350 - How To Build Recurring Revenue in Your Practice with Better Retention Systems

Imagine how you would feel knowing you have $100,000 or $50,000 or $30,000 or $80,000 of, of recurring revenue coming into your practice every month that you never have to worry about where your next new dollar is coming from. Meaning, how would that change your life if you knew a year from now, you knew a year out, you had still $80,000 a month coming in? Like, how does that give you the freedom to plan your future? 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. Stephen Fransen.

Welcome to another episode of the Remarkable CEO Podcast. CEO Podcast, chiropractic's number one business podcast. I'm Dr. Pete Camiolo, and today I'm honored to be in the studio with two more of my fellow Tennesseans now, Dr. Miles Bodson and Holly Jensen. Hey guys, thanks for, uh, joining me on this episode this week.

Man, are we excited to be here, right?

Yeah, I'm excited to be together. Hey, we just had a chance to be in Phoenix together at the most recent Remarkable business immersion. I love to hear, you know, your thoughts on that. I know I'm putting you on the spot. It was a remarkable event from my perspective, and I'll share a couple of things. Number one, the idea of taking the business conversation to another level in the chiropractic profession is such an important— such an important step for us. What we said was we've inherited as chiropractors a broken business model. And most chiropractors are trying to operate with a broken business model. And one of the reasons why I love working with Cash Practice and the two of you and your organization is that you are helping solve that problem and you've been doing it for a long time.

This isn't—

you didn't start this year. You've been doing this a long time. And so you have a unique visibility into the business model, into the, the broken belief systems and the broken or lack thereof systems. You understand it from a compliance perspective legally. You understand the dollars and cents. You see the actual numbers, profitability. You see that, all of that. So you have such a unique perspective of business and the chiropractic business that we're going to talk about money today. We're going to talk about your business today. And I'm excited for us to do that. So just real quick before you guys introduce yourselves, if anybody doesn't know you, which hopefully many do, 3 things we're going to hit on in today's episode. If you're listening, number 1, we're going to talk about retention. This is such a key to all of our business success moving forward is to get the retention piece right. So we're gonna dig into retention and connection between your money models, your care planning models, your financial models, and retention. Number 2, we're gonna talk about revenue specifically and organizing your revenue into different— there's different revenue topics and sources. We organize it into different stages in the patient journey. We're gonna understand revenue better today. And number 3, we're gonna talk about in each season of your career. So whether you're launching, building, scaling, or exiting your business, so wherever you find yourself, and I know this is the CEO Podcast, so many people are in what they would identify as the season of scale. Although I know we have a lot of, we have students that are listening, we have launchers, builders, scalers, and exiters that are all listening to this, to our podcast. So for all of you in all your seasons, wherever you find yourself today listening to this, we want you to understand this. We're gonna be speaking directly to you. And how this is gonna benefit you in all 4 seasons. You know, I'm gonna introduce you, but I want you guys to share a little bit with our audience who you are. So Dr. Miles Bodson, long-term friend of TRP, long-term friend of Dr. Stephen, and we've developed a friendship over the years. And then Holly Jensen as well. You guys are gonna introduce yourselves, but just an honor to have you. Thank you for being a part of the expert community that we're assembling, and we just wanna be surrounded by smart people. Like Steve Jobs said, we don't have to be the smartest in the room. We just need a find people that are smart and, and bring them in. So we feel like we've done that with you and you're only going to help the doctors we serve be able to be more successful in helping more people. So, Dr. Miles, I'll throw it to you. A little about you and then to Holly, and then let's jump in.

Excellent. Dr. Pete, thanks for that warm introduction. What a great way to start the podcast. We're thrilled to be here. I'm humbled to think you think we're the smart people in the room, but thank you so much for that. It's a very nice compliment. I do believe we have some expertise in certain areas that we're going to share today. That being said, coming off the Phoenix event, what an incredible event that was at TRP. I have the perspective that I get to travel around and see lots of different events throughout the country. Holly and I are often speaking at state associations all year long at different conventions, different private events. And what Dr. Pete and Steven are putting on at TRP is top-notch, one of the best programs. If you've never been, I encourage you to go. Certainly if you haven't been as a guest, at least go as a guest and check it out. That being said, we're very business focused here, and that is one of the areas, uh, we struggle with here in, in chiropractic is we're healers, right? We're all healers and we didn't— we're not business people by trade. Most of us, most of us just wanna help people. But at the end of the day, you could have lightning bolts flying outta your fingertips being an incredible chiropractor, but if you don't have the business wired, it doesn't really matter because at the end of the day, people aren't following through. The business models, the retention side of things. It really drives outcomes with patients. I mean, I think we could all agree that if, you know, a patient needs 6 months of care but they drop after 2 months, you could have all the best technique in the world. It doesn't matter, right? Unless you're getting them to follow through. So my real mission and passion is to help doctors get clarity, simplify things, give them systems so that it's very easy for them to actually have the outcomes we're looking to have, which is great financial revenue. But that's also associated with providing tremendous value to your communities where people are following through and getting incredible results. I also want to introduce Holly Jensen here, my sidekick here. Holly and I've been working together going on 25 years now in chiropractic, serving the chiropractic profession, everything from running a chiropractic practice for nearly 20 years to now you being the CEO of our, of our software company, KashPractice, and doing such a phenomenal job. Holly as well travels around the country speaking at different state associations as well. In fact, this weekend coming up, if you're listening to a recording or when this is, just depends on when you hear it, we'll be in Montana this weekend speaking. Uh, that being said, um, Holly, why don't you say a few words before we get started here?

Yeah, so first of all, I want to clarify, we are not an EHR. Cash Practice Systems— systems is in the name, right? We're systems to help you impact your patient retention, because we all know that it's great getting new patients, but if you're not keeping them, like What the heck are you doing? Like, you're just spinning your wheels. I also want to highlight the fact, Dr. Miles, that you and I have been working together for over 25 years. So not only are we speaking about patient retention, but I think we could also share some insights in regards to employee retention. Because when you practice is fun and you're witnessing the miracles of chiropractic and your team is able to participate in the patient's health and wellness journey, it becomes a lot of fun and very rewarding for your team as well. So I cannot imagine working in a pain-based practice. That would be zero fun for me. I need to be fulfilled and rewarded, and I see that in the health and wellness environment of the practices that both of our communities serve.

