064 - Fix These Three Things Before You Hire an Associate

I know for myself that realizing too that spending money to find the people who knew how to do things like digital marketing and finding the right partners to help us get the outcomes that we wanted was a critical piece of learning how to scale then too, because I didn't have the time to do it. It also wasn't my zone of genius. And so if I wanted to turn that dial up, I needed to find the people who were geniuses at that so that we could turn the dial up for our marketing quicker.

Yes, correct. The answer always, guys, is a who, not a how.

Hello and welcome to Build you'd Remarkable Practice podcast. This podcast is dedicated to chiropractors who are in the seasons of launching and building their practice. Join myself, Dr. Lona and my co host, Dr. Bobbi as we have conversations each week as it relates to building the practice of your dream. And remember, you can have a remarkable practice as part of a remarkable life, not instead of one. We are here to lead you on the way.

What's up, team? Welcome back to the Build you'd Remarkable Practice podcast with the amazing Dr. Lona Cook and myself, Dr. Bobby Lojasvic. And today we're having a conversation that is one of the most talked about things in chiropractic. It's not about new patients. All right, I'll put that number one. I don't know about you, Lona, but I would say the number one talk about thing in chiropractic is how do I get more new patients? But very closely followed behind that, I would put it as number second. And that is the associate game. So you're in practice, maybe you're at a point where you're growing, maybe you're at a point that you maxed out and it's time to add your either first associate, maybe it's your next associate. Right? But unfortunately, Lana, let's just talk about this for a moment. We know, and I think the statistic that I heard, the latest statistic that I heard probably about six months ago was at the moment right now, 67% of associateships fail. And when I hear that statistic, you know, and I also think to myself, how do we grow and scale chiropractic, which is the greatest healthcare product in the world? We need to fix that. Like, we cannot have 67% of associateships failing. Like, that's just a crazy statistic. And the thing that gets me also is that it doesn't have to be that way. So what it tells me is that a we're doing as a profession something Wrong. Okay. And we want to talk a little bit about today. What are helpful tips on the back of that to avoid. What are the traps? To avoid. It tells me we're doing something wrong, and that needs to be fixed. Right. That's the first thing. And the second thing that it tells me is that we need to make sure that we get the skill sets necessary to do associateships.

Right?

Because here's the thing. When they're done right, everybody wins. Like, literally, patients get a better experience, they get better care. Yes. Principal DCs. You think if I get an associate, they'll get inferior care? Incorrect. Patients win. It's more powerful when there's multiple people speaking the same message into somebody.

Your practice and the owner, I. E. You wins because you have this beautiful little principle now in place called leverage. And leverage is what's required to grow. So you win hugely. Let go of the ego of, I'm the best adjuster in the world. You win when you have a great associate, and number three, the associate wins as well. You've got somebody that's further developing their craft as you have somebody that's serving patients doing what they absolutely love and not have to be involved with the business side, which, let's face it, most chiropractors do not want to be involved with. And so they're living their dream life. They go in there, they adjust a whole bunch of people. They make great money. They. They care for you, they love people, and they don't have to do anything around the business side of things. So it's the ultimate win, win, win. But in order for that to happen, Lionel and myself have identified, look, there's three big things that really need to kind of happen, right? And there is an order to this. So, Lyna, why don't you take us through, first of all, give us your experience with associates. So tell us a little bit about it, right? How many associates have you had? What's the current kind of setup look for you? And then talk to us about, you know, the baseline foundation of how do you get associateships.

Right.

What's that first fundamental thing that we've got to get set up when we're thinking about this?

Sure, I'd love to. Also, I love listening to you speak on this, because your heart behind, like, hey, we've got this great thing called chiropractic that everyone needs to know about, but we can't do it without leverage, which is really the heart behind becoming a better CEO and a better steward. If you are the one that actually owns a Practice so that you can bring more chiros under your roof. Right. So more people are served. And I've got my compadre Max in the background that you might hear today. So I've got my dog and my four year old here. So, you know.

