328 - Turning Your Metrics Into Growth and Impact with Dr. Josiah Fitzsimmons

If you put a dollar into machine and it gives you more than a dollar out, how many dollars should you put in the machine? Yeah, unlimited, Right? Unlimited. You can borrow as many as you possibly can, right? Until you, you need more people, you know, to help you hold your dollars. Or you need a bigger vehicle, you need a bigger space, right? Or you need to expand hours to put more dollars in more frequently. Right? So that's the whole entire premise is that you need to first and foremost understand that basic framework of what is your return on Aspen Break even points.

Hello and welcome to the Remarkable CEO podcast, a show dedicated to chiropractors who want to transform their job into a business so that they can have a remarkable practice as part of a remarkable life, not instead of one. With your hosts, Dr. Pete Camiolo and Dr. Steven Fransen.

At Genesis, we help successful chiropractors implement spinal decompression with a fully turnkey system that handles everything from marketing and new patient generation to systems, protocols and ongoing support. The result, Massive value for your practice and life changing outcomes for your patients, all without drugs or surgery. This is the next evolution in chiropractic care. Welcome to Genesis.

What's up Remarkables? Welcome to another episode of the Remarkable CEO podcast, Chiropractic's number one business podcast. We got an extra special guest here today. I'm excited to bring one of our awesome partners on a couple ways, a couple levels. A partner in our remarkable money program, an awesome TRP alumni, and just a great friend of the remarkable practice. And of me personally, Dr. Josiah Fitzsimmons. You've probably heard his name before, especially now more than ever with his program, his product, his service, Lucro. So we're going to hear more about that today because I, I like to say the language of business is accounting. And if you don't speak accounting, you do not understand your business. We're going to change that. For those of you who are rolling your eyes right now, we're going to change that for you so you become fluent in your business. Because to grow your business, you need to know your business. Dr. Josiah Psychedelics conversation today, buddy. What's happening?

I love it. Thanks. Thanks for having me. You know, that's a huge tenant of my success is understanding structure. I know we've talked about that a lot and that's something that TRP does such a great job and I think you've led the way for the profession in the styling, the chiropractic operating system. No matter how you want to grow, no matter what you want to achieve, you need to have the proper structure, KPIs, and accountability to get to the next level.

Yeah, man, I love it. So you're a qualified guy to have this conversation. We're going to have a money conversation today, right? So, you know, at the end of the day, no money, no mission, you know, our spirit around that. So none of us are voluntarily running a nonprofit organization. But, man, there's all kinds of those around chiropractic. And now that you've got Lucro, you guys are in their books. In fact, you're creating their books for them, doing their books for them. So you get to see the underbelly of all of these businesses. You know, I say it all the time is most chiropractors don't lay awake at night worrying about their practice. They lay awake at night worrying about their business. So we're gonna have a business conversation today. We're gonna go across all five domains. We're gonna talk about, like, what do we see? Like, what are the key things in each of the five domains that. These are blind spots, or these would be key elements that if you're going to just. If you're going to get to one piece, like one constraint of the business to address, slay this dragon, get this right, and remove the interference to what your business is designed to do, which is to expand, to grow. Right? So I'm excited for this conversation. We're going to get into it. But you know what? Let's give you some street chops here. Why don't you tell them your story? Who are you, where you come from? What's your chiropractic journey been like? I love when you talk about your experience with Morocco practice. Of course, I love to hear that part of the story. And. But I'm going to give you permission to brag here a little bit because you got one of the biggest practices in the world where you know, what a. What a privilege to be part of that journey, and that gives you credibility with this group of people. It's like, you know what you're talking about. You know, we learn a lot from our successes, but we learn so much more from our failures. We've walked this road together. Let's talk a little bit about your experience in business, in practice. Let's set the table before we eat.

