How Virtual CAs Are Quietly Transforming Chiropractic Practices | #498

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode, I have an interview with a friend and business partner, Dr. Alan Miner, CEO of Chiro Matchmakers. And it's all around virtual chiropractic assistants. That might be a new term to you. It was to me. But now using a virtual assistant is an integral part of what I do in all of my businesses, including my practice. The evidence, evidence based chiropractor, the smart chiropractor, Movement health, AOMC diagnostics, read my.

Mri, all of them.

I use a virtual assistant and I believe that you can and should too. And Dr. Allen and I dive into what are the things these people are doing, who are they and how can this really work for your practice? Because a virtual chiropractic assistant can be less than 10 bucks an hour.

College educated, an absolute professional.

So without further ado, here is my interview with my friend, Dr. Alan Miner.

If you are a lone wolf, if you have a practice at scaling, maybe you have a business enterprise. Today's episode is one you're going to be want to pay attention to. We're going to talk all about virtual cas. What does that mean?

How are we using them?

How can you use them? And why this is so critically important pretty much to every single step of your journey as a business professional, entrepreneur and chiropractor. Alan, thanks for coming on and chatting today.

Thanks for having me, Jeff. Appreciate it.

It is my pleasure.

So we have a lot of docs that I'm sure have heard the term.

And many who have never heard the term virtual ca. Let's just start by defining what that is.

Yeah, in like I think of wellness 15 years ago, nobody, I almost feel like virtual CA is the same way. Everybody's trying to figure out what that means. In our case, we're talking about real life, offshore, remote people to help your practice. I see other people using the term virtual CA as an AI solution. But to be clear, chir matchmakers, we're in the business of staffing up offices. And so these are real people, they have college degrees, they're outside of the United States. And so that's the big secret is, you know, the cost for us to hire them is less than it costs to hire somebody in your practice in the US but because of exchange rates, because of cost of living, these folks are making a better living working for chiropractic practices than they do in their, you know, chosen studied field inside of their own country. So we have engineers, nurses, architects, you know, trainers, teachers, you know, all kinds of people that work as virtual chiropractic assistants. And they make a better living doing that for us than they would being a nurse or an engineer in their own country, which blows a lot of people's minds. But that's really kind of a fun win win. You know, I, I want to immediately. Sometimes people almost get this notion of like slave labor. It's like, no, not at all. We're actually giving people a better lifestyle and benefiting our practice by, you know, helping to lower some overhead costs on, on labor and on hiring people.

That makes total sense to me. And I, I want to get into the specific task that I've used a virtual chiropractic assistant for and as well as what you've seen. But before we get there, there's a couple things that you want to brought up that I'm sure perked up some, some ears and that is like, is management of these individuals challenging? Are they offshore? So is there accents? This will kind of tailor into the different tasks and benefits that they can provide and are currently providing in, you know, hundreds of chiropractic practices around the world. But what offshore? Like, what does that mean? How do you think about management? Some of those challenges docs are initially going to think of what's been your experience.

Yeah, I was sure hesitant about that at first. You know, boy, if I can't see them, how's this going to work? What if they disappear on me and let's just call a spade a spade? That is a possibility. But these are professionals and these are people with long work histories making a living. They want to make a paycheck, so not showing up is a good way to ruin that for them on their end. And also we check backgrounds and references and work histories. It's maybe a benefit of partnering with an agency like ours as we do all the lifting and the working for people to make sure we're finding good people with a solid background zoom. You know, I think folks are really surprised just how much you can do to train and bring somebody up to speed. Just like we're doing this interview on zoom and zoom and a screen share. And it's amazing how quickly you get somebody who's really smart and sharp. And that's maybe something I wanted to find. Jeff, right out of the gate is, you know, I still run 11 different practices in Florida, Nevada, New Mexico and Texas. So, you know, I value our folks that are in the offices greeting our people, taking care of them. So let me be clear on that. But then there's this whole backend suite of work that quite frankly I have found folks who make it through a four year college degree oftentimes are better suited for than the people that maybe don't have the college degrees that, that I'm able to hire for 20, 22, 23, $24 an hour. So I'm getting what we call these A level players. So they're quick, they're fast, so they can learn your EHR system and all. We can talk about all the different things they do, but just through zoom you really are able to coach up a professional quite quickly. These people are out of several countries. Honduras, Mexico and the Philippines are primarily where we are out of, but the majority these days are the Philippines. We've simply found there's a more willing, higher educated workforce. There are varying degrees of accents, but in general a Filipino accent doesn't seem to be so grading to the your typical, you know, United States citizen's ear. If you're using them for phone work. That's just one of the things we do. A lot of these people never talk to your customers, but you know, linguistics English is oftentimes something they learn very early in grade school. And of course depending on the job, a lot of people hire these virtual assistants to answer their phones or do outbound phone work. We screen that quite heavily. And you know, there's luckily massive US corporations, American Express, Dell, Tesla, a lot of these big companies, they have massive workforces out of these countries. So a lot of these people have actually cut their teeth serving inside of these companies. So a lot of times they actually find it appealing to work for a smaller business owner here in the United States instead of a big company. But they've been trained on, you know, basic phone etiquette and accents and a lot of the things people have, have concerns with when they're considering onboarding somebody offshore.

