Goal Setting for Chiropractors: A 7-Step Guide to Success

Welcome to the Practice Builders Podcast hosted by Dr.

Vince Leone and Dr. Kyle Pankinen, your source for building cash services. Let's dive in. Hello and welcome everybody to the Practice Builders Podcast. My name is Dr. Vince Leone, joined here with—

Dr. Kyle Pankinen, and we are glad to have you with us. I think we got a great topic today, which Dr. Leone will introduce for us.

I love it. I love it. I am excited about this topic, Dr. Pankinen, because it's the 2025 Planning Guide. And, uh, and then we're going to wrap it up with a word of the year, and Dr. Pankinen will kind of explain more about that. But the, the key here is even if you don't get this at the beginning of 2025, you can use this at any point. Um, you can use it for next year. You can, if you're in the middle of the year when you get to this podcast, you can use it then. Um, Obviously, ideally, you are planning, you know, in like November or December. So, we're well past that because ideally, you're kind of, you know, you're looking at— and we're going to go through the 7 steps, right, to your best year yet in practice. But you kind of, you know, I like November personally. I don't know about you, Doc, but I like November because we have a good sense of like towards the end of November, we have a good sense of how the year went. We can take the average of the first 11 months and then, and then kind of get a sense of what December is. And so you'll know what your total revenue is for the year and you'll have a really good sense if you hit your goals, what worked, what didn't, and then you can plan for the following year. What are your, what are your thoughts on that?

Yeah, I started thinking about my goals for 2025 already back in November. At least started formulating them in my head. And then as the year closed, right at the end of the year, I got up early on New Year's day, and then I wrote it all out in detail. But it was already here, and I was already planning it ahead of time, so it was just a matter of, okay, putting the thoughts and the stats and everything, put it down in concrete and writing. And that is an important step, and I'm sure we'll talk more about that. But setting goals is one thing in here, but putting them down on paper sets you apart. And I think you have some interesting stats. I think you've shared in the past about that, about the percentage of people that even do goals and then they take it a step further and write it down, and then the success they see from that.

Yeah, there was a study I read or had read about. So, I do want to make that distinction because then I subsequently heard that it was false. But who really knows? But the study was, I think it was at Duke. University or Yale. It was an Ivy League school, you know, whatever. Um, but the point being is the top 3%, um, and they, they kind of polled their students, I think it was 20 years after graduation, uh, one year. And the top 3%, they, um, you know, they were the only ones that, uh, had goals and actually wrote them down. And they collectively were worth more than the other 97%. So, um, I— whether that's true or not, I don't know that that really even matters. I think what does matter is clarity.

Yeah.

So, um, and frankly, brevity. So, uh, and what I mean by that is clarity in terms of having some tangible and tactical goals where you know for sure whether you hit it or not, and brevity in a sense of you don't need a million goals. Um, I think if you can have some You know, some key goals, maybe 3, 5 key goals for the business, I think then you can focus your energy there and you'll have a better chance of hitting them.

Yes, that's the key. If you get overwhelmed, you can overwhelm yourself if you're like, oh, I have this category of my personal health and I have 10 goals under this and I have my business goals and 10 goals under that and my spiritual goals and have a 10 10-step pro— it's too much. You got to keep it simple. Like Dr. Vince said, maybe 3 or 4 or 5 things at the most that you're really pushing towards and hitting. That gives you a much more realistic shot at accomplishing the goals. And ultimately, that's why you do goals, is because you want to accomplish something.

Exactly.

And, uh, and it's gonna Got to give you a benchmark, something to shoot for. And so, that's what we're going to dive into. So, let's look at some of these steps that you're going to share with us because these are really good, I think.

Yeah. And this is a training that we did for our private clients. We call this 7 Steps to Create Your Best Year Yet in Practice, the 2025 Planning Guide. And so, right from the beginning, Step number 1, we talked— just talked about some high-level tips. And the first one is be kind to yourself. And it's just, you know, whether we hit our goals or we don't, it's more about growth overall versus, in my opinion, necessarily hitting a particular milestone. But, you know, if you're beating yourself up, oh, I didn't do this, I didn't do that, Just, I just don't think there's a lot of value there. So, that's the first thing is just like, just be kind to yourself. Um, I do talk about plan your planning. This doesn't make a whole lot of sense in this case, 'cause for our clients, they are, um, the first step is to go through this training, right? It's a 45-minute training. So, that's step 1. Step 2 then is to then actually do the planning. But the first step is just the learning of that. So, for, for you, for everyone listening here, that step 1 then is just listening to the training. Um, And then take another session, right? Go to a coffee shop, go to a nice hotel and sit in the lobby, have a beverage of your choice, bring a nice journal, and then actually do your planning, right? Make this investment in yourself. And I would recommend making a ritual moving forward. And I even put it on the calendar. So, in other words, like, we are, you know, We're at whatever time of the year it is now. You're going to do your planning now for this year, but then in your Google Calendar or whatever calendar app you use, put it in, put like literally carve out 2 hours, 3 hours out of your day, put it on a date. So, and then, and then create a reminder. It says, hey, one week prior, it says you have a planning date. Your goals planning is coming up. If you put it in your calendar, the chances of you actually doing it goes up significantly.