Yeah, okay. So for. For my experience, I actually brought in my first associate by like, learning that I couldn't do it all by myself. So I had started to scale before I had any business to by opening a second location before I had figured out how to replicate myself in my first practice. And I quickly learned that I needed to get, you know, get my house in order. So I actually brought in an associate at that time, which luckily the universe connected me back with a schoolmate of mine. And she was my first associate. And we practiced together for four years. And then she became my business partner in the third practice. And at the same time she was coming in, I attracted a business partner for our second location. So we went from just me to three of us pretty quickly. And since then, now we've brought in, let me think here. I have another business partner in our fourth location and then three more associates. No, four more associates. So this idea of training up people and getting them positioned and, you know, being able to serve more people because there's more of us, we've got a crew now, is near and dear to my heart. And I love practicing with the team because it makes it more fun. Right. And you really get to see other people's skill sets and what they bring to the equation. So, Bobbi, I know we were going to start into like, what's the first step here? If you're like preparing yourself to bring in maybe your first associate. And I would say you have to take a real look at you as the leader and you as the main adjusting doc right now. Like, have you actually set up a culture in your practice where someone else can come in and be positioned well to do well? So if you, you know, can honestly take stock and say, have I positioned chiropractic to be the success? You know, the chiropractic is the hero here. Like, chiropractic is the one that's getting patients results. Chiropractic. Chiropractic. Chiropractic. Great, then you've probably done a great job of positioning yourself for an associate. Now if people come in and say things like, you're the best act ever, and you're like all ego based about you're the only one that can do your technique and you're the only one that knows how to communicate it a certain way. It's going to be challenging for you to likely bring someone in and be successful. At least it's going to take a longer learning curve until you position your yourself different, differently in that practice where you don't have to be the one that's getting all the praise, chiropractic's getting the praise, or the team of doctors are so awesome that you've trained up and brought in. So that would be my first status to really look at. Do I have a culture where someone else can come in and be seen as an equal, and their skill set and their hands and their communication can be trained into a place of success with, you know, mine still being there, but maybe not having to be the, like, main event?

So that's a really good point. In your experience, would you say that that culture already exists or would you say that it's a culture that needs to be consciously created through the principal dc?

I think it. It depends. I think if you've really learned principled chiropractic, then it probably already exists there where you, you know, when we say, like, you know, accept no responsibility, right? Like, you're not the one that's getting them the results. Their system, their innate is getting them the results. You're just placing the force, an educated force. Right. You know, because you're not also going to take the blame if. If they don't heal to the degree that, you know, they had wanted to. Right. I think if you've really done a good job of communicating what chiropractic is and what it isn't, then you're likely better positioned. Does that answer your question, Bobby?

It absolutely does. You. You took the quote out of my mouth and I was going to butcher it. So I'm glad that you said it. But the quote that always rung true in my mind was the one that you said, which I think was a BJ quote of accept no responsibility, but take no blame. And in the beginning, when I heard that quote, I was. It really resonated with me because when people would come in and be like, oh, my God, Dr. Bobbi, I feel amazing. Or, yeah, you know what? No migraines, literally from the day that I started getting adjusted. Wow. I slept amazing after that adjustment, or I feel phenomenal. It was always ingrained in me, likely because of that, that I would always just take no responsibility. I would say, loner, how amazing is your body?

That's.

That would be the line that I always say. And I would say, hey, how cool is to be Healthy, right? I would say, you know what? Your body did that. Hey, you know what? And I would always say when people say to me, you're amazing, you're. You're a miracle work, I would say, not really, just working with the principles of your body. Like, I would always do that. And then take no blame when someone come in also and be like, oh, I'm tender, I'm sore. That's a great sign, right? It means that your body's healing in the right way that it should be. And some tenderness soreness is completely expected. You can continue to expect that, right?

Yeah.

So it was never like, you know, me saying, oh, yeah, I know. It's because we had analyzed the X ray and we adjusted you the right way. And so that's a really fundamental part then of setting up a culture. Because even when I would do reviews of people, let's say R4s, R5s, RE examinations, RE reviews, and people are reporting phenomenal changes, I will take that same approach. I would say, hey, no surprise at all, you know, you've been an awesome practice member, Dr. Lonnie. You haven't missed a single adjustment. And you know what? Your body is amazingly intelligent. Shows you what's possible when you give it the right environment. Nowhere did I say it's because I adjusted you in the right way. Because we took those X rays. Your last coverage didn't do that, right? No, it was never about me, and it was always about them and their body. When we follow certain principles, and this is the thing, principles of chiropractic are just universal laws and principles. So we're basically just saying we're taking back to the fundamentals of what it takes to be healthy, right? Yes.

Expressing life.

Yep, exactly. So then that brings me to my next point, which is like when you onboard an associate, if you have that culture, it is so, so, so easy because you look at from clients point of view practice members, they might have a reservation. Will this person be as good as Dr. Bobby then? Okay. And so here's the way that I approach this from mindset point of view, learner, if you trust me with making decisions for your health, then you should trust me for making decisions about other people that can care for your health. Think about that for a second. Right? Like that's what a relationship is. A relationship is built on trust. So you trust your spouse to make a decision based on what you're going to, I don't know, have for dinner that night. You trust your spouse with a decision about where we're going to go for vacation in the next quarter as well. Right. It's just there's an implied trust that lives there across all decision making processes. So I would always say to a practice member when, let's say loner is my associate coming on board. Hey, Terry, I'm really, really super excited because you're going to have from next week Dr. Loner here adjusting you as well. And she is phenomenal. Oh, Bobby, she is good as you. Hey, guess what? As good as I am, you know my biggest disappointment in life?

