173 Introspection and Doctor Authority

Welcome to the KC CHIROpulse Podcast.  

This week’s topic: Introspection and Doctor Authority

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights, and is hosted by Kats Consultants coaches Dr Michael Perusich and Dr Troy Fox.  Both docs are seasoned experts in Chiropractic care and business development.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• Why looking inward helps you build your doctor authority
• The value of having a strong doctor presence with patients
• Why introspection is the pathway to authority and success
• Why your mindset matters in practice
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.

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Transcript

Dr. Michael Perusich: 0:00

Chiropractors, does introspection have anything to do with doctor authority? Hi everybody. Welcome to the KC ChiroPulse podcast brought to you by Kats Consultants and ChiroHealth USA. I'm your host, Dr. Michael Perusich and I'm joined by my co host, Dr. Troy Fox. Troy, you and I were talking about this before we jumped into the studio, this whole idea of being introspective. Hey, I said it right being introspective your practice and what's happening and how that actually leads to doctor authority. You had a great story that you told me just a couple of minutes ago.

Dr. Troy Fox: 0:33

Yeah. So I'll just give you the short version of that. So we had. A week that we had a little less patients a little I'd call it a down week. But if if you looked at it statistically week to week, we had a little bit slower week. My 1st instinct and my 1st response was to immediately start looking at our statistics and see where I was losing patients was. My education off was our communication with patients at the front desk off. And so that was my immediate response. And like we discussed, it was a blip on the radar and my practice leveled back out, but that was the first place that I looked rather than thinking the sky's falling, I'm not sure what to do. My practice is falling off instead. I went. What's going on? What's been happening here the last week or so? And what statistically can I look at to determine where I can do a better job with patients? That's what I mean when we talk about introspection.

Dr. Michael Perusich: 1:36

Yeah. And I just, I think that's such a great topic because. Far too often. I think we, we have a tendency to want to throw the baby out with the bath water and we just want to dive in and just start fixing everything or changing everything instead of just really drilling down and first looking inward. We always did this in our practice too. Anytime there was an issue that came up, the first thing was, what could we have done different? Whether it was a patient problem or the numbers were down or whatever, what could we be doing different? So I think that's a great place to start because I think the more you do that. The more inward you look, I think the better your doctor authority gets over time because you sharpen yourself up by doing that. And then you're able to lead patients in a much better fashion.

Dr. Troy Fox: 2:22

And I think it puts you in a position as well, when you're looking introspectively, sometimes you look and you see a patient that maybe you're working with that could gain benefit. Somewhere other than you, I know a gassed that every once in a while you have a patient that may benefit from a different treatment or something that you don't provide. It may be another chiropractor. In this case, I had a couple of patients that came in, they were looking for a specific technique. And like we talked about earlier my first thought was to put a square peg in a round hole. I was going to figure out how I was going to get that patient better, but I was going to circumvent what they really wanted to make that happen, because I thought, I've got a way that I can make this work. The problem was I really couldn't. And so being honest with my patients and saying, Hey, that's a technique that I don't practice, but here's a doctor that does. And from that standpoint, leading that patient to someone else, you know what that creates gratitude with that patient and it creates that doctor authority and we think about doctor authority in a lot of cases with a patient that we're specifically working with at that time, that patient that's laying face down on the table. Do I have authority with that patient? Are they coming to me and asking me? Okay. When they have digestive problems, what do you think about this doc? Or they have, a mole on their on the back of their neck and they're worried about it. Are they going to ask you about that? When you have achieved doctor authority, those are, you get questions like that. That are sometimes questions that you're not going to be able to answer effectively, but you are able to send them where they need to go and they trust you to do that. That's doctor authority. Exactly. Sometimes. When you get gratitude from a patient, meaning that you are able to talk to them and say, you know what? I don't think I'm the right fit for you. But here's who I think you should see. And it might be another chiropractor that you refer that patient to because they do that technique. You still develop doctor authority with that patient. I've had patients come back to me. With another problem and say, Hey, doc, I know, this, you referred me to so and so down the street, but what do you think about this? And sometimes I'm almost a bit surprised myself when I see that person on the schedule, I'm thinking, didn't I refer them to someone else, but they come back to you because I trust you.

