How To: $1 Million/Year in a Tiny Town

Well, I have Dr. Berchtold on a consult tomorrow with me, but I also had a consult with Dr. Karami, and both of them have similar questions or inquiries of me. They, they kind of want to know how the heck we're doing million plus in a town of 850, and I've had other doctors that have called me that aren't even part of our group. And so how are they hearing about it? It's all Dr. Vince, but please do. But, but I was thinking maybe of putting together some type of a separate recording for that. Is there any value in that?

Here's what I think we should do is a case study. And a case study, and by the way, I want to do this with Dr. Jim too, because Rarely does someone go from $45,000 a month to $93,000 a month in 3 months. And I've— and it's literally on my radar. Like, you know, you know my planner that, you know, and there's that little radar section. Case study with Dr. Jim has been on there for about 3 months now. But here's what's important. That's what I love about the planner is like, it— I will do it someday. It's just there's, you know, you, you have higher priority stuff that you have to get to. I think a, a case study would be great. So a case study is essentially in kind of an interview, right, where you just present, hey, these are the results. And then you just ask, you know, 5 to 7 questions about how you did it. You know, and, and it's just, you know, we're trying to elicit the model, right? What, what steps did you take? What did you do differently, if at all? You know, what were some of the bottlenecks you experienced in that growth? What big changes did you make? You know, one thing for you is the big expansion. I mean, was that at the beginning of 2023 that it was done? Or is that '22?

Well, it was finished in the last quarter or so of 2022, but 2023 was the first full year. Yeah.

And then, and then you hit $100K in March.

Correct.

So that was a big part of it was just space. Like, I sat from, you know, obviously this was our— these conversations were a couple of years ago, but if I recall, you were kind of It was just a space issue with, in terms of accommodating more volume.

Oh, that was, that was a big part of it. The demand was there. We just couldn't process demand and we needed more space.

And so then, and then the question is, oh, well, how did we get the demand? You know, and, but yeah, I think we should do a case study. But I think the biggest thing was, you know, for you getting the demand, right?

So No, there was no doubt the marketing was the game changer. I mean, I can't argue with that at all. I mean, we saw a substantial uptick in new patients with the marketing, and the more consistent we've been with— I mean, we've been consistent with it, and it's just like a machine. And actually, I was going to comment on that because, yeah, we had— I didn't do 10 new patients in a day like Dr. But last month we had 39, and this month we're going to be close to 50 new patients. I mean, so it's been, you know, 10 a week, pretty steady here lately. And, you know, that's— and a lot of them are coming in as a direct result of the marketing. Some's word of mouth, and— but it's, it's not any one source though. It's a couple from the radio, a couple from the newspaper, a couple from Facebook every week, and then, you know, some word of mouth. And so It's, it's just a testament to the fact that you gotta have diversity in the marketing and you gotta stay at it consistently.

Yeah, I think that's the big— the consistency is the big one. A lot of doctors will jump in and out from Facebook agencies or, you know, unfortunately most of them only offer Facebook and, you know, and Instagram. You know, it's nice to be able to help with the other platforms as well. But, um, what, what you have benefited from that I have, you know, seen in the, in the metrics is the consistency, because the, the algorithm learns, right? The algorithm continues to learn over time, hey, who should I, you know, who's the best person to show this to? Because we keep feeding it the information from the people that, you know, have shown up. So What it's like, you know, it's like seasoning a steak that, you know, the longer you can season it, the better it gets. So the same thing with, with the pixel for Facebook and the algorithm is like the longer it learns. So algorithms are essentially large data learning models, right? And so the more data it gets, the better it gets. So the longer you're marketing and using the services, the better it gets. It just is what it is.

Yeah, you're the master at it. There's no no argument. It's it's phenomenal. I never dreamed how many people would come from an hour away in all directions, and it it's it's just phenomenal to see it. By the way, Doc, that planner that he talked about, the radar thing, I have it right here. Planner is just— it looks blank like this. My writing is awful, but you just put these different categories on there. And that radar thing, number one on my radar is decompression presentation. So I'm going to start getting my presentation ready for September in the next hopefully few weeks here coming up.

Yeah, we just had a big, uh, big— our first Decompression Summit certification pre-planning meeting yesterday. So that was good.

It was good. It's going to be bigger. It's going to be better.

I want to hit 200. I want to hit 200 attendees. I think that's my internal goal. I don't see why we can't do it. We did 100 last year, so we should, you know, really, we did 100 with no paid marketing. So I think if we, you know, do the same thing we did last time is, you know, us and everyone else, you know, email their lists and let them know about it first. And then second is, you know, running paid ads. And I think we can 100% hit 200 attendees. And for everyone listening, it is gonna be bigger better and different. So if you went last year, this is not going to be a rehash, right? Which is unfortunately what most summits, you know, events do. They just kind of teach this, you know, this is the same stuff every time because that's what's easy, right? But we don't— we're not going to do what's easy. We're going to do what's different and better. So we will have— and we've talked about this, right? Well, one of the key things Advanced training on report of findings. And I think that that's gonna be super powerful for people.

