EP72: Your Q4 Is Already Decided

Your numbers this month aren't a report card on this month. They're a report card on decisions you made about six months ago.

Which means your fourth quarter is already mostly decided, and you can't fix it by working harder in October.

In this episode I break down what I'm calling the six month lag. Why the small decisions that feel completely defensible in the moment are the ones that cost you, why nobody in your building will catch them including you, and the five places in a practice where the slide actually starts. Plus three questions you can run with your team in fifteen minutes to find out where you're leaking.

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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 What's up, everybody? Welcome back, Austin Cohen Podcast. hopefully everyone's having a great finish to your summer. You've created some experiences, created some memories. I am... Let's see, we have one more trip left before we go out to Adventure Summit, which I'm so stoked to be able to do that. we're gonna go pick up my son next week at sleepaway camp. Man, for those of you guys that send your kids away to sleepaway camp, I gotta say, the first time is tough. I miss my buddy, man. It's been, like, three days, and they upload pictures every day at 10:30 in the morning. So every day at 10:30 in the morning, like, I look forward... Like, I'm so excited for tomorrow at 10:30 in the morning. I can't wait to see the pictures that get uploaded. although today when they uploaded the pictures, there was no pictures of him, so that was sad. but man, I know it's such a good thing. He's creating independence right now. He's learning to do it. Like, the one thing I told him before he left, I said, "Brody, you know, there's gonna be opportunities while you're there, whether it's the ropes course, water skiing, the blob. Like, I don't know what it's gonna be, but there's gonna be some hard things to do that, you know, for you may be scary." You gotta do it, man. and I think it'll be a really good experience for him to be able to do. So, you know, it's interesting, like these same conversations that I have with you guys, hey, you know what? These, conversations are transcending down to my children, as well. So the... A- and it's like j- everything is we were talking about today on the Ascend call, it's like everything is the same. Right now we're doing team experience. Like, we just got done building out what does a day one look like for a new team member? Because you can never get the day one back. And the mindset I want everybody who's in my Ascend program to learn is that when somebody comes back from their day one, people are gonna say to them, "How was it?" I want there to be a really good story that that person can share based on it. Most people wing their day one. There is a whole process that needs to be built out around that based on, the surveys that we've been talking about, the welcome kits that go out. Like, there's so much that goes into it. Cohort one, which started back in May, has 100% commit rate to it so far. If you are interested in cohort two, you need to let me know ASAP, because my goal is by August 15th, we will be sold out, that will be done, and we can move on and start the introductions and, everything else that goes along with getting everybody set up in there. because that starts on September 8th. You know, for those that are really looking to build, you know, true businesses and you're looking for tactical strategies, not just... Yes, there's a lot of mindset that's in my stuff, but, there's a lot of tactics, you're building o- on these calls. They're 90 minutes every week. And so it's not a rah-rah fest, man. this is stuff that I'm doing, in my practices day in, day out. I mean, my team of chiropractors are on these calls as well. So it's been a cool experience. So you gotta reach out to me on Instagram at Dr. Austin Cohen if you are interested in learning more about cohort two and my coaching program. so yeah, please reach out for that because that is, will be at capacity, once again, like I said, probably by August 15th is my guess. we typically tend to sell those out usually like three to four weeks in advance. Here's what I wanna talk about today, though, is for those of you guys that listen to the MrBeast Joe Rogan podcast, whoa. And like, I'm not like... Like, Joe Rogan podcasts to me are way too long. But when I saw MrBeast was on it, oh my God, I knew I had to listen to it because I'm just so impressed with what MrBeast has done, and there's something he said I can't stop thinking about. And he was talking about how his team, makes decisions, and he says this. He says, "Why make content that isn't great? We just ask ourselves, 'How do we make the best content possible?' As opposed to, 'How do we make the most money possible?'" And then he kinda shrugs his shoulders and says, "And shockingly, going with that approach, you just kinda make a lot of money." if you know his story, when his first video went viral, he made $10,000, he gave that away. Then he made like $100,000 and he gave that away, and his mom was always like, "Jimmy, you're never gonna keep... You're never gonna make any money. You just keep giving it away." Think about that for a second because what Jimmy said, MrBeast said, was not how I lived my life in the beginning of practice. I was doing the exact opposite for a very long time, and I've got definitely the wounds and the scar tissue based on some of the