I agree with that. And I actually wrote, I already have for the end of this year, towards the end of November, I have in my planner already for 2025, November planning date. And Dr. Vince is right in a sense, you need about a couple, 3 hours. I literally sat down right away New Year's Day and I, I, I typed out— and I'm a slow typer— but I typed out 2, 3 pages of just my plans, and I just called it my 2025 success plan. And, uh, wrote it all out, and, uh, it was actually fun. It was a fun exercise, and it made me reflect back on what year we had in 2024. And now looking forward and implementing the plan for 2025. And it's a, it's a fun process to go through. So I encourage everybody to do what he's saying.

Yeah, I mean, this is, this is your life, this is your practice, this is the future of yourself and your family. So I think it's worth the investment. So that's step number 1. Be kind to yourself, plan your planning, enjoy this investment in yourself, and create a ritual moving forward and set the date. So that's step number 1. Step 2 is We're going to put some thought into it. So what this means is we're going to reflect back a little bit. And so here's our kind of high-level thoughts. What worked well in 2024 or the last year? Again, whenever you're listening to this, what worked well last year? Okay. And why do you think it went well? And by the way, Dr. Pankin and I, we're going to kind of go through this a little bit, you know, just maybe a couple of high-level thoughts for that we have each written down, but For you, what worked well last year? Why do you think it did well? What didn't work very well, right? What did you try and it failed? Um, what did you really enjoy doing? In other words, um, and, and this is business related, but you could apply this to your personal life, but we're talking about the practice here. But what did you really enjoy doing in practice? And then what felt like a slog? What did you not enjoy doing? And then finally, how did you feel throughout the year? Did you feel like you were optimistic? Did you feel encouraged, or were you frustrated and felt like, you know, things were not working as anticipated? So, Dr. Pankinen, let's go through these a little bit. What worked well for you and the practice in 2024?

Yeah, well, I guess number one would be revenue. We had our biggest year in '24. Uh, years. And so that was really exciting. And, uh, second year in a row of topping over $1 million in total gross revenue. So fun, exciting stuff. So that worked well, but I didn't quite get to my revenue goal of increase. So we increased above last year's record, but we didn't increase as much as I had anticipated. But I really reflected on that. And a lot of it was simply my attention was a little diverted last year because I had a new intern and I invested a lot of time and energy training him. And I also had a son of mine come on board to be a certified board-certified health coach. And so he's learning functional medicine. And so I spent a lot of time with him too. And so.

Wow.

It was more of a year of I need to help invest and grow these guys so that then in future years they can help me to grow even further. And so I didn't have quite, I think, the energy to really, really focus on grow, grow, grow the practice this year, even though we did grow, but just not as much as I had hoped for.

Hmm.

And, uh, so that was a little bit of an energy drainer. But it was in a good way. And I also found out I enjoyed doing that, though. That was something that, even though it took energy, but I got a lot out of it in the sense I enjoyed the mentoring part of it, the teaching. And actually, it spurred me on enough that from a spiritual point of view, I actually am going to start trying to mentor some younger men in the church that I go to and offer kind of a coaching member mentorship model for them in 2025. Uh, that will be coming later in the year. So that was some of the things that came out of my, my thinking session, uh, starting the new year. And, uh, how about you, Dr. Vince? What worked well for you, or what did you enjoy in 2025? And maybe what didn't work so well?

Yeah, so what worked well for specialized practice was Our summit in this in September, so that's our decompression summit certification in Dallas. That worked really, really well. We it was a success. We had I think 115 doctors and staff show up to it. We had a great feedback. We had a bunch of doctors that returned that had you know attended in 2023. So that's always a good sign. And I felt like we expanded you know the um, the presence of Specialized Practice in the industry. So, um, that worked really, really, really well. I, uh, also feel, and I mentioned this to Dr. Pankinen, is, um, our, our Q&As. So when you're a private member at Specialized Practice, um, we do every single week, we do a live clinical question and answer session on Tuesdays, and then we do a live business Q&A. So Dr. Pankinen does the clinical and I do the business. And so I feel like these are working and supporting and providing a tremendous amount of value for our clients. And because they have support every single week, they have connection every single week, and they're able to share their wins, they're able to get consulting advice, whether it's clinical or whether it's on the business side, it's the marketing, it's the closing, it's the staff, it's the, you know, anything related to the business side. I think they always have someone to turn to And get support because what happens is what I've experienced and what doctors tell me is like you know when you don't have a coach, you kind of you're kind of on an island, right? You're you know you're running the ship. You are kind of trying to figure it out all on your own. You don't really have any sounding boards. You don't have a support community. Maybe you have a buddy or two that you're colleagues with, but. It doesn't. It's not really the same when it's when it's not structured, and and it's certainly not the same if they're not significantly further ahead of you in practice. You know, if you're just bouncing ideas off someone that's at the same level at you in practice, or maybe a little ahead or a little below, it just I mean who knows what their opinion is? I mean maybe they're right, but most likely they're wrong. What you really want is advice from someone that's been there and done that at a much higher level so that they look back, oh yeah, yeah, that's easy. You just do this and you follow that, right? And you save years, if not decades, of your life in that process. So, those are 3 things I think worked really, really well for us. Awesome.