Absolutely. I love it now. Appreciate it. Thank you for the kind introduction. But honestly, I want to go all the way back to third grade. I mean, that's where I really learned my work ethic. My family grew up very low Income. Nicest car we had was 500. I would literally steal pop cans from my neighbor's trash to turn in for nickels in Iowa. I don't know if they have that in all states that you can turn in pop cans. Like, we'd walk, we'd go on walks, and my grandpa would say, I see a nickel. And it would be a pop can on the side of the road that we would want to go turn in to the local recycler. And so I started waking up at 2:30am every morning in third grade, help deliver newspapers and help the family pay the bills. And that's really how I delivered, you know, achieve the work ethic that I did. But then when I got to chiropractic school, I'm 1 in 9 kids, I was super, super competitive. I found that there's all these different techniques. And I said, well, what's the best technique? And everyone said, well, whatever you love to do, it's up, you know, whatever your philosophy is. I was like, man, that's not how science works. Something's got to be the best, you know. And then same thing with business. I'm like, well, how do you run the rest? Best business? Oh, you know, that's totally up to you. And I'm like, there's got to be best business practices. So I became on a mission very quickly in chiropractic school. I was president of six different clubs, you know, while I was in school. And I ended up going to over 50 different clinics while I was a student in chiropractor school to try and learn and understand how to run a successful clinic. And so before I opened, just four months after graduating from Palmer, I already had over 400 prepaid appointments scheduled on my books. And so that allowed me to do over $1.2 million my first year in practice. Right out of school, paid off all my student loans, you know, within a few months after opening my clinic, and I took out maximum loans all the way through. And so then second year in practice did over $2 million. Third year in practice was Covid. And so as everyone else had more time on their hands, and I thought, okay, this is my opportunity to go back into deep learning loan. I now need to find all the other top clinics in the country that are doing way more than $2 million that I can learn and understand and study and grow from. Well, very unfortunate at that point that I couldn't find very many clinics in the country that were bigger than me. Only two years out of school, I was frustrated. I Said, we have the greatest health care product in the world. Who's getting more miracles in our practices than chiropractic clinics? You know, I always tell people it's Jesus and chiropractors, top miracle workers in the history of the world. If that's the case and we do have the best health care product in the history of the world, then how come there's such small utilization? How come the success in our profession is so limited? And I became very frustrated, know, with that. And I said, there has to be a better way. There's these other businesses out there selling far inferior products and services that are making people sick or that are absolutely useless. Just liabilities that people are purchasing, you know, and spending their credit card on. Why are they not doing that with their doing a much better job investing in their health? And so I started studying other businesses and I found that they have much better structure to grow and scale organization, key performance and indicators, core values, primary purposes, primary skills for all their team members. And they had this entire architectural structure of how to scale a business from any level to the next level and say, holy cow, I got to figure out how to do this. And then thankfully I found this dude named Steven Franson who had already taken that exact model and applied it to the chiropractic industry and said, okay, I gotta just join the remarkable practice, implement the chiropractic operating system into my own very clinic. And so the next year, that was one of the key parts of our growth that then go from 2 million to 5 and a half million and only 1800 square foot clinic. Okay, and so that was just a few years ago now, just finished seventh year in practice, just about $7 million in one location. And so as I've scaled along this way, doctors have always said, what are you doing? How is this? How does this work? Can you help me? What are you doing differently than me and my clinic? And so fundamentally, I would always ask them, well, just tell me about your numbers. I don't want to give a generalized answer. I want to, I want to help you. You know, I've had Doctors offer me $10,000 for a phone call. I said, you don't need to pay me anything, just I'll hop on a call with you. How can I help you? Like I want to genuinely help this profession. I've already made more money than I ever thought I would. You know, growing up with where I came from. And so always started back with asking people their numbers and nobody knew their numbers. No one I've talked to over the years, such a small percentage of them actually knew what their numbers were. And the few percent that did, maybe 5%, said, what do I do with them? Is that the right amount? Is that, should I spend more, should I spend less? What actually action should I take? And so I realized, even more than knowing your numbers, that's only 1% of value, 99% of the value is actually knowing what to do with your numbers. And so that was really the whole premise of launching LUCRO just last year. We do bookkeeping for chiropractors every single week, and then we give a financial analysis report every single month of what action steps they can actually take with their numbers. So now we have close to 500 clinics, and now we have almost $500 million in annual clinic revenue. And my big purpose for the profession is to start giving back. We're going to start coming out in 2026 with a white paper report of the financial position of the chiropractic profession. What's working, what's not working? What are the top performers doing? Who are they utilizing? What organizations are they utilizing for all the different services to scale a successful business and impact the world? Because like I said earlier, if we do have the greatest health care product in the world and we have these amazing testimonials all the time, then the biggest missing link is understanding how to scale and run that business better and more profitably.

