360 - What 500 Chiropractic Clinics Reveal About Growth and Profit

What I realized early on in practice is that most chiropractors don't have clarity on decisions. You know, they're talking to a random friend that they went to school with, maybe someone across town, maybe someone at a random conference, and they're like, what are you doing? Oh, I'm doing this. Oh, maybe I should do that. Oh, does that work? Oh no, maybe try this, you know. And it's a lot of just like testing, trying, gut feel, not really good systems and operations.

Hello and welcome to the 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 Franson. Welcome to another episode of the Remarkable CEO Podcast. CEO Podcast, chiropractic's number one business podcast. I'm Dr. Pete Camiolo, and I'm here today with my good friend and colleague, another CEO, Dr. Josiah Fitzsimmons. Dr. Josiah, it's great to be together today.

Yes, thank you for having me.

So Dr. Josiah is the founder of multiple businesses. One of them we're going to be speaking about today, Lucro, And today we're gonna have a conversation about money and really having a deeper understanding of your business. And Dr. Josiah, you and I have been talking about something that you're gonna be sharing with all of our doctors and listeners here today that you've been working on behind the scenes to build and give us all greater insights into understanding the business side. And we had our TRP Business Immersion earlier this year. We have the Practice Immersion coming up. And if you've been listening to our podcast, you know how Dr. Frantz and I talk about the two sides of the coin. You have the business side, which is the output, and then you have the practice side, which is the throughput of your business. And we've been speaking and teaching and communicating and having conversations around that language. Well, today we're going to combine those two because Lucro does that so very well. And Lucro is built on the conviction that, you know, chiropractic is one of the best healthcare products in the world. And I hope everybody that's listening agrees with that. And if you don't, well, just message us afterwards. But I believe you're here because you believe that and that you know, chiropractors are leading this charge and the doctors that are leading these practices deserve to have a far higher level of financial clarity and insight and strategic support than what the industry has traditionally had access to. So the vision has always been to help chiropractors not just have accurate books, but better understand their businesses, grow healthy and profitable practices, and make stronger decisions with confidence. And I know for me, Dr. Josiah, as a coach working with CEOs who work with Lucro, this is happening. The keyword: stronger decisions with more confidence. So I'm grateful for you and for the work that you've done and the vision that you had in, um, creating this amazing operation in Lucro. And so we're gonna be talking about a report that you've been working on now, been gathering data for years, and this is a report that represents this culmination of years of data working, coming alongside of chiropractors, working with them, gathering data all across the country. And I know we have doctors who are listening who are outside of the continental U.S. You're going to benefit tremendously from what Dr. Josiah has been discovering with he and his team as they've been analyzing the data they've been gathering diligently for years. So, Dr. Josiah, I mean, I know how fired up you are about this. Tell us a little bit about yourself other than the fact that you're just an awesome husband and father and coach of your kids' teams, which I always talk about that when I'm on the podcast. So we were talking about that right before we pressed record here today. But Doc, give our CEOs, if they don't know you or know about you, a little bit about you. I'd love for you to introduce yourself.

Yeah. First of all, husband, father, man of faith first and foremost. You know, that's what matters. You know, at the end of the day, faith and family at the top of the list and everything else that comes down. After that. And so, you know, for me, that's really where it all starts, you know, in the morning, in the Bible, you know, getting my mindset straight, get being heading in the right direction. You know, what's really the purpose that we do anything, whether it be running a practice or any type of business or working for somebody or whatever you want to do? You know, we have to have a purpose and a mission that we're on bigger than ourselves. And, you know, that's one of the things that I love about my faith is the ability to impact people. And that's one of the things I love about chiropractic is the impact that we can have. And I know Dr. France and I have had great conversations, you know, outside of the purpose of changing people's lives for Christ. What's a better purpose than changing the health trajectory of another human being? And so that's why I think, you know, chiropractic is such an incredible opportunity, you know, to have a much greater purpose on this earth, you know, than just most other companies and organizations that are doing things, you know, that don't really impact the kingdom long term. And so that's why I love, you know, chiropractic on its own. And then obviously with TRP and Lucro's missions to help advance, you know, chiropractors and advance the profession as a whole, we have such an incredible opportunity to give chiropractors more clarity and insights on how to grow and scale. You know, that's really what I did for my own self to grow my own clinic, you know, to $1 million my first year in practice, to $5 million, to $7 million, you know, in one location. It was really because of some of the insights we're going to talk about today on the podcast. And like you said earlier, having clarity in decision-making. And that's really what I realized early on in practice, is that most chiropractors don't have clarity on decisions. You know, they're talking to a random friend that they went to school with, maybe someone across town, maybe someone at a random conference, and they're like, what are you doing? Oh, I'm doing this. Oh, maybe I should do that. Oh, does that work? Oh no, maybe try this, you know. And it's a lot of just like testing, trying, gut feel, not really good systems and operations. And I know TRP has made a huge impact on the profession with Chiropractic Operating System, a huge impact on my own practice, you know, implementing the Chiropractic Operating, you know, System. And so that's really what we want to fundamentally do with LuCro is give additional insights, data, and value to make better strategic business decisions to continue to grow and scale, get to the next level, and more importantly, you know, impact more lives.

