Dr. Alex Kocken: Growing a Practice While Maintaining a Healthy Work-Life Balance

In this podcast, we engage in thought-provoking conversations with leaders in healthcare, business, politics, and various facets of life. 
Dr. Kocken is a 2013 graduate of Northwestern Health Sciences University and has been in private practice in De Pere, Wisconsin for the past 10 years.
Dr. Kocken talks about the crucial steps he took to open his chiropractic practice and shares valuable insight regarding the ongoing strategies he employs as he grows his business while maintaining a healthy work-life balance.

Transcript

SPEAKER_01 0:09

Welcome to the Wisconsin Chiropractic Association podcast, Active Basics. I'm your host, Dr. Chris Rush, President of the Wisconsin Carropic Association. In this podcast, our goal is to give you thought-provoking conversations with leaders in healthcare, business, politics, and various facets of life. It's our goal to provide you with knowledge, wisdom, and inspiration that you can apply to your own life. Today, I'm speaking with Dr. Alex Kochen. Dr. Kulkin is a 2013 graduate of Northwestern Health Sciences University and has been a private practice in the field classes for the past 10 years. Dr. Kulkin talks about the crucial steps he took to open a chiropractic practice and shares valuable insight regarding the ongoing strategies of key employees while he grows this business while maintaining a healthy work-life balance. I hope you enjoy my conversation with Dr. Alex Coken. Good morning, Dr. Alex Coken. How are you today? Good. Fantastic. So thank you very much for meeting with us on our WCA podcast this morning, back to basics. And I am going to fire away right away with a standard question that I like to ask everyone. What inspired you to become a chiropractor?

SPEAKER_00 1:24

Well, that's a fantastic question. Short version or a long version? Give me what you got. Yeah, the earliest I can remember, um, I don't I usually don't have a wonderful memory of um exact details of you know history and and things like that, but for whatever reason I seem to remember, you know, facts and things of that nature. But from what I can remember at a decent early age, and like I want to say about high school, like maybe freshman year-ish, um, we would talk about you know different careers to do, and that's kind of what spurred, you know, thinking about you know what to be interested in, what to look into, who to shadow. Um, started having some conversations with my parents about you know where to look for that, what kind of talents did I have, things like that. So going off of that, I remember writing a paper on chiropractic. Um, I have no idea how that occurred. I remember I think I had to interview um the chiropractor that I currently um my parents had gone to. And then the a bigger moment, more experiential moment, was uh I think we were going up hunting. And yeah, I think it was a Saturday morning, which I don't know how many chiropractors still have Saturday morning appointments, but that was a common one, you know, back in the day. And we were we were heading up, and for whatever reason, this particular time I remember going in and watching my dad get adjusted and just being wowed by it. It was just very different. It was hands-on. He kind of had that body language of like, you know, went in a little posturally uncomfortable, you could tell, and uh got adjusted and immediately, you know, the look on his face, the sighs of relief, you know, then it spurred me to ask a few questions of, you know, hey, like, you know, what is he doing? Or, you know, what's going on? And and his response was just, you know, you should go sit down with them and ask him those questions. I'm not the you know one who's gonna answer those, you know, the best for you. And so I think another, I think I had another school project where I, you know, I did ask him. I think I asked a different chiropractor that turned into um kind of fell in love with that a little bit. And then to cover my bases, I toured um a few other different practitioners, got to watch a couple orthopedic surgeries, hang out with PT for a bit. Those were super fun. But but at the end of the day, the other deciding factor looking back on it, I don't know that I would have known this at the time, but after looking at it, going, hey, I think I'm gonna go to school for eight years, you know, my parents sat me down and they're like, This is not free. We need to we need to have you working in the you know in the summer, and uh, you know, you need to make some money. And so um there's an entrepreneurship class that I had in in high school that we had to write a business plan. And so I wrote a business plan for a landscaping company. I won a little mini grant that kind of kicked it off. And then from there, I had that from maybe I think age 17 to 23, and it turned into paddy building patios and retaining walls, and so I got bit by that entrepreneurial bug. And chiropractic was the one where when I was touring it, it had all the stuff that you like, it was hands-on, less sitting at a desk pounding paperwork as compared to a few of the other practitioners that I toured, and um, you also had an opportunity to own your own business, which was attractive. And story-wise, I mean, there's there's a couple other things in there. I guess I had my own chiropractic experience once, once I was kind of pretty sure on that. I had had a bunch of sprained ankles in high school playing sports and basketball. And uh I had gone in to you know get adjusted because at this point I was very interested, but I hadn't had like you know, any complaints to go in and you know check it out. So I kind of used that, went in, and um, I think it was back pain. I had back pain from landscaping, and uh, it was like the secondary thing where the chiropractor was like, wow, you sprain your ankle, you know, both of them eight times, you know, a couple ER visits, you know, you're you're wearing braces all the time. And he'd kind of connected saying, Hey, you know, like how'd you sprain them? Do you land on feet? I'm like, no, I just you know, would land on in my, you know, when when go properly. And and so he would kind of connect, like, hey, you know, your low back, there's some, you know, nerve things, the nerves in your low back, they supply those muscles. If they're a tick slow when you're playing a sport like that, you know, and you're fatigued, maybe it's you're you're just not getting those muscles to fire, you know, catching you, and then your ankle rolls and it's too late. And I remember kind of thinking, I like that, but this seems a little out there. Reality was though, I mean, after I started getting adjusted, I did not, I mean, I had a couple sprained ankles, but they were they were more landing on a foot, rolling it on a football field. They weren't, they weren't like the previous ones. And for me, that was the one where I was, I think I was a little bit more solidified in, you know, this is pretty, this is pretty nifty. And then the other one is I think just like a lot of chiropractors, there's that attractiveness of we're gonna go at this from a you know natural standpoint. And the adjustment is it's a pretty powerful natural technique where you're not you're not it's not very invasive, you're not adding anything that that's you know different in there. Um, it's relatively safe. And that for whatever reason, that just that was something that I really connected with. And um I saw that incredible power of the adjustment and what it could do for people. And I just I like that that whole model. And it it kind of had steps and it grew, you know, through a variety of experiences.