So huge. That's a different topic we could do on a different episode. I would love to talk about employee retention and what it looks like to create— make a fun make it fun to be working. And that's a huge, that's a massive topic, which I would love for us to circle back to. So maybe we just make note of that. I've made a note cuz I would love to, in a sense, interview you guys on that because you have done something remarkable in our space where there's generally a lack of retention, especially retention of A players, right? You can, B and C players are fine to have you carry them and drag them around for as long as you want, you know?

Right.

But A players, are not going to tolerate that, you know? And so, and you guys are A-players, you have teams of A-players. So it's, it's pretty cool to see that. So one of the things we said at the event, um, was that when it comes to your, your mission, we mean business. And we talked about, and Dr. and Holly, you said this right before we pressed record for today, you talked about really the mission. And I think that resonated with you is talking about the systems that impact, you know, the mission. And then you just literally highlighted the fact that it's actually cash practice systems, which I probably didn't even say when I introduced you. That's how powerful every word is and it matters. So can you talk a little bit about your passion about systems specifically, the mission, which you just kind of referenced as well as y'all are chiropractors or a chiropractor and, and somebody who's worked in chiropractic for the better part of a quarter of a, of a century, you know?

So it's like, oh my God, that sounds so—

I know I had to say it. It just came to my mind when When you started throwing numbers, I was like, actually, that's a long time. Yeah, I know. So Holly, I, I wanna hear from you first on this, but talk about the importance of systems, the importance of systems on impacting your mission, the value of knowing like what the mission is, and, and then we'll, you know, kind of get into, and that you guys mean business when it comes to that.

I'll start with sharing at Kash Practice Systems, our mission is to help everybody. The doctor, the chiropractic professionals, the COOs, the whoever they are working in the chiropractic office. Our mission is to help each and every person increase patient retention because we know when patients are adhering to their treatment plan, they're getting better clinical outcomes, and we have a, a healthy community of the people that we serve. And so at Cash Practice Systems, We bring the systems and simplify them so that practice is fun and rewarding. And when it comes to the reward, there's many different levels of the reward that the practice has. And I'm actually going to throw this back to Dr. Miles. And we actually break this down very granularly in the rewards that the practices are having.

And to nail the question you just said, which is like, why systems?

Yeah.

Is at the end of the day, there's a formula for doing this. It's, you don't have to reinvent the wheel. We've now seen this in action so long that you can systematize and reproduce the whole notion that a patient comes in, they get into your funnel, they become, they join your journey of hiring you, and they end up becoming a patient. And either they follow through and they get to the end of care and they go on to wellness, or they leave you and fire you at some place prematurely. And there's predictable ways to prevent that from— there's predictable ways of preventing people from leaving, and there's predictable ways of having them follow through. The area that we have extreme excellence in is systematizing that into an approach that it's very predictable to have a person come in, go through your day 1, day 2, enroll in care, and then a year later they're still with you, and 2 years later they're still with you, and 10 years later— it's very predictable for us now. So to, to say why systems are so important is because if you don't run a system, It's willy-nilly. It's, it's, it's open to winds of change or whoever happens to be the personality there of running, of running the show. And as you said, there's kind of this broken business model that we've inherited, which is, you know, pay per service and people buy us, uh, one service at a time or one therapy at a time or one adjustment at a time versus them buying the outcome of what we're trying to sell them, which is better health. as an example. And that's— I'm not sure if I'm answering the question as well as I, as I could, but the, the point is, is that if you don't have a system to follow, you're doomed to fail. I don't know how else to put it.

Dr. Eric Janowitz, what's the impact of the reward that these practices get for implementing systems?

So specific to the, you know, taking it out of a generic topic of just systems, but specifically to the systems that we teach is The reward is, let me paint it this way. Imagine how you would feel knowing you have $100,000 or $50,000 or $30,000 or $80,000 of, of recurring revenue coming to your practice every month that you never have to worry about where your next new dollar is coming from. Meaning, how would that change your life if you knew a year from now, you knew a year out, you had still $80,000 a month coming in? Like, how does that give you the freedom to plan your future? For those of you listening right now, if you're in the model that every dollar you bring is dependent on new people showing up. I think we can agree that's a stressful way to live, right? You're always marketing, you're always getting new business. If numbers are down with new patients, your revenue is down. It makes it difficult to plan for the future. You spend half your time marketing versus taking care of patients. Not that there's anything wrong with marketing new patients, I don't want to beat that up, but my point is, is that how different is your— how rewarding is it for you, going back to that word, how rewarding is it for you to know that You can breathe easy knowing that you have your overhead met on day 1 of every month, or more than your overhead, your profit. Like, that's really where the reward comes from because that gives you the freedom to breathe and say, all right, I have the freedom now to hire the people. I have the freedom to go on vacations. I have the freedom to not worry about new patients. I have so much freedom comes along with that. And specific to the practices that are going to exit one day, what does that do to your valuation? When you are looking at a practice that's recurring revenue-based and systems-based versus a practice that's new patient revenue-based, the difference in the, the multiple of the value of that business is— it's tremendous, the difference between one versus the other. I know I'm kind of going all over the place here, but you asked kind of the generic statement of like systems and whatever rewards. There's lots of rewards that are associated with it.

And I want to check one of my most favorite authors, uh, James Clear, book Atomic Habits. He quotes, "Systems create behaviors. Behaviors become habits. Habits drive outcomes." Whether that outcome is the financial success of the practice or the outcome is the better patient health and clinical outcomes of the patient, there is some sort of outcome that happens when you apply systems, the right systems in place.

You know, and what's unique about the three of us in this conversation— if Dr. Steven was in here today, we would have been four of us— but is we have collectively have visibility and have had visibility into thousands of chiropractic practices.

Yep.

