072 - Why Your Day One Exam Matters More Than You Think

You can almost convert someone into care by doing a world class exam. So if you slow down, if you get into the right zone, you have intentionality with your hands, with your skills. This is the first time that you're putting your hands on someone. You can almost convert someone into care by doing a world class exam. So do not skip through it, do not rush it, do not just look at it as a to do that, you've got to tick off the list before you can get to the fun part of a day too, because the examination really is an opportunity now to really make it or break it.

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. Bobby as we have conversations each week as it relates to building the practice practice of your dreams. 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 your Remarkable Practice podcast with the amazing Dr. Lona Cook and myself, Dr. Bobby Ledasovic. Dr. Lona, we are fresh off the heels of immersions over in the US Immersions over here in Australia. Conversion, retention immersion. So how fitting that we're having another conversation about conversion today. How have you been going in the weeks after your immersion? Well, conversion and retention immersion. What have you noticed in your practice?

My newest doctor, she came with and I think she has had some epiphanies. That is why you bring your team with where they can hear things from other people and there's just a timing of things. Sometimes you're just ripe for things to connect the dots. And for her, I know she had some, some big aha moments by just being in the room and having to role play with other doctors and hearing it from, you know, multiple different speakers. So it was great. How about you? How was the last weekend?

It's funny that you should say that because I literally had somebody message me this morning that's in Canada and this person, Canada message saying, hey, I heard that you had an immersion in Australia and one of the guys that was at the immersion said they had a conversation with you that they really feel is going to break their practice through the next level. And I want to get in on that conversation and, and I'm trying to think what the conversation was because I spoke to, I don't know, hundreds of people at the immersion. But what I'm, I guess the message I'm putting out there is, isn't it amazing? This one person that's gone to an immersion thinking they're there for the content has had a conversation, me off with me offline. And then obviously in the mastermind has gotten back to this other person about, that's going to be the thing that's going to catapult the exact words, catapult his practice to the next level. And this person would love to get in on that conversation. So when you just said you had docs that were like the other docs they speak to and what happens on the back of the trainings, like in the break times, so often, that's what the big takeaways are, right?

Yeah, it's bj. You never know how far reaching something you think, say, or do will affect the lives of those millions, millions tomorrow. It's like the ripple effect of just getting in the same room and the amalgamation that happens from the speakers and the tone of the other chiropractors and just what you hear in passing is. Is really important.

Yep, spot on the mark. Exactly. So on that, we're going to continue on with our conversion conversations today. So last podcast, if you haven't listened to it, guys, go back and listen to it, because we are in our conversion series now. So we started off with the Day one process and the power of pre framing. Okay, so we discussed how, you know, if you had the option to do either an awesome Day one and Ordinary Day two, or an awesome Day two and Oreo Day one, which one would you take? And we said collectively that you'd rather an awesome Day one. I mean, ideally you want them both to be awesome, and if you're training, they will be. But day one really sets up for you to be able to score the goal on day two. And today we are jumping into a component of day one, which is a critical component. It is one that it's not only critical, but I often see that it's overlooked, it's maybe rushed through, it's maybe devalued in terms of the value that it brings to the whole patient experience. And I can, for one, put my hand up and say, I'm guilty of this. This process that we're going to talk about today is definitely something that in the past I was like, I can kind of skip through this quickly or I can kind of like just get through this. Right. Rather than really slowing down with intentionality. And that part of the process, guys, is the day one examination. Okay, so it is the first time now where we are putting our hands physically on somebody. And so never, ever forget the importance of that moment. Hold. Because here's one thing that I realized and here's what I recognize. You can almost convert someone into care by doing a world class exam. So if you slow down, if you get into the right zone, you have intentionality with your hands, with your skills, this is the first time that you're putting your hands on someone. You can almost convert someone into care by doing a world class examination. So do not skip through it, do not rush it, do not just look at it as a. To do that, you've got to tick off the list before you can get to the fun part of a day too. Because the examination really is an opportunity now to really make it or break it. And what I mean by make it is that if you have people on day one that are really difficult, let's say in the history that aren't giving you much, you can get them through the examination. Right. And what I mean by break it is if you have cold hands, if you're cold with your contact, if you're not exerting for your hands certainty, you can also break it. You can break the whole experience of a patient by doing an average day too. So I'm going to pass this over to you. Why don't you kick us off with your examination? What are the examination process? What are your thoughts on the exam and the whole journey and how much value does it hold? And then if you could, I'd love for you to take us through the back of your thoughts. Okay, Bit of an outline. What does your exam look like inside of your office? And we're going to talk a bit more detail about that as well. Give you some practical tips, guys, that you can take away with you.