So you've done such a good job of this, Doc. Systematizing, organizing. I remember the first time I sat with you and you showed me the app. You pulled up your phone, we were having dinner, and this was earlier days, right? Like, you guys had started, but it was like, it was still like newer. And I thought, man, this has such huge potential. And now here we are a couple years later, and I'm, you know, more and more doctors are, are working with you. And benefiting from having Lucro, I would say, on their team. And I see the data, I see the results, I see the confidence. Some of those attributes you discussed where historically chiropractors are two parts gut, one part data. We're now flipping that into two parts data, one part gut. You still have to use your gut, use your intuition, use your experiences, have those conversations in the hallways at conferences and call buddies up on the phone, of course. That's part of it, but let your decisions ultimately be data-driven and having that confidence to be able to do that. We now have that, and that's something that you're going to be sharing with all of our, our listeners here today is, is that. And so first of all, I just want to let everybody know Dr. Josiah is going to give you guys this access to this report, which is just incredible, right, Doc? You'll tell them a little bit more about the report and we'll add it into the show notes. You can easily get the gift that Dr. Josiah is going to give us. But, um, Doc, let's have a conversation today. I want to hit 3 things ideally, and I'll let you kind of decide where you want to go with this. I wanted to talk about number 1, building blocks. We want to talk about the revenue, the team, and the marketing, and how you've been able to take the data from, you know, 500-ish offices over years of time now, and you've been able to distill it down to some really great insights for us today as we're listening. So, Talking about revenue, the building blocks of that, the team and the marketing. Second, I want to talk about costs, you know, understanding the cost, cost structure, overhead, and how to get better control of that side of the business. Have a conversation there and what you guys are learning and what you can share with us today. And then the third would be profit. You know, the word lucro means profit. And, you know, this is at the end of the day what this is about, helping doctors have greater profitability so they can make a bigger impact. Have a bigger impact, income. Ultimately, that's what this is in businesses for, right? So let's do that. I'll let you kind of steer how you want to go. But if we can hit those 3 things during our conversation, I know we're going to go back and forth. That'd be awesome.

Yeah, let's do it. Let's jump right in.

All right. So talking about the building blocks of, you know, top line revenue, you know, we thought— we think about this, you know, most docs, when you ask them in the old days what your stats were, it was usually like how many new patients they got, how many adjustments per week. And what their top line revenue is. We know that, you know, revenue is vanity and profit is sanity and cash is king. I think that's the quote. I forget, but it's something like that. So first of all, if you want to frame this out in any way, like when you're having a conversation with a doctor, somebody who's listening in, help them understand like the way they need to be thinking about revenue and their team and their marketing as building blocks for building a successful practice and business.

Alex, yeah, absolutely. I mean, the first thing that I always talk about when trying to maximize revenue is maximizing what you're already paying for. So that's something that we are really, really big on with Lukro on our initial strategic planning session. We map out, you know, here's where you are, here's where you want to go, here's how you get there, here's all the financial opportunities or bottlenecks that are maybe preventing you from accomplishing that already. One of the top things that we, that we always talk about is You know, whether you have 100% full schedule or a 50% full schedule, your rent doesn't change, your payroll doesn't change, you know, your electric bill doesn't change, or, you know, utility bill, you know, most all of your expenses don't change whether you're maximizing your expenses or not maximizing your expenses. So when we're talking about revenue, okay, we want to maximize revenue as much as possible, but the great thing about our service-based chiropractic business model is that we can increase revenue quite a bit with expenses not changing a lot, right? And so that's one of the biggest things that we talk about so much, is that's the biggest opportunity for most clinics to grow very, very fast, is increasing the top line revenue while most expenses don't change at all. And so therefore, profit margin can really dramatically go through the roof. And so, you know, like I said, we're going to get you guys a download of what we call the Lucro report. And so it's accumulation of all the data across all of our clinics— what's working well, what's not working well. We're going to come out with a salary guide— what's everybody getting, you know, paying their associates, their doctors, their CAs, you know, what's a pricing guide, what's everyone charging for adjustments, exams, X-rays, decompression, you know, whatever different services that might be offered. But from a pure revenue standpoint, getting into the numbers, you know, we found is the median annual revenue across the clinics that we work with last year in 2025 was $813,000. That was the annual median revenue, whereas the top 10% performers, their median revenue was $2.1 million. But either one of those, the adjustment fee that they were charging was about $61 or $63. So really almost no difference in someone making $2.1 million versus someone making $800,000 a year. As far as what they're charging for adjustments. $61 versus $63, right? So what's the difference is those people, you know, making $2.1 million are doing a much better job of optimizing what they're already paying for, and they're generating a higher overall weekly number of adjustments. So those $2.1 million clinics are doing about 300, 300 visits a week, whereas the $800,000 clinics are doing about 170 adjustments a week. So maximizing what you're already paying for, you know, if you have an associate doctor, if you adjust 50 people that week or 150 people that week, he doesn't cost any more, you know, depending on your pay structure. Maybe if you're 100% commission, you know, based, you know, but a front desk team member, you're not paying them any different whether 100 people walk in the door or 300 people walk in the door, you know, for the same number of hours. So with revenue, that's really where I always want to start with Dr. Pete is helping people understand that premise. You know, the type of model that we're in. And so the whole goal should always be to maximize what you're already paying for. And that's really my simple framework for scaling. It's 3 parts. Number 1, understand your capacity. Number 2, maximize your capacity that you already are paying for. And then at that point, then you can increase your capacity, whether it be more team members, you know, more hours, bigger location. But first and foremost, you got to know your capacity. Secondarily, you got to maximize the capacity you're already paying for. And then once that's maximized, then you can talk about increasing your capacity.

Huge. Yeah. I mean, I already love everything that you went through. So, I mean, if anybody's listening to this, you know, we're having a conversation, you're like, okay, first thing they can look at is what is their collection visit average? You know, what do they, you know, what do you currently charge? What are you paying? You know, like. What is that right now? Like nationwide, we're saying $61,000 to $63,000 from $800,000 to $2.1 million clinics, top line revenue, the average cost per visit. Is that how I would describe that? This cost per visit is $61,000 to $63,000.

Is that specifically for adjustments? The median, median adjustment fee for adjustment.