We're not sitting here like pontificating and talking about how we feel about this. These are facts. These are brutal facts from really hard conversations with a lot of people. Yeah, people we care about. A profession we are fully committed to serve. This isn't coming from— this is like, we see it, we experience it on a day-in and day-out basis working with doctors and clinics, just like many of you who are listening here today. So that's why I did want to ask about the systems, because I see it every week in my work, and I know you see it every week in your work, and you've seen it week after week for years after year, year over year. When we did a— last year I had one of my favorite things we did last year was I did a masterclass with the, with you, and we did it on the conversion process specifically, if you remember. And we talked about the Four Agreements, right? Problem, goal, path, plan. And I remember, Dr. Miles, when you were going through it, we had a great time just jamming back and forth on all, all the Four Agreements. And I loved all your insights on them just as a successful chiropractor. And so But I remember when we got to the last one, which was the financial, remember there's a care plan, which is your clinical recommendations for care, and then you have a financial plan, which is, which is the agreement that goes with that. And too many chiropractors try to maybe combine them. They, they look at one, they're, they're one in the same. They're not. They try to jam 'em both in at the same time, and that doesn't work. There's a reason that's a system. Yeah. Those agreements are a system and it works because of the way humans work and because of the way the brain works and the way that people buy and the way that people build trust. 'Cause trust, right, is the thing that we have to establish at the beginning of the relationship. It's the thing we have to retain throughout the duration of the relationship. And when you miss on the money part, it's the fastest way to jack up a relationship.

Absolutely.

It's the fastest way to lose trust, lose customers, get a ding on your Google review. I mean, all the things that are going to backfire badly. So can you guys start— can we just continuing in this conversation? So we've laid down the fact how important systems are, even systematizing every process that the patient goes through specifically, but how important the money systems are.

It's 1,000% right. Yeah, it's so important. Like, if you just nailed it, like, if you don't get money right, it's the fastest way to sabotage the relationship. I'm not one to scare doctors. That's not my place. You know, it's not my role. But you got to have a little dose of reality. And the dose of reality is, is that in chiropractic, issues over money are the second leading reasons that doctors end up in front of state boards or have malpractice claims filed against them because they just screwed it. And that's the extreme case. Not to mention the times where you just don't do it right or something's not right and you just lose trust with patients where it doesn't have any, you know, compliance issues or legal issues. It's just loss of trust with people because money isn't handled right. It is crucial that it's handled correctly. And the challenge in our profession is, is that most chiropractors just— they have a doctorate of creativity instead of a doctorate. You know, their DC stands for doctor of creativity, and they're trying to make up these weird programs. And just—

they just—

I hear this stuff and I'm like, why are you doing it that way? It makes no sense. And there's clear ways of handling the money right, and you have to. You really have to do it. It has to be— the way you handle at the beginning will set the tone of how you'll always have it with that this particular patient. Like, that's the expectation from that point forward. If you don't handle it right from the beginning, you're setting yourself up for problems. But when you do handle it right and it's handled well, it makes your life easier, it makes it more profitable, makes the team's life easier, more joyful. It makes the patient's outcomes better because they follow through. You're not creating this wonkiness with people, and it creates this financial stability in your practice that's just a dream come true. I mean, again, I keep going back to the recurring revenue model that when you have a business, whether it's chiropractic or not, If you have any business that's just throwing off revenue every month regardless of new business, it's a really breath of fresh air. And Dr.

Miles, you know, just one thing that, that we hear often is doctors will come to us and consult with us about their habit. They have a really solid report of findings and, but then they're losing patients on converting to care because they have these wonky payment plans, right? And you just brought up. Recurring payments. Can we expand on that?

Sure. You know, here's the thing is, is that you talked about the brain, the brain, the way the brain works and the way we have this psychology of how we go and buy things, etc. What we found works best for retention is, is you want to have people getting in the habit of making a payment to you, sort of like when they go to a gym or anything else they're subscribing to. If we think about chiropractic as not a— you're not paying for a service, but you're paying a payment towards the overall plan to get an outcome. I'll use the analogy of an orthodontist. You're not paying for every visit you go to the orthodontist with your kid. You're paying a fee to get braces, to get a smile at the end of those braces. That's what you're paying for. You're not paying for every month's visit. Yeah, you're making a payment towards—

I'm—

I want straight teeth for my kids. That's what I'm paying for. I'm not paying for braces.

Right.

You know, so the idea here is, is that your, your model in practice is no longer selling 12 visits of care. It's now I'm selling a package or program to get you cervical curve restored or posture improved or whatever it is that doctor happens to be doing in their practice. From the standpoint of the recurring revenue model, one of the things I want to get to is, is that we see these funky programs where a doctor says, well, I want to have people prepay or I want to have people make, you know, 6 months of care and pay it off in the first 2 months or that type of thing where there's this big gap in time between when they initially started care and when it's time to go to wellness. And as a result, they end up losing a lot of people. Simply because when people, if they're making a payment all along, and I apologize, I could tell right now I'm not speaking as clearly as sometimes I normally do. My, my, my thoughts are not, I don't feel like I'm firing on all cylinders right now. So I apologize if I'm not coming off super clear, but I'll, I'll share this is that if people have a big gap in time between payments, that's a, that will sabotage retention. That's one of the things that'll get in the way of them staying, right? It happens all the time where I talk to doctors who are like, yeah, I do. I've been doing great. I do great day ones, day twos, and I'm selling care and I'm closing the deal all the time and I get all these prepays and they think they're rocking and rolling, but then they eventually confide in me and that is they're confi— they, they always confide the same thing, which is my re-sign rates suck. Like I can't get people to stay more than their initial program for the most part. And that's simply because they're closing the deal on prepays. That's the reason for it. And if those people had been on a monthly payment, if, as opposed to a prepay, The odds are they'll end up keeping them much longer.

Hey, Doc, Stephen Franson 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 it's 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 The Remarkable CEO Program has helped hundreds of chiropractors just like you turn the job that they love into the business that they've always wanted. Are you ready to run and build your practice on leverage instead of brute force? Do you want to create the scalability and durability that will allow you to make a bigger impact and a bigger income? What would it mean to grow your practice, increase your productivity and your profitability? Do you want to get your time freedom back? Are you ready to turn your pirate ship into a battleship? If this sounds like you, then the Remarkable CEO Program is for you. Just last year, 53 of our Remarkable clients received the 7 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 in creating the business that supports your remarkable life, not competes with it.