That's exactly right. Well, now all our listeners are listening right now. And let me just settle you down. This is not going to be a LUCRO commercial. This is about qualifying the opinions of two experts. Okay? So you're talking to two guys who are, who are, like I said, we are in the kitchen. We, we see the underbellies of, between the two of us, over a thousand practices, right? So we're talking about historically thousands of practices that we've looked at, both the operational metrics and the financial metrics. So everybody has to understand those are two different things, right? Operational metrics are the things that everybody talks about. Hey, how many new patients, what your conversion rate is, what's your stick grade, pva, cva? Right, those, those are all operational metrics, right? Financial metrics are different. That's when we start talking about revenue growth. We start talking about gross profit and margin. We start talking about revenue per employee ratios, right? So we get into the kitchen of these businesses and we understand what does a successful practice look like? And like, what is the DNA of a successful practice? Like, you have to know what you should be measuring, what those KPIs are what those KPIs mean. How do you influence those KPIs, right? And how do they interrelate, right? So for us, looking at these metrics, guys, it's like looking at the matrix, right? So it, when the metrics become the matrix, it starts telling you a story, right? So your business is talking to you. The question is, is, do you speak the language? Do you understand? Your business wants to have a conversation with you. So we are going to help you interpret your business, what your business is saying to you, right? Or at least start to teach you the Alphabet, even if we can't teach you all the words and all the language here on this podcast. But you know what? We've got our heads together. We're going to go across the five domains and we're going to pick just one of, let's call it a talking point in each of the five domains to give you guys just a running start. If you get one of these fixed, man, you're going to grow your practice 20%. You get two of these, three of these, five of these nailed, you're going to see your practice double, right? So ultimately, guys, literally a double, like, if you can, I will hang my hat on that. If you get, if you can, right size each of these numbers that we're going to go through, you will see a doubling, if not more, of your business and especially, and most importantly, your profit. Listen, guys, you're listening to two very successful business people who have had multiple, multiple businesses. And a successful business requires four things. A purpose, a product, people, and profit, right? So if you think about chiropractic, man, do we have an incredible purpose? Right? We have the second most important purpose in the world, right? So we have a spectacular purpose, right? So number two product. Oh, my gosh. You name a better product in the marketplace than the simple and elegant solution of the chiropractic adjustment, right? So we have an incredible product which is, by the way, almost infinitely scalable, right? So number three people, my favorite people in the world are chiropractors. We have seven chiropractors in my family. I married my chiropractor. Both her sisters are chiropractors. Both were married to chiropractors. My brother's married to a chiropractor. I'm raising at least one more chiropractor. My kids are surrounded by chiropractors. They thought everyone was a chiropractor until they turned 12. I think it's. I love chiropractors. I spend an inordinate amount of time. With chiropractors and chiropractic teams, we have the best people in the world, right? So no doubt now the fourth one is profit. The problem with chiropractic is the fourth one is profit. Profitability, right? So we have got to get this right, we have to get the money right. Dr. Josiah, I know your heart's the same as mine. No money, no mission, right? So we've got to make sure that this is like for chiropractic to take its rightful position if we're truly going to take part in making America healthy again. How do you make America healthy again? I'll tell you what. Chiropractic has a seat at the table. What are we going to do with that seat? Right? What are we going to do? What are we going to say? We need to get this profit picture right, so that we're not under capitalized in every worthwhile initiative that I see happening in chiropractic.

Amen. I mean, I love it. You are so spot on with the, with the purpose, the passion, the people, the product. I mean, if we're the top in all those areas and what's the missing link is that we just got to create awareness. We got to get the message out of what we deliver. The greatness, you know, within every human body that needs to be unlocked by removing nerve interference. And how can we do a better job of that? You know, we have to run successful businesses first and foremost. And that's literally what lucro means is profit in Italian. That's the whole goal is to help clinics be more successful so they can be more on purpose, have a bigger impact on their communities. Just like BJ Palmer talks about with the big idea.

