334 - How The “Last to Now” Exercise Turns Assessment into Real Execution for 2026

Doing the assessment piece right now that will inform the planning and preparing process for our action plan for 2026 so we can make the next iteration of your practice, your vision, appear in 2026. So the appear process once again is to assess last to now plan, prepare now to next to execute, assess, report and repeat.

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.

Welcome to another episode of the remarkable CEO podcast, Chiropractic's number one business podcast. I'm Dr. Pete Camiolo.

And I'm Dr. Steven Fransen.

And Dr. Steven, back by popular demand, you and I have some favorite episodes and this is a favorite episode that we are doing. This is not a rinse and repeat. This is fresh, just baked out of the oven, coming in hot. Yo, make sure that you use some hot mitts to take this one out of the oven because it's, it's gonna be exactly what you all need. I'm just gonna say it right now. This is exactly where you need to be. If you were wondering if you should listen to this episode, if you're wondering if this is the right day and time, wonder no longer. This is the one you need to hear. The topic that we're about to cover from a leader's perspective is one of the most important and unappreciated. The last to now is all about this process of assessing. And it's something that many of us as leaders who love to run ahead and go fast and go far and you know, we love that. We're energized by that. I'm speaking to you. This is something that requires discipline, it requires restraint, it requires a level of maturity, intentionality, and the results of this are going to be exponential because of what work you do here. So, Dr. Steven, this is the best practice that we've been thankfully able to work with so many amazing chiropractors. And if you're listening and we, and we work with you, thank you for the opportunity to serve you the privilege that it is to coach you and support you and your team. It's a great privilege and honor. And this is a framework that we use every year as CEOs. It's a remarkable best practice. And so we're sharing it with you on the podcast today. And we're going to have a conversation today around a two part series. Part one today is the last to now and it's an assessment. We have a process which we created called the appear process. Process actually turns out it's a manifestation formula and it's the acronym A, P, P, E, A, R spells appear. And each letter means something. The A is the assess. And we're gonna, we're gonna double click on that today and you'll be surprised how much is in the A. There's a lot underneath that one letter there. So A is where we're going today. Then the P. The first P is planning. The second P is prepare. The next letter is E is execute. And then the A is assess, which is another A and it's another assessment. We'll talk about that on the next episode. Then it's the R which is report. And then if we were to make the word extra special, it would have two R's on the end. Little BJ Palmerism right there. Throw an extra R on it, we own it. We can put a hyphen between any word we want. We could put an extra R in any word. Right Document. Especially if you're from Boston. So the reality is that we're gonna go. The second R is repeat. It's a process that's repeated. So by the way, we're just do. Practicing what we preach. We're repeating this two part series. We do it every year. But we're coming in hot, Dr. Stephen, why? Because we're coming in fresh. Fresh off of a year where we had a theme called new wine skins. And man, oh man, what a. What a prophetic declaration we made. So many of you who are listening are like, Dr. Pete, it's been quite the year. We're definitely getting a new wine skin. I'm like, yes. So you can receive the new wine because whatever you were gonna, whatever you had before would have burst. The new. That cannot be contained by the old container would have burst it. We got to have the new. You can't put that, you know, bolt that cannon onto a rowboat. You gotta make sure you turn into a battleship. So we've been running with this theme all year, Dr. Stephen, and I'm excited to do some assessment with you today.

Yeah. Dr. Pete. So you know we study success, right? So especially success in business and extra. Especially in chiropractic business. Right? Because success in the chiropractic space means helping more people. It means making a bigger impact. Yes, it means making a bigger income because money follows value. We study success and success. I love what Tony Robbins says about this. Success leaves clues. I don't know if he made that up, but that's where I learned it from. Success leaves clues. So study behaviors. We all want better outcomes, so guess what, guys, we know it. You can't do an outcome. You do the behaviors that drive the outcomes, right? So at the end of the day, we're not trying to modify your behaviors with this podcast. We're trying to change your belief system, right? We're going to go upstream from behaviors because we're not interested in short term behavior modification. And you revert back to your old way of doing things. That's not going to help you achieve your goals. You've got a big vision where we actually have to get a bigger belief system so that our big vision will fit inside of there, right? And it's your belief systems that organize your behaviors. Your behaviors drive your outcome. So what we know to be true is everyone that is successful, and I mean sustainably successful, and I'm not projecting you the definition of success. If you ask them and everyone around them, they would be recognized as being successful. This is one of the things that they do, okay? So they have the discipline. I love that you went there, Dr. Pete. They have the discipline to be consistent with this exercise, which is to assess, to be able to look back and say, where do we win? What did we learn?

Right?