Okay. I just want to make sure that everybody heard that. So think about where you land as you're listening to this right now. Hopefully you have this data. If you're not working with Lucro, Maybe you have this data in your already, so hopefully you do. It's really important. So where do you land right now on, you know, on that spectrum? It's only a $2 difference. So obviously if you're below that number, that's something we need to discuss. If you're above that number, good for you. And let's see where, where some of the other constraints are though, you know, because the idea, Doc, you know, Dr. Eric Janowitz, maybe speak to this for a minute. You talked about understanding capacity, maximize your capacity and optimizing for your capacity. What, what, so there's constraints, you know, one of them is you talked about was team. I heard that come up just now. Yeah. There's other constraints. You know, I look at systems as being, uh, oftentimes a, a constraint. Training is a constraint. You just talked about, you know, the constraint of being able to capital, having capital to reinvest inside into the business, the marketing side as a constraint. Can you, I, can you talk to a little bit about what you are seeing just as you're analyzing? Some of those, you know, those foundational building blocks, the ones we just talked about, and how docs can identify where the constraint is and where they have an opportunity to grow?

Yeah, absolutely. I mean, you hit it on the nail, you know, Dr. P, with systems, operations, training, processes. You know, to me, that's all going to fall up under team, right? And it's like, if your team doesn't have good systems, they don't have good operations, they don't have good procedures, right, then that's going to be a reflection of the utilization and efficiency and productivity of those team members who are running a system that isn't very well thought out or isn't very well optimized, right? You could have the greatest team players in the world, but they don't know how to play the game, then they're not going to be successful. I don't know if you saw this, Dr. Pete, but I thought it was really cool. A few weekends ago, they had the NFL flag football team versus the USA football flag football team because there's flag football in the next Olympics. In LA and the USA flag football team who has no professional football players. There's just these random guys who had to go back to work on Monday. Yeah. At their job, just completely smoked all the NFL players in flag football and they scored every single time they had the ball. And if the NFL, like head coaches, Tom Brady, Joe Burrow, I mean, best players in the world on this NFL flag football team, like their strategy was literally to stall the game, to not let these other guys even get the ball. And so if you look at it from a pure talent standpoint, who had the most talented football players in the world? Obviously the NFL team, right? But who knew how to play flag football, right? These guys knew the rules, they knew the tactics, they knew the plays, they knew how to run. It's a different game. They had their systems, they had their operations, right? They, they, they had all the proper training in flag football, right? These other guys, NFL players were amazing NFL, best NFL players, a lot of Hall of Famers, right? And they couldn't beat these guys that were going back to their job as a bank teller, you know, on Monday in flag football. And so I think this speaks to kind of what we were talking about is at the end of the day, you have great team members, but they don't have great systems. They don't have great operations manuals. They don't know, you know, how to do a proper day one. They don't know how to do a table talk. They don't know how to have proper retention, you know, or set proper expectations and agreements with a patient, you know, on their initial processes, right, then they're just never going to be as successful as they could be, right? And so from a team perspective, you know, that's something that we talk about all the time with Lucro clients because team is by far the number one cost, right? So I said median revenue for the clinics that we work with, about $800,000. Median team cost little over $300,000. So about 38% of all revenue, you know, across our clinics goes right back into team. And that's by far and away the number one category, you know, where the revenue is getting put back into team members, right? We found that the average typical team size of the clinics we work with is about 6 team members—2 doctors, 4 support staff. And like I said, about 38% of their revenue is going back into team. Well, what we also found is based on their team, how many, you know, adjustments they can do, how many day ones, day twos, how many different appointment types that they can do. We've found that only about 63% of the team capacity is being utilized. Okay. So less than two-thirds of what's being paid for is actually being turned into revenue. And so that leaves an actual $268,000 of unrealized or untapped revenue potential in the average clinic. So the average clinic is doing $814,000. They should be doing another $268,000 on top of that. So they should be about, you know, $1.1 million clinic is the average clinic should be if they actually maximized their team capacity, right? And so that's really where we always want to start with is the fastest lever to increase revenue and growth within your clinic utilizing what you already have, right? It'd be taking those NFL players and, and teaching them, hey, in flag football, you gotta do this slightly differently. You gotta do this. They already, already got great people ideally on your team, but they might need a little training that might need a little optimizations that might need to understand the SOPs better. They might need to turn someone in, you know, from a believer into an understander. Right, Dr. Pete? Good.

I, I didn't know you were gonna go there with that, but I, I knew they were gonna play the game. But I didn't know they played it. I didn't know the outcome. So I'm gonna have to go back and check that out first of all. So that's a to-do for me. But hold me accountable to making sure I watch that game in the replay. 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.

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Thinking about the framework. Well, first of all, a lot of things you just said, so we teach, and maybe you can speak to this, the, you know, the revenue per employee, RPE, and we teach that. And I was just, I just did some math real quick while you were talking. I was like, okay, so based on 6 FTEs, it would have been like $1.5 million. But I said, okay, let's say one of those docs was the owner. I pulled them out and said, so it was 5, that's $1.25 million. And you said about $1.1, almost $1.2 million. So our math is very similar. And I came up with similar numbers, like, about $270,000 to $300,000, you know, below capacity. In other words, the capacity on those, that median team of 6, 4, you know, 4 CAs, 2 DCs, we're underperforming. That $800,000 should be at 1.1, closer to 1.2, really realistically. So those numbers really speak to what we're teaching as well. The RPE concept, which you obviously So I think that's a really important thing. So if I'm a doctor and I'm listening to this, I'm like, Dr. Josiah, that's us. Like, that's my business right now. Do I need to let go of my team? You know, generally that's not the counsel that you're probably giving them. I'm not saying we don't analyze the people we have, make sure we have A players. Can you talk a little bit about just when you identify that, wow, we are— I'm going to go with your number, 263,000 or 268,000 of untapped potential, I think is what you used. I was like, dang, I like that language. So We have $268,000. How do I show up to my quarterly board meeting, this next one, saying there's— we're leaving $268,000 on the table, team, the team I'm looking at right now. Like, we don't need to hire anybody because, you know, somebody's saying maybe we should hire somebody. You're like, time out. So how, how do you as a CEO yourself approach this conversation, this constraint, this gap, untapped potential gap? I don't know, man, just talk to our listeners a little bit about how they— if this is them, how they would approach that.