That's exactly right. So that profit, it's going to free you up to invest in your business. So I want everybody to hear that when you hear us talking about profit, it's not just about having a big life. What we call the remarkable life, which I'm a massive advocate for me, I think we should be the. We have the second most important message in town. We should be the second most highly paid person in town. That's the question. Are you right? So you, you should be wildly successful, right? So. But there should be enough, enough profit that's generated by your business that you're able to invest. Everybody underline that word. Invest in the marketing that you'll need to do to increase your rate, your reach. Are you a mission driven on purpose guy, writer? You should be looking to reach more people. That's what marketing Means guys getting out to the marketplace, increasing your impact, right? So that takes money. You have to have the capital to invest in marketing so that you can reach more people, right? You have to have the capital to build the team that will serve those people. You. Most people are so understaffed. Either they don't have the A players that they need or they just don't have the manpower. So everybody's overwhelmed, so everybody's pumping the brakes. You need to have the money to invest in building the team that can serve the next iteration of your business. To pull that business forward, the time, energy, focus and talent that you'll need, you need to invest in that, ahead of it, ahead of the growth. That's why it's called investing. Investing is when you take your limited resources and you push them in, anticipating a return on the investment in the future. It's not a purchase, it's not a consumable. You're investing when you bring somebody on to create daylight in front of your business. To pull your business forward, you have to invest in training that team, developing that team, co dare I say coaching that team so you can bring out everybody's best and optimize it, right? So and you have to be able to invest in your practice, the technology, the space, etc. Dr. J is so critical. It's like at the end of the day for chiropractic to growth, it takes capital. And here's the thing is the capital has to grow with the practice. It can't be one day profit, someday profit. We need to be profitable all along and turn and push that money, invest intelligently back into that business.

Absolutely. You hit it on its head. It's like second highest paid people, you know, in town. If we're delivering the best product, you know, then isn't the value there? And that's why I think we've been so under capitalized in our profession is because we are delivering incredible value. And we're doing it at such basement prices, right? The value of what we're doing for changing people's lives. And Harvey Lillard could hear again. People can have, you know, babies for the first time. People can walk, people can feel their feet. People have these miracle testimonials for a few dollars. You know, my friend locally owns a company that helps fight insurance claims with over billing. Guess what, Dr. Fransen, he's found the most expensive cost someone's ever been charged for a bandage. What do you think it is?

Oh my gosh. How many money guessed?

1800 bucks.

$1200, $1200 is his record that he's found that insurance company has charged one of his clients for a bandage. Oh, yeah. Okay. And so they're charging $1,200 for a bandage. Okay, that's worth $1 maybe. You know, what are we charging for something that has infinitely high more value? And we're charging peanuts for prices.

Right. And guys, when you hear this, that is abuse, right? So that is taking advantage of that. That is out of integrity. We're not suggesting that at all. We're not. And we're not talking about increasing. Don't hear us say, when you hear us increase your prices. We're not saying, hey, just for the sake of making more money for you, you need to increase your prices. What I want you to. I'm going to change your frame on this. You're undercharging.

You need to.

Right. Size your pricing. Okay, so there's a value imbalance. Money follows value. You create value, deliver value, add value, and capture value. There's a balance in that. There's a universal law, and you are out of balance. If you are delivering value, you should be capturing value, which is getting paid. Right? So we've got to make sure that we just check ourselves on that. This is like you are literally disturbing a universal law or balance there.

Right?

Right. So this is about, right, sizing your charges, right? Sizing the cost of your care. Right? So because right now you are undercharging. Hey, Doc, if this message is hitting you, right between the eyes is exactly where we're aiming. This message is for you today. If you said, hey, man, that's me. That's the thing I'm trying to solve, or that's the thing I'm trying to accomplish. And now is the time. If you're ready, let's jump onto a strategy session. You'll see the link down below schedule. We'll jump on a call with you, and let's discuss exactly how we can help you create your own remarkable practice. All right, Dr. Josiah, let's get after it. Let's talk about marketing. So I love the LTV CAC ratio. I think it's a great set. It's a great framework for people to recognize. It's like, okay, so I've got. I'm trying to figure out how much do I spend on marketing. Right? So the punch line here is as much as possible. Right? So I love the expression, whoever can afford to spend the most money to get a new customer wins. Right. So obviously that's implied that you're doing it profitably. But that's the expression. Whoever can afford to. To pay the most to track a new customer wins. So that means that you've got to get your LTV CAC ratio. Right? Right. Your lifetime value LTV to cac. CAC cost to acquire a customer, you got to get that ratio. Right. If we're talking about marketing, CAC is the number we want to look at. What does it cost to acquire a customer? Right. So what we know to be true is the vast majority of chiropractors are underspending in their marketing. They're underspending in their marketing. The reasoning behind this in, in my experience is they lack the confidence to invest in their marketing. I don't know how to market. I don't know who to market with. I don't know what tactics and strategies to employ. I don't know how to measure my returns on my marketing. I'm unsure what good looks like and sounds like. What should I expect for an roi? Right? So because they lack the information that they need around marketing and they lack the skills they need around marketing, they really, really hold back on the marketing. And your practice, your business is an engine. And that engine has a potential output of horsepower. And every engine, it's very simple. It's a closed environment. You got fuel, air, and spark, right? So fuel, air and spark together, that's combustion that produces horsepower. And every engine is rated for a certain expected horsepower output. If you are not putting money into your marketing, what you're doing is you are robbing oxygen from getting into the. Into that engine for the combustion, for the spark and the fuel to do its work. And the output would be that horsepower. So think about the money that you put in invest in your marketing is the air that you're trying to force into the engine to create the biggest explosion, the greatest combustion, the. To create the greatest output of horsepower. So it's all about airflow. It's all about investment.