So relevant to how or relative to how we set our vision story and our goals. How did we do? Right? This part is so important, and for entrepreneurs in general, it's not natural. This doesn't come natural. Why? Because we're future thinkers, we're future oriented, we're future paced, we're always looking forward. That's our job in the village, right? Our legs are always moving, which is why it's so important that we pause, that we slow down to speed up, that we stop and we be like, okay, this might feel unnatural for you, but turn around, right? Look in the rearview mirror, Look. So you can learn, right? So you can be informed. And you're informed as you're putting together your plan, as you're putting together your vision, as you're choosing, like, exactly how do I marshal the limited resources that we have in this organization limited time, energy, focus and money of everybody.

How.

What's my strategy? In other words, how am I going to deploy the time, energy, focus and money? You can't do that unless you. You can't do it. Well, you won't be able to optimize it if you're not doing it with intelligence. Right? We're not having the business intelligence. Right. So hopefully, guys, you recognize that we're not just here teaching you information. So you. We change what you know, right? That's. That's one thing. It's a totally thing. It's a different thing when you actually get coached. Coaches changes how you think. We're trying to change how you guys are thinking about this, right. So recognize that this may feel a little unnatural. It may feel like, oh, man, I've got to do my homework.

Right.

What I'd rather be doing is future pacing and talking about what are we going to do in 2026. This is water under the bridge. 2025. It would be such a mistake to miss out on all of the gold, all of the lessons, all of the turbo boost that you'll find if you do this assessment process. Right, Dr. P. We're going to do the last to now conversation, which allows us to look back. We're going to go all the way back to 2024. We're going to take ourselves back in time to November 2024. So if you guys have been longtime listeners, you know, we've been doing this for six years. This is the sixth time we've done this exercise with you, man. My fantasy is everybody has a journal of the last six years of doing the last to now exercise and then out of next, right? So if we're in 2024 and we go all the way back to last year at this time, and we're going to be vision casting for 2025. Right? So you put together a vision, like a vision story. Close your eyes. I want to. I want you to see what I see. And you cast the story for your people that you're going to need to recruit to help you manifest it. That's the story that you tell. That's the first component. Then there's measurables. You have to make it objective. You have to set goals, right? So you have to have your data. So now it's objective. You set goals for 2025 and then you captured it all into a infographic, right? So the human brain loves infographics. We love images of pictures worth what, a thousand words, Right? So the fastest way to Gain clarity with your team. Get everybody on the same page is to literally get everyone on the same page. Right? That's the power of the accountability grid. It's an image that you can have in a snapshot in your mind and it says so much to your team. So we did that in 2024. The question is, did you? And do you have that handy? Because what we want to do is we want to assess. How did we do in 2025, Dr. Pete, relative to the vision that we cast in for 2024. For 2025. And I'm just going to tease you right now and let you know our next episode we're going to do now to next, which we're going to be talking about 2028, Three Year View and 2026, the next iteration of the business. You're going to want to capture that because imagine the feeling that you'll have at the end of 2026 when you say, oh, my gosh, I'm so glad I did this exercise. I'm so glad that I captured my vision story, set my goals, because now I actually have that content to compare and look at and do an assessment process. Dr. Pete, success leaves clues. And one of the things that I see is the discipline of being able to do this assessment process well to set us up for the next iteration of the business.

So the word that really jumped out to me as you were, as you were going there and really helping set the frame for today's discussion is the word outcome. And here's why that stood out to me is because a lot of times when you do an assessment, it's like, like you said, it's going in. You feel like you're going in the exact opposite direction of where you're going. And that's why we don't. We're not energized by that. Right. It's almost deflating. It's almost disappointing. Pointing. Are you, you almost want to roll your eyes, like, really, I can just solve that problem by getting more new patients or something like that. But it's this, the, it's the discipline of, of looking back. But here's what I wanted to make sure I stated, because you said it and it's really important, you talked about how our beliefs organize our behaviors. Our behaviors drive our outcomes. So if you're attached to better outcomes, which I hope all of us are, I don't know about you, but maybe you had the best year you've ever had this year. Amazing. How does it feel? Feels great. Right? Yeah. Well, would you want to repeat that process again, or would you want to have a less than amazing feeling next year? Of course we want to repeat that amazing feeling of best year ever. Maybe you didn't have the best year ever. And your feeling is, this isn't not. This is not great. I'm not really satisfied. I'm not thrilled with the way things are. Okay. Like, I understand it, I've wrapped my head around it, so to speak, but my heart is still not okay. I really want it to be different. That's a good place for you to be. And one of the most powerful things you could do, whether you had the best year ever, you were flat, didn't really see a lot of growth, or it's been a down year, is to look back because your greatest influence over your outcomes is going to be your understanding of what your inputs have been over the previous year. Your inputs and your outputs. Like, you start to see that. This is what we're going to identify during today's topic is, you know, hey, we're hitting on this subject matter called Last to now. And inside of this, identifying constraints and really understanding, like, hey, what, what did I say success looked like back in November of 2024. I'm telling you, if you haven't done this exercise, it's a. It's unbelievable. Like, you need to sit down when you do this exercise. You shouldn't be standing up. You should be sitting down. If you did this exercise last year and you've done it for six years, let's say with us, you break out the book. It's kind of like a photo album. Photo albums are much better to look at sitting on a couch. Do you know what I'm saying? You need to sit down and open the album up and look back and say, wow. Like, yeah, I did say that. We did put this out on paper. We did intend this. And just get a feel for where you're at. So the first part of this doc, Steven, the assessment, is just to carve out some time in your schedule to do an assessment.