Yeah, absolutely. I mean, I would really start with the doctors first and foremost, you know, really understanding, you know, what the capacity of the doctors are on the team, whether you're solo doctor or, you know, multiple doc team, you know, what is the true capacity that you or your doctors can generate, you know, first and foremost. And so you really need to understand, okay, if you are a full-time doctor, what is your potential, right? And that's where a lot of people, especially as CEOs, Doctors, you know, head of sales, head of marketing, head of janitorial, you know, head of everything, you know, do-it-all, jack-of-all-trades doctor, CEO, owner, you know, that's where it can be tough, right? Because you got to do all these different hats, wear all these different, you know, do all these different things. And that can be tough, you know. But if you really understand, okay, at the end of the day, what can a doctor do that can generate the most revenue if, you know, if it was full-time in those hours? Within the hours that you work, you know, what actually is possible. And this isn't increasing your hours. I mean, all of our data we calculate is like, don't change your hours, don't change your staff, don't get a bigger location. This is just as is, you know, most clinics are already only open, you know, for, you know, call it 20, you know, 25 hours a week, you know, for actual patient care to begin with, right? And you have maybe those extra 15 to 20 hours, you know, CEO time, opening time, you know, other doctor. Activities and tasks, you know, so first and foremost, you know, the hours that you already have with the team members that you already do have on your team, what is their potential? You know, so like I said, for doctors, you know, for example, you know, we want to track exactly, all right, how many adjustments are they doing? How long does adjustment take? What is generated per adjustment? You know, how many reports are they doing, other protocols, and really understand, okay, what percentage of their total time is actually getting utilized for direct patient care revenue-generating activities, right? And that's where you usually find the first opportunity, right? Is that your doctors are probably doing a lot of other activities that you don't need a doctorate degree to do. And so that's a big opportunity, you know, where a $20 an hour team member could do something that $100,000 a year doctor is doing. And how can you maybe offload some of those things that your doctors are doing to team members that you already have on your team that would be super pumped, you know, to step up into a higher level position or, you know, to take on some of those activities, free up the doctor, you know, if the doctor can continue to do higher level activities. And it's really just, that's just scaling an organization. You know, Dr. Pete and I, we were just talking about before we, you know, started the podcast about C-level activities, right? You don't want the CEO of the company, you know, unlocking the door in the morning and, you know, changing the toilet paper. You know, maybe a humble servant CEO does it occasionally, right? But that's not, you know, their main role within the organization. And very similarly, within other positions in the organization, you want your doctors to be doctors as much as possible. So that's where a lot of that unrealized or untapped potential comes in, is really understanding how do you maximize your doctors to be doctors first and foremost, and then go down the next team members within your organization that can have the biggest impact on revenue and sales potential. If you have case managers, if you have tech CAs that are maybe involved maybe with the sales process or the signup or day ones or day twos, You know, then those people are going to have a much bigger direct impact, you know, on generating sales for the organization. You know, how well are they freed up, you know, to do those appointments, right? Because the second I hear a doctor say, oh, I have a waitlist practice, or, you know, people can't get into me for weeks, you know, first thing I think of is you probably don't have as good of systems as you think you do. You know, a lot of times doctors kind of get really proud of the waitlist and I'm like, if I got a waitlist, I'm like, dude, that's not good. Like we got people that aren't going to show up for their appointments because they're waiting too long. They're not going to schedule. They're not going to show up. You know, they're not going to sign up. That's going to take too long. They're in pain. They want to get out of pain. You know, obviously want to turn them into an understander, but most people, you know, don't come to us for that reason to begin with. Right. So, you know, just really understanding, you know, where your capacity is currently, what your potential is. And then like you said, trying to close that gap, you know, a lot of clinics are just sitting on a goldmine of increased profitability because most expenses, like I said, aren't changing. You know, to generate all that additional revenue. It's good. So let's double-click on that.

So I told— I said at the beginning that I wanted to talk about costs a little bit too. So we talk about protecting the profitability as you grow. You talk about how, you know, as practices grow, profitability depends not only on, you know, generating more revenue but improving cost efficiencies. Can you talk a little bit about what you guys have gained from your analysis, your visibility you know, what would be important for us to think about, be thinking about as CEOs, uh, and understanding our businesses better?

Yeah, well, the big thing is there's, you know, costs in your practice. There's fixed costs and there's variable costs, right? And a lot of fixed costs, things like rent, phone, internet, electric bills, not going to, you know, vary too much, right? Those are gonna, those are gonna stay the same whether you're generating $50,000 a month or $200,000 a month, right? So understanding you know, that cost as a percentage of revenue is going to go down, you know, with time, right? You're not going to have to spend any more on rent, you know, to be at 20% or 50% capacity. Same thing with, you know, your phone bill, you know, or a lot of your other subscriptions that you have, you know, whether you, you know, at 100% capacity or 20% capacity, those don't change, right? So understanding that those are going to become more efficient, you know, over time as you grow, right? And so just maximizing all of your expenses in general, whether it be team members, you know, or fixed costs, you want to maximize those because that's really where the profitability in the chiropractic profession finds. We actually found when you're going straight into profit margin is there is kind of this, this sweet spot, um, that we found, you know, the lower income practices, their profit margin is okay. The higher revenue practices, they actually start to lose a lot of profit margins because they kind of can get inefficiency with a lot of bloat., you know, an extra cost at the top and kind of those middle of the range practices, um, are actually the ones that are generating the highest profit margin because they kind of have that ideal mix where they're maximizing their capacity, you know, as best as possible. And so they're getting, you know, those fixed costs are really down. They're at their peak capacity. So they're getting the most out of their team members, getting the most out of their space. And so kind of trying to find that ideal sweet spot. You know, for profit is something that we've really been trying to dig into our data and figure out where that is.