Dr. Michael Perusich: 4:43

And those are the ones I always found refer the most patients in. Because you built up such incredible doctor authority because a lot of patients, especially from chiropractors. It's not just us, but a lot of chiropractors, we don't refer out. We just wait till the patient figures out they need to go somewhere else and we let them drop out and walk away. But when you get ahead of that, we call that preemptive communication. When you get ahead of that a little bit and you refer somebody out, They think you hung the moon. Yeah. And I can remember one guy that he came in, he'd been to a couple of chiropractors and I did my evaluation and found out he had a huge abdominal aortic aneurysm, huge. And I called the surgeon down the street and said, Hey, I'm sending you a guy. I think he needs your help. And this patient referred 11 people back to me. I never once treated him. We referred 11 people back to me just because I was the one that found his aneurysm and he got it fixed the next day. Having that level of doctor authority and having that level with patients where you're willing to refer them out for other things, it's huge practice builder, which sounds

Dr. Troy Fox: 5:53

crazy, but that's a diamond level tip. And the reason that it is for two reasons. One, yes, you're going to get referrals from that. From a standpoint of what you're doing as a doctor. You just did exactly what you should have done. You don't wait for the patient to make a determination that, Hey, this is not working for me. I'm going to go do something else. You make the determination for the patient that this isn't working, or that you don't have the tools to make that work for the patient and you're honest with somebody up front about it. And I'm not saying that everybody's, I'm not saying that you're being dishonest with the patient when you want to treat them. Sometimes we say, Hey, we're going to treat you a few times and just see what happens where it goes. Sure. Yeah. We're going to see where it goes at this point. And if we don't make improvement in the first week or two, I'm going to refer you somewhere else. That's also preemptive communication. We really love using that in practice because it creates doctor authority, but it also is called just doing the right thing. You're leading the patient in the direction they need to go. And they're confident because you have told them what the roadmap is in advance. Here's what I'm going to do. Here's what's going to happen if this doesn't work. And sometimes it's, Hey, I'm going to change from doing a manual adjustment with you and we're going to run some cold laser on you too. I'm going to switch you over and we're going to do some decompression on your low back because we're going to see if that's going to be more effective for you. Yep. And so sometimes it's just a change of technique in your own office, but you're giving them that road map in advance rather than treating them for two to three weeks, not telling them what's going on. Because it's already in your head. You're thinking, okay, if this doesn't work, what should I do next? Oh, I should probably do some. So I should probably do some decompression with this patient because this is a disc problem in the lumbar spine at L5 S1. You've thought of that, but you didn't tell the patient that. So I would recommend that when you're working with patients that you do preemptively tell patients, here's the next step. And if that isn't working for us, then we're going to make a referral wherever that may be.

Dr. Michael Perusich: 8:01

Yeah. So we need to stop here for a word from our sponsors, but I want to come back and I want to explore this whole idea of thinking ahead of the patient a little bit and how that helps you build that doctor authority and how we do that by being introspective. So quick word from our sponsors. We'll be right back.

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Dr. Michael Perusich: 9:17

Hi everybody. Welcome back to the KC ChiroPulse podcast. Dr. Fox and I are sitting here talking about being introspective and thinking ahead of the patients and really doing the right things and how that builds your doctor authority and really builds your practice. So Troy, we were talking about, just thinking ahead of patients and there's some simple things that you can do. We all know. Patients are going to have certain questions or thoughts in their mind. Like, why do I need to come in so often? Be prepared to answer that. What are some of the other ones? Am I, why was I sore after my first adjustment? I thought you were going to make me better. We know some of them are going to ask that. So think ahead and get those things out. And you said this before the break, when you get it, you may think it, but when you get it out on the table in front of the patient, then they know that you're in command of their care. And when you're in command of their care, that's Dr. Authority,