Awesome. Well, that's great stuff. Let's go on to tip number 3 or step number 3 in this process.

Yeah. And really quickly, I would just point out on that step number 2, 2 things. What did you truly enjoy doing and what felt like a slog? One thing that we do with clients is we talk about a not-to-do list, a not-to-do list. And because what happens is the, you know, as the owners, we end up being, you know, the head cook, The dishwasher, the waiter, the you name it. And what happens is a lot of these are low-value activities that you could pay someone, you know, fifteen or twenty bucks an hour to do, but you're doing them, and it really it it brings you down, right? It's sucking your energy, your very valuable energy from doing those hundred or thousand dollar an hour activities that could really move the practice forward. So highly recommend do an audit on your time and figure out what. You know, what's really moving the needle in the practice? What do you truly enjoy doing? And what do you not enjoy doing? And find someone else to do that for you. So, any thoughts on that, Dr. Penkinen?

Well, I just think the best leaders, the best business people on the planet are the ultimate delegators. They only focus on the few core things because very few High-end leaders are good across the board at lots of things. They're usually good at 2 or 3 or 4 things that they do just do really well. And they, they know what they're good at and they know what they're not good at, and the rest can be delegated to focus on what you're really good at. And that's kind of what you're getting at. Create a not-to-do list of all these activities that don't bring you energy, that somebody else that are not high value that somebody else can do and pay them. And then you focus on what you're good at and things that are of high value. And that makes a huge difference. I implemented this 2 or 3 years ago at your suggestion, cut some things out of my life, and it was some of the best decisions I ever made. Create a not-to-do list. Who would ever thought it, huh?

I love it. Okay. Step number 3, it's reviewing the goals that you previously set. So if you have— if you didn't set any goals, then you would just skip this step. So if you did not set goals for the year that just passed, then, you know, that doesn't really apply. But if you did, then you want to go back and review them. Right. And so, you know, just high-level goals. Hey, we want— my recommendation, you want a total gross revenue, you want a total net revenue, you want your profit, you know, kind of a profit margin. You know, how much did you get through chiro? How much did you get through your first niche? How much did you generate through your second niche? Um, those are, those are some high-level goals that, you know, for the business that you— I would recommend setting. Um, so if you, if you did set those, then it's reflecting back and saying, hey, did we hit this? Did we hit that? Um, and if not, you know, what can you— you know, we'll talk about setting goals moving forward, but if you, if you didn't hit them, you want to put some thought into, um, what are some key reasons that held you back.

Yeah, that's it. So I think, you know, all doctors should know they have revenue goals, both gross and net, probably some new patient goals, probably some total patient visit goals, uh, maybe how much, how much you want to collect from niches versus traditional chiro. Those are some things to look at when you're thinking ahead Looking back and thinking ahead to goals that you want to have, those are some of the broad generalization categories that you need to look into and track those statistically.

Yeah. So just as an example, say you're doing $100,000 a month and, you know, at $100K you probably should have an associate. So, you know, maybe you say, well, I want $50 grand to be Chiro, you know, our core product or service is chiro. And if you have an associate, you know, maybe you're paying them $5,000 to $10,000 a month. So you're getting a nice return on the investment because they're going to be doing, you know, all the exams and the bulk of the adjusting. And then say you have 2 niches, and $25,000 is decompression and $25,000 is knee, right? And your care plan's, you know, $5,000. So you can really easily break it down that way, right? Okay, so. You know, we need five new patients a month for decompression and five new patients a month for knee, and then we'll hit our goals. And so that's you know that's why I love the niches, right? Because you can make up ground rapidly with chiro. You really it's a building. You know it's a it's more of a slow build to to generate any type of decent revenue. But that's just kind of a rough number, and then and then profit margin. If you're at— I always, you know, doctors always like, oh, we should be at 50% profit margins. Psych. I don't know, that's not my opinion. Um, I would push back on that because if you're at 50% profit margin and you're not hitting your goals, then you are not investing enough in your practice. So you're not investing enough in marketing, you're not— or, and/or you're not investing enough in team, and/or you're not investing enough in, in a new service like a Like a niche, right? So, um, I think at the higher levels, if you're, you know, 35%, 40%, I think you're doing just fine.

Yeah, couldn't agree more. That's the key, is too many doctors are thinking, you know, I just got to keep expenses down, keep expenses down, keep overhead low. But if you do that, sometimes you can't grow, because if you want to grow, you need more staff, you need more equipment, you need more space. And so you got to be willing to invest, and then later on recoup the rewards for that increased revenue. So sometimes you got to take a little bit of a, a little bit of a risk if you want to grow and think bigger.