The other thing I want to add on to just specifically in regards to the prepay is the other thing that we hear is not only do the re-sign rates suck, is that they're like, I'm still not profitable. Like I'm getting all this prepaid money, but I'm still not profitable. And so when we analyze it, we look at it we discover that their discounts are too high, they're not charging enough. So even though they feel successful getting all this prepaid money, they're really not profitable. And the other part of that is the revenue is constantly up and down because they're dependent upon new patients and enrolling patients into care. So, you know, it's like a whole vicious cycle.

Yeah. I mean, and Dr. Miles, I know you're going to share what you said, but I just want to double-click on something because you haven't been rambling. I think you're just You're hitting a lot of things in a very short period of time. We're hitting on a lot of topics. So I just want to kind of ground everybody, because what basically we've been saying is, number one, you gotta have a system for your money model and you gotta have it systematized and organized. It doesn't have to be as hard. You guys have proven this. You've spent, you've got a formula, you've systematized, it's reproducible. Guys, you hear those words? Those are peaceful words. Those are happy words. Those are happy words. You know, like, Those are words that you wanted to have to describe your business, right? And, and it's possible to have that, those words describing how the money works in your business. And I also heard, felt my blood pressure going up when you were describing the last situation, which was Holly kind of jammed on it too, where we're collecting all this money, but we're still stressed out about the money and our profitability. And it's because it's not organized, it's not systematized, it hasn't been thought out long game. I shared in at the immersion, and I'm not gonna go down a trail on this even though I could, the difference between an infinite and a finite mindset. And when you talked about the, the amount, the recurring revenue model, that's a, that's an infinite mindset. You talked about on the fourth season of all of our career, which by the way, death, taxes, and exiting, right, of your business. Those are, those are the three that were gonna happen, whether it happens on your terms or not. That's the variable. But when you go to exit, which we've helped a lot of doctors exit and walking through it now with several, is when you have the right model, the money model is right, that's a very different Transaction. It's either an asset or a liability. That's what I always say. Are you selling a liability or an asset? And getting this right is the difference and the value you will capture, which we've all dedicated. What, how much blood, sweat, and tears into our practices? Nobody sees the kind of work I put in. I'm like, yeah, I know, I know that what it's worth is here. But the reality is, do you have a system that's formulaic, systematized, reproducible, something that somebody come else can see the value and say, I'm happy. Or even if it's a, you know, Wall Street sale, not a Main Street sale, well, they would say, I see the value and it's worth X more. Yeah. I just wanted to say all that to say you're nailing it, Doc and Holly. You guys, you're hitting it. We talked about retention. We said 3 things we're going to hit: retention, better retention, better revenue, and in all seasons of your career. So I know you're going to share maybe a case study and say, hey, here's an example of a doc. So I'll let you set the story up, but I know we're going to see it broken down.

You know, those first two points of we're gonna show better retention, better revenue, they go hand in hand. It's not like, it's like the two sides of a peanut butter jelly sandwich or the two sides of a coin. Like they go hand in hand. If you have better retention and you have the right systems, you will have better revenue, but most importantly, a better profitability. Your profitability, like we all know, it costs you, studies show it's, it costs about 7 times more to get a new patient than to keep an existing one. So if you had 10 patients, or let's use the example you wanted 1,000 visits of reimbursement. You can either have 100 people that you get marketing to a lot of people and get 100 people, it costs you a lot of money to get them, and you keep them 10 visits. That's 1,000 visits. Or you could get 10 people that you kept 1,000 visits. I'm sorry, 100 visits. 10 people for 100 visits is the same number of visits, but I think we could agree that second scenario is much more fun. And much more profitable than the scenario where you're getting all these new people that you have to process. It's just easier and more fun. And to give an example of a case study, we have lots of these, but I'll just share this one. Let me share my screen here for a moment. What I'm showing on the screen when it comes up here, it's a graph. It's showing a graph of 2007 to the, to the year 2025. And what you're seeing on the screen right now is a bar graph that gets bigger every year, and it represents the gross revenue of cash. This is not insurance money, this is just their cash revenue coming in to this practice every year. They've been a member of ours since 2007. When they first joined us, they were doing about $100,000 a year, $200,000 a year those first couple years. And they went from $200,000 a year in 2009 to 2020 having their peak year of $2.2 million and staying just around $2 million since then. That's a 10x increase that happened over time. It didn't happen overnight, but it happened over time. And if you look, if you're able to see the graph, if you're watching this and not just listening audio right now, you'll see the graph has 3 colors on it, green, purple, and orange or gold. The green and the purple pretty much represents revenue from new people. So if we were to take away all that gold and redo this graph of just the green and purple, I don't think the graph would be as impressive. It would be, it would be showing some increases, but not nearly as impressive as the gold. What does the gold represent? That gold represents the revenue from their wellness patients, the maintenance people that are on recurring revenue that have been with them for years. In fact, I believe the next slide shows— let's see, I think, yeah, this slide that I'll show one more slide here. This is showing from right now that we're recording this right now. It's March of 2026, and it shows on the graph March of '26 through January of 2027. So into the future, and this practice is collecting about $150,000 a year. On the books scheduled to occur every month for the next year into the future. And that's how, how would you feel if your practice looked like this, where you knew you could stop marketing tomorrow if you wanted to, or just take a vacation, and the systems are just— that's profitability.

So at the end of the day, at the end of the day, I want to clarify for our audio-only people, we're looking at future revenue of $150,000 month predictable revenue over the next year in cash collections.