SPEAKER_01 7:16

That's very cool. You were inspired in high school witnessing chiropractic with your father, and then you take an entrepreneur class, start your own business in landscaping. I'm sure you gained a ton of knowledge doing that, which then still helps you today, and I'm sure helped you when you started your chiropractic business because I know you're an independent practitioner, and we'll get to that. So off to undergrad you went. Where was that?

SPEAKER_00 7:43

Um, I attended St. Norbert College in De Pere, um, got the pre-med degree, and then headed off to Northwestern Health Sciences University in Minnesota. Can you tell us a little bit about your time at Northwestern? So I didn't know quite what to expect. Graduate school prior to attending it is a is a little bit daunting. And then it was probably the farthest away from you know home I'd been. And the the other difference that I didn't think would matter, but greatly did was the kind of the going straight through the year thing. Like you'd even have school in the summer, which wasn't a big deal the first summer, but I feel like the second and the third summer, those it's very difficult to study hard, you know, in Wisconsin summer.

SPEAKER_01 8:31

Malacipical landscaping season for you.

SPEAKER_00 8:33

Yeah. So I I mean, there there very much was a um you could tell, you're like, wow, I mean, people people need rest. We can't, we're we're not robots, we cannot pound through things. And that's that was kind of always something I was accustomed to doing, you know, whether it was in sports or working, was just like, hey, we gotta get this done, like let's get it done. That that definitely led to a little um burnout. I think it was like fifth trimester. I remember thinking, wow, I can't believe, I can't believe how much more trying this was than than I thought. Normally you'd always kind of been able to put your head to the grindstone and and get it done. But that was a surprising aspect. Other than that, I mean I met my wife in Minnesota. I went trade going to another chiropractic school, if that meant not meeting her. Good answer. Yeah. And uh I we had great friends. I had I was had great roommates, great couple guys that we lived with in the same little uh facility, and and it was it was a wonderful, wonderful experience. I wouldn't trade it for the world. That was I don't know that I'd go back and do it a second time, but I don't I'd do it again.

SPEAKER_01 9:44

Okay, so you're at uh Northwestern Health Science University studying chiropractic, you meet your wife, so I'm sure that took a bit of your focus and time, but what about other things? Did you join any clubs? Were you part of any organizations while you're at chiropractic school?

SPEAKER_00 10:02

Yeah, I one of my chiropractic mentors who's now retired, Peter Shubi, WCA member, he had told me before I went to chiropractic college, he didn't give a ton of advice, which is good because it when people give small bits, when you really don't know what you're getting into, I feel like it sticks more. And um, he just said, go go be go be a great adjuster. Just make sure that you, you know, can that you can adjust when you come out of school. And so the clubs that were attractive early on were like motion palpation. There's a couple, I don't even know, I don't remember what they were, but basically we got to go and we were, you know, practicing, setting up adjustments, practicing some different adjustments early on, and uh getting our hands on people more than just was required in school. And that was those were big.

SPEAKER_01 10:54

Very cool.

SPEAKER_00 10:56

So let's move forward.

SPEAKER_01 10:58

You uh graduate from Northwestern and you are now in private practice in De Pere, Wisconsin. Can you connect the dots a little bit for me on the decision to go independent, to go private, and then choose De Pier?

SPEAKER_00 11:12

Yeah, so that was I was always aware that you know, going in and starting my own clinic or buying another one was a real probability. Um, I had no idea how to get there. I feel like as you approach the end of school, you know, you kind of it's hard to do. You can't people are it's really hard to, you know, meet people and and develop those relationships enough where somebody would take a risk on you with little experience early on. So I had, I mean, I had tried, but also contextually, we were, you know, several years past that uh great financial recession. So if you could remember back to that time, there were not chiropractors hiring other chiropractors at that time. It was kind of uh um, if you have a job, just keep rolling in it type of thing. And you know, it was not like today where I can look in a classified ad and I can find 25 chiropractic, you know, job openings and and such. It was you might find one and it may not even be in the area that you were interested in.

