after year. As we strive to obtain known personal objectives we get caught up in the ‘target event’ (obtaining) and may miss the ‘attainment process’ altogether.

Two Categories of Goals

Let me explain. There are two categories of goals, the known goals and the unknown goals. Known goals are the ones you have targeted as worth achieving. They are known to you and to people in your life who are committed to helping you achieve them. Unknown goals are deeper qualities and values that surface as a result of your efforts toward your known goals. They are the deeply satisfying needs that you have temporarily forgotten. Once you become aware of them, life has even greater purpose and meaning.

Here’s how it works. As you strive to achieve your known goals your deep down unknown goals get satisfied. If you fail to recognize these and assimilate them into your consciousness two things occur:

  1. Your wins feel hollow.
  2. Your failures begin to drain more and more of your energy.

The reality is that some goal is always being achieved in the attainment process. However, it isn’t always the one you had consciously set (Known). As an example, on your quest to earn more this year you might have attained recognition, better health, and parental approval, spousal “buy in”, inner strength, stronger relationships, and more time to enjoy your world. These are all examples of unknown goals.

We are not describing a ‘rationalization event, making excuses or denying failed attempts. We are describing a new way to look at this journey of success. Learning this process will change your perspective and behavior. It will liberate your beliefs and extinguish your self imposed limitations. Acknowledging your unknown wins will give you a self liberating perspective and energize your reinstated goals.

Reach for your star!

Practice Building Tip

“If you knew that one of your coaches or a classmate where coming to visit your office next week what would you do?”

Once you get past the performance anxiety make a list of the items that would need attention. We suggest you look in three categories.

  1. The physical appearance of your business. Do the carpets need cleaned? Do the walls or ceilings need painted? Do your tables need recovered?
  2. The practice systems. Are your systems flawlessly executed throughout the day? Does your team reflect the image you want?
  3. Your attitude. What leadership essentials will you need to master? What behavior and attitudes do you need to highlight and what ones need to be changed?






We speak with a lot of business owners who have a lot of complaints:

  • The economy stinks
  • Their work environment isn’t great
  • Their community doesn’t support them
  • It’s all the President’s fault!
  • Taxes

We encounter a lot of bitterness.

If you want to be successful, if you want to chase affluence and live the life you desire and deserve… You need to let go of the bitter.

Get better not bitter.

Remember, nothing gets better until you get better.

Surround yourself with good people, train like your life depends on it, and live each day with an attitude of gratitude.

Remove the bitter and enjoy the sweet fruits of your labor.


You bring who you are into your business. Typically you behave in business as you behave everywhere else in your life.  Wherever you go, there you are. Your practice is a mirror that reflects your behavioral patterns. These habits determine what you have, right here, right now.

The three relationships that shape your personal and professional life are:

  • The relationship you have with yourself
  • The relationships you have with others
  • And the relationship you have with your business.

You can assuage the pain of self-limiting beliefs through self-deception and you can even ignore many of your relationship problems. Yet, your business is a measurable, palpable accounting of your inner journey, your leadership competence and your work ethic.

Too many doctors fail to achieve the goal of Chiropractic Affluence because they never form the Character of Courage. They boldly push forward in some areas and push back in others. Because this kind of courage is situational, the consequence is mediocrity. Being a Chiropractic Entrepreneur is risky business and is not for the faint of heart. Risk taking is part of the terrain.

As you boldly face practice challenges, align your INTENTION with the things you are attentive to and the actions you take will work. You have two intentional choices, you can problem solve or create.

Problem solving is taking action to have something go away.

Creating is taking action to have something come into being.

Strive for healthy behavior in all your relationships: the one you have with your self, with others and with your business. Take the time you need to tackle the deeper, inner work. Embrace this process and learn to embody the following principles.

The Principle of Transformation

The process of transforming your practice into a business will also transform you personally.  Professional development leads to personal development as a by product of internalizing the essential principles. You will be transformed though your successes and your failures, your victories and your defeats.

The Principle of Excellence

When you begin to really work on the Business of Chiropractic, your awareness levels are sensitized to both your strengths and weaknesses as a leader. You will be confronted by your willingness to reach beyond your comfort and complacency.  And with the appropriate actions you will develop the ability to lead yourself, lead others and lead your business. This skill set will serve you the rest of your life.