And that's the beauty of recurring revenue, right? The beauty is, is that— let me, let me back up for a second. The profitability and growth of that practice was 90% influenced by the gold section of that graph. That's where the growth was really happening. And that's where I want the kind of the takeaway message to be is that if you want to grow your practice and have retention and have all of the That's where the profitability is. It's in that, it's on the back end. It's not on the front end of getting new people in the door and just processing a bunch of new people. It's getting lots of new people in, putting them in a system that truly turns them into lifetime wellness patients. And I think that's, I think we could agree, the audience listening, that's, we're all on the same page, right? We want to get people in, we want to put 'em through a, a form of corrective or rehabilitative care, get 'em to maximum improvement, have 'em transition to maintenance or wellness. If that's the model you want, you're in the right place. That definitely— that, that's the model. And my experience has been, doctors listening right now, if I put into a chiropractic Facebook group, what do you believe is the most important thing for retention, I'll get 90% of chiropractors talking about patients need to get the big idea, they need to understand the value of chiropractic, they need to understand what we do. And there's some truth to that, but I'm going to be be frank with you, it's a lie. That is not what drives people to stay with us. We've been lied to. Because right now I know for a fact every one of you listening right now has a patient who got the big idea of chiropractic and they still dropped out of care. I know you have them. Every time I say this in a live audience, every hand goes up. I have Mary, she got the big idea and she dropped out. And you had lots of these people. And I also know right now you have people right now who've been with you forever and they are retained patients and they don't have the foggiest idea what a subluxation is, but they've been with you for 20 years. And I came to, I came to realize, and this baffled me, that people got the big idea and dropped out, and people didn't get the big idea and stayed. And I said, there has to be another reason. There has to be another thing that drives people, these people's behavior to stay with us. And what I identified was, yes, patient education is part of it, and them understanding as a piece of it, but it is not the most important thing. The most important thing is really how did you set up their program? Did you get them on a plan? Did you automate payments? Did you stop reminding them of the money? Did you make sure you gave great service? Did you give people feedback along the course of care so they know they're making progress in a way that makes sense to them? There's a number of things you do, and I'm just kind of emphasizing this point because chiropractors, we live with our blinders on. We have our viewpoint of the way things are and And again, I don't think— I don't mean to get on my high horse here right now, but as chiropractors, we always think just educate the crap out of people. And I don't think anybody's a better educator in healthcare than chiropractors. I mean, we go to seminars to learn how to give talks, right? We go, we go and invest in our ability to educate our patients. And in spite of that, people get educated and they still don't listen. Like every one of you listening right now, I know you know someone who knows they should be eating better. Or exercising more, or quit smoking. They know it and they don't. They have the knowledge and understanding to change their behavior, yet they don't. And the reality is, is we're dealing with patients' behavior, the behavior of them showing up and following through. And don't mislead yourself thinking you could just talk them into listening to you. My point being is, is you have to have a system in place that facilitates the process of them following through and listening to you and sticking to care. That's ultimately what we're trying to drive here, is that The money is a side effect of it, but it is a major impact on how that actually, how people follow through with care. That's been our experience. And people might go, well, who's Miles to have some expertise on this? In my own personal practice, I'll just speak, you know, I've, like you, Pete, I've, I've consulted now and talked with thousands of practices. We have this perspective of thousands of practices. But just from my own personal experience and practice of 20 years, when I retired from practice in America, the average PVA right now is about 12 to 16 visits. For the, for a chiropractic patient. In my own practice, my PVA was just over 300 visits at the time of retirement. I think we have some knowledge around the world of what it, what's involved in retention, but retention with profitability. We wanna make sure we got that clear, right? We're not giving away our care, right? There's, there's revenue and profitability going on here. But bottom line is you gotta have these systems and, and, and that case study is a good illustration of what we're talking about there.

Made a comment earlier during our conversation today about James Clear's work with the Atomic Habits, and you're speaking directly to it, is if you wobbled or didn't ever have that system in place, you never really developed the habit, right? There was no behaviors and the outcomes have never showed up. So if you're listening today, and I just want to speak to our audience in a very just real way, like if you're listening to this and you're challenged, good, but don't be discouraged. Right? Don't get— there is hope for you. There is. There's, like we've said, this is a great time to be in chiropractic. It's a great time to be a chiropractor. It's a great time. We have the technology at our fingertips, systems. We have better systems. We understand the value of systems. Systems for interviewing and hiring A-players, systems for training and developing your people, systems for, you know, attraction, conversion, retention, team building, collections. Like, it's, it's there. So much support. You're not alone trying to figure this out, trying to wing it on your own. And you have an amazing resource, and resources like Cash Practice Systems to help you get the money part right, get the systems in place. So that— I love that graph, 2007 to 2026. It's like, whoa. And if you saw the graph, there was like these inflection points, and you realize, what if, you know, that, that— I love the image of the person like digging for gold, and they're like chopping away, chopping away, chopping away, and they're like get this close when they're like, turn around and give up. So many of us, if we just stick with it just a little bit longer, stay with it just a little bit longer, just right on the other side is just the next breakthrough. 2026 in TRP is the year of breakthrough. And just speaking with you, Holly, and Dr. Miles, I just feel like there's an opportunity for many who are listening to break through. And you've been struggling and you maybe couldn't raise your hand and say, I need help. Maybe you just haven't been able to be honest because, you know, money issues, it deals with our identity, right? We start to— we take it very personally and we struggle. And so I just want to encourage you guys, if you need help, reach out. Reach out. You don't have to go alone. There's no judgment zone here. You know, everybody's here to say, hey, we're here to help. We've all been there. Everybody has their own— we all have our struggles in different areas of our businesses and lives. And, um, chiropractic can be a very lonely road. I've just found that talking to a lot of docs. Can be lonely, and lonely is scary. But you don't got to go alone. So number one, if you need any help, reach out to me. And obviously reach out to Dr. Miles and Holly. How, how can people By the way, you had said earlier in the show you were a little bit all over the place. You weren't all over the place then. So yeah, I think it all came together. So we all felt it. I just want to put a bow on it and say thank you. And also, you know, if there's people in this who are listening and says, hey, I need to chat with you guys, talk through some of these things, these are the people we're recommending you chat with. So how can they get in contact with you?

