346 - Do Chiropractors Want to Help More People or Make More Money?

Money's always a heart issue, right? So I say no money, no mission. If you really want to make an impact, if you really want to increase your reach, you're going to need to invest in your business. That means investing in your marketing, investing in your team, investing in developing your team, the technology, your space, like making a better product, right? So that's what we all want for chiropractic. We have a simple and elegant solution. But it takes money to really make an impact. Hello and welcome to the Remote 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,

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

And I'm Dr. Stephen Fransen.

And we're coming in and we're about to be taking off. And so we're just going to welcome you into our, our moment, our studio. Dr. Stephen, I know that you are a man on a mission. I know that we are men on a mission. We are an organization on a mission. And our mission is to help you as listeners to be more successful in helping you reach more people and doing it in a more remarkable way. Not at the expense of your marriage, your health, your happiness, your life, but that you could have a remarkable life as part of a remarkable business and a remarkable practice. Dr. Stephen, you are going to be doing some intensive work here. Business evaluations, investigations, and deep work. And that's what we do. We want to go deep with all of you. And that's why we have to get this off our chest every week. So for those of you who tune in regularly and listen regularly to the show, hey, thank you for being a regular listener. We appreciate you. We're speaking to you. We see you, we hear you. Thank you for all of you who tell us, yes, you love listening to the show. It means a lot to us. We're grateful. And this is a series. Dr. Steven. We'll do a quick recap here. This is part five of a five part series. And as we've been going through the two sides of the coin, the business and the practice sides of the coin. So, Dr. Steven, why don't we just. Quick, we'll recap everybody reorient where we're at because then we're going to get into the money and the financial conversation, which is the fifth side, you guys are familiar with this, hopefully the five domains, 15 primary functions of your business, we look at it through the practice and the business lens. And this is going to be the money conversation today. So, Dr. Stephen, great to be together today.

Oh, Dr. Beat, I'm psyched. I'm psyched for this conversation. I love having financial conversations, right? So so many chiropractors shy away from the money conversation, right? Because they're more service hand than they are money hand, right? So, but we make the argument that you have to have a remarkable practice and a remarkable business to reach your potential. I think God's got a calling on all of our lives. It's our appointment to reach more people, make a bigger impact and make a bigger income, right? That's they're naturally tied together, right? So money's always a heart issue, right? So I say no money, no mission. If you really want to make an impact, if you really want to increase your reach, you're going to need to invest in your business. That means investing in your marketing, investing in your team, investing in developing your team, the technology, your space, like making a better product, right? So that's what we all want for chiropractic. We have a simple and elegant solution, but it takes money to really make an impact, right? So I love the money conversation today. If you listen up today, you're going to hear and you're going to walk away, closing some of the knowledge gap that you may have when it comes to the financial side, the economics of your practice. It's going to be a tip of the iceberg conversation. Dr. P, for those who are listening to this, I don't know when this is going to air, but hopefully it gets to you before our remarkable business immersion. It might be really tight, might be really close, at least the one in Phoenix. We're also going to be going on to Brisbane, Australia and be teaching the business, remarkable business immersion there. So I'm stoked to do that. But this conversation to give you a sense of like, what are we talking about in the remarkable business and what is the difference? Right, so quick recap. There's two sides to the chiropractic coin. There's the practice side and then there's the business side, right? So the practice side, that is the healthcare delivery entity that exists to deliver healthcare for the patients, right? So it's all about creating better health experiences and better health outcomes for the patients, right? So the other side of the coin is the economic engine. That's the chiropractic business that exists to drive greater productivity in the form of revenues and profit for the owners, for the investors and for the team. Right? So two sides of the same coin, but they are distinct sides of the coin and you have to be able to have an eye on both sides of the coin to reach your potential. As we've said many times through this series, there are lots of, let's call them, remarkable practices out there that aren't necessarily remarkable businesses, right? So and then there's remarkable businesses that aren't necessarily remarkable practices, right? And unfortunately, there's far too many practices out there that are really unhealthy practices and unhealthy businesses. I'm going to suggest you have to have both a remarkable practice and a remarkable business to realize your potential, right? Especially to do it in a sustainable way. Right? So we are teaching both sides of this practice, going through this series and throughout our work in the remarkable practice. So on the practice side, you have five domains. These are your operations, these are your systems, right? This is what patients experience for their health care. This is your attraction. Conversion, retention, team building and collections. On the other side of the coin, the business side of the coin, the economic engine, this is the five domains are marketing, sales, delivery people and money. Dr. Pete Two sides of the same coin, but there is such a clear distinction between these. And of course, we've got metrics for each of those domains. We've got five of our favorite metrics in all of the operational domains in the five domains of the of operations, and we have our five favorite KPIs or metrics in each of the five business domains. So that might feel like a lot, it might sound like a lot, but this is all you need to know about your business. And we've actually captured this in a really sexy infographic, right, so that we're going to do as a giveaway today, right? It's the first time we've given this away. This is fresh out of the oven, as you like to say. This is a brand new resource. On one piece of paper you get to see all of our favorite metrics in both the practice domains as well as in the business domains. We're going to give that away today as our gift to you. It's essentially a summary of this series as there's been a series of five where we've broken down each of the business domains. So you can be able to capture all of those domains in one PDF. So we'll just have a link to that in the show notes down below. So make sure you capture your own Copy of that. Fresh and hot, fresh out of the oven.

