EP61: You Already Know What's Wrong. This Is How You Fix It.

Every practice owner I talk to knows exactly what's broken in their business.

The number that's been red for three months. The doctor who isn't performing. The conversation they keep putting off.

They know. They just haven't done anything about it.

In this episode, I break down the exact system I use across all of my locations to stop tolerating problems and start solving them. It comes down to one rule: if something is red on your scorecard three weeks in a row, it goes on the issues list. No debate. No waiting. You deal with it.

I walk you through how to run that process with your team, how to find the real issue underneath the symptom, and how to turn a pattern that's been dragging you down into a solved problem in under 20 minutes.

Because the practices that grow aren't smarter than yours. They just stopped looking away.

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Transcript

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This is the Austin Cohen Podcast where we talk real strategies for chiropractors ready to grow beyond the adjustment. If you're building a business, developing your leadership, and trying to build wealth without burning out, you are in the right place. Let's get to work Don't forget to subscribe so you never miss an episode. What is up, everybody? Welcome back, Austin Cohen Podcast. Man, hopefully everyone had a great Mother's Day. Wanna shout out to all the moms out there. I think when you finally get to watch your wife go through having your first child, and then also the nine months, and then taking care of after, and man, all the sacrifices it definitely gives you a new perspective of Mother's Day when you become a father, and for sure, the respect that you would have for your wife but also importantly, just as importantly, your mother too as well, who took care of you for all those years, just knowing how hard it is. So man, shout out to all the moms out there. Y'all are the real superstars. Man, we got a good tactical strategy. I've been a little bit heady the last few podcast episodes, which I think is very important because there is an element of this business that is a lot of mindset. And so you can't just do to have. You've gotta be, then you gotta do, then you've gotta have, which is an equation many of you guys have all heard before. What I wanna talk about today though is a chiropractor who I know very loved, not, does not work with corrective chiropractic, by the way, but he's been in practice for about six years. We started working together, super smart, maybe has one of the biggest hearts in chiropractic, and is just, honestly, he's a great clinician, great adjuster too as well. Here's the issue. His close rate for last year sat at about 40 to 50%. And if you don't know what a healthy close rate is for chiropractic, I truly believe that it should be anywhere above 80%. 40 to 50% means s- five to six out of the 10 people who come in for a consult and got a chance to listen to the report of findings, and what was wrong with them, and what it takes to fix it yeah, those people are walking out without starting care. And when I brought this issue up to him and this red flag to him, because sometimes it's always helpful, right? When you have somebody else be able to see your blind spots for you. He goes, "Yeah, I know, Austin, just some people aren't ready." Dude, he had a story for every patient who didn't start. This person couldn't afford it, bad experience before, shopping around. This person was from a Facebook ad, a Google ad whatever event that they were doing. But dude, come on, 40 to 50% for a year? That is not a handful of hard cases. What we call that is a pattern, and that is something that he was tolerating, and it wasn't because he didn't care. But in those moments, what ends up happening in the financials is the conversation can feel hard, and you all know what I'm talking about. I used to see yellow on my schedule, which for me rep- report of findings, and I'd get fear of that. I'd be like, "Oh my God, I got a report of findings today. I don't wanna talk about money." And that was early on in my con- career. Because confronting the issue for him meant admitting that something wasn't working, and what does nobody wanna do? They nobody wants to do that. I've been in this business for 17 years, and I've shared this before. I've opened up 20 clinics. I've made the exact same mistake more than once. And every time I look back at a year that was harder than it should have been, there was a number that was sitting on red on the scorecard somewhere that I let slide for too long. And this is gonna show up in a lot of areas of our practices, by the way. So you've gotta see how this reflects all areas of practices today. But today I wanna talk about what to do when a pattern shows up. It's not a bad week here or there. This is a pattern. And what does it mean when you keep letting it go? So here's the rule I run across all my locations. If a number is red three weeks in a row, it goes on the issues list. And for those of you that have Chiro180, I just posted in our Circle app, I just gave you a two-page PDF of exactly how to turn your businesses into this operating system utilizing the technology. This is an automatic thing. There's no conversation about whether it's just a rough patch. There's no waiting to see if it self-corrects. Three weeks, it's on the list. That's it. And I know it sounds simple, and it is, but most practices don't have it because most practices don't even have a scorecard in the first place, or they're just following some scorecard that their coaches told them to do. Without a scorecard, you are running your practice on a feeling. And, you may say in your brain, "Oh, I've got a hunch that new patients are slow." Yeah, you may sense that visits are down, but you don't know for sure because you're not tracking it weekly in a place where your whole team can see it. And I like to put the goals in there. When we put it on our Chiro180 dashboard, I like to put the goals in there, and then it's red if it's been off, the average is off, and it's green if the average is up. The scorecard changes that, and it takes everything that is the fuzzies and the emotionals and what we think of as chiropractors, and what does it do? It turns into facts. Facts over feelings, baby. You've all heard that before. So right, green is you're hitting your target, and red means you're not. That's the system. And if it goes red three weeks in a row, you stop asking, "Is it a rough patch?" And you start asking, "What is actually broken?" Because here's what I've learned, and this took me a long time to really understand this. The first thing someone names is usually not the real issue. What is that? That is a symptom. Low new patients is a symptom. A low close rate is a symptom. Your visits are dropping. That is a symptom. Something underneath each of those is the actual problem. And until you find that thing, what are you doing? You are literally managing the discomfort instead of solving the issue. That's why we call it IDS, identify, discuss, solve. My team at Buckhead had new patients trending down for almost a month, and everyone's first answer marketing. We need more ads. We need to push