Yeah, I think, you know, Bobbi, I love that you pointed the picture that, you know, we can do this wrong by just kind of trying to rush through it or not communicating what we're seeing too. So maybe you're so good at doing your process that it's just like bing, bang, boom. You know exactly what you're looking for, you're getting your objective findings. But are you also thinking about how I'm conveying this to the patient? Right. So for the docs listening, one thing I'd like to point out is, you know, like Bobbi and I said last time, we're making the assumption that like there's a lot right already happening with your clinical skills and your heart and chiropractic and really your clarity and conviction. Around like patients are healthier in your practice than they are if they leave your practice. Right. So part of then getting to, when I say getting to be the doctor for them is showing them what you see and what you know. And that happens through what we're gathering in these objective findings. Right. So depending on what type of care and what type of technique you practice, whether that's X ray or insight scans or posture screens or bilateral weight skills, I mean, you might have a whole gamut of things that you do, but are you doing it in a way where you're actually helping the patient understand that all of these things are pointing to the fact that they have this issue called subluxation and that you know exactly what's going on in which locations for this person. And then like Bobbi said, when they get, when you get to the hands on part that you're able to convey that, like, you've got them and, and that you, you know, they can trust you, they can trust your hands, they can trust, like this touch that's going to happen, which I think is a big deal for patients as well, that, you know, they don't get touched. We lose reverence for the fact that most of us have no bubbles anymore. So, like, we're touching people all day long. And this is the first time you're building that relationship with them where you're actually going to physically touch them. So there's just a lot here to think through. Yeah. As someone who's never stepped foot in here before, what am I conveying when I'm leading them through the range of motion? What am I conveying when I'm doing some of these things? And then when I go to touch them, how am I preparing them for that?

Yeah, 100%. There is a great tool. You bring something very valid up there. And that is as you're going through the exam, are you making it known what you're finding, what you're doing? There is a great tool that you can use for this. So we use a scribe. We have an AI scribe as our note taker. So we don't have any physical notes in the practice. And on day one especially, the scribe forced us to level up our game around examination and outline out loud, saying what we're finding, because now we have to, when we're doing the exam, going, okay, hey, wow, why not? So your right leg is considerably shorter compared to your left leg. There's about a centimeter and a half difference there. Where you guys are there, you might say there's an inch Difference there, right? Has anyone ever told you that before? No. All right, let's bend your knees. Take your legs out. Okay. Wow. Does that feel tight for you? No, it doesn't. Why do you ask? Because your right hip is about 50% less movement and range compared to your left hip. Okay. So it's very obvious your right hip is not moving anywhere near as much. So I'm calling these things out loud. When I go through and palpate, I go, okay. So when I push him through here. Okay. That's not tender at all, right? No. So this is down in your pelvis. Is your sacrum not tender? These next areas might get tender. What if I go right here? Oh, yeah, that's tender. Wow. Okay. What about this one right here? Oh, wow, that's tender. So this loner is your. What we call your lumbar spine. These are the lowest two joints. L5, L4. That's right where your pelvis, which is fixated, joins to your spine, which is movable. That's a big sign there's something going on in there. So me calling these things out, the scribe, I have to do it because the scribe hears it and then documents. Right. L5, tender on palpation. L4, tender on palpation. Right. But also here is a big thing that I teach all of my docs and all of my associates and all my coaching clients is the purpose of an exam isn't to give all of these answers. So it's not like, oh, wow, you have a tight hip. Yeah. That means your pelvis is likely subluxated. Oh, let me check there. Oh, yeah, that means, like, you're subluxated there. It's instead to use the second most powerful motivating emotions that exist to humans, and that emotion is curiosity. So fear of loss is the first most powerful motivating emotion, full stop, hands down. Okay. In humanity, fear of loss is number one motivating emotion. Number two, though, is curiosity. And so through the exam, I love to build curiosity. So every positive finding for me is like, almost said with a question mark. So it's like, well, I'm going to get you to turn your head to the right side. Okay, so is that as far as you can turn, loner? So if you're looking at my face now, I have a question mark on my face. Is that as far as you can turn? Yeah, well, I can just stop right there. All right, so see how your chin stops there? Yeah. You're about 70% of the normal range to the right side. That's a clue. Okay, that could be a sign of something. Could be a sign of subluxation. Let's check the left side. So turn to the left. Okay. Wow. Even the left side. You're a little bit more than the right, but you're about 80%. All right, let me get. Let's tip your head back. Is that tender? Oh, yeah, it is.

Really?

Whereabouts? Right. Or reproduce it. Right there. Wow, that's interesting. Okay, that's a bit of a clue. That's a sign. Let's go through and check. So then we might go through and check reflexes. If I find a decreased reflex, I grab their gaze and I say, london, watch this. Look at your right bicep. Watch this. Okay. See how that's bouncing? Yet every time it bounces. What's the left one? What's it doing? Nothing. Nothing. Exactly. That's a big clue. The nerve that controls that bicep comes out of your neck. Lower part of our neck. So that's a sign there could be something going around the neck. So as we're kind of going through the exam, I'm just, you know, you hear people talk about touch tell. I'm literally pointing out key things, but then just putting the dots on the page. Not connecting the dots yet, not saying, oh, yeah, that means you're definitely subluxated. Oh, yeah, right there. Okay. That's the problem. No, it's like. That's interesting. Reduce range of motion. Dot on the page. That can be a sign. Right? All right, let's try and get you to check your reflexes. Oh, wow. Decreased reflex. Dot on the page. Lie down. Let me assess your spine. We go through, we check. Is that tender? No, no, no. Is that tender there? Yeah. Oh, wow. Okay. Interesting. Right there, right? Yeah. Dot on the page. So I'm just putting these dots, dots, dots, dots, dots down. And you remember back in the day, there was those books when you're a kid that have these dots and then they're numbered one through to, like 15. You gotta join the dots together. But if you kind of, like zoom out the easy ones, you could kind of zoom out and see what the picture's gonna be anyway. So maybe when I put all these dots together, I don't know, it's gonna look like some kind of vase, right? Or a vase. But then when you join the dots together, it's this nice picture and you're like, oh. And then, you know, I used to before put the dots in pencil. Okay. And then connect in pen and then rub out the dots. And then you got this beautiful Vase, which otherwise I couldn't draw on my own. But that's what my exam is. It's me and at the end doing a summary where it's like, let me join the dots together for you. So, lona, when we go through and check you, here's what we're finding. This and this and this and this and this and this. So these are all clues telling us likely, yes, you have subluxation. Oh, wow, doc, that makes sense. But here are the tests that we're going to order now so we can confirm it 100%. Because in this office, we don't guess we find that. Exactly. So that's what my exam. Essentially I'm thinking in my head, yes.