SPEAKER_01 12:18

Just to bring that perspective in, I mentioned in your introduction, but I'll just mention it again now that you graduated in 2013. So that's the time frame we're looking at when you're looking for either taking a job or creating your own job.

SPEAKER_00 12:32

Yeah, that was fascinating. So the other the other one was the that that was when we were doing the whole political government shutdown things, which created some interesting things when you're trying to do an SBA loan. Those were a whole bunch of factors, and ever I think everybody in in a different time frame has different hurdles that they're gonna be strung into. And at the end of the day, like getting through a lot of those things where you really got to have a strong support network. I mean, I was fortunate enough to have a plentiful amount of people that I could go and ask, you know, for help opinions, even if they weren't chiropractors, you'd be you would be asking them, you know, different small business questions, you know, other people who had gone to you know graduate school or um are trying to seek you know jobs professionally. Every one of those, you just you honestly never know. You don't know what you're gonna need. You nobody knows the future. So a lot of times, like having those relationships where you could go and lean on different people and ask some questions, people in those environments and who've had different experiences, you know, valuable ones whom whom you trust, those are invaluable. I I don't know that I could even put a price tag on it. I know I wouldn't be here today with without the support of a lot of different people, um, some more than others. Yeah, so then to kind of go forward, I I interviewed for a job, or I think I interviewed for one associate job. There was no other jobs in the area that I was looking at that you could even interview for. Um, I looked at buying, I can't remember if it was two or three different practices. I know two for sure. Again, there was not a lot of practices for sale, you know, at at that time either. Um, I think a lot of people are just holding out for you know two or three more years, and then they were gonna try to, you know, go ahead and do that. So anyway, it I I did an interview once. I do remember one that I did an interview and um we got done. And the chiropractor who I was interviewing with uh told me that they were not gonna waste my time by hiring me. They totally knew I was gonna go start my own clinic at some point. And that was kind of a bummer, but at the same time, I appreciated that they were like, Yeah, you're you're you're game ready. You should be out there.

SPEAKER_01 14:47

Apparently, that was really great advice because look at you today. You mentioned a point that resonated with me just yesterday when you were talking about surrounding yourself with really good support structure and good people. Uh, we had a staff meeting yesterday and we were reflecting on that. That some people just have great strengths in certain areas and right person for the right job, wrong person for the wrong job, that type of thing. And not everything needs to go across my desk to make sure that it's the it's the right way to do things. Some people are just more creative and they've got talents in areas that maybe you and I don't. So yeah, picking and choosing and like answering yourself with the right people.

SPEAKER_00 15:27

Yeah, and I feel like over time, I'm sure you could attest to this too. Um, there's things that you now know more about that you could mentor people on, but um, previous to walking, having a mentor walk you through a situation, you're like, I didn't possess that, you know, prior to somebody walking me through that. Um, part of part of just being a chiropractor and then being a uh business owner in general is just paying attention and and learning from the failures and then also learning from sometimes they're not failures, you just you're just doing something and you're like, man, I I could do that differently, and just kind of paying attention to all those different things and and learning them over time. And the cool thing about this profession is you get a you get the you get exposed to a lot, sure, a lot of different things, as I think a lot of small business owners get exposed to.

SPEAKER_01 16:16

Yeah, definitely. And you know, on the topic of mentorship, I know that's important to you, and being who you are as a chiropractor and a business owner, sometimes you have different mentors for different purposes. Do you have a source of knowledge or wisdom or mentor or podcast that you go to? And I'm gonna ask you from two different angles one as a chiropractor and one as a business owner.