Yeah, absolutely. And you're just like me, you know, it's like, I want to get the most detailed lifetime value, you know, customer acquisition cost. These are basic framework metrics that everyone should know. But I would just say, Dr. Branson, you know, I've been telling chiropractors this for a long time, but they're like, well, how do I calculate ltv? Well, I actually made a whole LTV calculator for how do you calculate. Calculate cac? You know, that's pretty simple as well. But for most people, they don't even have the data Points to get to that point. They don't even have, you know, the EHRs have difficulties, you know, the CRMs, there's some difficulties with that. So I've been trying to teach that for a long time, but I feel like it can be very difficult for people. And you know, one of my number one sayings I always keep that my grandpa taught me is kiss. Keep it simple, stupid. Right? And so like you just said, the biggest thing that people don't have when they want to scale their practice is certainty and confidence. And so that's really what you need to have when you're investing back into your practice. Because it can be scary. It's deaf. There's a risk component to any investment that you have and you want to try and minimize that risk as possible. And the way that I like to do it is with knowledge and data. And it's, I always say it's like, it's like Nancy Pelosi, you know, she's got insider information. Her stock returns are great stock returns. Yeah, exactly, exactly. So how can you have inside information of your practice? If you know the data of your practice, then you're inside trading because you know exactly how much you can spend on marketing. Specifically. A lot of people say, well, how much are you spending? How much is my neighbor? How much is my friend that I met at the conference?

Spending has nothing to do with it.

Exactly. That doesn't. That's the wrong question. You shouldn't ask how much you know, should you spend? You should ask how much can you spend based on knowing your numbers. And my most basic keep it simple, stupid formula is this. All you have to do is know your profit margin. Hopefully you know your profit margin at bare minimum. Okay. Ideally your true profit margin, not your profit margin after you've done all these different tax strategies to get it as low as possible. But your actual true business profit margin, if you know that number for most clinics that we work with is somewhere between 20 and 50%. Okay. Most clinics are right in between there. Let's just say for easy math, it's 33%. Okay? So let's just say we take 100 divided by 33, okay? That equals three. That means that's your break even return on ad spend numbers. So if you spend $1,000 on marketing, you need to make a $3,000 in revenue and then you have a 33% profit on 3,000, which would be also be $1,000 in spend, $1,000 in profit, your break even. So if you just know your profit margin, do 100 divided by that number, that's your break even point. Anything above that is profitability. So if you get 3.1, 3.2, 3.5, 7, 8, 9, whatever it is, that's all profitability. So that's where you want to then continue to spend that. Like you just said, if you put a dollar into machine and it gives you more than a dollar out, how many dollars should you put in the machine? Yeah, unlimited, right? Unlimited. Borrow as many as you possibly can. Right. Until you, you need more people, you know, to help you hold your dollars or you need a bigger vehicle, you need a bigger space. Right. Or you need to expand hours to put more dollars in more frequently, right? Yes. So that's the whole entire premise is that you need to first and foremost understand that basic framework of what is your return on Aspen break even points, okay? Track how much you're spending on marketing, track how much revenue you're getting. As long as you're above that mount, then you get to a issue, where am I maximizing my capacity?