Dr. Troy Fox: 10:12

and it's really easy to do because you can look through. How many conditions do we truly treat? When you look at the bolus of treatments that you're giving, most of them are going to be for care. Headaches, neck pain, mid back pain, low back pain, and all the things associated with, I'm not saying that we're not looking at, maybe numbness into the, into the toes or something like that. But if we're looking at specifically the areas of the spine that we're treating, the outcomes that we're looking for, we already know what's going to happen after we adjust the patient. They're going to feel better, worse, or about the same, right? Yep. Why not tell the patient that right up front? Hey, I'm going to start working with you. You may feel, and you may have a feeling because of, Other factors that the patient walks in the door with, I have fibromyalgia, okay. You know what, guess what we're going to go with a low force technique with you, but you may still feel sore. Oh yeah. I figured I would doc, but you went ahead and planted that seed in their head rather than them calling back later to the staff going, I'm really sore after my first adjustment. Is that normal? You should already let the patient know that's normal because you're working with a patient that may or may not, in the case of a fibromyalgia patient, I'm going to tell them chances are you may be sore, whereas somebody that's maybe a 16 year old kid that comes in that's just having a little bit of low back pain because they tweak themselves in sports. You may feel better. You may feel worse. You may feel about the same initially when we start to work with you. What we're looking for is that compendium or that large, that long term change in your condition. So I'm going to evaluate you each time you come in as well. And we're going to talk about it a little bit as I'm working with you. So that way they get that comfort level that you're on top of it. You're evaluating and monitoring them, but you're not expecting them to feel like a million bucks after the first visit. If you, Leave that opinion in somebody said, or they create that opinion on their own. The problem is there could be a really big let down that you could have avoided. So that's where introspection plays into. Okay. Think of it from a standpoint of how would I like to be educated? And when I say educated, I'm not talking spinal care class. How would I be? How would I like to be educated about the progress of my care? What's going to happen? Patients want to know what, am I going to get better? Can you get me better? What's it going to cost? How long is it going to take? Yep. And so we need to answer those questions preemptively. So to do that, you have to introspectively look at different conditions in your practice and cover those with your staff in your head, role play it with your staff. Say, what do you think about this? Is there anything that I missed?

Dr. Michael Perusich: 12:56

So I'm going to go back to something you said a minute ago, because we've all had this happen. The patient calls up after their first treatment and Dr. Kats made me sore. I don't know what's going on here. He made me worse. I'm not coming back. Use those opportunities to get introspective. And you're absolutely right. You have to do this with your staff too. Why did we allow that patient to call us up and tell us that because that's where it starts. It starts with us. So we have to think through why did we do that? What were the circumstances behind us doing? Oh, we didn't tell the patient that they might be sore. They might not feel any different or they might feel better. We didn't tell them what to do if they were at home and they experienced some soreness. We didn't tell them to take a hot shower, use ice packs or, whatever you tell patients. We have to start thinking like that. And so we've got all these ideas inside of our head. We know everything a patient's going to ask, because again, you nailed it. How many conditions do we really treat? Seriously. So because of that, we know what everybody's going to say. We know what their questions are going to be. So let's get all that out of our head. Let's have these conversations with our staff. So they're armed with the information too. And that way we're all preemptively communicating to the patient and always staying ahead of them. Another great example is the patient who you're on visit number five. And they start feeling better and we've let them go under the impression that pain is the moniker of success with treatment and they're out of pain. And so they get up to the front desk and say I'm feeling great. I'll call you when I need you, even though they still have 10 visits left on their treatment plan. We've got to

Dr. Troy Fox: 14:38

be thinking ahead of that. You have to know these things are coming. It's the same thing that happens with every patient that patient's going to question one, is this going to work? Because maybe they've been in a substantial medical model where the only thing they've ever done is drugs and surgery up to this point. And they're not quite sure that doing something that doesn't involve drugs and surgery is actually going to help their condition. So initially in their head, they're thinking, am I going to get better? If I don't, then what happens next? You can preemptively affect that. With that communication, because you've already become introspective and you've done it with your staff and sat down and thought, said, what are questions that patients may ask? What are some things that we've encountered in the past that maybe we've failed at? So you had to be willing when you're introspective to realize that you've failed. You know what? To be successful. You have to fail many times, failures,

Dr. Michael Perusich: 15:33

the stepping stones to success.