“Excellence is the result of caring more than others think wise, risking more than others think is safe, dreaming more than others think is practical, and expecting more than others think is possible.” 


I did a practice analysis for a new client a few years ago.  It was apparent in looking at his layout, that he could immediately boost his productivity and flow by removing a fish tank that was in the middle of his adjusting suite, between the waiting area and the adjusting tables.  No walls needed to go, just some fish.  When I suggested he remove the fish tank and attempted to give him my vision of what was possible if he did, I was met with an incredible amount of pushback.

“ Yeah but my patient’s love to look at the fish, I like to look at them, they calm me.  They are part of the ambience.  The kids would miss them if I took them away.  Yeah but . . .”

Each call the topic would come up and his excuses continued to flow, but his practice did not..

Another story:

The very first in-house evaluation I ever performed was another such structural flow stopper.  The doctor had just moved into a new office, one that was designed before he had hired me.  He’d been in the office for six months and was at a plateau with his patient numbers.  He felt he wanted to go open room, but wanted to know where he should put the adjusting suite.  I toured the office and found that if he eliminated this one room, he could make an adjusting suite that would be ideal.

That room happened to be his private bathroom.  It had a shower and sink and a toilet.  It wasn’t anything that spectacular. “Yeah but, that’s MY bathroom,” he declared. “And why do you need your own bathroom? There are two others over there.” I responded.

“But those are for patients.  This is mine.  I can go in here and not be disturbed.  And I have a shower so I can wash after I workout at lunch and not have to go home.”

Trust me! This guy hadn’t worked out in years.

Which would you choose?  A private toilet or increasing your paying patient visits?

Six years later I ran into the fish tank doctor.  He had an enormous smile on his face and the first words out of his mouth as he approached me were, “Hey Doc, I finally got rid of the fish tank!  I know, wasn’t that stupid of me?”

I wouldn’t say he was stupid, but I would say he was un-coachable.

The truth is many structural and procedural blocks are really emotional blocks. Like the stories above, doctors hold on to status quo and refuse to move forward because of some emotional attachment to a “thing.”

What are you willing to let go of in exchange for success?


What does it mean to be in “flow”? 

The concept of the “Flow Channel” was developed by a Czech researcher, Mihaly Csikszentmihaly. It’s a simple visual of a graph with the X-axis representing your skill level and the Y-axis representing the challenges you face. I will illustrate this concept with the following example.

I am a novice tennis player. If I were to take on Serena Williams in a tennis match I would be over challenged. Serena Williams would be under challenged. The match would be very unfulfilling for the both of us. She would tend to become complacent and bored. I would become frustrated and apathetic. Neither of us would be operating in our respective flow channel.

"Flow" by Mihaly Csikszentmihalyi

In terms of your practice, to understand your flow channel you must appreciate your current skill level. Whether your skill level allows for 30 patient visits per week or 30 patient visits per hour, you must come to realize exactly where your skill level is.  In order to grow and gain new challenges you have to elevate your skill set. This can be accomplished by learning more, reading more, training more, being coached more, etc.

A tree wants to grow to be as big as it can. It doesn’t place any artificial limitations on itself. It simply grows as much as it’s environment allows. You can be the same way. Your skills must be parallel with your challenge. If you want to increase the number of patients you see, you have to grow your skills.

Dr. SeaDr. Douglas Sea, CTO SIDECAR

One day I walked out into the reception room and saw my patient Nicole with one of her foster children, an old man in a 12 year old body. His body was hung loosely like a robe over the back of a chair. I went over to him and as I did he lifted his head but could not look me in the eye or stand completely upright. He reached out, grabbed my tie and said, “Hi my name is Aaron.”

I was blown away. At that moment I felt as if my only purpose in life was to help this boy. I asked Nicole for permission to examine him and because she trusted me; she agreed. His story was disturbing. You can’t imagine what I found during my case history and chiropractic exam. You see, Aaron had spent the past two years locked in a dark, damp closet. It was the way his birth parents chose to teach him a lesson. He could not carry on a conversation and had severe learning challenges.