And so that's, let me hit pause here for a second because I know that some people are swerving off the road as they're trying to take notes. They're re rewinding, listening to the last 30 seconds and being like, oh my gosh, it's like, I don't even know what, how would I get these numbers where these, I don't know what these numbers mean. I've never heard of that number before. Listen, guys, this is why we have, I know we have at least 75, probably pushing a hundred of our TRP docs in Lucro now. This is why we leverage lucre, guys, because as a coach, I'm data driven. I want to have data driven conversations, right? So it's like a pilot flying at night. I want the radar. It's like I don't care what you think, what you feel. It's kind of sort of maybe like that. It's like we're giving you directions, right? So as a coach, I want data. So I don't want my doctors, my business owners spending all the time toiling, trying to figure out their data, trying to sell. This is where a service like glue grow is just so critical. It's like, give me the numbers, give me the data. Now. What, what that is going to equip you to do is you're going to be a better leader, so you're going to make data driven decisions as a business owner. Okay? So if you don't have your data, what you have is drama. Data and drama are inversely proportional, okay? So data and emotions are inversely proportional. In a high data environment, you have low drama, and when you have low data environment, you have high drama, okay? So now what you have is you now have a situation where you're highly emotional in all of your decision making, okay? And here's the insight, here's what I know to be true. Nobody wants to work for a crazy person, all right? So the people around you are looking at you like, are you kidding? Because you're emotionally all over the place because you lack the data that you need to make decisions, right? So I appreciate what you guys are doing for chiropractic. I really love the fact that my clients now, when I ask them, they know the data, right? So they can pull their report right up, which is an impressive reporting system, and they can actually give me the answers so that I can tell them what to do. Start doing this, stop doing this, do more of that, do less of that. You need to do more of that. You need to do that differently. You need to do this better. Right? This just requires training, Right? So the purpose of data is to tell you what to do. That it's not rear view mirror. It's about telling you this is what you need to do now, and this is what you need to do next. All right, let's talk about conversions. So I have a intensifying perspective around conversion rate, right? So I hear doctors all the time. Oh, I've got an 80% conversion rate, 85% conversion rate, 90% reconversion rate, all these. I'm like, that's the marketplace telling you you need to be charging more. Okay? So, guys, listen, there's going to be a nexus between our philosophical orientation around just everybody needs to be adjusted, which is truth, and the economic decision of we need to be able to do this profitably and maximize profit. If this was only a philosophical question, it would be, well, don't charge anybody anything. Just do it for free, right? So just that's philosophically the extreme, Right? Right. The other extreme is all I care about is profit. And I will adjust five people a day. I'm just going to charge them five thousand bucks an adjustment and call it a day. Right? So I'm just going to keep pushing it until I'm optimizing for my collection visit average, right? So I'm going to suggest that there's a sweet spot in the middle, Dr. Josiah, where we pull that conversion rate in to be able to say, let's ramp up our prices until we land somewhere around a 70% conversion rate and that is high and it drags it up from 30 to 70 because of our purpose and because of our mission. To be honest, if we weren't purpose driven and mission driven, it'd be like triple your prices and just take a 30% conversion rate. You could probably double your prices and have a 50% conversion rate. But if you do the math on this, what you'll see is the numbers are extraordinarily different. Right. So if you have an 80% conversion rate with a $3,000 product, what's that? 240,000 bucks. If you have a 50% conversion rate with a $9,000 product, that's a $450,000 of revenue. And PS, the Delta there is enormous and it's all profit. Right. So you're going to drive that profit up by charging more. So you've got to find that sweet spot. If you're converting above 70% and your reconversions are 80, 85, 90%, you need to raise your prices and get that to 70%. The market's telling you they'd pay more.

Yeah, that's great. Value versus price. Right. Like we were just talking about earlier. At the end of the day, we want to help as many people as possible, but we also want to by help by running a successful business, we're going to be able to help a lot more people.

That's exactly right. So the short term feels like, oh my gosh, what about those 30% of people that don't convert? Well, I'd rather see you running a really successful practice where you were able to reinvest back into the community and you were able to invest in your team and the technology to deliver excellent care. You'd have enough money where you could have a hardship case, scholarship case, so you could actually take care of people that were into hardship. You'll make enough money to be able to do that. So it's ultimately where's your money is always a heart issue. What are you doing with the, with the money? And if you run an extremely profitable business over time, guess what, you're going to spend net 30, 40, 50 years in practice. Right. And not be the person that is smoked and burned out. 15, 20 years in practice and you're broke. Right. So at that point, who you're helping, especially if your practice fails and you have to close.