stories I've shared with all of you. You know, my second year when I was in practice, which was 2010, we had a whiteboard in the back office, and on it had collections, which was a number, and every decision that I made in my practice ran through one filter and unfortunately, it was collections. Hey, if we add Saturday, then we can make more money. Hmm, what would that do to collections? If we hire, what would that do to collections? You know, if we reduce our time with a patient, what would that do to collections? Or if we increase our time with a patient, what will that do to collections? What does that do to the schedule, and what does the schedule do to collections if we change it and add this onto it? Everything was filtered through collections and it... You know, we grew and it worked technically, but what happened? We grew slow, and something the whole time felt off, which for me took years to completely understand what it was, and that's what really today's episode's gonna be about. I don't know if today's gonna be most- more so about motivation as it will be most likely about a mechanism. Because once I understood that mechanism, I really... It's something you just can't unsee anymore, and listening to Jimmy and MrBeast, MrBeast today... Sorry, when I say Jimmy, I'm referencing MrBeast. but it just changed the way how I read every number in my business. You know, and for those of you that know me, anything I've done in my career that has been successful was never about the money. Like, I wanted to... Like in January, I started coaching chiropractors, and the first time I ever did that. The reason why I did it is 'cause I got, I got so frustrated of these coaches and consultants I see out there that are, everything's rah-rah. A lot of the stuff they're promoting are not things that they're doing in practice. Some of them aren't even in practice anymore, let alone have scaled to multi-unit, so everything's always been about, like a one location practice, which is fine if that's what somebody wants. But to teach scale, to me, really- There's gotta be a, a multi-unit that goes into this where you have what, you know, I think where we've been able to build really good leaders who are just doing an unbelievable job. and that's kinda what, why I got into coaching. And then Growth Summit, I started doing Growth Summit because I just got tired of going to the same seminars where the same speakers were there. And once again, it was very rah-rah-y. it was a lot of negative talking. There was a lot of conspiracy theories, and it just wasn't things that were gonna help me grow. And, you know, I was looking for people to talk more about possibilities than rather than just talking about problems, and that's why we started Growth Summit. ChiroIn80, that was born out of a need for our practice. We never had the vision to ever move ChiroIn80 to a commercial use. A couple years ago, when some of our friends wanted to start utilizing it to getting, you know, certain data points and metrics and spinal health scores, then, well, we started licensing it out to other chiropractors. Here's the thing I eventually had to figure out is, are your numbers this month a report card on this month? No. They're a report card of the decisions that you made about six months ago. This is exactly what I teach my team. So say that back to yourself. The numbers this month are not a report card on this month. They are a report card of the decisions you made six months ago. When your numbers dip, what do you do? Most likely, you're gonna go looking for the cause in the last 30 days, right? You're gonna start thinking, "Oh, what changed? Did the marketing slow down this summer? Did we lose a doctor? Maybe there was holidays. But the cause, underlying issue, is never what happened in the last 30 days. It's in the last six months of the standard that you slowly let slide. And I wanna be careful here because what I'm not talking about is I'm not talking about these, like, large failures, right, where, a location floods or there's a fire or a doctor walks out. Like, you know exactly what happened and you deal with it. Those, to me, are not the dangerous ones. Here's what's dangerous are the small decisions that are technically fine. So for example, report of findings that maybe runs over or runs under because the schedule was tight. That's fine. Defensible decision. But you did cover the important stuff in the report of findings. Or maybe you skip a follow-up day two call on a Thursday because it was late in the evening and everyone wanted to go home. That's fine. It's one call. Or a progress exam that was scheduled, and because you guys were double-booked and you couldn't get it done, you had to reschedule them. Patient got adjusted. Still fine. They still got care. All of those right there, by the way, in isolation are defensible. You can justify why you did it. But to me, that is what makes them also dangerous. Because is anybody gonna quit, care over your rushed visit of a report of findings? No. Or are they gonna write you a bad review because your report of findings was seven minutes short or seven minutes too long? Of course not. What are they quitting on? They're quitting over the accumulation, and the accumulation does not show up usually as one dramatic event. It is a slow bleed in your reactivation numbers two quarters later, and by then, what's happened? You've lost the thread back to where it started. That, to me, is the lag that nobody notices, not the day, not the week, not that