Yeah, that's beautiful. And I love the analogy of drawing because essentially what you're doing, they're drawing the pathway by helping you find these things and you're putting that together so that when you get to the day two, now they look back and say, oh, look at this drawing. That means that this is my solution.

Spot on. There you go. You can think of dots in your mind now. That's why my examination process, I'm not giving conclusive comments like, oh, wow, yeah, that means you're sublux at it. No, instead I'm like, that's a sign dot on the page. That's a clue dot on the page. And then very often they can connect the dots themselves, but if there's any doubt at all, I'll connect it all for them.

I will just add in here that by you collecting these dots on the page, sometimes people. Patient will ask the tough question, like, well, why is this not holding? Or why does my neck keep hurting? This is down the road, right? And the dots that you've collected that you've explained to them is also. Then when you go to a re exam and you're like showing them like, some of these dots are improved, some of them haven't yet. Like, there's more work to be done. This sets you up to. Have already explained that it's not just one of the factors we're looking at. It's all of these things that lead into us understanding the degree of subluxation that that person is experiencing.

Yep, yep. Spot on. So then, question I've got for you. Do you have an examination process? Like, do you have, all right, 11 steps that you follow or 13 steps that you follow? I'm assuming you don't just wing it with every single person. You kind of.

Yeah, we don't wing it. Although now that you say it like that. I don't know that I have it fully, like, labeled in like a numerical order of how we do it. For my staff, there's certain things that happen generally, obviously in the same order, which. This is kind of a curveball, Bobby. But we do like our scans and our posture screen before the doctor even goes in for the consultation. Kind of like a nurse does a blood pressure before the doctor actually comes in, which is different for most people. Right?

Yeah. Cool. Can you give us some enlightenment about how you guys chose to do it like that?

We just realized for, like, how our clinic is laid out and how we're walking through the rooms. It was just. We made the hypothesis that we didn't think it would draw back anything from doing it that order, and it bought less time from our CAS to be away from the position we wanted them in. So that's why we really did it that way. And it's worked out seamlessly for us. So again, it was just how our clinic was laid out that we thought, okay, we're going to just do it this way. So.

Yeah, yeah, that's cool. And then you obviously just measure the stats. The stats showed you what hasn't impacted it. So you continue to do it like that. Right, Right? Yeah, yeah, yeah, that's cool. Yeah. We, in our office, we. We have a structure. So what I mean by that is I prefer to use the term framework. Each test builds value for the next test. So we do have, if you really kind of nail it down, a. It's a 13 point exam, but if you count everything, it's really kind of a 15 point exam where it starts off with like, oh, we're going to go through and check and assess you. So I want to have a flow because what I used to do in the beginning, in my early days, I used to kind of just wing it. So it's like, oh, based on what you're telling me. All right, so sit up on that table. Let me examine you. Okay, so lie here. Or someone would start standing, someone would start sitting, someone would start lying face down, someone would start lying supine. I kind of was all over the place, so I was like, all right, I need a way to teach other docs this, so let me create some foundational structure here. So we have a 13 point examination where it starts off with balance coordination testing. So they're standing. We do all the standing tests. First, balance on one leg, eyes closed. Then we do coordination marching. The spot for Couters, we do a postural analysis, quick posture analysis, other up as well. Then they go to sitting. So we do sitting, range of motion, we do sitting, we call chems or orthopedic testing. We do sitting reflex testing as well. Then from there we go to lying down. So we go prone series next. So leg length check, hip analysis, hip assessment, pelvic assessment, lumbar spine, thoracic spine, cervical spine, up. Then from that point we do any special tests. So if it's someone that requires, I don't know, a special cranial test, we do it at that point. If there's someone that has a knee complaint, we put the knee test in at that point or anything else that's like out of the ordinary, we'll do it at that point. So that's just me. Then through these, through these tests, going through and putting 10 different dots on the page, dot, dot, dot, dot, dot, dot, dot, dot, dot, dot. Cool. Then we set the person up and we do a summary. So we do a summary of all the findings. So when we go through and examine and check you, there's a lot of clues that are starting to add up. So for example, and then I highlight the main ones. You know, when you close your eyes, your balance is really off. You find it real difficult to balance. That's what we call a soft. Neuroscience doesn't tell us what's going on, but often tells us something's going on either in the neck or the lower back, sometimes the feet, you know. Then we go through and check your range and it's really obvious your mobility is quite reduced to the right hand side. Left side is better, you're about 90%. But right side, you're about 50%. That's a big clue. Did you see that? Yeah, I saw that. Right. It's been like that for a while now. Right. And then we go through and check your reflexes. That's a big clue. Right. Bicep is really decreased, whereas the other ones are all nice and healthy. When we go through and assess your spine liner, there's a lot more clues. Like for example, your legs are quite out. Like the right leg is one inch longer than the left one. And so that starts to create a knock on effect throughout your whole pelvis. And it's very obvious because when we feel your spine, really kind of, this is important. When we feel your spine, that lower area of your neck feels quite good and healthy. But your upper neck, right at the top there next to your ears, that was really tender. You see that? Yeah. That's a big clue. Right? There's something there that's not quite right, could be subluxation, but it tells us there's definitely something going on. So I basically connect all the dots from up until that point and then I do a segue for, I guess what I would call our most important test for me in our office. And the segue is, all right, we have a core value around excellence and always like bringing the best technology. So we've got top of the range X ray suite with radiographer inside of our office. And then we've got multiple insight stations, scanners. We actually got three of them. So what happens is they then jump in the room next door, we do a call to action. So these are all clues at the moment, but we want to be conclusive with exactly what's going on. So for that reason, there's two tests that we want to order and here's what they are. Number one is we're going to get a full set of spinal X rays done. Not just a section, we want to look at the entire alignment condition of your spine, right. So we can see exactly what's going on, what's the cause of the issue. So we're going to jump in the room next door with our radiographer on site. Richard is going to get all that done for us. Then number two, we've got some state of the art scans here that's going to measure what's going on with your nervous system. So that's when I introduce thermography scans, EMG scans, heart rate variability scans. And so that's going to show us the impact it's all having on your nervous system. And essentially when we put the two together, your X rays and your scans, that'll give us a complete digital profile about exactly what's going on with your spine. Right? So then on the back of that, you know, we'll know A, what's the cause of the issue, what's truly happening and then B, can we help you?