That I can't adjust myself. Okay. And so guess who adjusts me? Dr. Lena adjusts me. And that straight away just cuts out everything for me, like literally. So Terri, if she's good for adjusting me, do you think I'm going to be picky about who adjusts me? You would hope so. Okay, so she is fantastic. And the big thing is here, your energy carries it across. Whereas if I was like, look, she's new, Dr. London's new. So she'll be kind of a little bit seeing you. Maybe she'll adjust you a little bit here when she's ready and when you're ready. That does not breed an environment of confidence. You're going to have a lot of trouble with that.

So good. That line just if she adjusts me or they adjust me and they're fantastic. Or I love their occiput adjustment, they're fantastic. That helps the person just recognize like, oh, okay, great. This is fantastic.

Yeah, exactly, right? 100%. So that's the first thing right now that comes down to culture and understanding that it's about the chiropractic and not about the chiropractor. And you got to get real with understanding and accepting that because if you do not, what we're about to tell you next does not work. Okay. And I find that especially if someone's very technique specific, that first step can be hard because it's not just a culture thing, it's a technique thing too. But I've, I've found, and you know, personally now I think I'm at 15. 16 associates successfully transitioned and exited. And right now we've got multiple as well and seen this with hundreds with the officers that we coach. If you do this right and if you edify the person arriving and you make it about chiropractic. Chiropractic, not the chiropractic door, it'll be so much easier to onboard people and you will literally get a handful. When I say a handful less than five. Okay. People that will kind of still Just want to get adjusted by you and that's okay for a period of time. But I still work on them. I still have a time like, hey, guess what line? I'm going to Europe for a month next month. Guess who's going to be adjusting? You, Right?

Yeah.

Terry.

Yeah. Yes. Yes. Yeah. That's one of the best things you can do when you do onboard an associate is make sure you have some vacation scheduled.

Yep, exactly. Spot on. So number one laid it out very clearly guys. Make sure the culture is set up right for a multi DC office. Really, really, really important.

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Second step then. So here's the other thing that we got to look at when it comes to onboarding associate, we need to make sure that we understand that by having another person there adjusting. We've just used the law of leverage and the law of leverage means that now we have maybe not twice the capacity to adjust people because by hiring somebody the whole purpose of doing that is so that you can buy back your time. Okay. You can buy back and scale back your time so that you continually reevaluate or what are high priority activities that I should be spending my time on now in the current season that I'm in, in life and in business. Okay. So by adding associate might not double your capacity, but you'll usually increase it by at least another 50%. Okay. And so when you've increased your capacity, what that means is the other thing that needs to go up into the same proportion is your ability to generate new patients. So the amount of new patients that took you to the capacity that you're on now, hopefully at max capacity or close to max, it's going to need to increase with each new associate that you add, because it's just the mathematical formula. Lorna, what's been your experience with that in the past? Where do docs stuff this up? So they've hired a new associate.

All right.

And from a new patient perspective, where have you noticed that they. That they get this wrong a lot?

Yeah, for sure. Well, again, as a bill doctor, many times people pride themselves on getting to a point where, like, they're able to grow their practice to the desired amount with just internal referrals. And they've forgotten that there is other pipelines that new patients can come from, like digital, like external events, dinner with the docs, screenings, et cetera. Maybe some of the things that built your practice that you kind of like went away from once you were at a certain volume. And as you certainly are bringing on multiple more docs, you are going to need all the pipelines going and can continue to learn how to leverage them. So I think we just forget that part and we think that we'll be able to do it all through internal referrals, but we're making it harder for ourselves than we need to because it's going to be a slow trickle then at that point if we don't turn these other dials on. So I think that is huge. I know for myself that realizing too, that spending money to find the people who knew how to do things like digital marketing and finding the right partners to help us get the outcomes that we wanted was a critical piece of learning how to scale then too, because I didn't have the time to do it. It also wasn't my zone of genius. And so if I wanted to turn that dial up, I needed to find the people who were geniuses at that so that we could turn the dial up for our marketing quicker.