Yeah.

Think bigger, not just stay at your small space or I've always used this equipment, it's paid off, so we're not going to get any more equipment. That type of mentality is going to ensure that you're not going to grow.

Yeah, 100%. And, you know, a couple tools, um, that we like here at Specialized Practice— we like, um, BlueIQ as a stat tracker, and then Lucro, um, is an online bookkeeper specializing for chiropractors. Dr. Josiah Fitzsimmons owns that. Um, so, you know, if you don't Like, if, if I just asked you today and you said— I say, well, what's your profit margin? And you're like, I don't know. If, if I ask you, you know, how many new patients did you have last month? And you said, well, I think around— or, you know what I'm saying? Or God forbid I asked you what your revenue last month and you said, well, I'm not sure. You need to most likely focus on your numbers, right? Because if you don't know where you're at, then how the heck you going to know where you're going? I mean, it just doesn't make any sense. So, one of our great clients, Dr. Cornejo, he had, you know, his words for 2025 was precision growth. And I really like that because he freely admitted, he's like, I'm just— I haven't been very good with my numbers. Um, and so, that's one of his big focuses. And he's, you know, is working with Blue IQ and Lucro. Um, and he really wants to know exactly what his numbers are. So, super proud of him for that. So, that's where you're at listening to this, then I think that's a great place to start is getting very clear on where you're at numbers-wise.

Can't agree more. The stats are huge. You got to know where you're at, at least week to week. But for sure, at the end of each month, you need to go. But you should know at the end of every week kind of where you're at and where you're tracking to as you're getting towards your monthly goals. And at the end of your month where you're at. So you're tracking right to get to your yearly goals. You can't just say, I think I'm doing all right. That's just, that's just not conducive to growth. So I think enough said on that. But I think it's— those are great points.

Yeah, that's, you know, one, just to compliment Dr. Pankin, and like, because he started work— we started working together back in 2020. That was something he always, he always knew his numbers. And I was always very impressed by that. Okay. Step number 4 is now we want to gather and assess the data. So now whatever your EHR system or if you're on QuickBooks Online, if, by the way, if you're not on QuickBooks Online or something similar to that, that's another easy way. I mean, it's like $35 a month and, you know, integrates with your bank statements and your credit cards. And, and if you're asking like, oh gosh, well, could they steal my money? It's like, come on, this is a Billion-dollar company. They're not going to try to steal from someone making, you know, in small business. Anyways, point being, QuickBooks Online, great resource there. But what you want to figure out is what is your total gross revenue? What was your net revenue? What was your profit margin? Right. So now we're going to get the numbers, whether you, whether you set the goals or not. Now we need to get the numbers right for last year. We want to figure out what our conversion percentage is. Um, we want to figure out then if you're doing niches, how many chiropractic new patients, how many, uh, decompression patients, how many knee patients, etc.

Yeah, and that's, that's so important to have those numbers readily available, even if you don't keep track of them yourself, in the sense you can delegate that to somebody else to keep the numbers. But the thing, the good thing is a lot of EHRs, it's just you can track your collections as you go, your new patients. It's, it's pretty easy clicking buttons and you can spit out reports to you. And so just use, use technology. It's, it's all available to us and, uh, you just got to take advantage of it.

Yeah, and that's a great thing to delegate, right? I mean, you just tell your, your CA or one of your CAs, you know, um, office manager if you got one, hey, these are the numbers I need. I want it in a week. That's it. Super simple. Um, just delegate. And then, uh, because, you know, this is not that— this is a— that would be a low-value activity. Like, I don't want you hunting and pecking in your EHR trying to figure out, you know, how many new patients and all that type of stuff. It's like, just, you know, hey, delegate that. Say, hey, I need this in a week, or whatever the, you know, number of timeframe is. Okay, so that was step number 4, uh, gathering and assessing the data. Step number 5 is reflection. Right now, hey, did we hit our growth? Did we hit our goals? Right? What part of the practice did really well? Where did you fall short? And why? Right? And, you know, again, we want to figure out if we hit our goal, why did we hit our goal? Because the reason why is because then we want to lean into that. Like, if you said, hey, we hit our goal with decompression, why? Well, because we were doing Dinner workshops, great. Then you want to lean into them, right? In other words, double down. If you, if you want to grow, then, or if you just want to maintain, hey, we're going to keep doing them, right? Whether, however often you did them, keep doing that. If you want to grow, then you add, you know, multiple. If Google worked for you, oh wow, you know, we started Google Ads, which by the way, very few doctors are doing Google. I don't know why, but if you're If you look at your marketing numbers and say, gosh, you know, in, in 2024 we put $10,000 into Google, uh, over the course of the year, which would actually be a very low number, but say we put $10,000 and we had, you know, $50,000 worth of patients. That's a 5-to-1 return. You know, if that was me, then I would say, hey, what if we put $20,000 in? Could we generate $100,000 in revenue and, and keep with that, that kind of ROI number. So, um, so we want to figure out, well, you know, what, what worked well and why, um, and then so that we know whether we want to continue with them. And the same thing with if it didn't work, right? What, what wasn't working? Maybe Facebook fell off. Um, in a lot of markets, especially mid and large markets, Facebook isn't working very well anymore. So, um, at least not in the traditional sense in terms of lead generation. So then you want to maybe pull back or pivot and do it a little bit different. What are your thoughts on that, Dr. Penkinen?