month. Nobody notices for about six months. I hate to tell you, 'cause I'm about to be the bearer right here, and here's what makes this worse, is the people best positioned to notice are the people who made the decision. Think about this, right? Like, your team isn't hiding anything from you, and they don't know either. They made a reasonable call on a busy Tuesday and moved on with their day, just like you would have. So two things come out of this that I think are worth writing down. The first one is this: You can't fix this month with this month's effort. You can fix it with this month's standards. We always talk about you don't rise to the level of your goal, you fall to the level of your systems or standards. If your numbers are down right now, working harder for the next three weeks is not gonna touch it. That will show up in the fall, which to you may be discouraging or freeing, depending on how you look at it. My suggestion, and I'd encourage you, look at it the second way. Here's the second thing to write down is, one, you can predict the fourth quarter right now. You do not need a forecast. You take an inventory of what you tolerated in July, and I will tell you right now, that will be your Q4 So let's go back to MrBeast for a second because I think this, kind of matters in translation here. For him, the thing is content. That is his product. That's what he's asking, how do we make this the best possible? How do we create the best content? Not how do we make the most money, how do we create the best content, is what he said. For us, as service providers, specifically chiropractors who are listening to this, and I know there's a bunch of acupuncturists who listen to these calls as well, it's the experience. And I want to be precise what I mean here because I could see somebody hearing this completely wrong. The adjustment in chiropractic is the product. It's gotta be great. Hopefully it's precise, you're confident when you do it, you deliver it like it matters because you're focused, you're not distracted, because it does. And if you're not excellent at the thing you went to school for, I don't know if anything else in this episode is gonna save you because you're gonna constantly have to patch the Band-Aid with just constantly getting a ton of new patients, right? Like, that is the floor, not the ceiling. So the non-negotiable is just, you know, listen, you've gotta be good at adjusting. That's the product, and I, I can't soften that any more than it's gotta be. Now, here's the uncomfortable part, though. What happens when you have great care because you're an amazing adjuster, but you deliver an average experience? You still lose. And I hate saying that because it's a hard sentence for our profession to hear. Not because the clinical part doesn't matter but because it's the price, like, that is the price of admission, not the differentiator. Your patient cannot evaluate your adjustment. They just can't. They don't have the training. They have no idea whether you nailed the segment or you were off, right? They have nothing to compare it to. What they can evaluate though, in your practice, is everything else. What it felt like to walk in, whether did somebody say their name, whether they studied their paperwork, whether they understood what was happening to their body and why, whether it seemed like, hey, did you have a plan for them and a program for them, or did they just get rack and crack and left? That's what they're grading you on. And that is when they- when you think about people and what they're telling their friends, that's exactly what they're telling their friends. It's all about the experience. So when I say experience, I, I'm not talking necessarily about like, "Oh, yeah, they had a water that was a, you know, fruit inside of it," or, you know, "They, they had a coffee sitting out there." Does a person leave your office like somebody's paying attention to them specifically? That to me is gonna be a real big, a real big thing. And you, and you think of like any doctor's office you've ever been to or like even look at like outside of the healthcare industry. Look at car dealerships, right? Like are they paying attention to you? Restaurants, same thing, right? Like it all translates into the same all these industries. So If it's invisible, where does it actually happen? Right? Like where does this occur? And I wanna give you five places, and I'm gonna give them to you in order of how invisible these can be. The first one you might catch. I don't think the last one you will. Here's the first one. You start doing report of findings and you did them a certain way. Well, what happens is your practice got busier, so then what ends up happening? Your report of findings get shorter. Not all at once. It just starts to compress. Minutes here, two minutes there, and then one day it's just a different conversation than it was a year ago. Now, nobody in your office is gonna tell when it changed, but this is the most measurable one on the list, which nobody measures. Like, look back at your report of findings and what you've decided to be defensible on and negotiate and how you've changed it to make it shorter to adapt. Now, you may have other team members who can handle the adjusting or somebody who does your report of findings for you, but I've seen a lot of doctors who slowly start to lower that down. Once again, do I think it's easy to get somebody to close into care? Yes, 1000% because somebody's making an emotional decision. But what we're