You talked about something, doc, which is the health, you know, healthy practice, healthy business, unhealthy practice, healthy business, unhealthy, unhealthy. The scenarios that we see. This is an area where I would say that all of us could use work, right? Because as a chiropractor, most of us have really leaned heavily into being the best practitioner and delivering the best healthcare and best health outcomes. As you should be, you know, taking that seriously. This tends to be an area that gets pushed to the side, pushed to the back, even delegated sometimes. But this is an invitation for you to enter into a conversation, to be a part of this, to say, you know, I do need to get, have a better understanding. I need to have a greater fluency, I need to go to school on this, I need to have a better understanding. We see that with many of the CEOs and doctors that we get to serve and coach and support in this capacity because we recognize that money is value exchange. And that's where we want to center our conversation today because we've just spent time going through attraction Marketing is what, it's an act of kindness, right? And so we talk about, it's just, it's the right thing to do. If you have a message that if you knew somebody was going to suffer or die out there and you had an answer for them, who gives you the right not to tell them that like marketing is telling people something that they need to know is going to change their life. The sales process, the conversion process like we just talked about is giving people the best opportunity to have their life changed. It's taking people through a process where they can see that you can help them solve the problem that they have that they didn't even know they had, that they thought was one thing, but it's actually something much bigger. Then there's retention, which is the ability to give somebody a service that they can keep, stay, stay with. Because ultimately health is something you do over time, right? And, and we give people the opportunity to choose that. We make it easy for people to make that choice, to enroll themselves and their family into real. A true healthcare model, a true healthcare system that's going to drive an outcome that ultimately everyone wants because they say until you lose your health, it's the greatest assets, the greatest value, it's the greatest resource you have, is your health. So we know that. Then we talked about the team and, and how important having a world class team is and what that looks like to build a Team, to build a team of a players, to put people into a position where they're. They're able to be equipped, be empowered, and to be successful utilizing the limited resources that they have of their time, their energy, their focus, their talent, and to put together an organization that. Where everybody wins. And so that leads us to this conversation today, which is about the money piece. So all that led to this. This would be the. At the bottom of the. At the bottom of the funnel, the thing that gets squeezed out at the end of all. Doing all those things, right?

Yeah, the output.

Yeah, the output should be this. It should be the revenue, the collection. So I'm going to go through. Dr. Stephen, what are our favorite operational metrics, performance metrics for the practice side? And then I know that you're going to unpack the business side, the money side. Yeah.

Dr. Pete, if I. If I could just interject something here, because I think that it's just. It's too easy for us to jump right into the pragmatic sort of coaching on this, right? Because that's what you and I want to do, right? So we want to. We just close the knowledge gap, right? So. But I want to talk to the chiropractors. Listen out there right now, because you're talking to two guys who have been there, done that, okay? So listen, listen, guys. We are limping into the room loaded with scar tissue. And we always teach from scar tissue here. So here's what my scar tissue sounds like from my trail, from my climbing the mountain, right? So I showed up in practice so broke, I couldn't. I couldn't rub two nickels together, right? So beyond broke, you know, my wife was broke. So I married a chiropractor fresh out of school. So we had, let's see, $500,000 worth of debt between the two of us with our education. And then we borrowed another $75,000, which was just enough rope to hang yourself opening up a practice, right? So it was like we had no patience. We had no. There was no. There was nothing, right? So it was going from zero to 60, like, as fast as you could. So you're smiling because you know this story, right? It's like we just hustled, right? And it was like we were so on purpose, we would just, like, do whatever it took seven days a week, all day long. I know you guys are laughing right now.