Yes, correct. The answer always Guys is a who, not a how. So if you don't know how to increase your marketing, there's someone you need to talk to. Maybe you gotta reach out to us. I can very quickly guarantee if you tell me what your marketing level's on right now, I'll tell you what the next level looks like. Simple. What do you have to do next to scale your marketing to the next level? And Lona, when you mentioned there, you know, you got to get outside of just internal referrals. People may not have seen this if they're listening, but I just, it was just an innate subconscious thing. I had to roll my eyes. I was like, oh, God, understand that. I do understand the mentality. Like when you give people out there teaching all internal referral, you know, get away from hard Facebook ads or get away from workshops. They're just saying that guys because they don't know how to do that. That's why if somebody says to you, get away from xyz, that just means that they don't know how to do xyz. Because if there's one person that does XYZ really well, that means it's possible to do it really well. All right, so am I a fan of internal referrals? Absolutely. I love them. They're amazing quality new patients. I don't even want to say the best quality anymore because I don't believe they are. I believe that you can educate people even better. In other marketing activities that we have available to us now, the person comes in pre educated with the care plan, finances, everything. So I'm just going to say that they're an amazing source because they're free. And it's the way that you really can quickly compound your marketing efforts, increase your marketing budget, and the person who can afford to spend the most on marketing wins the game. Right? However, there are other marketing initiatives out there. And anyone who says to you, oh, this doesn't work well anymore, it just means they don't know how to work that system. Okay, that's what you should hear. But yes, first steps, when you decide that you're hiring somebody should then be, okay, what's my marketing calendar? So when this person starts, what's my marketing plan? And what's my marketing calendar? Marketing plan means write down everything that's working for you already and write down the back of that, roughly how many new patients a month you get from that. Marketing plan means, okay, what new things will I be adding? And what's my expectation of new patients from that? And then marketing calendar means put that into a week by week calendar. What are we going to be doing to generate new patients? I think with each new associate, you're going to need to increase the number of new patients that you get so that you can max out and fill that associate. Because in order to retain associates, no one is going to be sticking around for you long term if they're just coming in the office at 30%, 40%, 50% capacity. There is nothing more demoralizing as a chiropractor and a person of service than coming to an empty appointment book.

Yeah, that's great.

Yep. So each new associate requires a refined marketing calendar and plan. If you have questions around that, please reach out to myself or lona. Literally within two minutes. I can tell you where your blind spots are when it comes to practice. But when it comes to marketing, absolutely specific. Yeah. That's number two. And then number three. All right, here's the last biggest mistake that we see. People like the new time that you create for yourself. If you have created time for yourself, where do you invest that time? So Lona just gave a hint there before where she was like, all right, well, you know, you hire an associate to help you with delivery, and so you can start to put energy more into other areas. Loner, where would you say those areas are? If we talk about specifically a build document, someone who's been doing all the adjusting themselves, they've just hired their new associate. All right. They've bought back some time. Where would be then the best place for them to invest that new time that they've now got?

Well, for a lot of build docs, it's first clawing back some CEO time so you can actually be the one that's visioning where we're gonna go. And spend more time preparing yourself to actually know when you need to hire and when do you need to bring in marketing and actually look at the business above the business instead of being so in it. So I would say buy back sometimes. So you have CEO.

Yeah. And what I heard you say there, CEO time is vision casting time, where you sit down there and you refine the vision of what does the next chapter look like? Yeah.

Yes. Yes.

Yeah. Anything else as a. Okay. In that CEO time? So there's going to be vision casting time. What are your other top two things they should do in CEO time?

Training your team. You're preparing more and more leverage by making sure your team is more and more tapped into where the vision is that they're heading and the focus that they need to be doing in the work in their roles.

Cool.

All right. I love it. So you're buying back time. You're going to spend some time vision, casting, getting clear on next action steps, direction. You're going to get spend more time training the team. Is there a third one that you want to chuck in there? What's the third thing that the person should be doing?

Well, likely many CEOs are the marketing conduits for their practice. So probably doing more marketing, whether that's putting on talks, getting out in the community, hiring the marketing team that's going to help you might be investing and looking. When you're at your next immersion, which success partners are there that could help you with marketing? All of that would fall on you, generally speaking, until you have someone else that's doing that on your team.

Yep, I agree 100%. So you got to level up your understanding and skill set around marketing new patient generation guys and then get people on your team that manage and run that for you. So if I was going to summarize it, bring it all together, lay on. I always like to make practice building as simple as possible because it is simple really. When you understand the game, guys, it's a very simple game. People just overcomplicate it. Okay. In its most simplest form, practice building is a two part. Is a two ways is a two part, two parts to it. Part number one is you increase your capacity so you can serve more people. In the beginning, you open the doors, you open yourself up for 25 hours, you had all the capacity in the world. Part two is increase the marketing to reach that new capacity. Then you've added, sorry, you've added first cas that help you with delivery and mapping your appointments and care plans. You've just increased your capacity to serve more people. So you've got to increase your marketing to meet the new capacity. And now you just added an associate, or maybe you've added a second or a third or a fifth or a tenth associate. Guess what, you've just increased your capacity to serve more people. So what's the thing that happens right after that? Increase your marketing to meet that new capacity. So it's really important that we develop our skill sets around marketing so we can reach that new capacity. Because that's how you keep scaling and growing an office. And at the moment the highest single office that I know personally, that I speak with and work with personally just this year now cross is on track for this finance assure you in mid year we introduced a mid year to mid year 7 million bucks in collections in One single office space, right? So it shows you the upside of what's possible. Imagine if every cooperating Office was doing 3 million. Like, it would completely transform the profession in the most monumental way. That's, like, unfathomable. So the marketing upside is absolutely massive and huge. So if you're stuck with that. Cause I know a lot of people often say to us on calls, they just don't know what they want to have to do with marketing. Reach out to us, guys. Follow us on Instagram, Dr. Leona Cook or Dr. Bobby Olajosevic. Right? Or, guys, send us a message and just send us a message saying marketing. And literally within two minutes of chatting to you, I can tell you straight away. And you can do the same with, like, what's your blind spot? Tell me what you're doing at the moment. Great. Here's what you should be doing next. And here's the action steps on how to do those things so you can scale to the next level. Internal referrals are amazing, but anyone saying just do internal referrals is leaving so much money on the table and leaving so many people unserved. And it's simply because they haven't yet nailed that. But when you nail it, the scale listing is huge.