You know, so speaking to somebody who's went big, right, you are— you have a, you know, $7 million, one-location size practice. You know, here you are saying, actually, we found that, you know, there's this middle ground. Can you speak to that? Because I think you and I both share a similar heart. We want to have more chiropractors having greater success, helping more people. Are we driving with our foot on the brake and on the gas? Like, what's your— any insights just to share with us as, as we're listening, we're learning, like you said, to use data to make decisions. Can you speak into that at all?

Yeah, I mean, it's a great— it's a great question. I mean, at the end of the day, that's why data is so important because, you know, you think, hey, doing more of this is just going to be better or doing less of this, you know, is going to be better., but it might not always be the case. And so that's where just that continual feedback loop, what's working, what's not working, you know, really gives you those insights, you know, into making those next best decisions. And oftentimes if, again, if you're making decisions with mostly your gut feel, you know, you might think, oh, this worked at this level, it's gonna work at this level. Unfortunately, that's just not the case. You know, there's definitely new devils at every level that you get to, and there's gonna be new things that you need to focus on that maybe didn't have to focus on at all. At your initial level. And then, you know, there's other things that you need to focus on way, way more, you know, at higher, at higher levels. So really understanding though that framework, you know, what got you here isn't going to get you there, you know, is really a big part of it. And it's just those are hard, you know, Dr. Pete, I think those are the, that's the nuance of being a successful entrepreneur. That's this nuance, you know, being a successful CEO is kind of getting that feedback loop because that's something I'll be the first to admit. You know, once I started learning how to scale and I got from $1 million to $2 million, you know, to $5 million, I'm like, I'm just going to keep doing more and more of what I did to get to that level. And then it wasn't working, you know, some things started breaking. You know, I didn't keep just scaling at this exact same pace by just doing more. There was new insights. I had to focus more. I need higher level people, you know, on my team and higher level people maybe want full health insurance coverage, you know, and they want 401 options and they want more paid time off, right? And they want, you know, better benefits, right? So those are all additional costs, you know, that I wasn't paying at a lower level that now I'm like, okay, well, I need to, I need to have retention of my best people. I can't build this incredible business and just continually having burnout and churn in my team members and, you know, trying to, you know, barely get by like I could on the front end, you know, and then, hey, I need to start going to more CEO roles. So I got to start getting things off my plate and You know, okay, now do I got to get a doctor to be as good as me, you know, at adjusting, and a doctor to be as good as me at sales, and someone to be as good as me at marketing, and continue to delegate and elevate. And so as you go through these growth cycles, you know, depending on what your strengths are, depending on the strengths of the team members you already have, you know, who do you need to hire? I mean, it really comes back to that who, not how concept, you know, that I know we love talking about. And so it's not just this perfect formula, you know, to go from A to B to C to D. For some people, they might go A, D, B, F, G, Z, you know. And so just kind of understanding your data helps you make those next best decisions when it might be a different decision for somebody of the exact same size as you, you know, across town.

Yeah, I'm so glad you said all the things you just said because I, I want our listeners, everybody's tuning in to just— I think everybody's looking for just the roadmap, just tell me exactly what I'll do and I'll do it. Not everyone, I should restate that. I think many people are, are looking for that. And I think what this— what you're giving people with this report is a framework, a template, something that they can use to help inform decisions. It's not telling them exactly what to do. And I find that even as a coach, you know, I have an opportunity to serve many clinics and I sit on the accountability chart as an advisor of some sort. And, you know, someone who has insight, somebody who has been down the road, somebody who's going down there with a lot of others. And I oftentimes will say the same thing, like, you can choose— there's a few different paths you can take. You have to do the thing that's in alignment with your vision and what success looks like to you, what you're trying to accomplish. You have to look at your core values. Always, always make decisions that are in alignment with your core values. And ultimately recognizing there's different seasons in your career and in your business, and you have to recognize what season you're in. So making the right decisions that way. And I think what's powerful about Lucro is able to do, and what we're able to do through these types of reports and insights, is we can make better decisions and you can have that peace of mind sleeping at night. You're going to be taking a risk one way or the other. You're going to quote unquote live with the consequences of your decisions, but as you ascend, And you ascend. We talk about the, the ascension of the CEO sitting in all three of your seats. You're an operator, you're a CEO, and you're an investor, right? You wear all three hats looking at your business through the what's important now, what's important next, and what's important ultimately. And being able to live inside of these three levels this way and these three levels this way, you find yourself here and you can make strategic decisions when you have this type of data. So Dr. Sy, I'm so thankful that you're a part of the Remarkable family. I'm so thankful for what Lucro is bringing to the Remarkable Money program, what you're doing for chiropractors. So can you just maybe remind everybody how they can get this resource? I believe we're going to add it as a link right to the show notes, if that's the simplest way. And then any way that they can get more information about maybe Lucro and what you guys are doing, and maybe if they need to have a chat with you or someone from your team, can you give us some insights? That'd be great. Yeah, absolutely.