That's right.

Push this. You can't rush this block a half a day. As a CEO, what are you doing today? I'm assessing. So I'm not taking any calls. I'm not having any meetings. I'm going to my favorite coffee shop. I'm going to my favorite lakeside, you know, whatever, cafe, poolside. I'm going somewhere in the mountain. I'm going somewhere in my car where it's quiet. Nobody's going to interrupt me. I'm Just going to assess, I'm just going to look back, I'm going to make sure I have all the things I need. The information flows to you as a CEO and you gotta do the assess time. It's gonna be a lot of just thinking, a lot of pondering. Bring a journal, bring a notebook, bring your pen, bring your computer, bring your laptop, whatever you gotta bring. And just make sure you carve some time very soon. And now if you listen to this episode now, you hopefully are doing this now and just create some space to start with the assess part. Dr. Steven it's just, I can't emphasize that enough. Otherwise you know what happens? Time flies and we're, and now we're scrambling, we're trying to squeeze it in and it's not a great assess.

That's right, that's right. It's such a critical best practice which is to block time for the most important things. So this is an example of one thing. You just like, you're, don't be like, oh, I'm going to find some time to do that. You're not going to, you're not going to find the time to do that. Like this is something that you'd be like, this is a priority. I do it every year. I'm going to look in the next, you know, here we are in November, in the next three, four weeks, I'm going to block a couple of hours to do the assess process and the planning process. Right. So we, we call it our appear process. Like Dr. Pete said, it was the manifestation process. Right. So I love the concept of manifesting your vision story. Right. So you know, we, we all know the law of attraction, right? But we're also all entrepreneurial and we're not really good at just sort of like sitting there cross legged envisioning things and hoping that they just appear. Right? So this is the appear process. Most of us, you know, we recognize that God gives us a bike and he wants us to pedal it. So it's like God gives us a piano, he wants us to play it. Right? So this is for how the, for those of you who want to actually take action and, and help manifest the next iteration of the business, this is all about getting clarity, right? So and clarity is the greatest accelerant. So you've got to do this process is going to take a couple hours. Assess, plan, prepare, execute, assess, report, repeat. Right? So this assess portion is what we're talking about now, the last to now. And we're going to use one of our favorite tools to do this, one of the most powerful tools that we have is the Accountability Grid. This is what we're going to do to create the assessment process and it's going to inform our planning and preparing so that we can execute in 2026 to help us manifest our three year view, get us to where we want to be by the end of 2028. And it's going to inform what does our plan need to be to get us to where, what must be true by the end of 2026. So I want to make sure, before we just jump into the tactical part of this is you guys see this whole arc, right? So it's assess, play, plan, prepare to execute, assess, report, repeat, right? So this two part series, these two different exercises are conjoined twins, right? In order to do your planning and preparing, right, which is the now to next, you have to first do the assessment of the last to now, right? So that's two episodes in a row in the podcast. We're doing it in our masterminds, right? So we'll do it in this whole conversation through November and December. It's assessed so that we can be informed when we create our plan for 2026. So Dr. B, we'll kick it off. We're going to give this tool away, right? So there's going to be a link in the show notes for you to download the new version, the new iteration of the Accountability Grid. So this thing is bitching, man. It is the next iteration. It's a total upgrade. It's a worksheet. We've gone from just being an image to an actual worksheet that's much easier to use. So you guys, we're going to give that to you. It also comes with a bonus. It's actually two bonuses. It comes with a. It's a PDF that has our favorite KPIs by domain. So that's attached to it also. And then there's a video training that actually you and your team can use to be able to do this exercise. There's. Guys, listen. There's a 45 minute training, okay? So this is good. We're going to give this to you as our end of year gift, right? So it's like anybody listening to this, download the tool and then you can get access to this video training that you can use for you, your office manager and then for your whole team, watch it together and you can actually walk through this exercise together and do the assessment so that we can say, where are we now? What are the brutal facts, the love language of the remarkable Practice the brutal facts of where we are now. And if we can imagine that this whole process is like a big GPS system for your success, for your future, for your vision. And the now is this is the starting point in the gps. Just like when you're ordering an Uber, like where are you right now? Pick me up here. And I want to go there, right? So it's a GPS system. This is where we are now. Brutal facts. We do this assessment and then we're going to plan to where we want to be three years from now by the end of 2028. And what must be true by the end of 2026. Dr. Pete. To make that a possibility, to make that a reality. So the accountability grid is going to be the gift. It comes with the PDF for the kit with all of our favorite KPIs on there because it's going to be data driven. And it comes with a 45 minute training video for how you and your team can actually use this tool. I want you to put that in your toolbox, put that in your back pocket. All we ask is that you actually utilize it. You got to do it right. So at the end of the day, good ideas are great. Implementation is everything. Dr. Pete, I'm stoked to explore this assessment process. 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, every 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 roll, 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.