I love that. I love listening to you. It just expands my mind. I love thinking about, like, what if the average chiropractic practice was seeing 3 million and that 3 million actually came from also chiropractic adjustments. Let's just put that out there also, right?

Yeah. 100%. 10x is so possible in chiropractic. The average office right now probably does 300 to 400,000 bucks, right? And I have a whole bunch of offices that we work with, single offices that are $3 million chiropractic offices. And it's like, you see, it's simple. It's far side simplicity. And far side simplicity means that there are key things you got to understand. It takes a bit of energy to learn, understand these things, but once you understand it, it's simple. It's like E equals MC squared. Like, that would have taken a lot of work, you know, for Einstein to think of that like a lot of E equals MC squared, but once it's there, it's this easy thing to calculate. That's far side simplicity. And taking a practice from 300k to 3 million is same thing. You got to learn, you got to get coach, you got to train, you got to get someone to show you your blind spots. What you don't know, it's the Quickest way to grow. And finally I'm going to add in this loner is I just don't understand people that want to grow. Literally, I'm going to lay this out there that want to grow and don't understand that the quickest way to grow is just to pay somebody to show you what I need to do.

Yeah. And then you do it.

Yeah, right, Exactly. I don't understand that. And I take the long way to like from A to B. It's just guys, you want to grow, fantastic. Hire someone. Pay them. They'll show you how to grow and just do that. But when you're paying and you're showing up to calls, you'll be held accountable. And research tells us that that is how you implement. You have high levels of accountability. So that's my final words for today.

So good, Bobby, say it louder.

Well, I just speak truth. That's it. People sometimes say that. I'm like, I'm just communicating the truth. That's it, you know, so love it. Arlena, awesome chatting with you guys. We're going to get this associate game right. We revealed three things there. Obviously there's a lot more to it than just that, but we wanted to touch on the high level thing. Get your culture set up right, get your marketing set up right and buy back your time. So you know that you should be spending more CEO time. You got questions around this guys, or anything at all? We'd love to chat with you. We love your messages. Reach out to us on Instagram is probably the easiest. We can definitely help you with all of that. Lona, I'll catch you next week.

Sounds great. Thanks, Bobby.

See you, team.

Hey, everyone, please listen in for this next bonus interview of one of our remarkable success partners. They all help us help more people find the benefits of of chiropractic. So listen on.

Hey, guys. Dr. Pete Camiolo here today in the studio with me, Dr. Dan Rudenbeck. Super pumped to have him on board. Thanks for joining me today. You know, we're excited because as a success partner with the remarkable practice, we we identify leaders and businesses that provide a service, a product that we believe is going to help our doctors who we serve inside of the remarkable practice, help them be more successful, help more people make a bigger impact, drive revenues and make a bigger income so that they can reinvest in their business and make an even bigger impact and everybody wins. And so we always look to align with organizations and businesses and leaders and products and services that share our values. And I remember when I First had my conversation with you, Dr. Dan. It was like, man, we're singing the same song. We're on the same page. Like, it's the same sheet of music.

You should.

You should be a part of the remarkable practice. It makes so much sense. So we met in 2024, and you decided to, you know, bring your business and come on board in 2025. So we're really happy to have you. And as an expert in this space and a success partner, I just had to have you on our podcast just to say, hey, what is it that you guys are up to? It's 2025, and, you know, you've got. You've got some cool things happening, and so I want to make sure I give you a chance to introduce yourself, but I just want our audience to know that you're just an awesome guy. We're super pumped to be doing this partnership with you with Shockwave Centers of America. So maybe bring us inside of your story, a little bit of your journey, a little bit about your business, so everybody has a better understanding. And then I've got some more questions for you today.