Because.

Because if we say we can help you, want to make sure you're definitely going to get results and we'll explain to you exactly what that looks like step by step by step. So I basically build this value up for those scans because then what happens is people are really, really dying to see like, what those scans hold. And that's what we base majority of our recommendations on. So, yeah, basically all in all, it ends up being like a 15 step framework where it's like, all right, this, this, this, this, this. And each test is building value for the next, building value for the next, building value for the Next, dot, dot, dot, dot, dot. And then I connect all the dots together for them.

Right, right. And when you're connecting the dots together for them, part of that is going to happen at day two then, right?

Yeah, yeah, correct. Now, one of the things as I've become more dialed in with marketing, one of the things that is a golden rule in marketing is the more friction that you add in the marketing process, the better and easier the sales process. So from a business sense, the primary sale in chiropractic, there's two sales that happen. One sale is to get a lead in as a day one. So that's when someone either calls your office or you're running a Facebook ad and you get a lead. There's a sales process that has to happen to get the person to actually come in. Right. That's a low ticket sales item. High ticket sales is the report of findings when someone chooses to invest thousands of dollars into your care. Right. So I've recognized and realized, I know that the more that I can be upfront with people on day one and set their expectations and actually reveal what's going to happen in day two rather than withholding information, the more that my day to conversion rate just goes through the roof.

Yes, I agree with you.

Right. So yeah, in the examination process, this is ninja move. And I'm sometimes reluctant to reveal this because you have to be. It's a bit more advanced. You got to be really comfortable with your day one. But when I finish my exam and my day one and I send it segue for X rays and EMG and thermal scans, I already kind of 95 in my mind. I already like 98% know what's going on. I need to find out listings, I need to find out levels. I need to find levels of degenerative change. I get it, all those things, but I know they're sublux. Adam, we just have to find out where and how long for. Right. So I already frame up to them what I'm thinking and most likely, if that's the case, what's going to be required on day two in order to get their health back on track. So I already frame up things around frequency of care. If they have questions, oh wow, they weren't expecting it. I already even talk about costing because I want someone that's coming to day two that's really ready to like take action on things rather than oh, wow, okay, that's a lot of information. It makes sense. Let me just go and have a think about all this now. Let it process and Digest it definitely makes sense. But I have to think about that. They should be thinking between day one and day two, not at day two.

Yep. I think that's great. And I think that's part of what I don't. Bobbi, I'd love your thoughts on this. Of like, I feel like in the 15 years I've been in practice, I feel like that's more important now than it ever was before of just like not withholding some of that and just being very upfront. Like, I think that bleeds into like more trust built and again, like a better experience for everyone.

Yeah. I've just found, like, even in early days, I used to get awkward about giving recommendations and then I just listened to my heart. I was like, well, you just, you're just being honest with people. You're telling them what they need in order to get the goals they want. So I just carry that through in everything. Now I'm just being honest with people. I used to feel like, oh, I'm withholding stuff. So what do you think, Doc? Oh, I'm not really sure. We'll have to wait till day two. I used to kind of think I've got to withhold this stuff, whereas I was like, no, don't withhold, have honest conversations. Here's what I think is going on based on what your exam is telling me. This, this, this, this, this is most like what's happening. But hang on. We need to get your X rays first so we can confirm 100% and then we'll know with clarity. But if that is the case, he's like, what's going to involve. Right. So, you know, I don't know what other way simpler to call that than just being honest with people.