So I'll share real quick and then I'll let Holly have Holly chime in here. I just wanna make it clear on why they should reach out to us. Like, what is the challenge they're facing? You know, we're talking about retention and systems, but let me just give you like a concrete solution to what we provide, uh, and what we can really help you with. We can help you with retention, no doubt. That is what we do. The question is, what are you getting from us? You know, we're not a coaching company like TRP. You go to TRP for the coaching, although we can coach in the, the application of our stuff, but that's not our role. Our role is we give you the actual tools. We literally give you the system software to use that will help you do the things you need to do. And let me just make it really clear for everybody. The, the key things we help you with is number one, it comes to your care planning. You can't make this stuff up. A care plan, financial plan, it's a legal document that you're reviewing with a patient, uh, or for them to agree to get care. Don't make this stuff up on your own. Don't make your own spreadsheet and copy your buddy's terms or whatever. There's specific language you need. It's, it's really important you get this right. Like I said, the, the second leading reasons doctors will get in trouble— you might be asking, what's number one? Unfortunately, the number one reasons doctors get in trouble, whether it's true or not, is allegations of sexual misconduct. That is the leading reason doctors end up in lawsuits. The second leading reason are issues over finances. So let's make sure you're not having issues with finances. So please reach out to us if you need help with your care planning. You may think you're doing care planning right. We'll at least evaluate what you're doing and give you the thumbs up or the thumbs down and let you know whether we're a better service for that. We also give you the ability to process payments. So they'll talk about money and recurring revenue. We have a whole system for recurring revenue for your credit card processing, your bank EFTs, for online payments, for, you know, what that integrates with your EHR, everything for your merchant processing. We handle that for you. When that subject matter always comes up, people always ask, you know, what about rates? And I can say this without getting into details or over, you know, without overpromising, underdelivering. We can ensure that whatever you're doing, we will give you better service. And in fact, I can, I can guarantee that if you look at our reviews online in comparison to some of the others out there. And number 2 is you'll pay no more with us and likely you'll pay less with us. And in many cases, we're able to save doctors money when they do the merchant processing with us. I'll say one more thing in that topic, and that is if you are with another processor and you want to switch to us, we make it really easy to make that switch. We're often able to import and transfer all your auto debits over if you have recurring revenue. Able to do that work for you in many cases. And we have some other systems as well. I don't want to necessarily— I don't necessarily have to go into the other systems we have. We have a tool for feedback and one for email marketing, some other tools as well. But the primary thing I want to make sure you're aware of is we are a— we are the resource for doing compliant care planning that's built on a business model that works so well, as well as your payment processing. That being said, the way to get a hold of us is you can go to cashpractice.com. For those of you who are TRP clients, you can go to cashpractice.com/TRP. If you're not a TRP client or you're a cash practice client, reach out. You know, if you're a cash practice client, thanks for watching and listening as well. If you're, uh, if you guys are neither of ours, please reach out to either one of us. We'd be happy to be of service. Holly, I'll let you tell you, say the last few things regarding how to get a hold of us.

Yeah, I'll just mention, so who we best serve is anybody who's looking to be a growth-minded practice and you're ready to stop trading time for dollars and you want to build scalable systems-driven businesses. Um, so whether you're a multi-clinic, high-volume, you need to be able to have automated systems that maintain your professional financial standards. That's us. Whether you're cash-based or a hybrid with insurance, we serve you. I know our name is Cash Practice, but a majority of the practices that we work with are hybrid. They're cash and insurance. Or you're looking to transition away from insurance and have some stabilizing revenue with recurring payments and care plans, that's us. If you're a retention-focused leader in your space and you understand the value of long-term wellness, not just new patients, that's us. So we help you in any of your seasons, whether you're launch, build, scale, or exit, we're here for you. cashpractice.com/trp.

Here's who we're not for. If you're a doctor who just wants to get them out of pain and out the door, then we're not the answer for you. If you're not that, everybody else, for the most part, we can provide tremendous value to.

Well, one of the things I can say as we wrap here is that you do provide tremendous value for those who you serve, who I also serve. So I can speak with confidence about that. So thank you for helping the doctors who we serve, who you help be more successful. They experience more financial peace. They have more— a deeper sense of security, which those, those are things you can't really put a price tag on. It's hard to when you have people in your corner who you can trust, who can help you, who have an expertise, knowledge base that they can share and help you achieve your goals. So for CEOs who— all of us who think in terms of what's important now, What's important next and what's important ultimately. Today was a conversation about ultimately this is what's important. So what are you gonna do about it now?

Correct.

Thanks for joining us on this episode, Dr. Miles and Holly. Thank you for being a part of our remarkable practice enterprise partnership. Thank you for investing in this community and people that we serve and for joining me here today. And until we meet again, until our next podcast next week. Take care, everyone.

Thank you so much.

Thanks, everybody.

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. It's Coach Dr. Eric Janowitz here. I'm excited to be in studio today with Mark from Aspen Live Well. Mark and Aspen Live Well is one of our Remarkable Success partners, and we just love our Remarkable Success partners because they help further our mission of helping our docs help more people. So welcome today, Mark. It's great to be in studio with you. Please take some time to tell the audience a little bit about you and what your business does.

Sure, sure. So, I was a college basketball coach for 17 years. Got out of coaching in 2010 and started the whole body cryotherapy industry in the United States. So I was the originator, one of the originators of that industry and launched that. Got involved in light therapy about 2015 and then went into that full-time about 2018. And I'm now with Aspen Live Well. I'm their VP. And we've got 4 brands under that. We do Class 4 medical laser. We do whole body, full photobiomodulation light beds. We do panels for in-home use. And then we do topical, the world's first optical clearing gel for on-skin and off-skin laser and light panels.

Great. That's great. And so, you know, we always are teaching our remarkable CEOs out there that, that every business exists to solve problems, right? So can you kinda share with our listeners what problems do you guys specifically solve for chiropractors?