You.

We've been there. Or maybe you're there right now, right? So it's like money. It was like, we need to make money. Like, we gotta make some money. Which means I gotta start adjusting people. It's like whatever it took, attraction, conversion, retention, it was all about, let's, let's serve people. And we're going to get paid to do that. Awesome. Let's generate some money. Fast forward. After a while, you start cooking, right? Next thing you know, there's a lot of money moving around. So no, you're not actually filling up your savings account or your bank because nobody at that point had told us that's exactly what we needed to be doing. But it was like there was a lot of money moving around and we were reinvesting in the practice, hiring people, starting to market, right? So just starting to buy the stuff that we need, pay down some of the debt that we had, right? So we get a couple of years of just. Man, there's a lot of money moving around. Now for young professional, the hundreds of thousands of dollars that were moving around, it was, I was like, don't worry, baby. This money, we're making money. Money's coming in, but money's going out. Unfortunately, it's going out faster than it's coming in. But it was moving. Next thing you know, you got on the other side of that, start taking on some coaches and mentors. They teach you how to start managing that money and how to grow wealth, right? So next thing you know, you start accumulating money, right? So there's. You're making more money than you ever have in your life, right? So. And if you're anything like me, I got to this place where I was like, okay, I know how to make money. So I would look at my wife and I'd be like, okay, honey, you need to manage the money. I need to stay focused on making the money, right? So I had this, this perspective, this really limiting belief that I didn't really have to understand money. I just knew how. I just needed to understand how to make money, right? So. And that for me was just such a handicap. And I'm just speaking into you guys right now. If I'm talking to you right now, this is like, at the end of the day, I did not understand how money works. I did not understand accounting. I did not understand economics, right? So. And the truth is, is as accounting is the language of business, and if you don't understand accounting, you just don't understand your business. In other words, there's no way you could be optimizing it, right? So in other words, you are just leaving so much on the table. So the answer is always, what? More? Let's Just work more, more new patients, more service, more justice. And when we justify it all by our mission and our purpose, so it just turns into a life of more, more, more, more, more. And guess what happens? God rewards that hard work. And there's more, more, more. But it's not necessarily good stewardship. You're just not demonstrating the ability to manage well, what he's already trusting you with. And that's what this conversation is, Dr. Pete. It's about just like you had to learn how to run the practice, you need to learn how to run the business.

And.

And that means you're going to need to understand economics.

We could end this podcast right now, right? I think everybody got what they needed to hear because in many ways you spoke to everyone in some capacity as you're sharing your story and I share that same painful but true walk. We walk, like you said, with a limp into this conversation. But we want you to walk out of this conversation without a limp and with these a little bit of direction.

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 revisit, 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.

So I want to share just a few of the our favorite KPIs. We're not going to be able to do a deep dive into all these.

Yeah, we'll. We'll blast through the operational metrics and we'll dive a little deeper in the business metrics, right?

Yes. So our favorite operational metrics, this one that no one's going to be surprised by collections. You know the classic, you know, how much did we collect? You got to know that number. You need to know how much money is coming in on a monthly basis, on a daily basis and a weekly basis, quarterly and annual basis. So what are your collections? That's number one is collections. And by the way, I'll say this, all these KPIs need to be owned by someone. Right. We say that, you know, one person's accountable. So there's accountability with all these metrics, including the, the money metrics Dr. Steven is going to review as well as these operational financial metrics as well. So one is collections. The second one is collection visit average. This is a, this one was a eye opening. I'll share something painful. So when you're collection visit average, what you're collecting per visit is less than what it costs you to deliver an adjustment. You have a problem.

Acute.

I'll just leave it there. So that was, that was an eye opening moment and experience that I had. Again, just wanted to serve and reach as many people as possible to the degree that I was paying them to come in and see me.

Yeah.

In air quotes like it can't cost you more to deliver the adjustment than it costs for them to get the adjustment. That's right, you're sideways. Not only size, you're upside down.

So yeah, if you don't know your CVA it's worse than you think, it's less than you think. Right. So. And a lot of doctors are afraid to figure out what their collection visit average is, which is total collections divided by total visits. That's collection visit average.