Wow, look at that. It's a business strategy, right?

Right.

Yeah.

Being authentic and being honest with people. So don't withhold all this information, guys. You know, use your exam. It's golden. You can almost convert somebody. We're doing a rock, an exam and have structure around it so you have flow because that gives you certainty and you might find it easy, but you're going to have associates in the future, so you're going to be able to train them what the structure is. And remember, it's about dot, dot, dot, dot, dot, dot. Connect the dots at the end and then, you know, tell people what your thoughts are. So for day two, they come in primed. I call it. I'm ready to rock and roll.

It's beautiful. Yes. So many nuggets.

Yep. Any final thoughts on it? Anything you want to add about how someone can learn?

I love how you ended that because I think sometimes we're looking at to be this like this thing that, oh, if I just do it like this, it's going to set everything up and it's like yes and yes. Your expertise, yes. Your clinical skill. Yes. Teaching people what you're finding when you're doing your objective test and being authentic with people is part of how trust is built, which leads to good conversion, which leads to great patient outcomes. It's all if we don't have that piece that's such a missing link in this whole process.

Yep, spot on. Nailed it. All right, team, so there you go. This is your call out to put some, put some thought into an often missed and maybe a little bit under loved part of the chiropractic journey, which is the examination. Don't forget about that little guy or girl. It's a really, really important part. And quite frankly, remember, you can almost convert someone by doing a great exam. In fact, that's what a screening is. Some people let a screening sit there and do motion palpation and convert somebody to come in as a day one. Peeling the back of their touch, their certainty and connecting with the person in front of you. Right?

So good. Yes.

Yep. Love it. I team so put some love and thought into that examination process and watch what happens to your office. Your conversions will definitely increase and go up if your examination process increases and goes up. So if you enjoyed this, guys, hey, make sure follow us on Instagram. In fact, on my Instagram I might do some behind the scenes videos around how we do examination process in our office. So follow us, Dr. Lana Cook, Dr. Bogdan or Jasvic at Instagram and you'll see behind the scenes how we put it together and make it all happen. Until next time, Lionel. Have a rocking day.

Thanks, Bobbi. You too. 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 chiropractic. So listen on.

Hey guys, Dr. Pete Camiolo here today I'm in the studio with Glenn David. You might have heard of him before. If you haven't heard of him, you might have heard of his company Davlin Design. They've been around the chiropractic space for a long time and I, I had the honor of meeting him and speaking with him before they actually joined us as a success partner. Got to know him, his heart and got to find out some of the people who he's helped over the years. And I said, hey, I know these people. You've helped some of the, the movers and shakers in chiropractic for a long time. You've been in the game and. But many people might not know you and they might not know your story. So Davlin is a success partner, which is you guys know, if you're listening to our show, if you've listened in the past, you know that a success partner is somebody who's invested in your success and they have chosen to invest inside of the remarkable practice to help more chiropractors help more people. So these are people that share our core values. Davlin is a company that shares the same values we have in remarkable practice. And they're on the mission with us to help you help more people. So it is an honor for me to have you today on the show and to be a part of our podcast. Glenn, thanks for taking the time to meet with me.

Oh, it's always my honor. Always my honor. Pete, thank you.

You're very welcome. So our audience may not know who you are. They may not know a lot about your company. Let's just say they don't. So take us through a little bit of a down memory lane, bring us up to speed. Tell us a little bit about your story, about your company. It's Genesis and then what it's evolved to and where you guys are at now. Love to help our audience understand who I'm talking to because you are the expert in the space.

Oh, thank you. To start off, we are, yes, we have been around a long time and we still are the best kept secret in the chiropractic profession and hopefully this will change some of that as well. We have been designing chiropractic specific offices and manufacturing a very specialized line of chiropractic furnishing systems for quite some time. It's a family owned and operated company. My wife Jean and I started Davlin in the early 80s when she was actually a CA and we're blessed the fact that two of our children are Davlin's next generation. So while I'm starting to get a little gray up here, luckily the kids are deeply involved and very excited about it. Christina is the head of sales and design and Nick is our production manager. He's been designing, building and delivering all of the solutions that we've created for almost 20 years now. And Nick's wife Frankie is our logistics expert. So it's a big happy family event. We have two primary fields. One is our chiropractic facility, design consultation services, which is a mouthful but very unique. And the other is our chiropractic specific workstations. Now we have a under roof, a specialized design and manufacturing facility here in central North Carolina. We started up in New York and we moved to North Carolina to expedite a little more centralized located. And we build things like chiropractic front desks, electronic health records units, portable T bars, modular walls, hospitality stations and reporter finding stations. And they're built all here exclusively for chiropractic. In other words, 99% of what we do is chiro oriented and we don't build kitchen cabinets. So it's very specific to that started back in 1987 when my wife went to work for a chiropractor on Long island. And they were working in a 450 square foot office attached to the side of the doctor's house. So picture that two and a half car garage, seeing over 300 patients a week. Now it was a straight chiropractic office. They did very few modalities, but it was still a pressure cooker to say the least. My wife would go to work extremely excited in the morning, come back totally exhausted at night and I didn't understand anything because I knew nothing about chiropractic, which was a blessing in disguise because she would go happy, come back miserable. And I wanted to figure out what can I do to help her job? Well, I was in residential and commercial construction, so I decided let me see what she does. So I walked in the office with big eyes and big ears and I watched what she was doing and I watched and listened to what she needed to do. And I figured out maybe I could build her a really cool front desk and put everything at her fingertips to make her job easier. And that's how we started. And that was 37 years ago. And that doctor had a bunch of chiropractic friends and they saw our work and they hired us and their friends saw our work and they hired us. And here we are, over 6,500 chiropractors that we've served over the years. So that's our starting point.