Yeah, I mean, light is a photochemical solution that most chiropractors can't address in their office. You, does it mean that adjustments don't have some chemical reactions in the tissue? They do, but not at a photochemical le— what level that would be like injecting somebody or giving somebody a chemical a drug. So, so first, it would be like morphine. I can take a laser and have a morphine or tramadol or Toradol effect on a nerve. I can turn a nerve off within 10 minutes of the first visit and get 90% of people pain-free right away. So that, that's pretty amazing in and of itself. But then that— the real benefit of light is the long-term tissue repair, ligament, tendon, bone, muscle, brain, disc, skin, all of those things. Every tissue in the human body heals about 30 to 40% faster with a photochemical infusion of light. And whether that's a laser or a panel or a bed, we're still getting those kinds of responses. So the first problem it solves is it gives chiropractors a whole nother patient population that they currently can't address with traditional chiropractic or decompression or the things that they're doing right now. So it's a whole nother SKU. And in business, we're always looking for as many SKUs as we can to bring revenue in. So it brings people in the door that may also take chiropractic services or may leave their chiropractor and go, well, I can go to my chiropractor and then I can go over here to, you know, Dr. Demartino and do light therapy. But why don't I just put everything over with Dr. Demartino and do it all at one stop? So that's the other part. The real problem we also serve for chiropractors is we give them a business within a business revenue stream that doesn't involve their brain, their time, and their hands and their back. A light business can operate completely independent of the chiropractor. Chiropractor doesn't have to be there, doesn't have to meet the patient, doesn't have to do an assessment, doesn't have to write a prescription. The staff can run the light therapy business and produce as much or more revenue than a chiropractor can produce with their own time and their own hands or their own talent. So that's a pretty big metric for everybody that's in the Remarkable Practice that's in that looking to scale, right? How do you scale if you're just one chiropractor and one assistant and one front desk billing girl, right? You can only scale so far and you can't clone yourself, right? And And assistants are more expensive, right? So staff and payroll are more expensive. So if you can clone a business within your business and it doesn't involve you and it can send you revenue, we call that freedom, right? I mean, that's when you get exit, when you get all the way to scale, grow, exit, that means it's sending me money and I'm, I can choose to continue to work or I can choose not to continue to be in the office and it still sends me money. And that's really what the light therapy business does for, for chiropractors. Absolutely.

And like you said, it helps solve complex problems when the body can't heal itself, right? And as chiropractors, we, you know, we remove subluxations to allow the body to heal itself and the body can do that. But when you can use other services that speed that process up, it's a huge advantage for, for the patient obviously, but also for the, for the, the office as well. And so just for my listeners to say, no, I use, Mark's, you know, Class IV laser in my office. We implemented it last year and it's just— it's pretty amazing what it can do. I was always kind of skeptical because I was always that hardcore chiropractor, no adjustment, only adjustment only. And then my— it's actually my associates that twisted my arm into getting one. And it was— it was amazingly impressive. And what I love about it is that it sells itself. Like what Mark said earlier, that literally he can turn off a nerve in like 10 minutes, like a treadmill does. It does that. And so it, it's the easiest sell ever. And we just started to offer it to our existing patients who had maybe other issues, knee issues, hip issues, or even spinal issues that just weren't progressing as fast as they want. We offer 'em a free session, right? And, and literally the free session sells itself because this person who's had years and years of chronic pain, let's say it's a shoulder issue, you do a 5, 10-minute session with laser, they go from a 10 outta 10 to like a 2 outta 10.

Yeah.

And suddenly they have this massive range of motion, like, Holy cow, I've had this for 10 years and now I can move like I haven't been able to in over 10 years. Now, obviously that doesn't last. We need repeated sessions to reinforce that, but it sells itself because they're just like, oh my gosh.

Right.

Whereas most services don't give that immediate response, but it sells itself. So we offer a free session, existing people, and boom, they just buy packages. It's really a simple thing in the office. So, yeah, super powerful.

Yeah.

And I appreciate you guys for providing that.

Yeah.

So You know, CEOs, we always talk about, you know, anything that we do, we want to get a positive return on investment for it. So how do you guys provide that positive ROI for docs? You kind of went into this a little bit, but I don't know if you can share like some of the, you know, the financial benefits that offices can see. What kind of return do the offices you guys work with typically see from using your services?

Yeah, from the laser, you know, we see anywhere from $12,000 additional revenue per month all the way up to $30,000. It just depends on how many sessions you're doing a day. A course of care in laser is 6 sessions over the first 14 days. That's where we start everybody, no matter what they're coming in for. We want to hit them with 6 sessions in 14 days. That package usually in the United States sells for somewhere around $360 to $450. So if you're selling 3 six-packs a day, it's over $1,000 a day of laser revenue. We don't really do it by how many sessions we do because those are prepaid packages, but we do it by how many laser sessions we sell a day. So what I talk to most docs is when I do a demo day, it's to say, okay, now you've seen these results, you've seen us do 15 patients and get 15, 15 out of 15 results, 100% batting, 1,000% batting average, right? How many six-packs do you think you could sell in a day? And they're, they're like, oh, a lot. I said, do you think one is— they say, well, I think, yeah, that's a pretty low bar. Well, great. I mean, if you're selling one six-pack a day, you just put another $6,000 into your bank account. And that's our super low bar. I've got docs selling 5, 6 packs a day. So that's kind of the light there. The light bed is even better because it can actually operate 24 hours a day. It needs no practitioner. So you could have it memberships and we do that in membership. So you could say we're going to have memberships and people come into the office anytime we're open and do it. And then after hours when we're closed, they just give a little key fob, just like your gym, right? Your gym is open 24 hours a day, most of them now, and nobody has to be there. You just slide that key fob, and if you have an active membership, the door unlocks and you go in and do it. Well, the Theralyte can be done the same way. It unlocks the front door and then unlocks the room. Now, everything else in your office is locked up— records, laser, right, you know, nutritional— that's all locked up. But the Theralyte room and the front door open with that key fob. Now you have a 24-hour income with zero payroll attached. That's the dream, right? Payroll is the most expensive thing we can do in business. And then when you've got the Therago, which are our light panel products, doctors are now selling our Therago panels to their patients for in-home use because the patient may say, look, Doc, I love coming up here and getting the whole body Theralyte, but I can only come twice a week. Is there something I can do at home to kind of accentuate and add to kind of homework, right? We're always looking to give patients homework. We know that when we— they come in once or twice a week and we adjust them and they go home and do nothing else, that's, that's an uphill battle. But if they'll participate and be compliant in the things we're giving them to do and the bridging exercises and all the stretching, right, they'll be better. So the same thing with light. People want something to do at home. So that's what the light panels. And then the last thing is the topical, which is Lucium, and that has just now hit the market. That's the optical clearing gel. You sell that to your patients. On the light bed side. They put that on their skin and then they get in front of a light panel or in the Theralyte bed, and that makes the skin no longer be a barrier to light. Where light is absorbed, it passes through like a window and goes deeper into the tissue. And then on the laser side with Lucium, you wouldn't actually sell Lucium to your patients, but Eric, you're going to find out when we send you next month your first bottle of Lucium. You're just going to put that on before you apply laser And you're going to have another level of response that you, you, you're, you know, ecstatically happy with what you're getting now. But now with that gel on there that optically clears the skin, light goes through even deeper and you get a faster result. So what's taking you 7.5 minutes on average to do right now with the laser is going to drop down to about 5 minutes, if even that much. So pretty amazing result with that. So all of those sweet package really build a business within your business. Again, that you can be gone for a month and you're— that business operates without you as a practitioner.