I think Einstein said the definition of insanity is doing the same thing over and over again, right? And expecting to get a different outcome. So, that's why you reflect, right? You look back and see what worked, what didn't work. And if you obviously are identifying, I tried dinner workshops or I tried Facebook, or I tried email marketing campaign. If you find something that just didn't work at all, well, then you got to shift gears and say, okay, I'm doing Facebook and that's not working so well. But by golly, this year I'm going to go hard into Google advertising, or I'm going to start a new podcast this year, or I'm going to have a— start a radio show or whatever. You have to be able to pivot. And, and based upon data and objective analysis and be able to pivot into, okay, we need to go a different direction with this part of our marketing to attract the patients that we're looking for. And that's, that's why you need that hour or 2 or 3 to just look back and reflect and just to see what worked and what didn't.

Yeah, 100%. And then finally, here on reflection on these goals, um, what is one big win last year that you can celebrate. And so I think it's important, right, to, you know, to focus on the positive as well as what didn't work. You know, I know for me, I think, you know, I think the summit was, was a big win. And then also bringing on Katie, our CSM, because that bought back a lot of my time. So that was a big win for me. How about you, Dr. Pankaden? What was a big win in 2024?

Well, I've been practicing solo for, like I said, 20— this is my 24th year. And I'm in a very small town of 850 people and a very rural area of the United States, southern Minnesota. And to be able to attract a doctor to come here that wants to be here, that's excited about being here. And so having a new associate doctor that just started with me, uh, just a couple days ago, that was a big win to be able to attract a person like that. And then also now, uh, my son coming on board to be a board-certified health coach, helping with the functional medicine— those are 2 big wins for me that I just look back on this last year like, wow, that, uh, Some things I didn't ever see necessarily anticipate happening, and both of them in the same year. And, uh, what a blessing.

It's a massive win. I remember back in 2022, uh, Dr. Khan and I were talking about his goals, and, and we're talking about, you know, time to bring on an associate. And we— and, you know, he was pretty frank. Hey, it's tough to find someone that, you know, wants to be here. Um, and but he got really clear on, you know, uh, what he wanted and, and who he wanted and, um, and, you know, prayed on it. And by golly, that person showed up. So it may not always like, you know, in terms of setting your goals, you— it's not— this is something that was always interesting I've heard. It's you don't really need to figure out the how Your job is to figure out the what, right? Your job is to figure out what do you want, and then, um, you know, that the how of— it's the how of the equation will be taken care of if you do the right things. So I really like that, uh, and really happy that that worked out for you. Um, okay, step 6 is now set your targets, right? We're gonna land the plane, as they say. So Um, setting our targets for the next year, 2025, or whatever year you're working with. Um, and I would, I would say, first of all, how do you want to feel in practice? You know, do you want to feel confident? Do you want to feel peaceful? Do you want to feel energized? Like, how do you want to feel personally on a daily basis and about your practice? What is your vision for the practice? In other words, like, if you are, um, a one-doctor office with One CA and you're just doing chiro. Well, what's the vision for your practice? Is that where you want to be in 5 to 10 years? Or— and it's okay if you— if that is it, like, if you're, if you're content where you're at, great, you know. Um, but this is the Practice Builders Podcast, so we're probably attracting doctors that are a little bit more ambitious than that, you know. So, uh, if that's the case, what is your vision? Uh, because the practice is not going to grow itself. Right? So you need to have a vision for where you want to go. Um, love to hear your thoughts on that, Dr. Penkinen.

Well, that's a proverb: where there is no vision, the people perish. So you have to have— if you don't have a vision for where you want to go into the future with your practice, it's surely going to dwindle. It's not going to grow.

Yeah.

And so that's just wisdom. And so You have to have, you kind of have to have that 10,000-foot overview. You got to have the big picture. And once you have that cemented in place, yeah, the how, you don't always know the details of how you're going to get there. You can have some ideas and generalities, but that, that's the way, that's that way with anything in life. I mean, we, we only, only can see so far ahead. We actually can't see hardly far ahead in the future at all. And so that's where faith, and that's where taking that step forward and, and saying, you know what, this is what I envision my practice being like in 5 years from now, these are some of the things I want to reach for, the goals I have in mind, and this— and setting that down, writing that down, cementing in your head, cementing it on paper, then your chances of fulfilling that Will go way, way up.