Yeah, so this is such a rich topic and I'm glad we're unpacking this. You talked about beliefs, organized behavior. So we're talking, we've talked about beliefs. Now we're starting to get into behaviors. Right? So we've got into some of the behaviors now. So let's start to get into Dr. Steven, some of the tactics. Right? So now we've set the tone. We, we've hopefully challenged your belief and you're either on board or not. But I'm on board. And then, you know, we've talked about, so there's some tools that we've given you which don't mean anything if you don't know what to do with them. So then we're going to explain to you exactly what we do with these tools. For example, we're not going to spend 45 minutes going through the accountability grid because you have a training that came with this. That's your gift. But we are at a high level going to explain what it is that we're going to, you're going to be accomplishing by doing that. And then we what the audit of your business over the past 12 months in relationship to your vision story and all the work that was done, all the projects that we invested in doing, what did that produce? We're going to identify where the wins were, where the lessons were and where the constraints are. And that is going to be what we're going to walk away from an assessment with. And then from there it's going to flow into the second half, really of, of we're going to do a two part training, but this really is how you prepare for your end of year, you know, last to now and then now to next. So this is part of that. So, Dr. Steven, let's jump in, let's get somewhat tactical as much as we can in a podcast. And, and, and like you said, dig into the a, the assess.

Love it, love it. So it might add that we're going to edit this video with some of the imagery in there. So if you are like me and you like to watch podcasts on YouTube, you can follow us on YouTube as well. We'll have this on YouTube and then we'll have the imagery up on the screen. This is a perfect example of an episode. We would like to watch it on YouTube because now you're got, as we're walking through this exercise, you actually can see the accountability grid and some of the other imagery that we have associated with that. So follow us on YouTube. And frankly, this is, this is a perfect example of a time when you can make that transition from just listening to, to actually watching us go through this. Right? So, all right, so the accountability grid to this colorful graphic, this is a tool that we use. And what you'll see across the top of the graphic are the five domains of the business, right? So attraction, conversion, retention, team building and collections. If we're talking about the practice, right? And then it's marketing, sales, delivery people and money. If we're talking about the business, right? So guys, we're free to have this conversation on either side of the chiropractic coin, right? So either side of the chiropractic coin, you've got the practice and you've got the business. Remember, the practice is an entity, a clinical entity that exists to deliver healthcare and better health outcomes for the patients, right? Whereas the business is the economic machine that exists to drive productivity and profitability for the owners, the investors and the employees, right? So two different things, two different sides of the same coin, right? So in this accountability grid will help reveal both of those, those things, right? So we're assessing is the business optimized? So when we look at this, what we're seeing is there's five domains across the top, right? These are like divisions or departments of your business, right? So and if you look below in this image, what you'll see is we've created subdomains so that we can be more specific, right? To assign accountability, right? Because everything that we want in our business will be found on the other side of greater accountability for you and for everybody else on the team. So as we gain more specificity, it allows us to create focus. And focus is what makes the difference between busyness and productivity. So this tool is very powerful because it creates focus, which drives productivity and creates accountability. And everything that we want out of our business will be found on the other side of greater accountability. So this is an incredible tool. It's a grounding mechanism and it's the entire business all in one image, right? It's the entire practice all in one image. All of your operations are captured in these, what we call 15 primary functions, the 15 boxes. So we've got five domains, there's three subdomains underneath each of them. So three times five is 15. These are the 15 primary functions of your practice and of your business. These are the things that are happening, okay, Whether you're aware of them or not. They happened last week, they're going to happen this week, they're going to happen next week. So it's not a question of whether these are happening inside of the chiropractic practice in business. The only questions you have to ask are, number one, is it optimized? And number two, who owns it? Okay, so when we look at these 15 primary functions, let's just talk about attraction for now, right? Marketing, lead generation. We subdivide marketing into three different tributaries, right? You should have three tributaries of new patients coming into the office from your marketing efforts. Efforts, right? So you should have internal marketing, external marketing and digital marketing. So you have internal lead generation, external lead generation, and digital lead generation. So internally generation is your referral generation, right? So you've got organic referrals, you've got process driven referrals, you've got campaign driven referrals. That's all internal referrals, right? So external referrals is everything you do outside of the office that's not leveraging the Internet or your patient base, right? So this is your traditional marketing. So radio, newspaper, but it's also your paraprofessional networking groups. It's your professional networking that you do. It's your informal networking that you do. It's corporate wellness programs, spinal screenings, dinner with the docs, right? So lunch and learns. This is everything that you do outside the practice. Chiropractic's greatest hits, including your signage, you know, what do you call billboards? Anything that's external, that's offline, right? So. And then finally we have digital, everyone's darling, right? So, so this is your digital footprint. This is your website, your SEO, this is your paid traffic, organic traffic. This is your ads, this is your social media footprint, this is your email marketing, et cetera. Right, so this is all your digital marketing. Right, so Dr. Pete, this is all about three tributaries of New patients coming in. So we want to be specific because of course, each one of these boxes identifies the behaviors that drive the outcomes that we want. And behaviors are always measurable. And those measurables are called KPIs or Key Performance indicators. So we have key performance indicators inside of each one of these boxes so that we have a data driven assessment that we're doing. And of course we set goals for the KPIs, right? So you've got a person who owns the function, they're assigned the responsibility and they are assigned the KPI. So they have accountability. So now we've established exactly what we set out to do, which is creating focus and, and creating accountability. Hence the name, the accountability grid.