Yeah. And so let's say you find that nexus, Dr. Franson, like you talking about 100% in agreement with finding that X marks the spot. Sweet Spot in that attribution. Now, okay, let's say it's at 70%. You know, would you, would you rather have 70% of a grape or 70% of a watermelon? And that's where most people really miss the boat. And so the biggest thing I always tell chiropractors and asking me this very simple question, you know, if you had a line of a thousand people, let's just take new patient appointments, for example. If you had a line of a thousand people next week waiting to get into your clinic, how many of them could you actually process for your initial consultation? Day one in your office. Most chiropractors say it takes anywhere from 30 to 60 minutes for a day one appointment in their clinic. Let's say the average Office is open 20 hours of open hours a week. Let's just say it takes an hour. Okay, that's 20 a week. You know, that have the potential to process as a day one appointment, 4.3 weeks in a month. That would give us 86 new patients as the potential to process with the same staff hours and capacity that you already have. Now, if you ask that same doctor, say, well, how many new patients are you averaging over the last six to 12 months? Most of them are going to say 15, 20, 25, maybe 30. Let's just call it 20 for easy math, 20 divided by 86, you're going to get around 20% or so you know, is the actual percentage of schedule fill. Okay, this is the one of the most common stats that you track in all other health care industries. Dentists, medical clinics, they all track utilization of their providers, how much of their provider schedules are being maximized. And it's the number one stat that I think that we're missing in the chiropractic profession. And here's why. Let's say you have a 70% conversion rate again, 70% of 20 people a month or 70% of 86 people a month. Now, whether your schedule is 100% full or 20% full, does your rent change, does your utility bill change, does your Internet bill change, does your payroll change? Most all of your expenses do not change whether you have 100% full schedule or 20% full schedule. So going back to attraction like we were talking about earlier, if you know your LTV, your CAC, or even more simply, if you know 100 divided by your profit margin, what's your break even point? Then you know exactly how much you can spend to fill your schedule, and then you can convert. Like I said, obviously you always want to try and Optimize that nexus point like we're talking about. And so to me, that combination of factors that we're just talking about right there, we found with lucre. The average clinic in the profession should be generating five times more revenue than they are. Five times whatever the number was. And you're listening to this right now, whatever your number was last year, or what if you're tracking for this year, multiply that number by five. That's most likely the true potential of the clinic that you're in right now.

That's exactly right. And the word is potential. To listen to that, guys, is like if you, if you have a five hundred thousand dollar practice right now. First of all, guys, congratulations. That's awesome. It's $500,000 worth of value that you're delivering into your community. You could be a 2.5 million dollar business, okay? Which means you have a 2 million dollar problem to solve. And you have to think about it that way. It's like if you think about capacity, this business is operating at 20 or 25% of its capacity. So when you're thinking about expansion, adding features, adding services, think about you are operating at 20 to 25% of your capacity right now. So if you approximate your capacity, I like to push for 85%. You should be at 85% capacity so you don't experience overwhelm with your team and they start pumping the brakes. 85% plus is the goal, right? So not 95%, not 105%. Right? So because ultimately that's untenable, right? It's unsustainable. So 85% plus somewhere in that zone, 85 to 90, right. Stay right there in that stretch zone. Stay out of that stress zone, right? So that's where you're going to be net over three years. That's where you're going to be winning without breaking, right? So I love the concept of capacity. All right, so last one we got time for one more. We got, we're into delivery and retention. So let's talk about ltv CAC again, but from the other side of that ratio, ltv lifetime value, right? So when we talk about lifetime value, guys, think about it. Don't try to memorize, understand? Lifetime value. What's the lifetime value of a customer or a patient? So over their lifetime, what does a patient pay the business? Right? So ltv the simple back of the napkin math on this is collection visit average time, patient visit average, right? CVA times pva. This number, obviously this has to do with two things. How much do we charge per visit and how many visits do they receive? That's going to get you there. Right. So you get a sense of like what is the lifetime value of a customer, so to speak. Right. So when you're doing ltv, looking at that being like we want to stretch the time that they stay under care. So again this falls under delivery and retention. Dr. Josiah the big idea here is to drive greater retention, reduce churn rate, which is the rate at which people are dropping out of care. Because as we say, losing patients is off purpose and bad for business. This is all about two things. It's about educating the patients and delivering value. Right. And by delivering value we mean giving people a better health outcome, but even more importantly, giving them a better health experience throughout the arc of their relationship with you.