Oh, yeah, that's, that's where the rubber meets the road. I mean, you gotta, you can get the patients in the door, but you gotta be able to work them up correct and then finish the deal in a sense. And that's where the, the report of findings is, is key. I mean, you gotta at least be hitting 50% or higher. Otherwise, You're kind of wasting your marketing dollars.

100%.

100%. And along that lines, I was gonna say the group. I mean, it's not only gonna be new material. It's gonna be. That's why I want to emphasize we're gonna do. I'm putting together a brand new presentation that I didn't do last year, and Dr. Burkhardt's gonna be doing new material, Dr. Vince, and we maybe will have a surprise speaker as well. Plus, there's gonna be. A lot more for the CAs at this seminar as well, with breakout sessions and training in areas of decompression, but also laser shockwave and other things as well. So it'll be the— it'll be a full meal deal.

At one point, or maybe in a subsequent— I don't know if we can, if it makes sense to do it at this one. But almost have a training specifically for the financial portion, because then sometimes that's a doctor, but sometimes it's the staff member, right? So I think we'll be going through, obviously be covering, you know, how to, how to talk finances with patients in this year's summit. So I think what we want to make sure to do is not have maybe a big CA thing during that, because the CAs A lot of times are doing the finances, you know, and so we want to make sure that they get that, that information downloaded and dialed in as well.

Agree. I think a lot of doctors— I mean, I'll be honest, my CAs do my financial, the financial stuff, and if they're confident and well trained and you've done— you've worked them up good clinically, answered their major questions. You know, what's wrong? Can we help? How long? All those things. And, and address a few of the Four Horsemen and so forth. And, you know, the finances, that's just the final step. And that can be handed off in some instances if you have somebody that's well trained to do it.

I think in a perfect world, it is handed off. You know, I kind of like the idea of separating the finances from the doctor. I didn't, you know, and that's why I put the training in there so that because some doctors, there's, you know, I personally did not like handing over my, you know, kind of quote unquote financial destiny to someone that made $20 an hour.

Yeah.

But because it's sometimes it's tough to ask for $5K or whatever the number is if you can't afford it yourself. That's when I think it's better for the doctor, but to do it. But if you have someone that's trained right and they don't have— some people, regardless of what they make, they don't have a problem asking for money, you know. And so that's who you want, you know, in terms of your, you know, whatever, you know, office manager, you know, patient success manager, whatever you want to call them, someone that's talking finances with patients. Call them a financial manager. I don't care. Point being is that person should be unafraid to discuss finances and it should not seem like a big deal. That's really the, you know, I think ideally, you know, it's nice to be able— the doctor brings them up, front half, Four Horsemen trial, and then handoff.

Yeah, I agree. And under ideal circumstances, that's good if you got that person and Because that, that can be very time-consuming too, right?

Because you're going through each option. Not always, but some, you know, sometimes they just pay upfront and it's done. But sometimes you need to go through each option and, and talk with them about it, right? And, and figure out how are they going to be able to pay for it. Then maybe they need to do financing. Then they have to fill out the form. Well, all this stuff is time that the doctor could be treating patients or doing another consultation or, you know, working on his goals or, you know, taking notes in his book about, you know, how that report went, etc. Et cetera. Um, anyways, the, the time-consuming aspect, um, is almost reason enough to pull the doctor out of that, uh, aspect of the ROF.

Yeah, I couldn't agree more. I mean, that's, that's, I think, one of the biggest keys to growth in any office is, is it's— I mean, it's no-brainer to say it, but it's the staff. You got to have, you got to have a couple rock stars around you, or at least close to that. That are, you know, high-end A players or at least high Bs. And that will— and then you can hand off so many things so you as the doc can just focus on— I mean, truthfully, my day is I examine, adjust, and then my— and do some documentation. But my staff's helped me with that. But my staff does almost everything else for me.

So I think that's one of your big differentiating factors is the quality of your team. You know, because we can talk about the marketing, we can talk about, you know, the clinical, but man, if you didn't have that support team, there's no way you would hit $100 grand a month, you know. So we should make a mental note about talking about team hiring, managing, encouraging, supporting. Um, it's just, it's just massive.

Yeah. And the more responsibility you give them and, and make them feel as a valuable part of the team, the more, and that, that they more, they just embrace their roles and see. And, and well, the other day I, I went back to the back of the clinic where we have all of our therapies and so forth. And because I had just finished stats for 2023 and all of our niches, and I just went back and told those else, what a great job you're doing and how many people's lives that you are positively impacting with these high-end therapies they're doing. They just light up and they just glow because, you know, they feel like they're making a difference in this world and that they're part of something bigger than just collecting a paycheck. And, uh, so it, uh, so it, you know, it's, it's— but without those staff back there doing that, half of my practice last year was the stuff we're doing with niches and laser and neuropathy and decompression and shockwave and all that stuff. So it, uh, and they just, you know, I got 2 staff, they just do, that's all they do all day long. And, uh, you know, so valuable.