Sure. Well, super excited to be on. And like you said, I think it was love at first sight when we first got together on that first zoom call, where we both very much have the same values and we want to bring as much success to chiropractors as we possibly can. Being the role I'm in now as the owner of Shockwave Centers of America kind of fell into place where I didn't actually plan this. It was one of those things where there was a huge need, in my opinion, in the world of chiropractic, but also anybody who's in a holistic therapy environment to have something like Shockwave, great access to it, great training to it, and a really accessible team behind it. And so I grew up in London, Ontario, Canada, and shockwave is a big, bigger thing in chiropractic. It was one of the jobs that I had as a CA before I went down to chiropractic school. And I almost forgot about it throughout the process of chiropractic because I went to life, and modalities are not a big thing in life university, which is a good and a bad thing. We want to be at least aware of it if it doesn't suit your practice. But if it does suit your practice, you want to be really well versed in it and know the differences and understanding where to go and who to talk to and how does it fit into your practice, all those important things that I think everybody should know. And so I got out of school, started my practice here in Marietta, Georgia with my wife. She's a chiropractor as well. A lot of us get together, but we did meet before chiropractic school. So she's Canadian too. She does all pediatric and prenatal stuff and I take care of everybody else. And we're still in practice. She's off on maternity leave right now, but she'll come back after the baby's all settled and we'll keep rocking and rolling. I have no plans on leaving practice at the moment, as much as this is a full time job too. I love seeing my people, even though it's only two days a week, but I still want to keep seeing them. And so I got out of school and I started having all these clients that I thought would be a great fit for Shockwave. Leaning back on my experience as a CA and I didn't even know where to start. I looked at machines and they were all too expensive for me. And I talked to the companies like, hey, could I get a refurbished one? And I was like, what does the training look like? How is it relate to my practice? There was no support whatsoever. How do I fit it into my chiropractic office without, you know, this huge investment? Or how do I fit it into there without having to start from scratch on. On what kind of protocol can I use that fits in well with the cervical adjustment? What protocol can I do, you know, for my plantar fasciitis patients, even though I'm still working on the lower back in the chain that way? So it was very cloudy and it didn't make a ton of sense. And so I leaned on my resources back in Canada, I got myself a refurbished machine, brought it down here, started using it in my own practice, and five years post that, we decided to launch our own with American parts and our protocols that are all based on the research themselves. And then we do all the support on the back end that nobody else really does, which is how do we introduce this to clients? As a chiropractor, what do we do when we hit a roadblock with therapy? Whether it's this or with anything else, we've got a group of over 700 doctors now that are working together to collaborate to get great results for their patients. And again, it's not something I planned. I just kind of fell into it. And now I have a big group of people that are relying on me that I wasn't expecting. And it's been so thrilling. And it's been such a fun business to build to be able to help more patients by proxy, by training these docs on how to use the therapy.

I love the genesis story. I had forgotten that you started as.

A CA and you were actually doing.

This work as an assistant in Canada before coming to life. I think that's awesome, man. In that you, in your experience, knew there was more we could offer for our patients, and you wanted that. And here you are, like you said, thrust into this position of now being a supply and a demand, supplying the demand and the need and a solution for chiropractors nationwide. Talk to us a little bit about those things, because I know from talking to you the first time, the thing that really attracted me, in addition to just you being a principled chiropractor and being committed to your practice and your chiropractic practice, but also being able to offer this kind of support and service to add more value to your patients, was when you talked about the training that you guys provide, you talked about the support that you give to your. The doctors who work with you guys for their team, because that tends to be a pain point for a lot of. Of practitioners. Can you talk a little bit about that? Just that side of what you're doing and then maybe, you know, what are the, you know, who are the patients? You use plantar fasciitis as an example earlier. You know, it's part of the chain. Like you said, you're still working the low back, but we're going after this very specific area. So talk to, talk to our listeners about, you know, who are these patients that you're serving right now? The doctors who are using shockwave. Talk about, you know, the doctors and how this is actually helping them become more successful. You know, I think that's a big thing for us. As I'm listening, if I'm a listener, I'm like, okay, I don't use this in my office. This is foreign to me. Walk us through, like, the journey, the. The client journey from your side, but also the patient journey, you know, from the side of the practitioner as you are.

Sure, yeah. I mean, and you hit the nail on the head as we're kind of serving both populations. We're trying to serve the chiropractor who's bringing in new technology, but also by proxy serving those patients that need the therapy that we can offer.

The first answer, I guess, is.

For the chiropractor and the training and how to implement this into the practice was a big hurdle that I ran into. Myself and I never wanted our therapy or any therapy to take over the identity of the principal chiropractic that we're also delivering. It's supposed to be a great tool in your toolbox and even in my office where we do a ton of shockwave because we have a ton of clients that receive it. You don't know until you get into this room, which is our shockwave room that I'm sitting in right now, that that's part of our offerings other than, you know, it's listed on our website and they can find out about it. But it doesn't take over the attitude of my practice. We are a family based chiropractic office where we definitely see more kids than we do adults, which we wouldn't think serves the shockwave population, but we do. We see a ton of Osgood slaughters, which is one of the big things for kiddos and severs disease. And then for the adults, you've got, you know, frozen shoulder, tennis elbow, golfer's elbow, you know, osteoarthritic knees is a huge one. Knees and shoulders. You could fill a whole practice just with knee therapy and shoulder therapy. Plantar fasciitis is one of those things that we have the longest history on research in. And so that's why when you Google shockwave therapy and plantar fasciitis, it's going to pop up with 30 or 40 different articles. And it's great. It's not something I want to fill my whole practice with, but I like having that option to help serve my people and keep them in the practice.