We'll get— definitely get a link in the podcast notes to get the LUCRO report. Like I said, we'll also have a pricing guide of what are all the clinics that we work with, what are they charging for all the different pricing in their office, as well as a salary guide of what they're all paying all their different team members, as well as some really valuable insights. Because that's what I realized about our profession is we don't have a lot of consolidated data. And that was really my heart, honestly, behind LUCRO to begin with, is I want to help advance the entire profession as a whole but it was very difficult to understand what the top performers are doing. As I continue to grow and scale, I always was like, I don't know what I don't know. What are the next people doing? I try and find a few random doctors, you know, that are at that level that I could ask a couple, you know, random questions to, you know, but it was very much he said, she said, you know, there was some insights, but there was never really consolidated data for a whole profession. So that we really want to bridge the gap with Lucro, help advance the entire profession. You know, like I said, we have the greatest healthcare product. In the world. We have the second greatest purpose, you know, in the world. We have amazing people in our profession, right? But we don't have the profitability and the impact that we should have with amazing product, you know, and purpose that we are able to deliver on a consistent basis. So if you want to work with Lucro, you know, I definitely would recommend scheduling a strategy call with one of our Lucro doctors. Morelucro.com is our website. You can schedule a strategy call on there, but At the end of the day, we do your bookkeeping for you and we give you CFO-level insights, you know, to make action steps and to make better decisions. You know, most people just paying a bookkeeper for that one day a year they want to file taxes. You know, we want to give you insights on decisions that you can make every single month, you know, to optimize your capacity, optimize your profitability, scale your clinic to the next level, and start making those data-based decisions on a consistent basis so that you can make decision-making feel much more confident rather than, you know, I think I should do this, or I hope this is the right decision. You can really make lots of individual-based data decisions based on your own practice on how to continue to scale, you know, with extreme levels of confidence. So I would highly recommend, yes, scheduling a strategy call with one of our Lucro doctors, morelucro.com. And yeah, if you want to download this amazing report, we'll have it in the notes.

Well, Dr. Sykes, thanks for popping in and having a conversation with me and joining me on the Remarkable CEO Podcast. You are a remarkable CEO, and it's an honor to just be able to be in relationship with you and to be walking this road with you and all the listeners, you know, who are tuning in. I know we have a lot of regular listeners, so thanks for joining us today. And if you love what you're listening to here, remember to tune in next week and every week to the Remarkable CEO Podcast until our next episode. Dr. Isaiah, thank you, sir. God bless you and your family, and God bless all of you who are listening. And, uh, hopefully we'll be back again together next week. Until then, take care. 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. All right, welcome everybody to this portion of the podcast. I am Dr.

Chris Greer. I'm a coach here for the Remarkable Practice.

And I have one of the favorite people that I get to talk with on, on these. It's Dr. Steve Tullius from Waitlist Workshops. And just so you guys all know, I've used Waitlist Workshops now for a couple of years and just have had fantastic results with those. And I love the process and I love the patients that I get from them. And Dr. Steve started this for very unique reasons and in a very big purpose. So just with that, Dr. Steve, introduce yourself to the people who might not know you and and give us a sense on what is Waitlist Workshop and what is it there, what's it exist for? Yeah, absolutely.

Thank you, Dr. Chris, always a pleasure chatting with you, and thank you for the opportunity to serve you and your practice, you know, with Waitlist Workshops. So welcome. I'm 24 years in practice. Um, like many of you listening, I believe I was born to be a chiropractor and help get this big idea to the masses, and I take that really seriously. And, and I, I got so frustrated in practice with what I saw as a big problem for myself, which was I wanted a pediatric and family practice. I wanted a wellness type of practice. But the reality was I had a neck pain and back pain clinic because the majority of people, if they have a positive impression of chiropractic, think we're good for neck pain and back pain. And, and our attraction models and our websites and our brochures typically match that. Belief system. And so I, in 2012, I sold my practice and, uh, I went on a, a 9-month trip around the world. I didn't work for a year. I, I took that time off to, to reset with my family, see the world, go on this cool trip, and with the vision of coming back to create the practice of my dreams, which was a pediatric-focused practice, you know, and being 100% cash and all those things. And, uh, it was an amazing time, amazing trip. But, uh, and I did come back with a really cool vision, but I also came back broke. Um, it was a lot more expensive to travel for 9 months without a job than I had, uh, budgeted for, especially because the dollar was getting killed at the time in Europe. And I had to figure out a way to, from, with, from scratch, to build a brand new practice on a shoestring budget. And I also came back with a severely ill child who developed an autoimmune encephalitis at the time. So, you know, like many things in life, we sometimes are able to build and create things out of necessity and with our back against the wall. And that's what I had to do to feed my family and figure out a way to build this practice. So I started doing workshops as, you know, workshops have been taught and preached about since, I don't know, the earliest years, you know, BJ was telling us we had to go out and share the word, right? So, uh, but. Back in the day, for those of you that were around pre-social media, uh, we did it by hitting the streets and taking flyers, uh, to Jamba Juice and the local health food store. Give it, have our teams take 5 to 10 flyers each and that, okay guys, you gotta pass 'em out. You gotta put 'em up. And that's how we filled rooms and it worked, but it was a lot of work and it was a lot of groundwork. And then the world changed. Turned into this thing, you know, that we have now with social media, you know, coming on the scene. And I'm a puzzle solver. I always have been. And I thought, okay, well, what if I start doing Facebook ads? And I started playing with it and I knew that I could solve this puzzle. And I did. I, I figured out how to regularly attract 15, 20, 25 people to my workshops and other docs saw what I was doing and asked if I would do it for them. So that's how it all was born. It was born out of a deep need to solve a deep pain, which is an unspoken pain for the profession. You know, I talk with docs quite a bit, and there's a lot of successful practices out there. If we look deep enough, we often find that the types of people we're serving are not the types of people that we set out to when we left chiropractic college. And not that those people don't need the help, But it's the types of cases, you know, we, we, this profession was built and saved upon the principle of helping the sickest of the sick get well and stay that way. And if we take an honest assessment of our landscape, we have fallen far from that. And so I wanted to solve that for me personally, never in my world, my dreams that I ever dreamed of having a marketing company.. And, but what I realized is that I have the opportunity to help create the demand for this massive need. And that's the beauty of Weightless Workshops is that we're not doing workshops around musculoskeletal stuff, although we, we have some that you can give and we've, we've honestly created those because so many docs just want that so badly. And, and, but once they experience the gut-brain connection, or the No Developmental Disorders workshop or the Mental Health Matters, and they see, oh wait, we can, we can attract these people who we always used to attract, and we can explain this in a logical way where it makes total sense and gives people the emotional certainty. Well, why wouldn't they want to do that? And so that's what we have. We have a system to attract the sickest of the sick, you know, pediatric, you know, fill pediatric practices and offices that want to help people with autoimmune issues. To digestive, hormonal issues, you name it. And, um, it's a turnkey system to do so. And I just really appreciate the opportunity to help do that for you and your practice too.