All right, so Dr. Stephen, so the reality of the assessment really goes back to what your 2024 goals were. You talked about goals and how important that is. So again, as an annual routine, if we do this every year, it's a rhythm, right? We created goals in 2024, in November for 2025. So when you're going through those attraction goals and you look at your internal, your external, digital, like Dr. Steven, you just laid out what we should know. What were our goals that we set for attraction for 2025? We had a goal of a thousand new patients this year, let's just say, or 500 new patients this year, whatever your number was. And the distribution was we followed your rule of 1/3, 1/3, 1/3. So for a thousand, we were looking for 300 new patients roughly internally, 300 externally, 300 digitally, add another 30 to each one of those and you get 1,000. So that would be if you created a goal and you said, hey, our goal is to have a thousand new patients or 500 new patients or 300 new patients this year. Whatever your number is, that would have been your goal. So then your assessment will be based on that goal that we set this year. How did we do? Okay, the 10 would be as you said, and you'll go through this in the training is we exceeded our goal, we smashed it internally. But this is what's possible. You could have smashed your internal goal for the year, but come up short in your external and digital. So when you score the attraction as a domain, it might not be a 10 because you might have a 10. In one of the categories, a seven in another one and a six in another one, and you actually average those out together and you get like a 7.5. And so your marketing as a driver of the business, as a domain inside of the organization of one of the five domains is a seven and a half. It's a C. Okay, so we know that there's room for growth, right? There's room to improve. And so then that becomes. Dr. Stephen, what we're going to lead to next, which is the constraints. And I know you're going to talk about this a little bit more, which is one of my favorite topics, which is the throughput and the output and how we need to be very specific, not general when identifying constraints. Because if you don't identify what the constraint is specifically and you just generally approach it, you don't actually break through, you don't get the results that you want. And that's maybe what's happened historically is you can say, yeah, Dr. P. This has historically been our problem. We've just really struggled with churn in our retention. We just have a really tough time getting people to complete their care plan. The initial one is fine, but people are dropping out of care. It's really hard to get families under care, to stay under care or whatever, whatever your area of constraint is, that becomes an area. We just shine two floodlights and we just, we put all of our energy on that constraint in the retention domain and we shine bright lights right into that area and we just start getting, just chipping away trying to identify what are the, the causes of that. Like what are the things that are influencing that, preventing us from achieving our goals. Because we've set goals, Dr. P, we just haven't hit them. So the next step from here, Doc Steven, then is to identify the points of constraint and then what we do with that.