SPEAKER_00 16:42

Yeah. So I I would say, especially for you know, a young practitioner, the you know, forge those relationships with other chiropractors. And I feel like the the big one is that you know, you're thinking, well, I mean, how would I do that? You know, ask ask people if you can go out to lunch with them, um, just develop natural relationships, get their cell phone numbers. So if you have a question, you can text it to them and ask, or you can, you know, shoot them a call or an email, whatever it may be. Those were invaluable. And one of my mentors, he told me to join the WCA, and that led to more mentors. And so there, you know, there's like a thing where you know, when you're showing up to a you know, fall convention, especially when you're you're a one or a two-year, you know, new chiropractor, you know, meeting people. Obviously, it's great getting continuing yet, but there's there's a whole bunch of other events, like there's there's some different get-together events where you can meet people. Um, there's different political events that you could show up to, which those are great. Um, I always just tell people to show up to them because guess who you're gonna meet? You're gonna meet chiropractors who care about the profession, and those are people that you you should be interested in being mentored by. Those relationships are invaluable. I mean, there I could think of you know five or six off the top of my head, but there's there's many more. There's also that version of a mentor that you may not reach out to, but you learn about them, you hang out with them, you see their style of practice, and you go, Man, I'm learning stuff from you, and I didn't even ask you a question. Very true. And then uh business standpoint. I mean, I was I again, I was extremely fortunate that I mean, my parents were the I would break up my parents all day. They were super, super supportive. I hope to be that supportive of my own kids um in a way, and they were supportive in a way where they didn't they didn't do stuff for me. They they like thrust me, let me, you know, get thrust into a situation and um kind of learn from different stuff. It was just, I don't think it's super normal that that parents were you know letting their 17-year-old drive around with a trailer taking on landscaping projects. I now look back as a dad and go, man, that must have been like a second job for my father. Um, but I greatly appreciate it. I learned so, so, so much from it. Um, and and his, you know, it didn't stop there. I mean, they were supportive going through starting the business. I would reach out to him like every month and ask him various uh, you know, business stuff, tax questions. Hey, I got to know a question about this. Like, who do you ask for that? It was invaluable. And then the other one that I haven't said yet is my um when we started out, it was my mom was my front desk, and she her and I just learned insurance and contracts and in HICFA forms and billing. And um again, same thing. Like, I don't there's no way that you know I have a practice, you know, if I don't have that have that support going going through it. And I think for a lot of chiropractors, I think that sentiment holds true. It's you know, it's it's it's usually family, it could be your wife, it could be your spouse, it could be, you know, your mom, your aunt. That's the other one. My aunt is also my other front desk person, and we hired, we just hired one maybe about a year ago. So that's we've only had we've had this, we had the same two, same crew of three, including myself, for 10 years, and we just had one other one. And so over time, like we've just we've been very blessed with uh consistency. We've all learned things together, and you just really can't. I now I don't think a lot of practices are blessed with that. I mean, it's it's so it's so incredible when you have a front desk person who's learned everything with you for uh 10 years and knows probably more than you.

SPEAKER_01 20:39

It's interesting because you mentioned you've got a lot of great resources with your dad and his business background and your mom and your aunt working in your practice. But where did you learn the valuable lesson to ask questions? Because I'm actually I'm picking that up on you right now.

SPEAKER_00 20:58

Uh, I definitely have a stubborn streak. Again, I don't I don't know where I learned that, but I would I would venture to guess that I definitely probably learned that the hard way. Um, whether it was, you know, out doing a landscaping project and just grunting away in 90 degree sunny weather, and then having uh my dad stop in on his lunch and then look at something and be like, Man, I can't believe you're doing it that way. Like, this is so easy. And then he drives away, and there's this feeling of, man, I'm glad he told me that, but also wow, do I feel defeated from the sun, you know, beating down on me. And I think next time I might shoot him a call if I don't, you know, if I have a question. I would venture a guess that it was probably a stubborn streak. The other big one is just I don't know that I would ask questions to people that I don't trust. And so you got to figure out how to have relationships where you trust people that you can reach out and ask them. I mean, I wouldn't ask for advice from you know, chiropractor I met 10 minutes ago, but those take time.

SPEAKER_01 22:00

time to you know develop relationships and and feel that natural ability where you can just kind of reach out and and ask ask questions but yeah I would I'd say I I was probably uh I probably got broken into being able to ask questions there you go like I said very valuable lesson and it's a skill that you have to set pride on the side to do yeah but moving forward a typical day in the life of Dr.

SPEAKER_00 22:26

Alex Cokin you're a family man married children you run a busy practice let's talk a little bit about the business side of your typical day yeah I feel like one of a one of the very attractive parts about being a chiropractor and being an entrepreneur is the long-term ability to work for 40 maybe 45 years I mean I we do you do not hear of people working in a career that long that is rare and you go to like a convention you hear it all the time I mean there are chiropractors in their you know 38th year their 42nd year and they're they don't I don't even know if they're planning on retiring. They just love it and I mean I think one of the longevity pieces of that the nature of the job is something that's very sustainable to have a family with it's it's very sustainable. You're not working night shifts you're working during the day you're able to make sporting events. I mean I always hear all the time that from other chiropractors that they're able to you know be at their kids sporting events or even better um coach volunteer chiropractors are always volunteering in different areas I know for the WCA chiropractor of the year award that one of the criteria is what a candidate is doing outside of just you know their business and I I love that definition of success there's more than just clocking a certain amount of revenue per year. There's more than you know patient visit average you know how many office visits you're getting um things of that nature that that the chiropractor of the year that there's a component of hey what's this person doing in the community and people are busy what a great opportunity that this profession has to have time to you know volunteer serve and get out there. It's a super great opportunity that we have um professionally like day to day I mean I usually I mean there's there's kind of those hot spots that you find that people like to book in at so I I think most people figured it out but usually it's that like the morning timeframe like you know eight to 10 and then usually there's a little lull and then you kind of see a bunch of people like 11 to 1 and then there could be you know a little lull and then you see a bunch of people about two two 215 to kind of the end of the day. And so in those little pockets of breaks that's where from a business owner standpoint that's where we kind of work on like hey what are we doing marketing wise how's the accounting going do I need to do anything for you know different note audits or other stuff that's usually in a typical day that's kind of what we're it's kind of how we structure it and and kind of look at it and there's always stuff to do in that downtime as we have it. Let's flip over to uh work life balance your family man can you talk about that a little bit what a great blessing that's the other thing when you when you go out and you start a practice uh your your spouse better on be on board I mean we didn't make money for two years starting out and we were I mean I was totally reliant on um my wife's income and her getting out there and doing that and that can be mentally straining it's one thing to say it um but kind of living it's a whole different thing and um I think for a lot of chiropractors that have started their own business I think they can all say that you know your your spouse is a major component of your success and even you know even to this day I I still couldn't run my practice if my spouse wasn't 100% all in on board even though she doesn't work there I mean what she does affects your business and kind of what you what we do together you know affects the business. And I know you know that you have you guys have your um situation where you guys work together. That's fun.