Yeah. Yeah. I mean, once you have the vision, Jim Parker talked about this, your FCB and your PSI, your faith, confidence, and belief in your product, service, and something else. So, I can't remember all these things. And something else. FCB and your P&S. How about that? And then I would be thinking, you know, what is one skill that you would like to develop as a doctor? And then what is one skill you'd like to develop as an entrepreneur? So, I think that, you know, is, that kind of falls in the tactical side of things. You know, maybe as the entrepreneur, one skill, hey, I want to get better with my numbers. You know, I want to gamify my practice. And I promise you, it's a lot more fun this way. Like, when you actually know your numbers and you're working towards them and you're checking them on a weekly basis and a monthly basis, And you kind of gamify things. It, it, it's just a little more fun, frankly. And so, um, but, but what is one skill set you want to develop as an entrepreneur, you know, as a business person, and then one as a doctor? So, um, on the doctor front, hey, maybe you haven't made the leap into niches yet, and you say, I want to become an expert in disc and focus on spinal decompression.

Great.

You know, I think it's a That's a great one. Or you may say, I want to, you know, I want to— like what we're doing here is creating a world-class exam. I want to, I want to be able to perform a world-class exam where patients walk out of that room and say, I've never had an exam like that. You know, it'd be a great— I think that'd be a great goal. Um, well, what are your thoughts on that, Dr. Prankinen?

Well, that's, that's how in practice you go from being— you, you don't ever get stagnant or burned out. And one way you don't get that way is you always have something new that you're learning, whether it's a new skill or a new, uh, you know, as an entrepreneur. And when you're learning new things like that, that's why that keeps the juices flowing. All right. And there's a lot of doctors out there that are kind of on borderline burnout or are burned out. And that's, that's, I think, one of the biggest things. They haven't, they haven't read any research studies in a while, or they haven't been to a— learned a new technique in a while, or they haven't read a book in a while on business or something like that, it's because they just— it's the same thing every day in the office and they become stagnant. And you have to every year strive to learn something new, and that keeps your mind sharp. But it also just, you know, that's the fun stuff. That's learning is fun. And it'll keep the spark going. And not only will you feel it in your life, but it'll reflect on your patients. They'll see it too because they'll say, ah, Dr. So-and-so, he's got— he's kind of fired up today. Must be learning something new.

Yeah, I agree. I mean, if you're not growing, I mean, life is rarely stagnant, right? If you're not growing and learning, you're typically regressing. Right. And being in a state of regression is— it's not very fun, right? It's not a very fun place to be. And people aren't attracted to that. People are attracted to leaders. People are attracted to people that are growing and learning about new things. And so the— and, you know, gosh, there's no shortage of information right now, that's for sure. And most of it's free. So, um, so moving on Continuing on step 6 with setting your targets. Now we got to get a little tactical and like, hey, so what do you want your gross revenue goal to be? What do you want your profit margin to be? So then, and then subsequently, what do you want your net profit to be? So what I would do then is have your— the big number say, hey, I want to— I want to do, you know, I'm going to make this easy on the math. I want to do $1.2 million. So that means you want to do $100,000 a month. Or average $100,000 a month. Um, and then you just want to figure out, okay, well, you know, I want my profit margin to be 40%, right? So that means you're, um, you're going to pay 60% of that. So $600,000— sorry, 60% of $1.2 million. Oh gosh, now I'm getting into math, Dr. Pankinen. Um, I'm gonna pull out my calculator. So $1.2 million, um, times 60%. So You know, $720,000 will be your expenses, the balance of that. So what is that? Gosh, I should have had an assistant on board with this to figure out our— so you have $480,000 in net profit, right? So that's a 40% profit margin.

Yeah.

So you figure out, you know, what you want your gross revenue to be, what's your net revenue to be. And then I just break it down quarterly so that, you know, if we want to do $1.2 million gross, then, you know, that means you want to do $300,000 per quarter. And that way then you can even break it down per month. And so, you know, hey, very clearly I'm on track, I'm ahead of schedule or I'm behind.

Yeah, couldn't say it any better. And the key is what we've been saying all along, tracking it as you go along. If you got in setting that realistic goal, That's gonna stretch you a little bit, but it's still realistic. And so if you're a smaller practice and you're not anywhere close to $100,000 a month, well, what's— if you're, say you're at $20,000 a month, could you realistically get to $30,000 a month?

Mm-hmm.

Or, you know, probably not gonna double your practice in a year unless you're really new in practice, but You know, can you bump it up $5,000 or $10,000 a month? And almost all doctors can. And if you, if you're not in niches, that's the easiest way to do it, in my opinion, is to add in cash-based services in niches where you can take whatever you're doing with your traditional chiropractic practice and add a niche in, master that niche, and watch yourself add $5,000, $10,000, $15,000, $20,000 of additional revenue. Really, that's not that difficult to do.