Right. So it's a really important stat to know and there's layers of depth. We can get into it. I'm not going to get into that now, but just at a high level, you need to know what your collection visit average is. There's another one, this third one is favorite, and that's monthly recurring revenue. Now this wasn't a favorite of mine, early stage, because early stage I was all about paying fulls and everything for me was about, you know, if someone's going to be fully committed, they're going to be all the way all in. So they're going to be paying in full for their care. I have no problem with people fully paying and committing to their care. I have no problem with that. But what I see is chiropractic is a lifestyle success strategy for healthy human beings. Therefore, for them to have it as a lifestyle strategy for them for the rest of their life style the life time, then they would need to make sure this was something built in. And most people don't pay in full for things ongoing forever and ever. Amen. They build it into a monthly part of their budget. It's budgeted in, so therefore it's part of a monthly. Most people operate on a monthly budget. So monthly recurring revenue makes sense for people living month, having a monthly budget and building your life around it. So it actually makes more sense for the consumer, the customer, the patient and that family to do that. So transitioning that from that model into a monthly model made a lot of sense based on my product, not product confusion, because my product is, you know, lifetime family wellness. Right. And so I knew that I needed to deliver that care and they needed to be able to purchase that. So monthly recurring revenue is a really important financial stat to see and to see growing. The fourth one is percent monthly recurring revenue. So if you're total collections, what percent of those collections is monthly recurring, which is a beautiful number. And it's a, a great tension that'll live in that number. And that's a number you can and, and, and a percent you can see grow over time. You should see it grow over time. You want to see collections grow, but also the monthly recurring, so both those numbers can grow together, which is beautiful. So monthly recurring revenue as a percentage of your total revenue. And then the Last one is collection percent. So this is percent collected or versus build, build monies or goals of collection. So the KPI is collection percent. So if you delivered $100,000 in services and you collected $80,000, then your percent collected was 80%. Does that make sense? So this actually applies very much to people that are in working with third party and are billing and there's a lag time between billing and accounts being and money's received. There's this accounts receivable. So that talks about efficiency and how well we're doing that and there's a lot of layers to doing that better. But that's another one that's a favorite because you want to be paid for the services provided. So collection percentage, those are our top five. We have more, but those are top five practice KPIs and operational metrics for you.

That's right. And it's, you know, I'm so proud of you, Dr. Pete, for showing so much restraint going through those five. Because I know that we want to unpack them all. But this is the business side of the coin conversation today. But we just want to frame it against the operational side, the practice side, right? So it's like you, okay, see those are practice metrics. Those are the stats that we call them in our braddock, right. That we're used to tracking. That speaks to our systems, right? So how are we doing? In our systems are our systems of attraction, conversion, retention, team building, and this one, collections. So let's flip the coin over and let's look at the economics of this, right? So if we were to go to the financial metrics, let's talk about our favorite five financial metrics when we're talking about the business, right? So number one is revenues, right? So we talked about collections, right? So in the real world, in the business world, they refer to that as revenues, right? In a business, that's top line revenue. So in the chiropractic practice, we very often talk about collections, right? So it's like what do we collect across the counter? What do we collect this week, this month, whatever. And the business, when you look at the business economics, when you look at the financial statement sheet, it's going to be represented as top line revenue, right? So how much did the, the business make as far as revenues are concerned? Number two is revenue growth. This is a comparative study. So we always want to be growing, right? So revenue growth would very often be expressed as year over year or yoy. All right, so year over year revenue growth, which is comparing the, let's say the Revenues, Total revenues collected in 2024 versus the total revenues collected in 2025. Let's say you did a million in 2024. Let's say you did 1.2 million in, in 2025 in revenue. That would be a 20% revenue growth, right? So which would be a very healthy revenue growth, right? So that would be year over year, or yoi revenue growth of 20%, you grew from 1 million to 1.2 million in a year over year, okay? So really important to track the growth of the business. Now, number three is gross margin, okay? Or gross profit margin. This is a tricky one, right? And it's a really important number to watch, right? So gross margin really tells you how scalable the business is. You know, everybody asks their question, can you scale it? The better question is, should you scale it? Right? So the expression, when you find yourself in a hole, the first thing to do is stop digging, right? So it's like, you don't want to like grow a business that doesn't have the gross profit margin that you're trying to accomplish, right? So gross profit margin is basically taking your revenue or your collections subtract what it costs you to deliver the product, right? So in a service industry, you use this expression, cost of services delivered, right? So that is what does it cost to deliver an adjustment? If we're having a chiropractic office conversation, right? So cost of services delivered is like, what does it cost us to adjust a patient, right? In the chiropractic space, that typically means you got to pay a chiropractor to deliver the adjustment. Very often there's a tech ca or a clinical CA that's involved in that office visit that you have to pay them, whether they're assisting the doctor or maybe they're working a modality or doing exercises or traction with a patient, whatever that's part of that clinical visit, then that would be in cost of services delivered. And then you have your consumables, right? Consumables in a regular adjustment, typically like face paper, right? It's a consumable, right? So but you have to buy the face paper. That would be consumables. And then number four would be the credit card merchant account. Like every time there's a, there's a cost associated with swiping that credit card, so to speak, right? That 2%, 3%, whatever you're paying on your merchant account, that is actually a cost associated with the services delivered, right? So COSD cost of services delivered, that's an important number to keep an eye on because you want to know what does it cost us to deliver an adjustment? Now, this is expressed as a percentage gross profit margin. When you hear that, that's usually a percentage you're talking about. So that percentage in a chiropractic office, and I mean an adjusting centric chiropractic office, you want to see that number be somewhere between 70 and 80%. Okay, so 80% of your owner operator. 70 if you start hiring other associate doctors. Right. So it's like really important that you do your financial modeling, right. Because Dr. Pete, very often the financial model breaks, you know, when chiropractors start getting more sophisticated. Right. So the chiropractic business model works. Well, if you're an owner operator and you're the owner of the practice and you're adjusting all the patients, you pay one or two or three CAs around you, that, that is a lifestyle business, right. But as soon as you try to turn that into a real business, when you're hiring associate doctors, very often that financial model breaks. And the first place it breaks is right here in gross profit.