That's right. So let's get into the scoring system. We're not going to walk through all 15 primary functions, but to Dr. Pete's point, it is has to be data driven, right? So it's like we're gonna, we're gonna look at it from the perspective of you set goals in 20, 25, and relative to the goals that you set, we're gonna ask two questions. Number one, is it optimized? And the second question is, who owns it? Okay. And we're gonna ask it in that order. So the first question, is it optimized? We score each one of these 15 primary functions 0 to 10. And these numbers aren't just like, oh, I Feel like it's a nine or I feel like it's a six. That's not what we're talking about. We're doing. So you actually have the data, your outcomes from 2025. You set the goal, right? And then you say, is it optimized? 0 to 10, 10 means you actually exceeded goal, you smashed your goal. 9 means you hit your goal. 8 means if we finish strong in December, we're going to hit our goal, right? So we're close. So as long as we have a strong finish in December, we're wicked close. We're going to hit our goal. That's an eight. A seven is close, but no cigar. You know, you're like, we're gonna get close but we're not gonna hit goal. Or we got really close and we didn't hit goal, right? That's a seven. A five is worse than a seven, a three is worse than a five and a one is worse than a three, right? So score yourself accordingly. First question, Is it optimized? 0 to 10 based on the outcomes based on data, not how you feel? Okay. The second question is, who owns it? We're going to come back to that. I want you guys to understand the this concept of constraint first that Dr. Pete's making reference to. So I love how Alex Hermosi teaches us. It's brilliant. If you envision there's an image on the screen here, you can see there's a five lane highway, right? So if you've ever been on a five lane highway, what you recognize is that there's a throughput potential of that five lane highway, right? Which is five lanes of traffic. So on a five lane highway, everything clear and running, that throughput potential, how much traffic can get through that five lane highway is five lanes of traffic. Made sense. Now if there's an accident or a construction site and those five lanes get constrained or they reduce down to three lanes or two lanes, all of a sudden that five lane highway goes to two lanes. The throughput potential of that highway is now two lane highway, right? So there's nothing you could do before the two lane constraint or after the two lane constraint that could change that, right? So the constraint is the two lane car accident or construction site, okay? That's how you want to think about your business. Any one of the places on your accountability grid, will you score a 7 or below? 7, 5, 4, 3, 2, 1. Like if wherever you score a 7 or below, that is a constraint in the business. So I want you to imagine this, a visual. So when we say 5 7, 53 1. What's the difference if you score a 7? What it says to me is that 5 lane highway just went to 4 lanes at that place, okay? The throughput potential of your practice has changed from a five lane highway to a four lane highway. If you gave yourself a five, what that says to me is that five lane highway just went to a three lane highway. @ that point, if you gave yourself a three, that five lane highway just went down to two lanes. If you gave yourself a one, the five lane highway is all the way down to a one lane highway. That's how. What we're speaking to is the severity of the constraint. Okay? So when you're grading yourself, I want you to just think about yourself as the practice has a throughput potential. That's about capacity, guys. That's about patient volume, okay? So throughput is capacity and patient volume. Services output is the revenue and the profit, okay? Throughput is capacity to serve, okay? Impact output is the economic machine spitting out productivity and profitability, right? That's the output of the machine. So right now we're having a throughput conversation which drives output, right? So a seven or below is a constraint of the business. This is critical, guys. This is it. You're identifying the constraints of the business, right? So, and what those constraints will do, we're going to identify as we go through the same exercise, is it optimized? 0 to 10 out. Out of all 15 of these, what we're going to do is we're going to identify any place where you score a seven or below. And those are the constraints of the business. Those constraints will become the projects for your planning and preparing for 2026 as we look for now to next. Okay, so you're identifying the constraints and as Dr. Pete said, we're going to point all our resources at those constraints and we're going to fix our shit. We're going to address the constraints of the business, right? So that we can increase the throughput of the practice. So Dr. Beat, there's a series of questions that we'll ask. The first one is always who, who owns it, right? Because it's almost always a who, not a how, right? And what I want you to do is identify that person who's accountable to that responsibility. Who's the person that owns that task, right? That primary function of the business, right? Who owns it? And we'll ask questions like do we have the right person in the right seat? And then is it how they focused on the right work the right way? So first question is who owns it? Because very often it's a person, then we'll get into, well, if it's not a person, then maybe it's a process. We just don't have the system that we need to do it. So it's a process issue. Or maybe it's like, no, we have the right person and we have a good process. It's just that they're new and they need to be trained up. This is a skills issue. So we call that proficiency. So we've identified the cause of that. Restraint is a proficiency. Right. You might say, no, it's not that. It's actually, it's just we haven't made it a priority. I heard you talk about churn rate, patient turnover and people going inactive. Well, man, we need to shine a bright light on that because that's actually problematic in our business. We attract lots of new patients and so many people start care. But my goodness, people are dropping out of care. Right. So we need to look at that churn rate in your example. We need to make that a priority. Right. So that becomes a priority in the planning and preparing as we position ourselves for 2026. Right. So these all end up on the project.

Planner.

Right. Which will be part of the next episode when we talk about the now to next because we're doing the assessment piece right now that will inform the planning and and preparing process for our action plan for 2026. So we can make the next iteration of your practice, your vision, appear in 2026. So the appear process once again is to assess last to now plan, prepare now to next to execute, assess, report and.

Repeat. Please stick around for more business insights from this week's bonus interview with our remarkable success partner, dedicated to helping you more successfully help more people.

Enjoy.

Hello, remarkable CEOs. This is coach Dr. Eric DeMartino with remarkable practice. I'm excited today to be in Studio with Dr. Chad Glines from Genesis Back and Neck. Genesis Back and Neck is one of our remarkable success partners. And we just love our success partners because they really help our docs help more people. And so welcome to the podcast, Dr.