No, it really isn't. I mean, our average care plans are around $5,000. You know, some doctors are a little lower, you know, around $3,500. Some are a little bit more, around $7,000. But, you know, say it's $5,000 if you're in a mid-market, which is where most doctors are. You know, if you want to add $10,000 a month, it's 2 patients. Really not that difficult to do. But I think, yeah, if you're at $20K, $30K, I think adding $10,000 a month consistently is a good Next goal. If you're around $50K, then you have a little bit more money to invest, right? So, I think, you know, getting up to around $75K consistently would be a great goal. Okay. So, just some tips and tricks on this. I would— I like getting, you know, we talk about getting this stuff down on paper. So, I like— there's that really big wall calendar. There's this guy named, I think his name is Jesse Itzler. I-T-Z-L-E-R. Um, and if you, if you Google his— this, because he makes this calendar, it's called the Big Ass Calendar. Um, and it's literally like 4 feet by 5 feet. It's massive. I just got one. So, um, but that way you can, you know, put it up on the wall, uh, so you can see it, your staff can see it. So you can put your goals on there, you can put your marketing efforts on there and what's happening and when, and, you know, workshops and trips and conferences and just You just get it all up on there. So I like that. Um, I talk about planning for your well-being, so you can put your, your vacations on there, your, um, you know, maybe your big vacations, maybe a weekend trip, um, the conferences that you're going to attend. You know, obviously you should be putting the Decompression Summit— if you're in decompression, should 100% be coming to the summit in September. Um, and then also schedule your check-ins. So, the check-ins is where you're going to reflect back on the past quarter. So, you could do these every month, but if you haven't been doing this at all, then I would just start per quarter. And so, that'd be the first day of the new quarter. So, the first day of quarter 2, you're going to put it on your calendar and you're going to reflect back on the first quarter. Did you hit your goals? If so, what went right? What went wrong? And you're going to basically do what we're talking about today. in a miniature format.

Yeah, I think it's really critically important to plan out your year. And there's a lot of doctors out there that— are you taking a break this year? I don't know, maybe we'll see. Well, the wife and I will talk about it or something, and then maybe we'll spur— no, plan out your— build in your breaks. Know exactly when you got your next break coming so you got something to Look forward to. So plan out at least 2 weeks out of the year you should take off, something like that. And, uh, but it's so important to do that because if you don't do them, you'll get through half or 3/4 of the year and it's like, oh, I haven't had a break and I'm crabby and I'm tired and I'm wore down. And so build in those things, plan out your year right from the get-go, and, uh, And those intervals, like Dr. Vince says, quarterly to look back and see, okay, where are we at now? And those are, those are, that's money. Those are tremendous high-level tips.

Yeah. So, step 7 is just wrapping it up, right? And, you know, we talk about this, you know, we need to kind of look back before we can look forward. And we do this so that we can learn, right? Learn from our experience. Again, what? What worked, what didn't work. Because the worst thing is to kind of continue to do something that's not working, obviously. So, but, but if you don't put some thought and effort into, you know, reflection and, and figuring it out, then, you know, you— people do tend to make the same mistake. That's why they tend to stay at the same revenue level, because you're making the same mistake. It's like the video game. You didn't finish— figure out how to beat the big boss. Right? So you didn't figure out that you need the sword back in the room to kill the big boss. Well, we're trying to teach you how to, you know, kill the big boss so you can go to the next level. But if you do this, I think you're immediately putting yourself in the top 3%, you know, and anytime that you can just invest a little bit of time, a few hours of your life, and put yourself into a a top tier of people that are, um, you know, really trying to do big things with their life. I think that's, uh, an excellent use of your time. Um, you know, use a planner. Um, you know, use something that you can work with every single week. Um, and then, uh, I'll— on just on this, uh, I have one question is, is what is the one thing that if you focused on in 2025 or whatever year you're watching this, that it would give you your best shot at achieving your goals. And so here's some, some things to think about: clinical outcomes, conversion, marketing, or team. So if you're not getting the clinical outcomes, whether it's for chiropractic or whether it's for your niches, then you will stay stuck, period, end of story, because you're not doing your job well, right? So it starts there, starts with clinical. That's our first principle here at Specialized Practice. Uh, we are going to be the expert in our particular niche. So, um, if you got that covered, clinical outcomes, great. Move on to the next one, conversion. So in other words, if people are coming in seeing you, um, and you can help them, but you haven't figured out how to show enough value in your service that they will invest in you, then you will stay stuck because you, you haven't figured that part out. You haven't beat that boss of the level. So then you have to work on conversion. And that, what that means is you have to work on your report of findings. If you figure that out, then you need to move on to marketing. Okay, so now you need to get out in your community, whether it's online, offline, whatever the different avenues are, and figure out how do I get more people aware of my products and services and drive them into my office. Okay, if you figure that out, then you need to build your team because you can't do it all yourself. Okay, so then you need to start building out your team and duplicating yourself and delegating and, and having people at different parts of the business that's going to help run it for you, and then you can truly scale. So figure out of those— now, this does not mean you get to skip all the other stuff we talked about already. You're still going to do all the planning. But now we're going to take a 30,000-foot view of this. If I focused on one of these 4 things— clinical outcomes, conversion, marketing, or team— which one? Where am I at on that? You know, which ones do I have covered and which ones do I not? Um, and then focus on that next level in that, in that kind of hierarchy so that you can be putting your time, effort, and energy into the thing that's going to move the needle the most, the biggest lever that you can pull in your practice.