It's huge, Doc. And I think, you know, looking at this through the lens of scaling and that question you asked, should you. This is a really important. Because it causes us to stop and have to actually evaluate where we're at right now and then make the decisions to invest, when to invest, how to invest in the business, which again is going to be a part of the next one or two KPIs you're going to go through. In the, in the money side, this speaks directly to that, you know, to be able to make. Because leaders are, at the end of the day, you are yoked with making decisions, deciding how you're going to proceed forward, how you're going to invest, when you're going to invest, what you're going to be investing in. And so this is a really important. And the lifestyle. Transformation a lifestyle business into turning into a business job in the business. That, that's a conversation a chiropractor we're having all the time. Some want to go back to that lifestyle business, but we can help make sure that, that you can scale and do this well profitably. If you actually understand the numbers and

you're not guessing like the way you can affect your profit. Right? So we've already talked about this. There's three ways it's price, increase your price, lower your overhead, or increase volume. Right? So your profit margin, you can't volume your way out of a profit margin, Right. Because it's just going to be that volume times that profit margin than the gross profit margin, right? So that's really important, they understand that. So it goes right up to price and overhead, right? So it's like, and here in this example with if you've got associate doctors, you really have to look at your pricing structure to make sure that you are priced appropriately. So you can pay another chiropractor and there's still margin left for you. So you can have profit, which is number five, that net profit, right? So let's talk about four and five. It's net profit margin, which is what percentage of your top line revenue is left over for profit. That's the percentage, that's profit margin. And finally our favorite number, number five, which is net profit as an absolute number. This is the dollar amount, right? So you can see, Dr. Pete, these numbers all work together, right? So but you have to understand, taking a look at a strategic financial report is what you do with like a fractional cfo. You look at your money, the way your money works in the business. And it's so critical to understand each step of the process because you don't want to be at effect. You want to know where does the number come from and most importantly, what can I do about it? Like, what are the choices I can make in my business to make sure that I'm increasing my net profit margin and my absolute net profit, right? So you have to understand which, which levers you can pull on. But if you don't speak accounting, you don't understand your business. These are our five favorite financial metrics. Guys, if you'd like to get your hands on that PDF summary that has all five domains in the practice, all five domains in the business. There's a link down below here in the show notes. Click that link. Use that to create a more remarkable practice because you know the truth. What the world needs now is chiropractic. And what chiropractic needs right now is more successful chiropractors.

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.