SPEAKER_01 26:35

Yeah I have the uh I have the benefit of being married for 33 years and working with my wife in the office for 33 years as well. So and now I've got a couple of kids that are chiropractors and physical therapists as well. So yeah we're speaking the same language Alex it's yeah huge it's a huge benefit to have someone on board with what you're doing.

SPEAKER_00 26:58

And my daughter told me my oldest daughter told me to make sure that I drop in the podcast that she's interested in being a chiropractor because I asked him I was like hey what what do you do you want me to say anything about you because there's they're they love that stuff and um and then the my second oldest that's how she wanted me to rephrase it I have two two daughters and a son and uh the second tell us tell us the ages Alex um eight seven and five and so we're just ending the school year for time time's sake you know context and uh yeah the my oldest yeah she said hey drop it that we're that I'm interested in being a chiropractor in the future and I'm like that's super cool and then um the probably be hearing from the admissions department at Palmer in northwestern Charlotte can I start paying now the um then my second oldest daughter uh she said she's interested in being a vet I don't know if she understood the context of the podcast but I'm like it's that's fun to fun to see.

SPEAKER_01 28:04

Hello everyone I have a question for you where do you go when you face a business or administrative challenge in your practice? I'll tell you what I do. I go to the Wisconsin Chiropractic Association help desk. WCA membership services director Tana McGowan has an extensive career in chiropractic offices and with the WCA. Tammy can assist you with a variety of topics ranging from billion coding, insurance, compliance, documentation, HIPAA, record retention, and Medicare and Medicaid. If you have a question about work compensation or personal injury we have Dr. Jeff Wilder who is a national consultant and former practicing Wisconsin chiropractor who can help out with all those pertaining issues. If you're looking for legal advice Attorney Barbara Zavalla is on our team from the Center of Health and Wellness Law to provide legal counsel. The other great thing about the help desk is it's super easy to access. You can send your inquiries to wcahealt at WICIro.org or simply call 608-2921804.

SPEAKER_00 29:10

So jump on board with the Wisconsin Chiropractic Association number one member benefit the WCA Help Desk WCAHelp at WICIro.org or simply call 6082921804 yeah no work life balance I I think being a chiropractor offers a great work life balance especially being a small business owner um you can scale your business to whatever suits you and there is one thing I'm always curious of just those uh the chiropractors where they're their father or their grandfather and how how far back it goes I I would always be curious to like to listen in on that. I that would be I think I I feel like that would be even more information. That's something that I've never you know experienced that'd be a super cool thing to listen into.

SPEAKER_01 29:58

So one thing you can do is go back to uh podcast we did with Dr. Steve Yeomans. Yeah he's a multi-generation chiropractor and obviously one of the most respected chiropractors in the country. Oh yeah not not just the state of Wisconsin so that's an interesting podcast that we did in the past.