Dr. Troy Fox: 15:35

Exactly. That's how you get better at what you do is by making a mistake. And you're like, man, I wish I had told that patient this because they probably would have been successful with their care, but you may be at that point. Already, that one's already, that one's already water under the bridge. When you get to that patient's already decided I'm not coming back in to see you. It may be that they don't dislike you. They liked you as a doctor. They just didn't think you were effective, but you didn't preempt any of this. And you also didn't tell them, Hey, here's what we're going to do if this is not working. So you have to look at. If they feel better before they get to a point, are we discussing what our ultimate goal is? Is it just for you to be out of pain or is it to create function for you? And I talk about that with every patient when they come in long lasting function. Exactly. So I talk about the get better, be better. And that's a really easy one. I always tell people we want you to get better. And for those of you listening and not watching, I've got I've got my fingers about an inch apart here. Get better in inch tall letters and then stay better or be better in three inch tall letters. The most important phase of your care is getting you to a point where you're functional and keeping you there. That's the hard part. And that's the one that wins the marathon. So when I was introspective and I looked, I answered those questions to myself, and then I went out and told my patients what made sense to me. Now that doesn't make sense to every patient. You're going to have a patient that it just doesn't resonate with. But a lot of your patients think the same way you do, they just don't know as much as you do. So you have to impart that wisdom on them in a way they understand

Dr. Michael Perusich: 17:19

in a way they understand it. And you just made me think of something, and this is really important. Not every patient is going to be your patient. Not every potential patient is going to be your patient. It's just not the way it works. And I know when you're first year in practice, you're trying to hang on to everybody. I get that. But, if you've been in practice for a while, you should be bringing in patients who believe what you believe. And when you fill your practice up with Everybody who believes the same thing, suddenly it's like fire hose gets turned on and everybody's referring patients into you with that same belief in mind. We've been studying this and we studied this in mastermind about how you have to understand your purpose and your belief because that's the people you want to attract into your practice. So it goes back to that introspection of what do I believe? And you just made a great point of, I tell myself what I want to hear and I create that dialogue so I can have that same dialogue with my patients who believe what I'm doing. Yeah. And

Dr. Troy Fox: 18:24

you have two scenarios with this one as a new doctor, you may not have that sharpened down razor sharp yet at this point. You're in practice, you got a pretty good idea, but as you go along, it becomes sharper and you understand where you want to be. So you're going to go through phases of what I call shedding or molting in your practice, where you're going to shed patients that don't agree with where you're at in your practice and the type of practice that you want to run. The other type of practice that'll happen with, which is exactly what I have been through, and I've actually been through it both ways, but the other one is when you buy a practice. And you buy it from another doctor and they had a philosophy in their practice of how they practiced. Now, some patients are going to go along and go, you know what, doc, I totally understand where you're coming from and I agree with you. Others are going to not agree with you and you can hang on to them kicking and screaming on the way out the front door and they're still going to walk out. And you're still going to walk out. So you have to realize that you will attract that type of patient into your practice. And if you're going through that process, realize that it's not a one step process, it's a multi step process. You will shed and molt multiple times before you reach that maturity in your practice to where it seems really stable most of the time. Yep. And that's a really important concept to understand because when you have those ups and downs, it can be a bit disheartening because you're like, man, I'm putting my heart out there. My soul. I care for these patients so much and they just don't get it. If they don't get it, they're going to find somebody else that gets them, or they're going to find somebody that their thought. Process assimilates with,

Dr. Michael Perusich: 20:06

or they'll eventually be back if they come to find out that you probably were as close as I'm going to get to what I believe. Yes, and it doesn't mean they're going to necessarily be the best patient. Maybe the patient only wants to come in 4 times a year. That's okay. They not everybody's going to be that top notch patient. No, but when you fill your practice with as many of those as you can find, all of a sudden they start finding you too.