looking for are commitments to care because a close into care is easy 'cause somebody wants to feel better immediately. A commitment is somebody staying for more than... You know, they're completing a care plan. That is a commitment. Big difference between the two, by the way. We're looking for commitments, not just closes. So the... Reevaluating a report of findings. The second one is the... This is a problem. The progress exam, the re-exam, whatever you call it, it's becoming a rebooking event. This is a big one. And think of even... By the way, even like progress reports. But like this is why we built the re-exam structure the way we did. The re-exam is supposed to be the most valuable time to me in the entire care plan, and this is a patient finds out whether this is working. It's where they decide consciously or not, and they may tell you or not. Like, are they gonna keep coming or not? And you know, I'm excited for those of you guys that are joining me in cohort two because there are some questions that we now have on our re-exams that I think tell a story on where the patient's headspace is at. Once again, I'll give you guys all of this, for those that are joining me in cohort two, but it is legit. Like, our progress exam process I think is one of the most dialed in. most healers, like, they're checking the boxes. Maybe they show them a couple numbers here and there, and they get it back on schedule. Okay. When you start to get busier and you don't have like built out scheduling, what'll end up happening is like a progress exam gets moved out. A progress report, you're too busy, so you don't have time to sit down with the patient and go over progress report, so maybe you end up doing it by the adjusting bay, and you just go through it real quick, and you don't go through what I teach, which is past, present, and future. here's another one Number three, the front desk stops using names. The moment your front desk goes from greeting a person to more so just, like, processing this person as an arrival, the office feeling has changed. And I don't know if they're gonna complain about it to you. They're gonna stop coming to you. Everyone expects you to do a really good job day one, day two, because you're in the sales process. But what if you were always in the sales process until they got to visit 100, right? Like, that's what I like to look at, is think. Is like, to me, the sales process is zero to 100. And we talk about what's called our WOW experience, which stands for welcome, optimize, win. You know, this, it's so important though, is that experience. and how does that front desk person make it memorable every single time? Number four, the doctor stops explaining, and what they're doing is they're just assuming now. This is a big one. This one gets me, because it comes from experience and, you know, you've all had this conversation hundreds of times. You know where it's going. So you start skipping the part where you explain the why. Because you already know why and it feels redundant to you, but it's not redundant to them. So for example, we have what's called inside the bay and outside the bay. When they're outside the bay, I talk about the weather, sports, whatever I want to talk about. When I'm inside the bay, we talk about why they're there, what I see, what I felt, what I'm feeling, felt, found. And then future would be when their next appointment will be. So I'm always want to tell them, "Hey, here's what I'm feeling. Here's what I found. Hey, when you lie on your back, see how one right leg goes out and your left leg is more neutralized and it's straight up and down? Yeah. Hey, here's what we're looking for. Hey, by the way, w- do you feel this area where it's tender? Yeah, we're feeling for tender top fibers. Yeah, there's also, like, temperature differences between your left side and your right side, so we're gonna make sure we focus on that." So we're, I'm making sure that that all happens because we're explaining, we're not assuming. The second you go to assuming, I do think you start to lose some credibility because now you've become their friend, not their doctor. Not officially, like nobody updates the document. The follow-up call stopped happening in March, and now it's July, and it's just not a thing anymore you guys do. if you asked your team, they would still tell you that it's probably still part of the process. They believe that, but it isn't happening. It's very important that we're constantly evaluating these SOPs and making sure that the things are getting done and things aren't slowly starting to slip through the cracks. This is why things get thrown on the issues list. So for those of you guys that are ChiroMate subscribers, these are things that get thrown on your issues list that you will discuss and solve during your meetings, is finding things that are not getting done anymore in your SOPs, evaluating them, and then somebody will take it on as a to-do and figure out why it's not happening anymore. So what can you do with everything I just shared? And here's the three questions I want you to take, because I think they're a little uncomfortable, but they can also be productive. and it's definitely something to do with your team. here's the first one. What's one thing we used to do for every patient that we now do for most patients? And that word most is where the drop lives. Like anything you do for most patients is something you've stopped doing on purpose and started doing when it's convenient. Anything you do for