And I think, you know, I'm sure we've all heard about the love languages, right? Um, team members have quote unquote love languages as well, right? Not all of them are motivated by money. And in fact, if they are motivated by money, it's probably not the, the, the best thing, right? I mean, you can, you can certainly, you know, support them in that manner, like with bonuses. Like, they should be performance bonused based on their role, right? So, um, not, not like bonus if the— you know, I don't like the rising tide lifts all ships bonuses. Like, in other words, like, okay, the practice says $100 grand, everyone gets a piece. I like when, you know, team members are bonused Based on their performance. In other words, front desk is, uh, uh, bonus based on number of consults that are scheduled and show. Um, techs are bonus based on testimonials and referrals, um, and reviews. Uh, your, your, your financial person is bonus based on closes. Um, but, you know, none of them are making $1 million a year. We're, we're all— we're the one that's making all the money. To be totally frank. Um, but what Kyle was just saying is like, hey, the recognition, you know, and the involvement in a, in a bigger mission and purpose and, and, you know, you know, changing of the lives of the people in the community, that those are the things, right, that you can really help support your team and build their, their buy-in. with the company, with the practice. Um, that's where you get long-term, you know, team members, is when they, when they buy into the mission, they feel supported, they feel praised. Um, sometimes just giving them a, a, a different, uh, title, you know, like maybe someone's been with you for a long time, maybe they elevate to the office manager position so they get a new title and maybe a little bit of a bump in pay, whatever it may be. Um, but you need to figure it out. You, you need to figure out what with each individual person what motivates them outside of money and remember that and, and then, you know, incorporate that into how you manage them and support them.

Absolutely. Praise goes a long ways. Telling them thank you frequently goes a long way. Bonuses goes a little ways. Money goes a little ways. But some of those other intangibles, that's, that's what And then if they start to view it not as this is, this is not my job, this is my career.

Yeah, that's what a, what a great observation.

That's huge. When they trend, when they transition to that, then you know you got a high-end staff member.

Yeah, that is a really, really great observation. Um, yeah, job versus career, because then they're in it for the long haul, and that's, that's what you want.

Obviously. Yeah, we've been able to have that now with several of our staff members that have been with us for, you know, 10 years or more. There's 3 or 4 of them that are that way. And so, and, you know, things could change tomorrow, but to have that stability is huge. And that they, they don't seem like they're going to go anywhere anytime soon because they, they can look ahead 10, 20 years and say This is where I want to be.

And especially if the practice is growing and being successful, everyone wants to be on the winning team, right? So that's part— that's part of our job as well, is building, you know, the, the successful practice so that, you know, that they can be proud of where they work. Oh yeah, you know, I work at Dr. Pankinens. Oh, you work at Dr. Pankinens? You know, that, that's a big deal. Again, not a money thing. Not a money thing, a pride thing.

Especially in little communities like I have, because people see them around town, they just— there's— oh, they— people talk about them seeing them at the clinic, and, you know, they recognize them in public. And so they get, you know, they come in on Monday and say, I saw patient so-and-so, and they were talking about you, Dr. Kyle, or whatever. But they— it brings a sense of pride. to them.

100%. 100%. Well, it'll be interesting to, you know, uh, have those conversations with Dr. Jim and, and Dr. Marjan. Um, and, but I do think we should do a case study because we can dive in a little deeper on some of these topics. And, um, and I think it'd be valuable for everybody.

Sure. I'd be happy to do that anytime. And, uh, so just want to get your thoughts on that. And, uh, that's That's, that's for us. That's all I have to say about that.

Perfect. Well, on that note, we'll wrap up this business Q&A. So thank you for everyone that attended, and thank you for everyone that's watching on the replay. Great call today. Again, you know, this, this being part of a community like this, I think, is super important. A lot of times we can kind of feel on an island. You know, when you run your own practice and you are, you know, the driver of the practice, there's not always someone that you can talk to about your wins and your, you know, the highs and the lows and everything in between. That's, that's kind of what this is, is designed for. And I think that, you know, the more doctors we get in here, the better it gets. So that's it for this Q&A. Hope everyone has a fantastic rest of your day. Keep in mind now, this is the end of 3rd quarter. So we're moving into not 2nd or 3rd quarter, end of 1st quarter. So do an assessment this weekend. I highly recommend, hey, you know, are you on track with your goals for your 2024, you know, total goals, right? Your broad, broad-reaching goals. So now you have 3 months in the books. Go to Starbucks, go to whatever, you know, just— but, you know, get your notebook, get your stats, and put some time with— this is working on the practice. I'll certainly be doing it this weekend, working on the business. Hey, am I ahead, on schedule, behind of my goals for this year? What's working? What isn't working? What needs to, you know, what needs to happen to make it work, you know, and, and then plan for second quarter. So I'll leave that with— leave it on that note. Hope everyone has a fantastic weekend. We'll see you all next week, same day, same time. Take care.