I mean that number. And when you shared that with me, I thought, I don't know if there's many other businesses inside a chiropractic space that have served 6,500 different chiropractic clinics. I mean chiropractic offices, I mean that's a significant number of people that you guys have been able to serve and impact. Just, just think about that. If you're, as you're listening to this, that's a lot of experience over the last three, three decades plus. And I wanted to maybe from a problem solving perspective, one of the questions that I have for you is that, you know, every business exists to solve problems, right. And you want to solve a problem for somebody else. That's what makes your business, which yours was initially, I'm going to solve my wife's problem. Right. It turned into people. There's others that have this same problem. So if you're talking to me as a chiropractor, listening right now in 2025 and we're interviewing, you've been doing this since in the nineteen, late nineteen eighties. So how would you describe the problem or problems that you're solving? And talk to me a little bit about how the problem that you solve, what it's producing on the other side. So really combining, you know, maybe two different questions. You know, here are the problems that we come in and we see, and then as a result of us fixing these problems, what are the outcomes? What are the results that we're getting on the other side?

Great question. You know, I talk about 37 years and 6,500 doctors that we've served. Not to impress anyone, just to impress upon you that this is our profession. You know, when doctors talk to me, they talk to me like a chiropractor. Many times they ask me if I am a chiropractor. And that's very rewarding. Means I'm on purpose. What we found over the years, here are some of the basic problems. 87% of the chiropractors that we've went into severely underutilized their square footage. So that means they're paying for more than they really need. 73% have staff working in beautiful environments. There's some gorgeous work out there, but they function terribly. And 95% of the clients that we deal with can reduce the amount of time that a patient spends in their office by making small changes to their office. So if with all of those issues, we've listened to a lot of experts in the field and come up with a lot of different solutions to create that. Let me give you an example. I was listening to your last podcast with Dr. Steve, and he talked about operationalize, professionalize, and optimize. And we understand the philosophy of creating systems to run a practice. People run the system. Use the least expensive qualified for that system, and your patients will receive the same consistent and predictable results. Well, we create the workplace to simplify that job. It's kind of like someone wants to race the Indy 500 of chiropractic, but they're driving a Volkswagen now. Nothing wrong with that. You can get around the track. You just can't play at a higher level that you want. So we can either provide the Corvette, the Ferrari, or the Indy race car, depending on what the doctor's needs are. Makes sense.

Makes a ton of sense. So I want to kind of go into all three of the points you made. One of them was the underutilizing, the environment, the workspace. You talked about that being a significant percent in the upper 80s. You talked about beautiful but not functional. You talked about time also flow and the time issues. All three of those. In my mind as a coach, I'm like, yeah, all that's going to cost you money. It's going to. It's going to reduce your ability to make a bigger impact. It's not optimized. Right. It's harder to scale. It's not as durable. And you're putting the lid on your company's growth. So you're talking about it through the lens of physical space, whereas I might come at it as a coach from a slightly different perspective. So talk about that, because you guys analyze it through the way that a business is set up in the physical structure, but you're actually creating, through adjustments that are being made, an increase in the ability to drive more revenue, create a bigger impact, creating a better experience for both the providers, the staff and the patients. So I don't know if you want to hit on one of those three, but I always love the functional conversation because, you know, as a chiropractor, we're always about structure and function and, you know, so where. Where you want to go with that? I'd love to just hear you, maybe unpack some things from all those experiences that you have had and you're continuing to have to this day.