Chad. Hey man, happy to be back on here. It's a lot of fun with you.

Guys. Absolutely. So let's start by having you tell the audience a little about you. What's your.

Backstory? Yeah, so Cairo for 20 years went to Parker. My wife's a chiropractor, her brother, her dad, her sister in law. But funny enough, I was actually looking at being a surgeon. So I was like taking MCATs and the whole thing. And then, you know, when I was talking to the neurosurgeons, those guys are, like, really cool. Then you talk to the orthopedic surgeons, you're like, those guys are rock stars. I want to be one of those guys. The problem with that industry is they don't really have any way to help people except ways that don't help people. And so I was talking to my wife, and then the chiropractic made a ton of sense to me, and so I knew how to adjust before I got to Parker. Really love that. But I still wanted to help those people that had disc.

Issues.

And. And I read this study from a doc down in McAllen, Texas, and his name is Dr. William Martin. And he said, I can help a disc patient 86% of the time. I was like, oh, that's what I'm going to do. So I graduated Parker a month later, had a drx. I had my own practice, and I've been doing that thing for 20 years now, just using the.

DRX. Amazing. Yeah. It's funny because I was just having a conversation yesterday with one of my patients, and. And they were newer patients. They came to our Better Results Faster workshop, and they kind of learned about chiropractic and nervous system. And she had said to me, she's like, doc, how come there's no focus on the nervous system in healthcare? There's like, no doctors ever talked about or checked my nervous system. And she just learned it's the most important system in the body. And I would kind of have the conversation. Well, there's no drugs that really can address spinal nervous system issues. The surgeries are horrendously unaffective and. And cause more problems than they fix, like you alluded to. And so it's just. It's just something that's just missed in healthcare right now. The most important system in the body, and there's really no way for them to address it. Obviously, that's the role we step into as chiropractors. So that's great that you had that realization so early in your career. So in trp, we always say that every business exists to solve problems, and the bigger problems you solve, the more you're compensated. So what problems do you guys at Genesis Back and Neck, what do you specifically. What problems do you specifically solve for.

Chiropractors? Well, so me. And it's a funny story because my partner, Dr. Caleb Braddock, a lot of people know him. He's. He's done a real big Cairo office For a long, long time. And he's circled himself with a lot of chiropractors. Now me, on the other hand, I was kind of the oddball out because all I ever used was a drx. And then I developed this, the protocol that we use at Genesis. And through that period of time of me developing that, I took away a lot of my adjusting. And when I teamed up with Caleb to partner Genesis to move out into the space, he's like, so you don't adjust? I was like, no, because you know, you have to imagine if, if you have a clear like pool of water and you throw one muddy pebble in it. Well, now you really don't see clear through that. And so I had to find a way to create a standard of care for decompression that made sense, that you could track without outside influence. I wanted to be sure that if this machine is claiming to actually repair a disc, I want to prove that. And you're going to stand on your, your research. So I developed all that. And so the, the problem that we now solve for chiropractors is being able to reach just disc patients through really targeted marketing, but give them a way to treat them without abandoning, abandoning your principles. So it's funny that we call it just evolved, we call it principal decompression because, you know, then the chiropractic adjustment allows the body to innately heal itself because that's what it's designed to do by removing nerve interference. Well, we're doing that same exact thing. We're just doing it using a machine machine to pull the disc back in where it belongs to allow the disc to heal. And so we really only treat disc patients at Genesis and we partner with docs all over the country now helping them do that. And it's really rewarding to see what Genesis has become with 80 something clinics.

Now.

Great. You know, and there's a lot of decompression. We see it all over the place. Some chiropractors do it, some don't. I'm sure there's a lot of listeners out there there may be interested either doing it better or starting from scratch. So what, what does Genesis back and neck provide? Like why would I go to you guys versus just going out and buying a DRX and trying to implement, implement it myself? Like, what value do you guys bring that doc should go to you.

Instead? Yeah, that's a good question. That's the number one question that we get asked. So you can go buy a DRX9000 and you can treat people the problem is if you buy one, you're going to treat people one way. The guy down the street with the tables treating people a different well. So we created a standard of care. The protocol that I developed, that's the first thing. The second thing is we don't just bring people on for the sake of having locations. So our business model is totally different than anything else. We actually partner with every single doctor. Another thing that we do is we do not ask that chiropractor to provide Genesis any patients. Now does that happen? Of course it happens. But we stand on the fact that we understand decompression marketing so well that we will drive patients into your clinic. But it's an island. So we create an entirely new business. We put that business inside your already successful chiropractic office and they are two separate things. And so one does not interfere with the other because it just gets messy in business. So we cleaned all that up, provide all the systems, the protocols, and then we run a real deal decompression business. And at the end of the month we collect money and then we do a partner split. And it's just, it works so well. I didn't really expect it to take off like it has, but it's been really awesome to see chiropractors that been wanting to tackle these disc patients that are so hard to reach a lot of times and now being able not to just find them, but successfully treat them and get them better and holding the doctor's integrity, the patient's integrity intact while doing it. It's not like a big salesy thing. It's very, very uniquely positioned to have the highest level integrity. That's what we stand on the.