SPEAKER_00 30:15

Yeah I had the opportunity to listen to that and um I I knew of some of the stuff but just kind of listening to that journey and how he had you know gotten into other things and in some of the doors that were open there where you know he was able to just kind of walk into a clinic setting and then certain chiropractic pavers had been laid and um he it's it's almost like his chiropractor brain you know is more developed than you know some of ours before we even like you know get into practice and then he just he went full bore into some very cool opportunities you know with other you know medical doctors and research opportunities. That was a fun listen I would highly recommend that people do that. But yeah other information I I mean I'll I'll listen to a couple podcasts I I think Dean Smith runs a chiropractic science podcast that I enjoy. There's an evidence-based chiropractor podcast that I enjoy um and then books a lot of them I just pick up you know you go to a convention and there's different speakers that come and sometimes they take you by surprise sometimes you're already interested in it but one of them I know the WCA brought Don Murphy and um man I mean if you have not read Don Murphy's Crisp Protocols wow I remember reading that book and that was uh I mean that's in one of my top 10 books. It's so realistic. You gotta you spend all of school learning all these orthopedic tests and then there's Don Murphy walking you through well why would you do that test when you can just you can do this one. You only you know he's under the impression like hey there's limited time we want to solve problems you know in a limited time and tell me your hardcore very specific purpose of you know why you would choose this or choose that to figure out you know the person's you know answer and get them better as fast as possible. And it I felt like uh when I read his book, I felt when I read it I was like man I've I've already been through you know like maybe 40% of this process of kind of figuring out what he literally wrote down verbatim. And so then it was kind of like you know as I approach the chapter where I'm like I haven't been there yet I'm reading through going yeah that logically makes the best sense to clinically you know dive into that. And then from there there was another um I think the WCA was the first state association to bring the McKenzie method or you know to kind of go through and get one of those classes in in the entire country. I don't think they'd ever partnered with the state association on anything. And um I got to go down there to um Jeff Surgent's Cedarberg um chiropractic office and that was another one of those things where you know we got done and I went on Amazon and bought all the McKenzie books read through them and that's been um man those are so useful again I I would tell any young chiropractor I mean if you haven't heard of those I would go get those books immediately very very useful.

SPEAKER_01 33:24

Alex you mentioned podcasts and you also previously mentioned multi-generational chiropractors. I want to mention also that we did a previous podcast with Dr. Jason Mackey from LSM chiropractic in there at 19 plus clinics in the South Central area of the state uh Jason has a ton of great information about being a multi-generational chiropractor. And then in addition we also did a podcast with Dr. Tom Edwards that isn't out yet as we are speaking now, but that will be out at the end of June. Tom is a multi-generational chiropractor and he has a lot of fond memories of working with his father and then branching off and then opening his practice here in Wisconsin. So those are great podcasts to circle back to along with the podcast that we did with Dr Stevie Ellen. All right next so let's talk a little bit about your toolbox patient care. Obviously there's the adjustment and there's everything else. Alex I'm gonna ask you a question if if you had a patient with whether it's acute back or neck pain and you had one tool in your toolbox to get that patient better, what would that be?

SPEAKER_00 34:40

Besides the adjustment I was I was hoping you were going to say the adjustment but I guess that goes without saying so I was like yeah 100% the adjustment um if I'm if I'm if I'm leaving out the adjustment as a as a total assumption I'd probably go with like therax therapy therapeutic exercises and then if we wanted to be more specific I would say if I only got to pick one I would probably take that McKenzie method of therapeutic exercises. Yes so dangerous man you get a person with a you know disc injury in there and you're doing chiropractic plus a McKenzie protocol and then they're like they experience that relief in two weeks and if they didn't come to you they're a they're an MRI injection surgical candidate. I mean in two weeks you know you're like already making progress reversing this thing and then pretty soon they're they're on to the you know like that Stu McGill's got some great stuff that'd be another book that I'd recommend I totally forgot about that. He has like a he has a book called Back Mechanic and then I'm gonna mess up the other book but if you just search his name I feel like you'll find it it's like ultimate performance and fitness something like that with you know with back and man those are great books. I I mean that's usually like kind of how I would progress somebody through like your you know ridicular you know neck or ridicular back is um you know go through the evaluation you know whatever imaging we need adjustment pick the style that's gonna you know work the best for that patient situation and then I'd start with McKenzie stuff keep it simple for people once they get those results then I start to kind of layer layer in some of the Stu McGill exercises to kind of solidify it and kind of pull back on McKenzie.

SPEAKER_01 36:36

Sure McKenzie people out there probably I don't know if they like that or whatever but all right you graduated in 2013 so now it's 2024 so you are 10 years in practice I'm still gonna uh categorize you as a young practitioner Dr.