Right.

Because the other option to some of these chronic issues, and this is mostly a chronic problem or a chronic pain therapy. So things that have been going on for four to six weeks or longer, that's kind of our target market. And those are the flags that you see when you talk to your patients when they come in either for the first time or when you're doing reassessments like, hey, my back feels great, I still got this shoulder issue going on. What would you suggest? Or can you give me a referral? And if it's something that's on our list of therapeutic benefits and we have research behind it, then we'll definitely address that and be like, hey, great, let's start doing a little bit of shockwave and see if we're getting, getting the results we were looking for. If so, let's keep you here because the steroid injection and the exploratory surgery and all that kind of stuff, it just has Become so rampant and so like automatic. You go in and you get a steroid injection. You come out, it's like, well, they're not thinking long term with the damage to the tissue that they're treating. And we give them a holistic option that's not going to cause more damage to the tissue. And so you get to expand the width of your practice by seeing more issues, but still the same type of people that you want in your practice. And if you get to the next level, to the business building side of it, your staff can actually run the therapy for you. It's very easy to learn. We train you. We have a whole certification program that your staff can take so that they can become the resident expert in shockwave therapy in your office. And you can just keep doing the chiropractic stuff that you would love to keep doing. So it's a great practice builder. It's a great problem solver for chronic issues. Low back discs that you can't adjust the way you would like to because there's a lot of rods and stuff in there. You can use shock shockwave on that you give people another option or level up their patient care experience, like I said, without taking over the attitude or the identity of your practice.

Yeah, this is really good, man. I mean, I think right now, all of us, we're seeing more and more complexity, more and more challenges, more chronically sick people. And as you said, the alternative is exploratory surgeries and directions, drugs. It's like we all know that is those are last resort things. Not, not first resort. Even the, even the word exploratory surgery, really, who would have thought that? But that's where we're at now because our medical system is failed so, so miserably in terms of getting to the root cause of what's really going on with people. And, and this technology, from everything that I've learned about it, it just sings the, the chiropractic principle song so well in it as it unlocks your body's innate healing power. You know, it works with the body and it just speaks to the power of why you should be getting adjusted. Because if you're not, if you're subluxated, your body's going to be inhibited in its ability to heal, even by adding these technologies. So how they work together, it's an and not an or conversation. Right. And so talk a little bit about the business side then. You know, you shared about some of the conditions, adults and children. I love that. Actually, you're the first person really talk to me about kids and how this can actually really help them, which I work with a lot of kids and a lot of athletes as well. So that, that makes just opens up a whole nother conversation. But talk about roi as a business owner, as I make an investment in this and I mean you run this in your practice. Like you said, what are doctors looking at like first year, if I bring this technology in in terms of, you know, investments to return, if I do things the way that you guys are teaching us how to do it right, If I'm a good student, you know, and I'm implementing what you're recommending, what are just, I don't general, you know, generally speaking, what are we looking at here?

And one of the goals for our business was to solve one of those issues because how some of our competitors make money is to kind of keep them on the hook for, for routine maintenance. And it kind of eats into the ROI experience and it makes your clinical decision making a little bit more skewed. Where we wanted ROI as fast as humanly possible on this machine so that you use it when it needs to be used and you leave it alone when it's not a great fit for your patients. So we really big on making clinical decisions, on using the shockwave versus just financial decisions. Yeah, you're going to make money with the machine. You're going to pay it off in at the most 90 days. And that's, that's a slow person's ramp up. Right. You're talking about 10 to 15 care plans total is all it's going to cost to take over one of the machine overhead. And then the maintenance cost is less than $100 a year in perpetuity. Right. And so it's very, very easy to overcome the, the burden quote unquote, or that first initial investment into the machine so that it becomes a great clinical tool that will continue to build your business. And you're looking anywhere from 8 to 12,000amonth in, in recurring income because of, of who you are as a salesperson, who you are as a practitioner. It can vary for sure. It's, it's how much you want to put into it. But we're big on, don't force this to be the biggest financial gain thing in the world. It's really about amplifying what kind of things can you see in your practice successfully. And maybe you don't even offer all the different therapies that you can get in shockwave, but you hyper focus on, on a niche. Maybe you only do knee and feet and ankles and stuff, or just shoulders and neck stuff, because that's the expertise that you have. Right. Or that's where you feel really comfortable. All of that is possible. And we're very open to people making it make sense in their practice instead of trying to offer too many things and making it cloudy. But the ROI is super fast, and I really want it to be knocked out within 90 days. So we don't even have that conversation. I like the conversation of which is really cool for us, is that 10 to 15% of our buyers have at least two machines because they found that the ROI within their first year was so big that they filled the space with one machine and they need to have another one in our office.

Wow. 10 to 15% of your practitioner. That's significant.