Most.

Right. I love that. You know, a lot of our CEOs are very busy docs, right. And, and certainly they want to maybe add services to, to further help their people in their community. How? You know, I'm always looking, if I'm going to do something, I want to be turnkey, right? Because I'm a busy guy. I don't have a lot of time to reinvent the wheel is, is how turnkey is your system. How much time as the CEOs listening to this call that might be interested, how much time is required on their end versus what you guys will do to to make this implementation.

Simple? Well, the implementation is the, the part that we hear the most praise on. So Caleb and I, as we grew, we really invested in building a corporate team that's going to help us streamline the whole thing. We call this A bolt on turnkey system so you don't really have to do anything. Once you sign up, if it's for you, you sign up every step of the way. We're kind of holding your hand and making sure that the entities created. We create the bank account, we get you all the systems, we take care of the training. You come to our office, we train you, you get to watch us do consults, you get to see our flow. I mean, all the things are done day to day. All the doc would need is 10 to 12 hours a week dedicated to just doing consultations for decompression patients, if you can do that. And then the timeline is a little weird because the machines have to be built. So what happens is from the time you sign on and you say, all right, let's go to the time you Open is about three months, because it takes 90 days to build the machine. But within that 90 days, all the steps are handled for you. So you're not constantly going back and forth and taking all this time and you're confused what's going on? No, it's all laid out, drawn out for you. So it's a very clear path from I want to do it to let's see a patient on day.

One. That's great. And so it takes kind of the guesswork.

Out. It.

Does. You partner with a doc. You know, most of our docs who have not done this have no fluency around how to do it. Right. So you guys come in and give the protocols, give the systems and procedures, even drive the new patients to them.

Correct? Yep, that's right. We handle all the marketing and we teach you how to do everything that I've been doing it 20 years. Genesis has been expanding for seven and a half years, and we've gotten really good at it. Now, I always tell everybody when we talk about this stuff, it took us about 50 offices, 20 to really dial it in, but now we've got it down really well. It's really turned key.

Now. Great. So we always coach our CEOs that they need to focus on return, on investment. Right. Whatever you do, people will ask me, hey, doc, how much should I spend a month on marketing? And I tell them, as much as you can, as long as you're getting a positive return on investment. Right. It's not the amount you spend, it's what do you get on the other side of that? And so can you give any. Some basic numbers or stats or want what a typical new client could expect as far as a return on investment for Working with you.

Guys? Yeah, absolutely. So it is its own business and it has its own overhead and but I'll say this, so we've had docs that tried to do decompression and they're like, I've done, I can collect 6 to 10,000amonth. Pretty easy. If we're not doing 40,000amonth, then we feel like we're failing. So 40,000 is our floor. It runs about a 60% profit margin somewhere in there. Now that being said, we've have, we have docs that start with us and they're happy with 40,000 every month and that's great. They're putting pretty good money in their pocket. Or we have some really high level achiever partners and they did 146,000 in their very first 30 days. So the spectrum is how, what's your bandwidth like? What do you look at? Where can you focus your energy? If you have some energy to focus. The ROI speaks for itself. We don't have anyone that's really losing in that, in that.

Manner. That's great. If you can do a 60 profit margin and you can get, you know, 40 grand is your, is your floor. Some basic math was about $24,000 a month in.

Profit. That's.

Right. So that's the.

Floor. Yep.

Yep. That's great. Love it. So what is the next best, next or the best step for our listeners to get in contact with? They want to learn more about how Genesis Back Connect can help them in their practices. What's the best way for our listeners to, to reach out and contact you.

Guys? Yeah, the first step would be just go to genesis back.com join if you go to that, you'll fill out a very basic form and then we'll contact you. You'll probably get a call from our coo. She's been with us from the beginning and then we'll, we'll get some basic info and then you'll get connected with me and Caleb. We'll have a call, we'll do, we'll start the process. If it sounds like something that you want to do, then the process gets started. We do market analysis for your area and the whole, the whole bit. So genesisback.com join.

Perfect. Well, thank you Dr. Chad for joining us today. Thank you so much for being a remarkable success partner and again supporting our docs and, and getting out there and helping more people. So remember, remarkable CEOs tune in every single week to our remarkable CEO podcast. I hope everyone has a blessed day and we'll see you guys next.

Week. Thanks for having me. See you.

Guys.

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.