SPEAKER_00 36:52

Alex appreciate it so for the students that are listening to this or the young practitioners that really want to go out there and just open their own practice can we circle back a little bit and talk about some of the things that you found invaluable to developing your practice whether it's location community involvement software yeah where would you steer someone that asked you how can I be successful in chiropractic just starting out yeah I would say um location is massive especially starting out I I think as you develop a reputation in your community I'm not sure on this but my guess would be that location would matter less and less just because people are gonna people are going to know who you are and they're gonna be able to find you especially with the internet. But starting out man location's big um the other one would be and I I didn't really know this but software was big having a software that does more for you especially from a billing standpoint. So I feel like one thing that I learned was picking a software based on how well it documents for you and then forgetting that you have to account for patient ledgers and billing and claims different softwares do that way way better. I would encourage people to pick a software that does all the all the billing stuff really well collects payments maybe it can store a credit card like an HSA card for people really enjoy that makes it easy for them something that can you know auto download EOBs and take the EOB numbers and then put them into your ledger so you're just reconciling most stuff at the end of the day. And if it fits those things then maybe look at you know how it documents from you know your perspective I would just say don't pick a doctor centric software pick a staff centric software because you're if if you can get that component that that seemed to work a lot better for us. That's excellent advice another one would be learning accounting and cash flow um learning how you want to do accounting getting a really good accountant I mean I guess I can't stress enough on like man guys get a good accountant like if you don't if you're doing your own taxes I mean you're you're missing out big time because because the things that your accountant teaches you help you look at your books and make business like make business decisions. And so I would encourage people to like just get a really good accountant for um chiropractic but also get a good accountant for small business what a major benefit that person can be to you. Yeah other ones trying to think for practice growth I'm like I feel like there's always a lot of different things and modalities that chiropractors can add into their practice and I would always stress to people don't try to do everything you know try to pick try to pick the ones that are really really good. So if you're gonna do nutrition um my advice would just be hey go pick go pick one nutrition company use them don't make it super complicated and use like five um we use standard process they are fantastic they're unique they're they have whole food stuff they're based in Wisconsin their service guys are like second to none in like almost any industry shout out to Cody and um another one like laser we kind of take that simple approach instead of having you know 10 modalities we just I just have laser and it works great and and the nice thing is clinically when you're when you're trying to make a clinical decision to like hey should I what modality should I add in like you're not picking from you know 10 um you're you're just picking from your you know your go-to your go-to thing and um yeah that's pretty pretty nice we use a uh a power medic laser that's been great that's blown my mind on some of the conditions you can you can really help people out with um works great for different you know tendinopathies um sometimes I call it my you know when it when a back pain or a neck pain patient isn't getting better as fast as I'd like I kind of call it my way of cheating. No I get it trust me yeah yeah and then um the other one we just added in uh we just added in uh foot levelers so I guess time will tell how that works but so far so good it's been a great thing to be able to to offer custom orthotics and it kind of fits our model of it's super simple people come in they scan their feet and um it's very affordable compared to their their other options in in this area oftentimes it's a fourth of the cost of you know the same or comparable thing that they could get somewhere else and and that's kind of one of our you know one of our core principles is like we want things simple and we want things easy we want them convenient and we want to deliver more value than that person is even expecting.

SPEAKER_01 42:05

Very cool. One little thing that you taught me is actually you do an email blast in the newsletter format on certain topics and then you do offer online scheduling. You taught me a little bit about educating your patients on a certain condition and then having an icon where they can schedule online and that's been very successful for you from a business builder standpoint.

SPEAKER_00 42:31

Yeah that's that's been a newer thing I feel like as the internet has developed um and maybe not the internet I would say probably more like as smartphone smartphone use has developed and become the the more popular way that people are doing things that online scheduling thing is guys that's a crazy realm. I I want to say I'll bet you 70% of our appointments are booked online.

SPEAKER_01 42:57

I mean that is that is wild to me if you would have told me that in 2015 I mean I would have I don't know if I believe you yeah well if you think about it when someone's at home at seven o'clock at night and they've got back pain and they think about scheduling an appointment with you if they have to call they're not going to get a live body at that time. So why not schedule online?

SPEAKER_00 43:17

Yeah it's great and um it's one of those things where that's that's what we need the internet for. That's what smartphones are for that's what makes it easier. I also feel like with the smartphone comes great distractions but also there are great great uses that come out of it.

SPEAKER_01 43:32

All right well as we wrap up here you mentioned a little bit about the WCA and convention uh I'd like to definitely invite everyone out there to consider coming to convention it's a great way to collaborate with practitioners collaborate with vendors some of the assets that I have in my practice have come from either either advice I've gotten from other chiropractors or meeting with certain vendors on Where to refer people for an MRI with different uh financial packages or software, laser, all of those things. So that's where I met you actually was at a convention.

SPEAKER_00 44:13

Yeah, that's great. I I mean, I have a lot of great memories, um, spring and fall convention, and I think there's you know hope to have a lot more. Are you guys releasing who the keynote speaker is for fall convention yet? I got wind of it, so I was very excited.

SPEAKER_01 44:30

Well, I guess I'll take this opportunity for the big reveal. Our keynote speaker at the WCA Fall Convention will be Dr. Michelle Myers. So she has quite an extensive background. And uh, as a lot of you may know, she's a former board member of the World Federation of Chiropractic. She's a past American Chiropractic Association president. And she currently is the executive director of research and innovation for Northwestern Health Sciences University, and she's also the co-director of the RAN Corporation. So she is one busy person, and I'm looking forward to her keynote address at the WCFall Convention, which just happens to be at the Kalahari once again. Great location in Wisconsin Dells. And the date for that is September 19th through the 22nd. So yeah, very much looking forward to hearing Dr. Myers again at the WCF All Convention at the Kalahari. So yeah, Alex, you heard it on the street. So there's the official reveal.