Couldn't agree more. And if you have— if you identify where you're deficient, that's where you're going to put your most of your energy in, into this upcoming year, because that's what's holding you back. So you gotta reflect, identify where you're deficient, and then come up with action plan to move your needle, move things in the right direction. And, uh, that's what I teach a lot of doctors. That's my job with a specialized practice, to help doctors with the clinical part. And if you're going to be a specialist or claim to be a specialist, you better, you better darn well know your stuff, whether it's excellent histories, exams, consults, all those things, and how to deliver very high-end clinical results for challenging conditions. And that builds confidence in you, it builds confidence in patients, who then that increases your Conversion rate, and then it goes on from there. So for what we teach at specialized practice for most doctors, and most doctors are pretty good, but there's a lot of a lot of docs out there that need to really polish up on some of their clinical skills is what I see, and and increase their confidence and their expertise, and then everything kind of flows from that.

100%. Um, okay, so that's going to wrap it up. That's our 7 steps, uh, to the best year yet in practice. Uh, that's our 2025 planning guide. Um, and then one last thing. Dr. Pankinen has, um, one last tip for y'all. What is it?

Yeah, so this was introduced to me several years ago, and it was a book I read. It was called One Word That Will Change Your Life. It was written by John Gordon. And it's just a short book, but his concept— there's a lot of people that, you know, people that are probably listening to this are, you know, they're business people, they're entrepreneurs, they're looking for growth. But sometimes goal setting can be, you know, a very daunting task. And so one thing that's worked with me, I, I do set goals, but one other thing I do is I, I set a— I choose a word I really think about something I really want to focus on in the upcoming year, and I narrow that down to one word. And then that, that's going to be kind of a focus. So I write this right down in my planner so I see it. I have a category called Word of the Year. So last year my word of the year was invest. And so my theme was I'm going to invest in my intern and my son. And I'm going to pour a lot of energy into them because I know if I invest in them, that's going to pay dividends down the road. And I've had other years where my, um, my word of the year was growth. Uh, my word of the year for this upcoming year is wife. And the reason being is because in many years of practice, I've worked so hard at Growing the practice, investing in other people, investing in patients. Sometimes we as husbands don't put enough focus on what's probably most important, which is our our wives. And so this is going to be a year I'm going to make that a focus. But it's it's my one word for the year. So I think a lot of doctors out there though would find it helpful if they utilize this concept of. a one-word theme for the year. And whatever it is you come up with, and probably for a lot, it will be growth or invest or whatever, but something that has great meaning to you. And I have talked to a lot of other people that have done this, and it has been really a meaningful, impactful thing in their life when they picked that word out and kept that front and center, top-of-mind awareness as they went throughout the year. And so, take it or leave it, but it's worked for a lot of people. And the book is, again, One Word That Will Change Your Life. And short little easy read, but a lot of wisdom in it.

I love it. And I don't even know if they need to read the book. I mean, you explained it so well. And I think you could probably just take it and run with it. And even like we talked about at the very beginning, like simplicity and brevity and having that kind of North Star, right? That one word as your North Star for the year. Because what happens is— and that's why I like this, this, the concept, like one word, one thing, you know, how we're going to focus on one kind of high-level, you know, lever in the business— it's like, if you can accomplish, you know, for instance, say, say you got the clinical down, but you're gonna— you, you, you suck in the ROF. No harm, no foul. But if you took all of 2025 or the next year and said, I'm going to become a master at ROF, well, that's going to now serve you for the rest of your career, right? But you take one year to master that skill set. That is a year worth remembering. That is a— that is an excellent investment in your career. And I just think, you know, people tend to want things so fast. They want it tomorrow. They want to double their practice in 3 months or something crazy like that. But if you can zoom out a little bit and say, hey, if I'm looking at the next decade and I can, and I can accomplish this one piece here and it's going to serve me the next 9 years, oh man, I'm going all in on that. So I like the simplicity of that, that kind of one word, and I like the simplicity of just Hey, take this year. You have the tactical things that we talked about, and then, but then kind of, kind of going higher level, right? And getting more simple, simplistic with it. And, and just, it's going to allow you to focus your energy more in accomplishing this one main thing. And I think you'll be much better off for it.

All I can say to that is a hearty amen, Dr. Vince. Preach it, man.

I love it. I love it. Well, look, um, I— that's going to wrap up this episode. This was longer than our normal episodes, but hope— hopefully it gave everyone a ton of value for, um, you know, planning out their, their next year in practice and in life. And so, um, with that being said, uh, for Dr. Pankinen, I'm Dr. Leone, and We wish you all the best. This is another episode of the Practice Builders Podcast, and we will see you on the next episode. Take care.