Absolutely. And that's, you know, I think what you've already said should get people thinking. So, docs on the line, what you should be thinking is, oh, am I serving the population that I set out to serve? And maybe even the bigger question, am I serving the population that chiropractic was designed to serve, which is the sickest of the sick? You know, if we go way back, this is what we have historical evidence for just having phenomenal results with the sickest of the sick, not just people with conventional low back pain, headaches, neck pain, those sorts of things. And Dr. Steve, you're right, those people need, need it too. Like the people who are doing the reactive short-term, you know, chiropractic thing, they need help too. But it's not what your system does, right? It's like there's all sorts of marketing systems out there to help get those people in the door. The doc on the line that I think ought to be really tuning in or leaning in right now is the one who's like, yeah, I think there's more. I think there's more that I want to do in my community. And how do I do that? So I'm one who I also started before the time of social media, like, and we were doing all like trying to fill workshops. I do workshops all the time. And, you know, my workshops were good and my delivery was good, but it would be really hard to get more than 3 or 4 people. To them, you know, like we really had to work for 10 people to get to them. And so when your solution came in front of me and I was like, okay, they do the work on digital so that people show up at my office like they're going to tomorrow night, by the way. Like I've got that already locked in. I haven't had to do anything. They're showing up tomorrow night so that I can do what I love best, which is actually deliver, actually go out and inspire people through the message of chiropractic and how it relates to, in tomorrow's example, neurodevelopmental disorders or the gut-brain connection, which has been my most successful one at connecting with people. Like, those are the docs that I think need to be leaning in and need to be reaching out to you. Now, one of the things I wanted to point out is like, you do your attraction to these events digitally. One of the common concerns with docs is that digital new patients are harder to convert and harder to retain. Now, you and I have talked about this many times because I'm a client of yours, but do you mind if I take a second just to talk about that specific issue?

Yeah, no, I'd absolutely love you to tackle that one because it's— that's not a concern for our clients. So yeah, I'd love for you to, to tackle that one.

It isn't. Yeah. And I've had this issue with digital attraction, right? Like, boom, people are coming through the door. Oh, this is great. But man, they're difficult conversion processes. And whoa, if they do start, they're way harder retaining through your processes. And what I found with waitlist workshops is that I— first off, my, my reception room, which is where I do my workshops, is full. You know, it's like we've got in that from my office is 12 to 20 people. Like, that's full. It's great to have that energy in the room. Then the people who schedule new patient appointments from that, which is a pretty high rate in our office, they are ready. They know us, they like us, they trust us. We are already— our office is already their expert in the issue. So they convert well. And then what we've found now that we've done this for a couple of years is most of the people who we start through waitlist stay. So retention. And that's where, I mean, I'm just so bullish on retention. I just love it. I just— anything I can do to do something to improve retention, I want to get that word to the masses. And so I want to thank you personally. Like, it seems like this has solved the issue for practices who love to do workshops but struggle to get people in. And they love to do workshops because they know when people start from workshops, they stay. So I just know your system works great for that. And I don't— I know that that was one of the reasons that you started doing it for your own office. Maybe if you want to speak any more to that, or if you feel like I covered it.

Yeah, yeah, no, absolutely. So I refer to workshops as day zero. Right? We talk about day 1 and day 2 all the time, but day 0, man, if you get people coming in with— again, the— here's the formula: massive needs equals high-quality leads, right? Number 1. So these people, they're not— this is not a dinner workshop either. Not that dinner workshops are bad, but dinner workshops are typically around people with— maybe they have a perceived need, maybe they don't. Now we— now we're talking about people with the biggest needs in, in society. Right. And so, like, for neurodevelopmental disorders, there's no bigger need than helping your sick child get well. Yes. And so people come to these workshops with a very targeted need, and then they sit through an hour of your class. And we don't always just leave you with the group. Like, we give you the formula. We give you the formula to give people the logical and emotional certainty. I've given these workshops over 300 times. Our doctors have given them over 10,000 times. And we coach our doctors on how to present and how to give that logical emotional certainty. Because the reality is, as chiropractors, we're fortune tellers. We, we know what the future looks like. If people were just to have that exam and to take our recommendations and move forward with care, we know that their future looks much brighter with us and chiropractic in it than without it. So the— so all we have to do is get a group of people with a big need, help give them the logical emotional certainty, which we build into our presentations teach our docs how to give it, and then invite those people in for care. So what I always loved is— and, you know, I got, I got kind of frustrated too. I got frustrated when someone came in with low back pain and, and was questioning whether I could help them or not. When I was helping kids who weren't speaking begin to speak, and, and people with seizures, you know, their seizures go away, I was starting to get a little ticked at that. And so You know, these people, they see you as a specialist. They— that we are, and they recognize our value, and we show them exactly what it's going to look like to work with us so that when they come in, well, it's no— it's no wonder there's high, uh, conversion because they've already bought. They bought at the workshop. You told them what it all looked like. You told them what a care plan looks like. You told them all these things. Well, now they're just coming in to find out what are the findings and what are your recommendations, right? What a concept, right? And then because of that, they understand the process of correction. That's going to take time and repetition. And so they don't balk at 12-month care plans. You know, this model was— this was built in 100% cash office. Um, they, they're glad to, to pay. And then they, they probably noticed this. They also know other people just like them who also now have high retention, conversion retention, because they have these big problems too. So yes, I'm a little partial to it. I hear that problem all the time, that digital produces weak leads, but that's only because people are thinking of all these other attraction models that are based upon selling exams, right? And not— and that's commoditized. You know, that's, that's been commoditized. We're talking about establishing you as a specialist, and you don't have to sell your exam for cheap. You, you know, you can offer it for, you know, as I did, you know, my exam was $350 and I offered it for $150, which is still a discount, but it's not of this massive, massive discount. Um, so anyway, that's my That's my take on it.

