Solving the Practice Puzzle - Part 1

Canadian Chiropractor
October 29, 2008
Written by Canadian Chiropractor
Can coaches help?? After climbing a great hill, one only finds that there are many more hills to climb.” Nelson Mandela could well have been speaking to the graduating class at any chiropractic school, when he uttered these words.  For, after years of grueling studies, the new graduate embarks on the road to, hopefully, a successful career – most begin this journey by opening a practice.  And, within the first five years, many find themselves disillusioned with respect to their work, or just not able to build the business that must sustain their careers – and families – for years to come.


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 Can coaches help??
Building a practice is somewhat like putting together a puzzle. The difference is that
whereas most puzzles can be completed in a measure of hours, a practice requires years of adding new pieces.  As well, if left alone, a puzzle will remain intact, complete and brilliant but if tampered with, it will fall to pieces and be destroyed.  The complete opposite is true if one means to cultivate success in a chiropractic practice – one must be active with it all the time.

Many, if not all, chiropractors reach a point in their practice where they find that something is missing and/or they need help in meeting their practice goals.  This can occur at any or all levels of practice.  From the new grad to the seasoned professional, independent DCs can find themselves hitting a wall, with respect to practice growth, life fulfillment and a host of other practice issues.2 

When this happens, many DCs look for help in the form of a chiropractic practice
consultant or coach.  A culture of these has arisen, making it difficult for chiropractors to decide which coach or service to work with, or whether such a service is right for them at all. 
Furthermore, some coaching services have marketed themselves in ways that have resulted
in remonstrance from the profession, making it even harder for the independent DC to
decide whether working with coaches or consultants is a good investment of their time and money at all.

This two-part article will review some of the general features of chiropractic practice consultants and coaches, who might benefit from these services, how to choose the coach or consultant who is most appropriate and what to be wary of when selecting whom to work with. 

Consultant versus Coach
For a DC seeking outside professional help and guidance in practice growth and management, the first question to ask is what sort of help is needed.  If the answer leans toward the business and administrative mechanics pertaining to the practice, then that chiropractor might benefit from the guidance of a practice consultant.3 

A consultant, or consulting firm, will employ templates to examine the existing protocols within the office with respect to items such as billing, patient software, accounting practices, office flow, staffing schedules, training and protocols, some aspects of marketing, admission sequence, patient care packages etc. and make suggestions on how to establish, change or build on these protocols.  This may require some days of observing the current work environment before offering assessments and suggestions for the DC to employ.  Following that, the consultant may assist in implementing new strategies and following their progress to evaluate whether these strategies are efficacious for that DC or not.   Strategies can be tweaked as necessary until a formula is arrived at that ensures efficient flow within the office but adheres as closely as possible to the consultant’s guidelines – the purpose here is to streamline the administrative structure of the practice.

A DC’s relationship with a consultant is usually much shorter than that with a coach – its goal is to be finite with the endpoint being the successful implementation of practice management protocols that facilitate staff proficiency and practical business structure and efficient patient flow.4

The career point when a consultant might be extremely helpful to a chiropractor is usually somewhere near the beginning – five years or less in practice.  Many technical aspects of practice management are being taught more in chiropractic colleges, in order to prepare graduating students to run the practice they plan to build.  In Canada, the chiropractic program at the Universite du Quebec at Trois Rivières (UQTR) offers courses in practice management and administration in the last year of the program.5  The Canadian Memorial Chiropractic College (CMCC) will, as of this year, also be offering this to its students.  However, a boost in efficiency, guided by a practice consultant, might be helpful when a young DC is trying to get a practice “off the ground” or at any level along the subsequent journey.
In contrast, the impact of a coach may begin at the business and administrative level but will extend beyond this to touch on many other aspects of being a chiropractic practitioner.

Coaches are usually equipped and trained to address broader issues such as the chiropractor’s paradigm, approach and communication with patients – especially new/potential patients – staff fulfillment and satisfaction, approach to marketing, overall life balance and the practitioner’s confidence and satisfaction with his/her own work.  These are issues which crop up, of course, with new graduates but which also are faced by practitioners at all levels of their career.  Furthermore, the right coaches can benefit those chiropractors who are involved in the profession beyond their practice in activities such as teaching, association positions, business/franchise development, community programs, etc. 
A DC’s relationship with a coach could be finite – if that is the appropriate direction for that DC’s situation – or can become a permanent fixture, benefiting the practitioner until he/she retires.