SPEAKER_00 45:37

I I I love how those things come to pass where it's another chiropractor who knows another chiropractor that can get, you know, that can ask, you know, these these people to come to Wisconsin, the state that nobody passes through. And and the other thing is just, you know, when you have a convention, like you can get you can get speakers like this, and you don't have to travel, you don't have to travel far to get um national and and I would say world-renowned chiropractors to um come to your convention that you can sit and learn from them. Um, I mean, there over the over my years, there's been people that have spoken that I've disagreed with, but still uh they're listening to them, you know, come and and talk. Uh it's invaluable, like you can learn a lot. And more often than not, there's um there's just things that that you're unaware of. Like I'm not gonna be, I know I'm not gonna be fully aware of what all of what Michelle is up to um in chiropractic. And I'm looking forward to um seeing what she has to say and what she's up to, and um seeing if there's you know different ways that myself, the WCA, or other chiropractors can participate in that, you know, with whatever she's up to. I have no idea. I'm I mean, I always get excited about those things, those are great opportunities. Absolutely.

SPEAKER_01 46:59

So, Alex, being a young practitioner, I'm sure you're up to date on all the latest and greatest. What is your opinion of the future of chiropractic?

SPEAKER_00 47:08

Yeah, it's interesting. I like where it's going. I think there's a lot of uh, I think there's a lot of drive, a lot of cool things. Chiropractors have always been um unafraid to stick their nose, you know, in different places. And um, as much as we can be different, we're unafraid to go and you know, go into uncharted territory. And um, there's a lot of lot of different practitioners out there that are doing that. Um, I I think was it uh Eric Kirk was what was what was he starting here? Is it the first private chiropractic internship? I'm probably getting the language wrong on that in the country. That's super cool.

SPEAKER_01 47:47

There's a couple things on that front going on. There's a fellowship that's being started with Freighter. Okay. Uh Dr. Jeff King is a big part of that. And Eric is also very instrumental in their residency program that they're going to be doing at Aurora.

SPEAKER_00 48:02

Yeah, that's just super cool. Um, other ones are um, I know we have we bat we bat big in Wisconsin, which I love that that state pride. Um uh I I know was it Brenda Holland's big in in working in that chiropractic congress, which is like a association for all the state associations. And that's that's super super cool to see that strategic vision of what they have going on. The other big one that I see for growth from chiropractic across the country in a variety of different ways is just more involvement in treating chronic pain. I think we're positioned very well for that. I think it's up to us to capitalize on that in a variety of different ways. The other ones too. I mean, even since I started the VA and chiropractic has been um growing. There's a lot of great, I mean, there's a lot of chiropractors going to work in a variety of different areas. And I know sometimes we can we can dog on people for like, oh, this person is a chiropractor and the VA, and this person's a cash practice. But I mean, guys, we need we need all of those. All of those people are driving the profession forward. And there's there's patients that can benefit from chiropractic in every one of those avenues. I see it as a pretty big, pretty big deal. Just having having good connections in colleges. I think I'm a little bit far removed from it now, but having the colleges just have solid teachers and having chiropractors connected with colleges, having chiropractors connected with their state associations, um, having them connected with their national associations, just there is value to institutions that I think people can kind of get rubbed the wrong way with various institutions, but stay in it. I always tell people, even if there's one thing that rubs you the wrong way, uh, there's there's there's value in moving forward together on different things. And and it's good. Like if you have a problem with somebody, just you know, go talk to them about it. Like, don't don't just leave or don't cause a scuffle. I'm like, go go try to resolve your problem, you know, face to face. And that's one thing that I've appreciated about the WCA is we're a big tent chiropractic association. As a solo practitioner, I can participate in the WCA. And right next to me, there could be another chiropractor who works for a hospital participating in the same thing, and we can get along and we could both drive the profession forward. We can talk about the things we care about, and I just I love that. I mean, there's diversity within it, and that diversity is a strength, it's not a weakness.

SPEAKER_01 50:45

Alex, as we wrap this up, do you have any final comments that you'd like to share with our listeners?

SPEAKER_00 50:51

I would share joining an association, getting to know chiropractors face to face, such a valuable experience, guys. Don't go through your whole career and miss it. If you haven't done it in your 30 years in practice, I would encourage you to do it. If you're two years in practice and you just thought, man, I don't need any continuing ed, I'm like, get out there. It's we're always working on an island or in a bubble, and it's it's nice to get out and um meet other chiropractors and develop those relationships. And we just don't even know where it's going to go. And that's kind of the exciting part. I would just encourage people to value that face-to-face time, value the in-person time. Um, it's it's such a blessing to be able to do that. And um and then I I thank you, Chris, for inviting me on the podcast. And then I apologize if there's any background, you know, Lego car noise for my son.

SPEAKER_01 51:44

Okay, work-life balance right there, taking the time away from uh family to spend some time with us today. So so there you have it, Dr. Alex Coken, born and raised in Northeast Wisconsin, 2013 graduate of Northwestern Health Science University in private practice in De Pere, Wisconsin. Alex, I want to thank you for everything that you do for chiropractic and what you do for chiropractic patients. And uh, you're a true inspiration for many. Thank you very much. Thanks, Chris.