His back was rigid and riddled with misalignments. He had adapted to this physical and emotional drama by assuming a standing fetal position. As chiropractors we are probably the only health care providers who truly understand that this was innate’s way of protecting him from the physical and emotional pain of abandonment. Nicole told me that her previous chiropractor had said it would be a waste of money to treat Aaron because he had no real symptoms.

Holding my rage inside I said, “I understand,” but I lied. I asked her if she would like to hear my opinion.  I told her what you would have told her, “Aaron may not have the typical symptoms, but he has signs and plenty of indicators of what we call a subluxation. And there is a chance I might be able to ease his suffering, would you like me to try?”

To Aaron and his foster family the spinal adjustments were more than treatments. I don’t fully understand how, yet his foster parents and I witnessed firsthand his release from an emotional prison. As a matter of fact the adjustments kicked the door wide open. Six months later he was mainstreamed into school. No, he wasn’t the top of his class and yes he still has challenges, but he no longer suffers.

No one profession has all the answers yet what we do as chiropractors matters to our patients. There are hundreds of thousands of people that suffer needlessly and will continue a life of drudgery and hopelessness unless you stand up and shout.

You are Chiropractic. You have it in you to be great!


A strong philosophy often spells the difference between success and struggle, passion and boredom. Your philosophy must be practical not theoretical, tangible not invisible, dynamic and fluid not dogmatic and rigid if you are to touch lives. As a Chiropractor you have no choice about the fact that you need a philosophy. Your only choice is whether you define your philosophy by a conscious, disciplined process of thought or allow your brain to accumulate a tangled mass of unconnected ideas, undigested slogans and blatant contradictions. Failure to refine your philosophy leaves you with a sobering consequence, chiropractic uncertainty, self doubt and anxiety.

That’s just part of the story

But that’s just part of the story because the reason patients leave your office, or stay and never refer, is not due to money or time. It’s a consequence of perceived indifference. At the raw core of this indifference, behavioral miscues and procedural breakdowns is a leader who lacks confidence in his/her adjustments. You may be reading this and saying to yourself, “Not me, I know exactly what it is I do.” I hope for your sake that this is true. Yet many of us go through this dark period of ‘chiropractic uncertainty’ but never talk about it. The evidence is right in front of us for all to see in our trade journals.

We have become an ‘industry’ with an identity crisis, not a profession with a mission. On one end we have the disciples who tell patients that the foramen magnum is the ‘mouth of God’ and on the other end failures who teach us that all a person needs is six adjustments. Where do you see it? Are you somewhere in between? Maybe you haven’t really thought about it much and have sort of gone with the flow of yet another super conference fad. Be careful of what you feed your head or you will wind up ‘parrot –phrasing” bromides that are tainted with occult teachings and religious agendas that leave a patient feeling cold and indifferent.

Here’s a quick check list to determine if your philosophy needs updated. Do you use one or more of the following care plans?

Ridged Care Plans: E.g. “Every one needs 40 regardless of age or circumstance.”

Weak Care Plans: E.g. “Their plan only covers 10 office visits so that’s what I recommend” or “They only want to come in twice a week so that’s what I recommend” or “They can only afford . . . so I alter my recommendations.”

Capricious Care Plans: E.g. Winging it depending on your mood and passion barometer for the day, “Let’s get a few adjustments under your belt and then we will see what’s next. We’ll see how it goes.”

Now for the good news, you have a brain and thinking changes thinking. And better thinking builds bigger practices Begin that process by sitting down with your coach and clarifying where you need the most development. Is it core philosophy, post adjustment confidence or patient communication skills? All of these can be learned, if identified.

Chiropractic Health Care is Life Altering!

We are a profession with an unprecedented vision and you are, beyond a shadow of a doubt, the only people who can inspire hope and witness first hand the awesome healing power of nature.

If you are bold enough and dedicate yourself to defining your philosophy, mastering your technique, becoming a skilled communicator you will inspire everyone you come into contact with. People will be attracted to you and your message and the word will spread from the patients, to their friends, family and co-workers.

What you do matters because there are hundreds of thousands of people that suffer needlessly and will continue a life of drudgery, hopelessness and mediocrity unless you stand up and shout. You are the Chiropractic vision and you must stretch and grow as leaders.