Absolutely. I've— man, I, I am absolutely using that so many times. Massive needs equals high-quality leads. And that's exactly what you guys do. You market to folks who have massive needs, and therefore the people who come and sit in your office have— are high-quality leads on day zero, not even on day one, on day zero. They're there. You also touched on the fact— and make sure, docs, you listen up to this because this system, weight loss workshops, they train you. If you're thinking like, oh my gosh, I'm not— I don't have a presentation ready, I don't exactly know how to present, I don't know how to close at a workshop. We don't need to go into all the detail, but Dr. Steve, talk a little bit about the training that a doc receives so that they can deliver that high-quality workshop.

Yeah, absolutely. So, you know, I used to be deathly afraid of public speaking. Right. So I understand the, a lot of the challenges with just even getting up in front of a room full of people. So number one, but not everyone shares that, like that, that fear that I had. However, I do know how to crush that for anyone who does, and we do it all the time. But the other piece is, and I didn't realize this was, this was really one of my limiting beliefs. I, I didn't realize that I had really perfected a system of Communication to, to create that logical and emotional certainty so that people like, this makes total sense, you know, at high conversion rates. My associates who also were deathly afraid of public speaking, but had to because they were employees, they also developed really high conversion rates at workshops. And so the last couple years I've been really focused on this problem because our number one problem as a workshop company is not getting butts in the seats. That's just a math formula. And it's, it's one that's reproducible. That's why we can have a doctor give a workshop in 4 weeks and expect on average right now we're averaging 20 people in attendance. We're, and that could be from 15 to 25, but, but right now we're averaging 20. And that part's easy. It's just a math formula. The hard part is making sure that the docs are ready to convert that room. I just got off a, so here's how we do that. We give them extensive trainings to understand the principles at play, not being Steve, right? Because no one can be me and I can't be them. So, but there are principles that we can follow to take people to that end result, which is, again, we're all fortune tellers. We know that those lives can be transformed and will be if people move forward with care. So then what do people need to know? What do they need to believe? What do they need to feel? And what objections do we have to handle so that they, we can even get them to that place? And so that's what I've really obsessed over, that process. That's what I built for me. It's only until recently that I fully understood it so that I could teach it. And so now we, we do one-on-one coaching prior to every first event. I just got off a call just before this. We're on a, we went through all the slides. Well, and I'm so grateful that I did. I didn't used to always do this. Because there were slight nuances at little key points where people are killing their credibility or they're— they haven't established trust yet and they're selling chiropractic way too early. That happens all the time. And so it's just little tiny tweaks, little tiny principles to understand that, okay, that makes sense. That's why I shouldn't do that. And so now we just— we have a great process of identifying those things. And then doing some one-on-one training to make sure that they're ready to hit the ground running.

Awesome. So good. Well, hopefully by this point, the, the listener is like, oh my gosh, like, this is the next thing for me. If that's you as a, as a listener, like, wow, I love to educate, I, I would love to see the sickest of the sick, I'd love to have a bigger impact in my practice, then get in touch with Dr. Steve. And that's the last thing, it's what I want to end with. Thank you so much for being here, but tell the folks, how do they get in touch with you?

Yeah. Easiest way, go to waitlistworkshops.com. There's a calendar on that page to set up a call. It'll be with me. Um, I do all the calls because I want to, I want to make sure it's a great fit and we're going to walk through all those things and make sure not everyone, this isn't for everyone. This, this is, this is for offices that are super passionate, want to transform their community, uh, want to see the sickest of the sick. Want to see that not everyone has to see kids like with Bowie. If you want to see kids. I don't know anyone who does it better than us to get kids in, into offices and also be super passionate about education and growing and knowing that you, we can always grow in our communication. If that's you, then go to the website weightlessworkshops.com. Also Steve Tullius on Instagram or Facebook.

I'm highly accessible that way too. All right. Awesome. Check it out, everybody. Dr. Steve, always a pleasure. Thanks for being a success partner with us as we all help each other help more people. So we're looking forward to continued success for everybody who's involved. Awesome.

Thank you so much, Doc. I love being part of TRP and I just love the mission and the great work you guys are doing to, to make docs really prepared to, to meet that need, right? Because it's one thing to get the patients in, but it's another to make sure that they stay and their, their experiences there and the systems are dialed in and you guys are crushing it there. So thanks so much.

Absolutely, thank you.

Thanks for listening to this episode of the Remarkable CEO Podcast.

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