Well, key factor is simplicity, speed and efficiency. There's no rocket science here. It's once you understand what should be done, what the task at hand is. If you start with a clean sheet of paper, you just create the best workplace because it doesn't cost more to do it. Right. But let's put this in perspective, Dr. Pete. Something that, that your members and any of the listeners. Listeners can relate to. How does a doctor grow their volume? I speak to so many doctors, and one of the big questions I have is, what's your goal? And they say, I'd like to double my practice. Well, that sounds kind of scary. Now you give them the tools to do that. But a lot of doctors can't wrap their head around how do I double my practice. So watch this. Very simple, number wise. And this formula works anywhere. And it's not a special formula I worked up. It's like compounded interest. So watch what happens. Let's pick a mediocre practice or a Moderate practice at 160 visits a week. Okay, let's just use the statistics of 20 new patients a month, patient visit average of 35, and fee per adjustment of $40. Okay, so I went conservative on a lot of those numbers. I call it the 1% practice explosion. Because if you take each of those three statistics and increase it by 1% per month, tiny little change over a month. So if it's new patients per month, 20 next month will be 20.2, then 20.4, then 20.6, then 20.8. Eventually you get to 21. And you do that for 28 months. Eventually, after 28 months, it's 26.4 new patients per month. It's not terrible. Two years to grow, six patients additional. You're not trying very hard. Patient visit average. Okay, how do you increase patient visit average? Education, knowledge, experience in what chiropractic really has to offer. Let's start with a PVA of 35. After 28 months, that's 46. Well, heck, I've been adjusted, you know, for the last 30 plus years. My kids have all been adjusted since they were born. Their progressive PVA is hundreds, if not thousands. Let's go to fee per adjustment. Fee per adjustment at $40. If we did increase that by 1% per month. Now you're not going to tell the patients, oh, next week it's next month it's $40 and 40 cents. But the perceived value of your care. I have to backtrack a little bit. Chiropractic saved my first son's life. I'll get into that story. Maybe one day I could kind of get up and tell doctors how important what they do really is because it saved my son's life. What's chiropractic worth to me? Whatever you want to charge. Just don't tell my chiropractor because I pay cash. But $40 a visit after 28 months is 50, $52.85. So what that does is it takes a practice at the original numbers of $336,900, give or take a few, and it grows the practice $777,192 more than doubles the revenue stream just by 1% increases to each statistic. So it's not that difficult. You just have to focus on increasing and making things a little bit better. Well, that's what we try and do. Unlike other designers or interior decorators, their goal is to make it look really impressive and pretty. It's important. But a lot of people spend a lot of money on something that functions terribly well. We're going to sit there and figure out a workplace that supports and enhances everything that a staff does, put what your CA needs at her fingertips so that there's truly efficiency and allows you to pack 21 pounds of chiropractic into a five pound office. And then after all of that's done, then we make it look great.

I love that you went down that path and gave us a bit of a exercise to do. And you think about what's able to happen in 28 months if you make these small incremental changes of just 1%. It's powerful, powerful exercise and it's really important for everyone who's listening to actually do things like that. I think it's important that you connected that to also what you do. So if I hire, let's say I have an. So there's a couple of different scenarios that somebody's listening. I'm listening to your this interview today, and I have an office. Maybe I have multiple offices. I think it's functioning pretty well. What would you say to me if I'm listening to the other end? Okay, that's one and the other, the other person that might be listening is like, hey, I'm looking at opening a new office or I'm looking at opening my first office, whatever. Maybe speak to me too. But let's speak to the first person first, which is, I have a clinic. I've been functioning. Maybe I'm not. Maybe my space is not optimized. What do you say to me? What can you do for me? If I've already built my office, I'm already established, I'm already in. Is there anything that you guys can do to help me potentially increase my flow or improve my experience for my cas? Enhancing and supporting them with the work and the important work they're doing. What do you do for an established practitioner who already has a clinic or clinic?

Well, we kind of do an efficiency audit to their clinic and during our webinar we asked them to send some photographs and some drawings, no matter how crude they are. And we take a look at the office and see just what the operating efficiency really is and can they fit more case in point, one of your members here in North Carolina owned a 1200 square foot brick and mortar building, freestanding, and it was literally brick and mortar. So you couldn't add on to the side of the building. Well, he had one primary adjusting room, one secondary adjusting room, two modality bays, and he had two front doors. Front door in the front of the building had parking and the door in the back of the building had parking. And he was using both front and back doors. So people were entering and exiting from the middle of the clinic. We analyzed it and with some demolition work and some modular furnishing systems, we were able to give him four primary adjusting rooms, five modality bays. We created a separate consultation and reporter findings room. So he was able to more than double, you double his services and revenue stream. And that allowed him to bring in the associate that he wanted to. And he was able to do that without closing the office. He cluster booked a little bit. The contractor worked over the weekend. So the contractor knocked a couple of walls down. Guys came in and redid the floor, repainted it. We came in with the modular furnishings and he's up and running into it. Allowed it took the pressure cooker off of his office and it allow him to grow to whatever level he wants to powerful.

So you'll, you'll meet a doctor right there. At that moment, I'm in a brick and mortar. I'm, I have this space, I'm locked into this space. And you can take that and transform that space. That's beautiful. Whether you're listening right now and you're like, hey, that's me. I'm trying to bring on an associate. I don't know if I'm optimized for that or hey, I just like to bring in some more modalities or maybe I'm looking to expand my offerings and grow, but I'm in a lease or I own my building and I'm not really ready to change or move any of those things along. You can come in and very efficiently transform that space into something that's optimized, which is one of our keys that we talk about in a remarkable business is you reach these, what we call break points, we call it the rule of 1 and 3. And you reach these breakpoints. And what you're talking about is, yeah, I can come in and hit a breakpoint and I can transform that and you can exponentially increase. So that's one group. Talk to me a little bit about the group that's hey, I'm going to go out and Open another clinic or open my first clinic. How do you support doctors who are doing that?