most patients is something that you've stopped doing on purpose and you started doing when it's convenient, especially for the schedule or like whatever else comes up. And hopefully I said that the exact same way, so from memory. But, that's the thing to start thinking about. Here's question two. What did we stop measuring because it got uncomfortable? And everybody has one. There's a number that you used to look at every week and at some point it started telling you something you did not want to hear and it fell off the dashboard. Find it. Like I know for us, if we have goals and if one, and if when we look at our Chiro80 dashboard, if we're underneath our goal, the number average shows up red. So if in six weeks time we're still underneath our goal, then that number will get thrown to the issues list so we can discuss it and solve it. We need to, we wanna tackle that. And it's like, you know, listen, I, I don't know, this is kind of a distraction conversation we're talking about, about to talk about now, but it's like AI. When you talk to AI, AI agrees with you. So to me it's like the same thing. If I tell AI, I'm like, "Hey, what's the best practice in the world?" "Oh, corrective chiropractic because of this." No, I want you to now disagree with me and tell me why it's the worst practice or where the opportunities are for growth in that practice. So what I'm trying to do is disagree and find weaknesses and get uncomfortable. And to me, those of you that can ask those questions are gonna be the ones who will win the game for sure. I had a conversation with somebody today who asked a really good question. She said, "How can we get the most out of your Ascent program?" And I thought that was such a good, vulnerable question. Now, she, you could tell she was being very honest and authentic with it, which I loved. So now it's just a matter of like knowing when you are exposed and those hard things do come up, what are you gonna do with that information? Here's number three. If a patient described their experience here to a friend this week, what word would they use? Not what word do you want them to use, what word would they actually use? And if the honest answer is it's fine or easy or quick, then that's your project. Does fine generate referrals? Heck no. That's where the... That to me is where the re-exam system had to get built around. Because the re-exam is a place where the slide is the easiest to see and the easiest to reverse. It's the checkpoint. The conversation is strong, most of the rest of it holds, right? Like we call ours now, there's the set, which is like the first one, there's the shift, and there's sustain. Like we have different like re-exams that we kind of like just named our re-exam. Now that's more like internal language, but it's something where we've really dialed in in that experience. Here's where I wanna leave you. Like I, I'm not telling you to ignore your numbers. I look at ours all the time, and I can tell you right now where we are on new patients, close rate, the black hole across most locations. That to me isn't the point. The point is, is that the number is the scoreboard. It is not the game. And when you make the scoreboard the game, you start making small defensible decisions that cost you something you will not be able to trace for how long? Six months. Mr. B said, "How do we make the best content possible?" Ours in our company is experience, and the adjustment is at the center of it, and it has to be great. and me and my team need to have confidence that the adjustment that we are delivering is worth the value exchange that people are paying, by the way. Because if it's not, people read right pa- right past that. So it's gotta be worthy of that. And here's where you may wanna sit with this week. Look at the last decision you made when nobody was watching, and the thing that maybe would've been easier to do. That to me is gonna be your next three years. So many of you guys who have been coaching with me, you know that I always say leadership to me is what you do when nobody's watching. When you hit snooze on the alarm because you are justifying why you're tired or you're making these justifiable decisions because it's easier for your practice Or, like some of you right now have justified why you don't need business coaching actually and why to work with me or whoever, anybody else. and it may be because you've been burned in the past, which makes sense in this profession for sure. So I get that. But you know what? Like I have three coaches where I'm paying $12,000 a month for that has been one of the greatest investments. But I've also, my issue always was sometimes tolerating people that weren't getting me to the next level. Once again, they were talking problems, not possibilities. So like, what can you do this week to set yourself up, not just for the next six months, but for the next three years? I hope to hear from a lot of you on Instagram for those that are interested in the coaching. And for those of you guys that are looking forward to want to hear some of this content that we talk about live, make sure you get to Growth Summit coming up in February 2027. You can go to kyronade.com to learn more about that and click attend Growth Summit. Have an awesome day and let me know your thoughts. I love when you guys share with me your thoughts on these podcasts, by the way, and your takeaways. It's so great to hear that on Instagram. So keep letting me know that. 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.