Chiropractic coaches – culture or cults
Because the relationship a DC establishes with a chiropractic coach can be long and touch on issues and practice aspects that are deeply important, it is crucial that coaches respond to their individual client’s needs by setting reasonable, practical and attainable goals. Conversely, since the relationship is built on trust, it is imperative that the DC ensure the coach’s values reflect his/hers, and if lifestyle and professional goals can be addressed by that coach. 6

In addition, chiropractors are advised to enter into a coaching relationship with longevity in mind as much time and energy can be lost when one skips around from coach to coach.  This “jumping around” leads to a hodge-podge of approaches that lack continuity, precluding the DC from mastering systems that are meant to serve for years and years.7 

A good coach must be able to provide personalized formulas that will empower the chiropractor to fulfill his/her role as a practitioner, a business person and an employer, while recalling the DC’s accountability in all practice-related situations.  Finally, a coach must be able to access the key to a particular client’s fulfillment and satisfaction in order to establish balance at work and play, while enriching each individual practitioner’s commitment to excellence in his/her practice.

Many coaching services aspire to these – and perhaps other – results when working with their clients, and this makes them, one would think, a desirable entity within the profession of chiropractic. Why, then, is there still some cynicism toward chiropractic coaching? 

Detractors of the coaching culture may be concerned with the empty “cult-like” potential of some coaching paradigms as well as whether these may project a negative image of the profession’s direction to its critics. For example, the all-encompassing “guru” coach, or coaches that promise exorbitant financial gains or expound on how to exponentially multiply patient numbers, are considered less than credible entities of which practitioners should be wary. The concerns are twofold.  The first is that the individual DC will waste time and money and then be disappointed with the results. The second concern is that this type of coaching casts a bad light on the profession, making it appear that a lucrative business is the foundation to the chiropractic purpose and that pushing as many patients through clinic as possible – thus reducing the amount of time and attention available per patient – is the paradigm of the profession as a whole. 

A good coach will note that no one coach can help meet all the challenges for every chiropractor. This is where the DC must be discerning in choosing a coach who is aligned with his/her practice and lifestyle goals and values and will help to meet these through a customized and realistic program.  
Furthermore, although salary is a real, and global, consideration for any field – and, in fairness, chiropractors cannot be expected to be considered an exception to this – chiropractors, as a group, and regardless of practice paradigm, realize income is only part of the raison d’être for any health professional.  As well, most DCs know that a lucrative practice does not, alone, make a successful or happy chiropractor. Success and happiness are also related to excellence, practitioner efficacy, wellness-oriented patient-centred care, life balance, and fulfillment, both personal and professional.  And, with this, a good coach will also agree.

For those chiropractors who feel lacking in the latter considerations – and who might also, in fairness, need some help boosting practice numbers – the right coach can be most helpful and, in fact, necessary for the practitioner to stay afloat, maintain staff consistency and morale, and prevent burnout for him/her self.8

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 Dr. Janet Hughes is a CMCC graduate and has recently established herself as an independent chiropractic coach. 
Dr. Janet Hughes is a CMCC graduate and has recently re-established herself as an independent chiropractic coach.  Previously, Hughes ran a successful coaching company in Canada – called WowCoach – based in Brantford, Ontario.  Following that, she spent one year at Palmer College coaching senior students through the Palmer Institute, and then joined The Master’s Circle, one of the biggest and most prominent chiropractic coaching services in North America.  As well, Hughes has developed practice management programs for students at Life Chiropractic College in Atlanta, Georgia.

Hughes notes that successful people in many walks of life employ coaches in their fields.  Many CEOs of companies, business people in all fields, educators, politicians and other public figures, etc., work with coaches to build or boost leadership and organizational skills.  These people begin working with a coach at various stages of their careers and may continue to do so until they retire.

Therefore, Hughes feels chiropractors of all types, practice paradigms, ages and stages, might, potentially benefit from a relationship with a coach – but the key, notes Hughes – along with many other coaches and consultants – is finding the one that is the right fit for you and your practice. •


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