First place we take a look. Once we do our consultation, we listen to the end result, not what they think they can get. Because a doctor might be seeing 100 visits a week and he doesn't think he could see any more than 150 a week because he wants to spend more time with the family. But deep in his heart he knows the community needs three or 400 patients a week coming through his doors. Well, if you take the preconceived notions out of the way. And because, just because he doesn't want to spend more time doesn't mean he can't see more patients. So if you're at the end of your lease and you're looking for a different space, we listen to the end result, then we tap back into our past experience and that's where 6,500 other mistakes that other people have made before they came to us tap in here and we can then guide them into how many square feet they should look for. Now, square footage isn't the key because let's say 2,000 square feet could be 10ft wide and 200ft deep, and that's terrible. It could be 40ft wide and 50ft deep, and that's terrible too. But depending on their treatment technique, there's a certain geometry that we've realized that allows me to pack that 21 pounds of chiropractic into a five pound office. So they would go out and start to search for different locations. And then let's say they picked 10 locations, narrowed it down to three. We then take a look at those three and guide them and tell them, here's what to look for in this number one space. Number two space is perfect to negotiate. Really strong on that number three space. Don't even bother because it's going to cost you a fortune to build out. There's inherent problems and I do that by looking at photographs and sketches and it helps narrow it down so it gives them something to negotiate on. Because like negotiating TI Tenant Improvement Allowance, it's just a game unless you have ammunition. So if someone said, well, you know, the landlord offers $15 a square foot in TI and I go in and say, no, we want $40 a square foot in TI. But here's why your H Vac needs to be totally replaced. Because you could look at the ducks, because I just looked at them, they're all cobwebbed, infested. Your bathroom doesn't meet code and that's 15 grand right there. It's not wheelchair accessible. And on and on. So I'm feeding them information. And that's all part of our services. You don't pay extra for that. It's part of it. Or we have the other extreme. Maybe someone's happy where they are, but their front desk works really inefficiently and the girls are pulling their hair out. Or they say, hey, Glenn, we need to hire a second CA for the front desk. But I find out they're only seeing 100 visits a week. Well, one CA can process three or 400 patients a week before you need a second one if they're done efficiently. So what's the value of saving a little bit of time? That's another thing. Here's a little statistic, a fun fact that I've come up with. And you can see I'm a number cruncher. If someone wastes 30 minutes, 30 seconds here and there throughout the day, it doesn't sound like much. 30 seconds here a minute there, 30 seconds here, a minute there, could easily add to 30 minutes a day. So let's just randomly say 30 minutes a day, it's 150 minutes a week, 650 minutes a month, 7,800 minutes a year. That's 18 and a half days per year. That if you could be more efficient and not waste that time or let your patients waste your time. From a doctor's perspective, 18 and a half days per year. How much more can he spend adjusting patients? How many more hours can he spend learning he can go to more TRP conferences and learn how to grow the practice better or be more efficient? How much more family time could he have? Or a front desk ca. If you now knew that your front desk ca, let's go conservatively cut that number in half, had nine days per year, uninterrupted. How many new patients can she get you? One. Nine and a half days? Two? Can she get you one a week? Can she get you one a month? She better be able to. So you can invest a little bit of money into a new chiropractic front desk, put everything at her fingertips. Now she has all this free time or you don't have to hire the second. Cause you know what happens when you hire a second CA and the two are working side by side. You don't get twice as much work. You're lucky if you get the same amount, maybe a little bit more, because there's an overlap. So that's another way that we can help them. Tremendous or Report a findings room. I mean, report a findings room. Maybe you're not getting the conversions you want because there's all kinds of distractions and that's key. So many doctors don't realize that you could deliver the best report of findings in the world. But if there are distractions, the patient doesn't remember any of it when they leave. The key to a report of findings is not what you say, it's what they remember when they walk out your door. And that's where we can help you as well.

I love this conversation and I know everyone who's listening to you right now is enjoying hearing your wisdom. And from all the experience you've had, you've looked in a lot of chiropractors eyes, you've talked to a lot of chiros, and you've dealt with a lot of problems and that just makes you a tremendous resource. We're thrilled to have you as part of a Resources for Remarkable Practice and obviously for our podcast listeners. So if someone's listening and they want to get in contact with you or learn more about what you guys are doing, which you've shared quite a bit already, or take a next step with you, what's the what, what direction can you give our audience here today?

Well, certainly do the research on our website davlindesign.com and the initial consultation. We will gladly get on the phone with you and we have some homework we'd like you to do so I can make it as productive as possible. Because every doctor I speak to is different than the other doctor I spoke to. So we'd want to know what makes you unique, what your teachings are for TRP members. That audit that we had kind of discussed, we can roll that out and actually analyze their space for them to let them know how much capacity they really have and whether or not they need to nuke the place or do a slight change or it's time to move. And you know, I think we can roll that out with you hopefully before the next conference. And certainly if you're at TRP in Orlando, we're all excited about it. I'll be there, Christina will be there, my family will be there. So we'd love to meet with you and talk and show you what we can do because our webinars are quite extensive.

I have personally witnessed multiple doctors even in this last this year, this current year, who've been very pleased and thankful for their time with you and the way you supported them. So coming from me directly, who's working directly with doctors who you've had the opportunity to meet with and serve the value you provide on your webinar. And then even those who have decided that they're ready to move forward and take a next step with you has just been awesome. So thank you for the work that you're doing. Thanks for taking the time to meet with me here today and be a part of this podcast. And for all of you who are listening, thanks for tuning in. This has been Dr. Pete Camiola with Glenn David from Dablin Design. And remember to tune in next week for the next episode of the podcast. Until then, God bless you all. Take care and have a great rest of your week.

Thanks everyone. Be well.

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 get connect with us personally, please click the links in the show notes to schedule a call.