Absolutely. I mean you hit it on both aspects. In our practice we call it the Disney experience. If you haven't read the book called Selling the Invisible, it's one of my favorite books. It talks about all the little details that you can do in a service based business. Business. Now when you go to a store or retail shop, you know, you buy something, you're walking out with a bag, a product, something that you wear, something that you can see, touch and feel. When you go to a service based business, you walk in, you get adjustment, you walk back out, there's nothing to hold tangibly product. So how everyone makes you feel, whether it be the front desk greeting you by by name, the sights, the sounds, the smells, all the interactions that add all up to create incredible experiences. And so that's why it's so, so important to be on purpose and on mission for your staff so they can deliver that above and beyond experience. And that's why people are going to say people want to get great results. But you know what they also want is they also want to feel love. They also want to feel like they're at home when they walk into your place of business and they want to feel relaxed. They don't want to feel like a traditional medical setting where they're tense and uneasy. So combining that, you know, with amazing quality care first and foremost, right, we have the greatest product, health care product in the world. How can we surround that with incredible customer service within our clinic? Right. To drive the patient visit average as high as possible, 100%.

All right guys, this is where we're going to land this plane. So an on purpose practice recognizes that chiropractic is a lifestyle success strategy for healthy human beings. Don't limit it to a short term Treatment modality, right? So we do love to help people that are already in struggling with their health, are already in trouble. It's. It's incredibly common that every person's going to show up in your office and they've got something going on. There's some crisis symptoms, syndrome, there's some type of issue going on with their health, right? So there's some kind of body signal. At the end of the day, guys, what you're faced with is a human race right now that is sick and suffering, right? There's no shortage of new patients in the world, right? They've got you surrounded. They've got us surrounded. Our job is to educate those people to create value. Create value means change the way people think about their health, their life, right? And chiropractic. So when we change their belief system, and the belief system is like, oh, yeah, you're just out of fact. I love what Chestnut says around this. That sickness just comes from bad germs, bad genes, and bad luck versus the truth, which is bad behavior, right? So if you educate the patients, teach them the chiropractic principle, shift their paradigm from outside in to inside out, and make sure that they see that chiropractic is a lifestyle success strategy for healthy human beings. When you shift that belief system, you drive that culture, you deliver great value through their experience and their outcomes. Dr. Josiah, they'll never leave you. And you have walked that out and lived that out, man. And I appreciate you that now Lucro is helping these doctors do the same. Bro, we appreciate you. Thank you for helping us. Help more people. Help more people, bro. Appreciate you.

Amen, Amen and Amen. That's all I got to say to that preacher.

All right, guys, have a great week. Have a remarkable week. Hey, Doc, Steven Fransen here. If you're like me, you know that we're in the business of saving lives. And when business is good, everybody wins. That's the good news. But here's the bad news. Most chiropractors don't own a business at all. They own a job. It's a job they love, but it's a job. And far too often it feels like that job owns them. Is this true for you? Do you own a business or a job? Have you built and do you run your practice on brute force? Does it rely fully on your time, your effort? A pound of your flesh? Are you responsible for all growth, for all new patient generation? How about new patient conversions? Is it all up to you? How about patient care and delivery? Are you a sole practitioner? An owner operator who owns the practice but is also the only one that is head down and bum up taking care of all the patients. Is revenue generation or collections all up to you? Let me ask you the most telling question Doc. What would happen if you took 90 days off? What breaks in my experience, most on purpose chiropractors do not lay awake at night worrying about their practice. They worry about their business. Let's slay that dragon. The Remarkable CEO program has helped hundreds of chiropractors just like you turn the job that they love into the business that they've always wanted. Are you ready to run and build your practice on leverage instead of brute force? Do you want to create the scalability and durability that will allow you to make a bigger impact and a bigger income? What would it mean to grow your practice, increase your productivity and your profitability? Do you want to get your time freedom back? Are you ready to turn your pirate ship into a battleship? If this sounds like you, then the remarkable CEO program is for you. Just last year, 53 of our remarkable clients received the Seven Figure Club Award, meaning they hit the million dollar mark for the first time or their next million dollar level, be it 2 million, 3 million, 10 million, up to 36 million and growing now. Doc, is it crazy to imagine that your practice could be next? Click the link below and learn how to apply for the next cohort of the Remarkable CEO Program. We look forward to working closely with you and creating the business that supports your remarkable life, not competes with it.

Thanks for listening to this episode of the Remarkable CEO Podcast. Remember, what the world needs now is chiropractic. And what chiropractic needs now is more successful chiropractors. If you like this podcast, please subscribe, share with a friend and leave us a review. And if you'd like to connect with us personally, direct message us on Facebook, LinkedIn or Instagram. Now go and be Remarkable.