harder on Google. And I'm sure that was part of it. But when we sat down and looked at it, the referral process had completely fallen apart We weren't asking for referrals as part of our new pat- as part of our patient experience. There was no system, no script, no expectation. What does good look like? The marketing spend was the same. The community was the same. We just stopped doing the one thing that was driving, thirty to fifty percent of our new patients. And if we just threw money at ads, we, yeah, probably would've spent a few thousand dollars and still had the same conversation a month later. You gotta go one level down. Is this the real problem, or is this what the real problem looks like from the surface? Go one level down, and that's where the solve lives. Identifying it is identifying it by seeing three weeks red in a row. We discuss it, going a level down, and then we solve. So let me walk through exactly what this looks like when it runs right. You track your numbers every week, whatever your key metrics are, new patients, visit, close rate, collections how many people are on recurring revenue, wellness plans, whatever it is. Whatever matters most in your practice right now, you put 'em in your scorecard green or red. Week one, new patients are red. Okay, noted. Week two still red. Let's pay attention to this. Week three, red again. Issues list, not in your head, not a text to your team, not a discussion you have on the side with your spouse if that's your business partner, not a side conversation you have during a shift. In the system, visible under your issues list 'cause at your next weekly meeting, you bring it to the table. "Hey, new patients have been red three weeks in a row. We're gonna solve this today." And then you do three things. Identify the real issue, so that's a one-sentence, very specific. Not new patients are down. That's what you're seeing, not what's causing it. The real issue might be, "Hey, guys, we have no active referral ask process and haven't followed up with any of our existing patients about friends or family." That's something you can solve. Then we discuss it. Everyone in the room gets to share what they know about it, but you keep it tight. We like to keep it at five minutes. No tangents, no bringing up things from, a year ago. "We used to do blank." No. The facts that help you solve the issue, and then we solve it, and it becomes one action item, so it's a to-do, with one owner and then one due date. So in Chiro80, you drag that issue to-do, you assign it an owner, and you assign it a due date. And then by Thur... by Thursday, Dr. Madison owns building a referral script and doing a role play with the team. That's it. The issue go from just being a weight, a thing you're just carrying around to a to-do with someone's name on it. And guess what you do the next week at your staff meeting? "Hey, did you get it done? What happened?" That's the system. Or it moves to somebody else's to-do to keep the system moving along. And I wanna come back to that doctor I mentioned at the beginning because his close rate was not a scorecard problem. It was a tolerance problem. He knew that number was low, and he'd known it for months. And every week that passed without a real conversation about it was a- Choice. Not a conscious one, maybe, but it was a choice. And we do this all the time in our practices. If we hire a doctor and they're not growing their patient base, they're not connecting, they show up and they do the work, but the energy isn't there, you know what? Yeah, your team knows it. The patients probably know it, but you're tolerating it because the conversation feels impossible. I'm gonna just tolerate this person. They're doing average. They're doing fine. Or an office manager who's been with you for years, loyal, cares, but they stop growing. They're not learning anything new. They're comfortable, and you let it go because you don't wanna hurt that person. Or there's maybe a procedure that's been working less and less, and you just hope it turns around. This is all the same thing, by the way, and I talk about this a lot, which is tolerance. Tolerance is the enemy of a growing practice, and the longer you're willing to tolerate it, that to me shows me the limits of the practice, of the growth. It gives me the sh-- it shows me the lid of the practice. There's not a bad market, not a bad economy. It's not an insurance problem. This is a tolerance issue. Think about this. The things we see and choose not to act on because acting on them feels uncomfortable, that is tolerance. And the three-week rule, the one thing I love about it is it forces you to stop tolerating. To me, that creates a line in the sand that says, at this point, you no longer have the option of waiting. You have to deal with it. And what I've seen happen when practice owners actually install this system, when they start running a real scorecard and taking issues seriously, they stop carrying the same problems from one quarter to the next. And the things that were dragging them down for a year, th- what happens, they end up getting solved in a week. And did the doctor get smarter? They care more? No. They just stop looking away. The discomfort you feel when you know you need to have a hard conversation and you're not having it, that's the cost of tolerance. Every Monday, the tightness in your chest when a t- a staff member may say something and your numbers are low than what they should be, and you're not sure what to do about it you can solve it. You just gotta be willing to get a little uncomfortable. The chiropractors I've watched grow the fastest are not necessarily the best adjusters or clinicians, which I hate to say. And they're not the ones with the biggest marketing budgets or nicest offices. But what do they do? They face things early. They look at the scorecard. They name what's wrong. They have the conversations before it becomes a crisis. And they just do that week after week, and they never let the small problems turn into big ones. Three weeks, it's on the list. It gets solved. That's it. If you're running your practice right now, and there's something sitting red that's been there for a while, you already know what I'm gonna say. Put it on the list. Have the meeting. Find the real issue one level down. Solve it, one action, one owner, and one due date. Then, stop tolerating. And that toleration is showing up in all areas of practice too as well. We've gotta stop tolerating as clinicians and business people because when you do that, when you really commit- It doesn't just change your practice. This to me is the most important thing because this is what I'm seeing now with clinics that are stalled in growth. It changes how you lead and that shows up everywhere. If there's something in your issues list that you're stuck on and you're one of my clients, whether it's in Cairo and 80 or Ascent Program or Empire Program, share it in circle. If you're stuck somewhere, share it. Use your resources. You've got a lot of people in your circle that want you to win. Share it in there. Hope you all have a great day and I'll talk to you all next week. To learn more about building your business, leadership, and life on purpose, visit chiro one eighty.com or follow Austin on Instagram at Dr. Austin Cohen.