Welcome back everyone. This is Coach Day and I have the privilege and the honor to interview Jeff Langmaid with the smart chiropractor. And he is someone that I have employed as part of my team to help reach the patients that were once in my practice and have, you know, stepped out for whatever reason, they become inactive. And you know, they're great people. They just, you know, potentially forgot that they, you know, that their spine was important and they forgot to reschedule that appointment or somehow they fell off. And I'm sure all of you listening have had that happen at one point or another. And so Jeff has created a fantastic product that I, that I hope he's going to be discussing with everyone today and how they're able to, you know, bring those people back into your practice. And so those downstream metrics is the one that's going to be influenced the, the most is your netmo, right, the one that everyone loves to talk about, net momentum. So your new patients plus those reactivations, minus those that are going inactive. And Jeff's just done a fantastic job for us, increased our bottom dollar just by getting those reactivations in there. So, Jeff, thank you for that. And I want to go ahead and open up with one of my very first questions for you is, you know, what is the specific problem that you solve? You know, all businesses, they exist to solve a problem, right? So what problem is it specifically that you solve?

Yeah, it's a great question and I appreciate your kind words. A lot of what we solve are the ability to stay engaged with your patients over time. And we think about that through three specific life cycles. We think about new patients when they come in, ensuring they have a great patient experience and are onboarded appropriately. And that generates more referrals up front. We think about improving active care retention by showing up each week through email, teaching and inviting consistently, and then reactivations as well for those patients that have gone inactive, consistently showing up, teaching, educating and inviting them back with the reactivation offer. So the biggest challenge I'm going to say that we solve for many chiropractors is that they don't communicate often enough with their patients to do a great job knee to knee, heart to heart, within the four walls of their practice. But outside of the transactional missed appointment texts or maybe the occasional phone call, they're not consistently showing up in a way that enables the patient to stay connected to the practice. Whether that's again, referring a friend, a colleague, a partner early on, staying retained during active care and not falling off and out, or if they happen to, ensuring that you're staying consistently communicating to your inactive patients to generate those reactivations, which is such a critical component of building a durable business.

That's absolutely right. And like I said, some of those downstream metrics are so crucial, like net momentum, but the one that I like the most is profit. Right. So in communication is everything too. Right. So, I mean, you know, the more clear that we are with our communication, the more likely our patients are going to convert, which is obviously a big step of it. Right. But then they're also going to understand chiropractic care so much better. So we get that retention aspect of it, which is great. So there's a lot of CEOs on the line right now. And you know, whether we're just getting started in practice or you know, whether we're 25, 30 years in practice, we always look at the ROI or the return on investment. So when we talk about your guys service or services that you guys have for us chiropractors, what is the anticipated return on investment that these people listening can anticipate when they leverage you guys?

It's a great question. What we see is to keep a patient and or reactivate a patient. I'm gonna use the term client because when we look at some of these stats, they go outside of just chiropractic. It's 42 times more expensive to acquire a new customer, client, patient than it is to retain or reactivate an existing customer, client or patient. So if you're spending any money whatsoever on any sort of paid advertising on any new patient acquisition, you got massive holes in your bucket and you're just wasting money. You don't have the ability to communicate over time and sort of patch some of those holes. We all got water coming in the top, that's the new patients. But if they're falling out the sides because your retention's not where it needs to be, or they're going straight through to the bottom and becoming inactive just when they complete that care plan, if not before, you're just missing a massive amount of opportunity and probably spending too much money in other places because then you're going to look at your net momentum, realize you need more new patients because you're not offsetting it with reactivations and because your retention struggling. So you're going to spend more than necessary to really generate the net momentum that you want, which would be positive so you can be an infinitely growing and sustainable practice. Now, in terms of the key critical question, how is this going to work for me? It's a fantastic question. And I'll be direct when I answer really is going to work for you. Depending upon two things. How big is your patient list? A bigger list gives you more opportunity, doesn't mean a small list isn't valuable. But if you've been in practice more than a couple years, you got a list. And as long as it's 3, 4, 500, if not in the Thousands. You got plenty of opportunity there. The more is there, the more opportunity there is for you. The second component is what's your patient experience like? If patients want to come back well, then showing up consistently, teaching and inviting is going to make it really easy for them to do so. So we always think of this also like a little bit of a truth teller, where if a doc is saying it's not working, I always say, well, that'd be like saying, well, I opened my practice, but nobody in my community ever wants to come in and see me. That's probably not the truth. The question is, is your offer in line? Are the campaigns that you've chose within our system aligned with the patients that you're trying to reactivate? Is the reactivation offer price, what's included? 30 days, 45 days? How long since you last saw them? Are you calling that out? And the beautiful part in our system is you can edit that so it's no big deal, and we make it really easy to do. But really critical components are understanding one, that momentum equation that you discussed earlier, Dr. Kevin. And number two is understanding, hey, you got a few levers. We're going to give you the opportunity to get in front of your patients consistently. That's positive no matter which way you slice it. And then you have the opportunity as the doc to say, hey, let me pull some levers, push and pull my results based upon the offer I'm going to make.