There's definitely drive and demand there that you're seeing. Can you talk a little bit about the. Just the ongoing support? It sounds like you guys have a really strong community and strong network there. What does that look like for us as practitioners?

Yeah. One of my. My key values in. In Shockwave and in chiropractic is that if I'm to make any recurring in income from this machine, it's going to be on the education side. How can I help people advance their clinical skills? You know, how can I bring new information to the table? How can I support them as they get into harder cases? And all that kind of fun stuff too. I don't have any interest in making money on the support of making sure. To make sure. Making sure the machine works the way it's supposed to work.

Right.

And so that's where we. We differ with our machines in general. But that's my big goal is to consistently get patients asking for the therapy. Because we're talking about how we can level up from the chiropractic profession is how can we keep people away from the more harmful therapies that are out there or the other options that they have. Can we keep them away from the orthopedists with stuff like this? Yeah, I'm all for orthopedics. They have their place, and we have one of the best trauma care systems in the world. It's just we're horrible at holistic care and making that the priority. So the more people asking for this therapy will get more people in your office that might not even thought of coming to see you as a chiropractor, which I see all the time. It's like, hey, I want to come in for Shockwave. Well, guess what? You're In a chiropractic office, you're going to learn about why we do what we do and how they work together. And I'd say 90 to 95%, at least, are both shockwave and clients. I don't have very many just shockwave clients.

That's great. So if I was to launch this right, you talked about your first 90 days. You should be able to, you know, pay off the investment. How quickly does things typically just does this get up and running? Like, let's say I listen to this today, and I'm like, all right, I'm getting on a call with Doc Dan. I want to learn. I want to be able to integrate this in this year. From the moment that, like, we get started on a call, like to it's up and running and it's starting to produce. What is that timeline generally?

Sure. So let's give ourselves a week for phone call and getting the machine into the office. As soon as we got a commitment, we get you into the back end and start training the staff on what's coming. How do we have the conversations with the new clients coming in? What is our goal for how many clients in the first couple of months? But the first couple weeks, I recommend getting it in there, doing it on yourself, on your staff, on your three or four favorite patients that have been with you forever, that are like, hey, I want to try something new. Let's bring it. Or you can do, you know, some free trials for some people that are on the table as you're table talking them. Right. All of that stuff is on the table to get you really comfortable with the therapy. And once you have that confidence of, I've had five people on the table, and four out of five were jumping off and they were feeling so much better even immediately. That gives you the opportunity to like, okay, this is worth talking to my client base about, which is a very important mindset shift for bringing in new therapy to the practice. Because I can say that it works all day long, and you can have other docs say that it works all day long. But once you get that first couple of patients tell you you're never allowed to get rid of this machine, you got to keep it forever, then that builds a whole new level of trust with you and the therapy and that you can see it fitting into your practice. So that's what the first three or four weeks are about, is find your favorite people to try it on and get really comfortable with it. Dig through all the videos that we have on how to do it, how to Service the machine, all the back end work. And then you start with like an email blast or something that's totally free to the doctor to do outside of table talk and doing handouts at the front desk and putting up the posters that we provide for you. Do it kind of a soft launch there. And when you're ready, then you can do all the crazy stuff that you want to do. If you want to do, you know, Facebook and Instagram ads, we can help you, you know, point you in the right direction of somebody who's really good at that. We're more on the education of how to get great clinical results and how to make it make sense for free in your practice. But when you want to get into the, you know, paid ads and stuff like that, we let the experts take over for, for that stuff.

Awesome. So, doc, while I still have you, what's the, what's the best way for our listeners to get in contact with you, to learn more, to take a next step?

Yeah, I mean, shockwavecenters.com has a big, you know, it's a big informational page for patients as well, so you can see how we introduce the therapy to your community as well. But shockwavesunders.com the remarkablepractice, there's a great video on there of what makes us different. Our contact is on there as well. You can give us a call anytime if you have a specific clinical question. Dr. Dan@shockwavecenters.com is always available for an email. If you have something that you're really interested in learning more about or want to research on something, I'm happy to develop that for you.

Hey, Dr. Dan, thanks for joining me today. Really do appreciate you. Thanks for the work you're doing. Thank you for responding to the calling on your life and bringing this awesome technology to the US and to all of our doctors here. And thanks for taking the time to meet with me here today.

I appreciate you. Always.

Awesome, guys. Well, you, you heard it here. Dr. Dan from Shockwave Centers of America, honored to have him. And you can go to his website like he said and check it out, learn more, take the next step. Hop on a call with him and his team again. Our goal is that we would help you help more people. And this is one way we can absolutely do it this year and moving forward. So until our next episode, take care everyone. God bless.

Thanks for listening to this episode of Build you'd remarkable practice podcast. Remember, what the world needs now is chiropractic. And what chiropractic needs now is more successful chiropractors. If you like the podcast, please subscribe, share with your friends and leave us a review. And if you'd like to connect with us personally, please click the links in the show notes to schedule a call.

Sam.