Dr. Troy Fox: 20:35

And you might be shocked sometimes that patient that you really were at odds with and butted heads with initially sometimes become some of your best patients because They actually because here's the thing I can lead a horse to water. I can even shove their head down into the water, right? But I can't make them drink, but if they understand the concept and you continue to gently reinforce and your message stays the same, there are times when that patient will evaluate that critically because our patients are smart, right? There are a lot of smart people out there that are coming in to see us because they are. Feel the need to get chiropractic. They just may not understand why they're getting chiropractic when the light bulb comes on and they get it, why they're trying to do it. They're not trying to win a sprint. They're trying to win a marathon, right? They're trying to get to the end of the race, which is end of life, right? Which is called wellness, chiropractic care, or a lifestyle change. When they make that lifestyle change in their mind, they care less about how much pain they're in now. If they have a little tweak here and there, and they care more about the cadence of care, making sure that they stay functional longterm, those patients, sometimes once they get that in their head, they become very dogged about that. And they're even concerned when you're leaving town for a week, I've got to get in there before you leave because my appointment's scheduled next week when you're gone, that's the type of patient that you sometimes create when you let somebody use their critical thinking skills. And you have given them the information they need to prepare themselves.

Dr. Michael Perusich: 22:11

You made me think of something that there was a patient I had who, when I first started treating him, he literally told me after I presented the treatment plan, he literally told me, I think you're just trying to get into my pocket. I'm going to give you a try. But I feel like you're just trying to get into my pocket and he didn't follow my treatment plan. And he came in, I don't know, a couple of times and then I didn't see him for a couple of months. Then he'd come back and, but he kept hearing about other patients who were having great success by following our treatment plan. Yeah. And he finally came back one day and he said, all right, I'm ready to do it your way. And I said it's not my way. It's the way your body needs. And he became a great patient after that. I referred a lot of people in. So sometimes it takes people just a little bit longer, but introspectively you have to be prepared for those people. How are you going to manage those people? How are you going to talk to those people? And you'll know I'm right up front because they'll say something like, I'm going to come in, no matter what you tell me, I'm only going to come in when I want to come in. Okay. How are you going to handle that? Think about that. How do you get ahead of them with that? That communication factor that. Answers that question while they're still trying to formulate it in their mind. How do you think ahead of them?

Dr. Troy Fox: 23:31

And before you beat yourself up, let me go ahead and tell you that there will be some that are like that, that no matter what you do, they're never going to change. Never. And you are probably going to handle them sometimes because of difference in personality. You will find that you don't handle them very well. And they probably aren't going to be in your practice very long. And that's okay. There'll be others that you're somewhat on the same wavelength, but maybe they just don't get where you're coming from that you will get along with and they will continue until they come to a determination in their mind. And those patients become the ones that we're talking about. So don't beat yourself up if you try to talk to someone and say, Hey, Here's what I always tell patients. We have two rules in this practice. Number one, I work for you. And number two, we work together as a team, which allows me the ability to at least tell you what I think you need to do without any animosity, I'm going to tell you what I think you need to do. And there's no hard feelings if you don't follow it, but I feel remiss if I don't tell you. So those patients, when I tell them that. If we don't end up, because sometimes you get a little bit of pushback. Sometimes we tend to push back, or at least I do my personality type. So if somebody pushes back on me, I tend to push back a little bit. And sometimes that patient and I are not going to see eye to eye. It just happens. And that's probably, that's an introspective thing that I've looked at over time to realize that I tend to have that personality trait. And sometimes that's detrimental to the patient relationship. There are others. I tell them what they need to know and they appreciate the fact that I told them, but they're not ready to commit to anything. And that's okay. And that's

Dr. Michael Perusich: 25:13

okay. Yeah. I had a patient one time, this, you would have thought she was a sweet little old lady. She was meaner than wet snake. And every time she came in, she had something derogatory to say to me. She even called me a used car salesman. One time. Yeah. So a couple of years later, I sold that practice. And when I moved away, obviously I told all my patients when I moved away and I sat her down and told her I was leaving, she cried. You're the only doctors ever listened to me. So sometimes you're getting ahead of them and you don't even realize it because your personalities just don't