That's right. You dropped a lot of truth bombs there. And, you know, a couple of them that I, that I wanted to just kind of echo was you need to have a system in place to onboard these people that are coming back. Right. And one thing that I always like to coach to build docs, and even skill docs too, is like, when you have these patients reactivate, you need to avoid having the same talk track that allowed that person to think that it's okay for them to step out. So to step out and, you know, not keep their focus on their spine and their nervous system. So I think that's a crucial thing. And then you're right developing an offer around that for those people to be incentivized to come back in. And then the other thing too is, you know, remembering the remarkable standard for a patient to go inactive is 30 days. Right. So, you know, how many patients have not been in your office in the last 30 days? Right. And they're no longer, you know, considered to be an active person following through with your recommendations for care. And here's what I love to teach on this too is if you don't document that they're stepping out of the practice, you have no way of marketing to those people. And that's what I absolutely love about what you guys do is, you know, you, you, you give us the opportunity to reach those people that, you know, otherwise would not get any information about chiropractic care. So that's, that's one thing that I, I personally love. So a couple other questions for you, Jeff. I know you're a busy guy, but I want to make sure, you know, everybody gets the opportunity to, to hear this. But considering you know, what's important next and as you look ahead and assess the need for our profession, how are you helping doctors be prepared for success in the future?

I think the number one thing is to stay connected to the community and ecosystem that you've built. We see over time, algorithms can change, things can change really quick. So the question becomes, well, what are those controllable items that you have? And unfortunately, it's difficult to control some of these large tech companies that, but you can absolutely control your email list. You can absolutely control via email the communication that you have with your patients. So in some ways, I'll say, you know, this goes back to the basics where it is about a direct communication line with the individuals who know, like and trust you. And that's your patient base. And doing having consistency with that communication is one of the best things that you can do for your business is not only today, but also in the future. Because one thing we do know is that paid acquisition for new patients is not going to get cheaper anytime soon. There's always a different way to think about it in a short term fix. And that's why there's those individuals and helpers out there that can assist in that and get you the best bang for your buck. But ultimately reaching out and connecting with the individuals who you've already spent that customer acquisition cost on. Doubling the lifetime value. Let me be super clear with something as well. Many patients that reactivate in your practice should not be coming back for one adjustment and see you later. This should be literally doubling potentially the lifetime value every time you are, you know, multiplying the lifetime value of that patient because when they come back in, theoretically you're going to do an exam, you're going to do what's right for that patient. You're going to, you're going to have a care plan, a plan of action based upon what you find in your examination and their personal health goals. So every time a reactivation comes in. Not only is your customer acquisition cost zero because it's already been handled, but now you are into your favorite thing, Dr. Kevin which is profit. That enables you to be as profitable as possible by increasing, doubling, tripling potentially more the lifetime value of that patient. And as business becomes more evolved, more advanced, more challenging in many ways, being able to maximize the lifetime value of your existing patients, being able to keep your customer acquisition cost under control and having reactivations as a zero in that equation helps really keep your new patient acquisition cost under control is just a really good business idea.

That's right. That plays into one of the big things we're going to be discussing is LTV CAC lifetime value to the cost to acquire a customer. That is such an important metric to understand. So Jeff, thank you for the clarity on what it is that you provide for this profession. And you know, thank you on behalf of TRP and myself as well in my practice for what you guys have been able to do for us and what you're continuing to do. So I think the last thing for you to do is let everyone know what's the easiest way for them to get ahold of you.

Yeah, easiest way is to head over to thesmartchiropractor.com thesmartchiropractor.com Great place to be able to connect if you would like to schedule a demo, you'd like to get started today, or you want to connect across any of our social channels. If you want to follow us online, we're constantly putting out, you know, emails, blog posts, videos and things that everything we can do to be helpful so that we can similar to remarkable practice, we can help you help more people. That's what we are in this for. So there's a bunch of tools and resources over atthe smart chiropractor.com Very good.

Thank you sir. Have a great one.

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.

Sam.