Yep. It's that monthly recurring revenue model we love to have as CEOs as well. Yeah, that's great. And, and my experience was we, you know, we got a pretty nice high-end laser that, you know, wasn't cheap, but within 4 months it was paid off. And we honestly didn't even promote it that well. We could have probably done a way better job, but in 4 months it's completely paid off. And so everything now is just pure profit that comes in from it. And, you know, patients getting great results.

So with light therapy, you go from being pursuing and trying to sell and convince to, like you said, give them that first session and then they say, can I come back tomorrow? And usually it's no, but I'll see you in 48 hours. Right. It's a process, not an event. We just follow the process. But it makes your staff— a lot of us have a really good as practitioners in closing, but who's the main closer? It's not us every time. It's our, it's our staff. And some of them aren't real great at that yet, and we're coaching them and we're sending them to the remarkable practice and we're teaching them how to close and overcome objections and reverse the risk if the patient's gonna walk out the door and they're not gonna buy, right? But the, the light therapy part of it makes the patient pursue them. So I've taken some really terrible closers and had them at about an 80, 90% close rate cuz all they have to do is apply a laser and go, Say nothing. And the patient goes, I wanna do, I wanna come back, I wanna do it again. Can I buy more? And I like, yeah, well let's, let's start you with a 6-pack. We just did the first one. Let's buy 5 more and we'll schedule you for 48 hours from now. We'll have you come back in again. So that's a really refreshing change. And then if you, if you look at the explosion of full body red light therapy right now in the marketplace, it's amazing how rampant it is and how fast it's growing. So now you have people going full body light therapy near me. Boom, you pop up, they walk in the door and you haven't spent a dime bringing that, that new prospect in, right? We're always— cost of customer acquisition is really important. When you spend $0 on customer acquisition and they buy a $200 a month membership and stay with you for an average of 13 months, can you beat that return? I mean, you can't beat it in the stock market. So it's a pretty good rate of return.

Oh, absolutely. And what I really love about you guys too is your customer service, like your onboarding. And so like I'll share with the listeners, you know, when you— one of my hesitations about bringing laser in is I just didn't understand it and I didn't know how to sell it. Right. That was really one of my things. And but what you guys did so well is you, you know, you know, Mark came into my office, flew to my office on his dime, spent a whole day with my team, explained like the chemistry behind it, like what light does in the cells and why it works so well. And so my team would understand on a very basic level. And he told me, he had me do something. I was shocked. He said, bring in 10 of your, your biggest challenges, their patients, yours, bring 'em in and we'll do a free session with them and I'll walk you through and actually do it. So we did that. We brought in some really challenging cases and these people got unbelievable results. Like unbelievable. I mean, I'll share the one guy had horrible knee arthritis. I don't know if you remember this guy, Mark, but horrible. He is probably only 60, not that old, but man, horrible knee arthritis where he kind of walked crooked. 10 years of this pain, did laser on both of his knees. He was able to walk normally with no pain.

No pain.

And he was just blown away. And, and, and so I was like, I could not believe immediate results happen with that. And so it's, and so I love how you guys really kind of hold the practitioner's hand with you, explain it all, you, you train the team how to do it. So it's, it's just a really easy onboarding process and just makes everything much simpler.

So I really appreciate it. Yeah, I always prefer to do that in person. I mean, they, yeah, a lot of them will do, send you a manual and do some online courses. And I, I think that face-to-face person, cuz we're not just showing you how to use the device, we're We're showing you how to educate the client. Your educated patients are your best patients that know why you're doing what you're doing. They buy in, they, they're compliant with everything you ask them to do because they have the most education. The people that are just there and go, I just walk in, get fixed, and walk out and really don't think about it, they tend to drift off. And, and that— now we talk about ROI again, lifetime value of a patient decreases the higher the education the, the higher the lifetime value of that patient, the longer they stay with your practice.

Absolutely. It's great. So, Mark, tell me, where can our, how can our listeners connect with you guys, learn more about what you do?

Yeah, I always just give people, I mean, obviously you can go to the website, askthenlivewell.com. It's got everything under there, all 4 brands. But I just give people my email and cell phone that I like people just call me directly. I mean, I have thousands of clients like you across the world in 21 countries. That have my cell phone, and that's the way I like to do it. So email is Mark Murdock, first and last name, M-A-R-K-M-U-R-D-O-C-K, at aspenlivewell.com. And then cell phone is 214-641-1827. If I'm not asleep and I'm alive, I'll answer.

That's true, you always do when I text you. So that's great. So listeners, definitely reach out, see how Aspen Livewell can help you guys help more people. So I want to thank you so much for being here, Mark. Thanks again for being a success partner, for supporting our— the TRP, supporting all our clients, and again, just helping our docs impact more people in our communities, which is what TRP is all about. So Remarkable CEOs, remember to tune in each week to the Remarkable CEO Podcast. Everyone have a blessed day. We'll see you guys next week.

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.