Dr. Troy Fox: 25:52

gel real well. Yeah, so here's your homework. Get together with your staff and you don't have to start with. You don't have to unload on every condition. You treat pick 2 and say, okay, let's talk about and just make 1 of your staff. An example. You've got low back pain. You come in to see me. Let's talk through every scenario that you guys hear and see at the front desk. What phone calls are you guys getting? After care, or what phone calls are you getting before the patient even starts care and how can we get ahead of this before we even ever see the patient and how can we also get ahead of any complications or any questions that may arise after I've seen the patient and you guys come up with a plan. It's a really easy thing to do introspectively. And unfortunately, you may find out the first time you go through this, that your staff is going to make you aware that the procedures that you're using now are ineffective at best and may be detrimental to your practice at worst. So you have to be willing to go ahead and stand there in front of the firing squad, which is your staff, And let them go ahead and tell you what you need to hear, because sometimes we're avoiding it. So yeah,

Dr. Michael Perusich: 27:07

be willing and jump in there and do it and develop communication strategies with your staff while they're saying the same thing. Cause when you tell a patient now, after you do this and you tell a patient after an exam, Hey, we may have stirred things up a little bit. You may be a little sore at home. Here's what I want you to do. They get to the front desk and the front desk says the same thing. Guess what? They start listening.

Dr. Troy Fox: 27:29

Wow. What a concept that the staff and the doctor on the same page, I tell you what, that is another diamond tip right there because the truth of the matter is when you and the staff are on the same page, they come up front and they go, Oh my gosh, the doctor told me the same thing. You're all on the same page. Now, how many offices do you go to? Like when I go to my dermatologist, they don't, I don't go up front and they tell me something different than what I got told in the treatment room. If they say, Hey, we're going to follow up and do this. I have staff at the dermatologist. Oh my gosh, you're going to love this. Your skin's going to look so much better after you use this product or whatever. They're always positive. They understand the product that's being put in front of you. They also understand. The positives and negatives. In other words, Oh yeah, you might get a little redness in your skin. The first time that you use this, whatever, I'm just using this as an example, but they are on board because they've been well trained, a well trained staff that works together with their doctor. Makes it much better. And if you're just introspective on your own and you don't involve the staff in this at all, they're still going to be, they're going to be providing a different message because now the patient gets to the front and goes, I was sore after the first adjustment, instead of the staff saying, I know doctor talked about you that about that, you might be better, you might be worse. You might, you might be about the same, or he talked to you a little bit about maybe stirring this up. And sometimes with a. I'll use the fibromyalgia patient again. I'll actually walk to the front and tell the staff, Hey, I've talked to Kathy a little bit about icing and I talked to her a little bit, how she may be a little sore after this because of underlying conditions that she has. Yeah. Boom. Now the staff knows that as well. They're putting that in the notes. Cause my staff is top notch and they know that they won't remember everything. So they just put it in a note right at the beginning. When they pull that patient up, there's the communication that we made with the patient. They call in, they pull it up. Oh yeah. Kathy, we talked to you about that the other day. Yeah. That's quite normal. Boom. We'll see you this afternoon.

Dr. Michael Perusich: 29:29

Talk it over with the doctor. We'll see you this afternoon. We'll let him know that you're you got a question, he'll spend a couple extra minutes with you, just go through these scenarios. You'll be amazed at how it changes your practice. So get introspective, use that to help build doctor authority and stronger patient relationships. And we gave like triple diamond tips today. We did. This is amazing. All right, everybody. Be sure to subscribe. It's down here somewhere. Subscribe to our podcast. And we appreciate everybody always listening. If you haven't done so yet, go to katsconsultants. com. Check us out. There's all kinds of free downloads on there and see what we're doing to really help chiropractors build amazing long term success. KC ChiroPulse podcast brought to you by Kats Consultants and Chiro Health USA. We will see you next time. See ya

30:23

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