Yeah, that, that totally makes sense. So you mentioned some of the cost of what somebody with the level of skill and expertise that many people overseas have, what that would cost, you know, 20 bucks plus min. In terms of what you see here in the States when we talk about cost of virtual cas, what's roundabout numbers on that? What's a doc looking at? What do they have to bracket and think about in their mind?

Yeah, we charge flat rate, it's $9.87 an hour. The way we do that for our customers is our specialty. Jeff is really in sourcing people. You know, for an average hire, for a chiropractor, we interview, we find and interview on average about 200 different people. And you know, it's, we have to do an onboarding call with the owner so that our team can really extract what's the skill set of the ideal person. You know, there's not a unicorn or a jack of all trades. So if a clinic owner, they might want somebody doing more of the design editing work to handle their social media, it's really easy for us to find those people because we know where to look. Somebody else might need help with phones so maybe their voice and past history and work experience is going to be more important. Somebody else might be looking for. A lot of people hire us for data, for their bookkeeping, for creating their KPIs, their daily metrics, EOB insurance, you know, mapping people out, doing work inside the ehr. They might want somebody that's more of that kind of data analytics, bookkeeping, accounting, kind of a background. So and sometimes people want somebody that does all those things like a traditional in office ca and we can find that. But you're going to give trade offs. You know, the person who's maybe great live with your person might not be so good at the details versus the person who's really good at the details in the back office stuff might not be the most personable stuff. You're going to make the same trade offs with somebody offshore. And what's really been remarkable to me Jeff, is simply at, you know, when you're paying in the US 20, you know, we place in office CAs for docs and the average is around $23. And there's some, like I said, lovely people. We've got a great team of them. But oftentimes these folks don't have degrees in the U.S. usually when you talk degree you're talking 50 to maybe $80,000 starting on average. So for this $9.87, you're getting yourself into this executive assistant level atmosphere and again the 987. Then after we find and vet a person, as I was explaining, then we send video clips of the top people we find and our owners pick two and then we facilitate the interview with them. And once they hire them, then we run the payroll twice a month. We have to hire people a minimum of 20 hours, Jeff, because they, this is their livelihood. So we found less than that. They're trying to piece too many different jobs together. So typically it's a minimum of 20 hours a week at $9.87 and we handle all of the international payroll, the exchange rates, we do all of that and we make A small margin on that payroll is how we stay in business. But what it does for the practice owner, it gives them an, an expense, a line item expense, you know, like you're paying your EHR system or your phone service that now you're not having to deal with, you know, PTO and vacation time and hours. Of course, virtual assistants do take vacation time off, but it's simply unpaid. Now some owners, you know, when they get that person over time, what's happened to me is we, we have, you know, these folks that are absolutely integral parts of our business, then we want to give them perks. So, you know, but we can accommodate that with our owners. When you find somebody really good, like somebody working in your office, you want to take good care of them.

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Did I answer your question? Did I go around it?

No, totally. Yeah, you totally did. And I can speak into this for a moment as well because, you know, within Chiral Matra makers, I've used virtual cas and I've used them for, for a pretty diverse range of work, maybe beyond what, what many of the listeners will, but I'll throw it out there, really just piqued the interest. We've done, well, web design work, we've done research work based upon being able to understand a market and then marketing as we move forward with that, amongst a host of other items as well. So I guess when I'll ask you, Alan, you touched on a couple of these things, but a doc listening what is typically maybe a couple of the first projects as you're speaking with docs that it's like, oh, I'm interested, I want to dip my toe in, I'm not ready to turn over all my office operations. But like what are maybe one, two or three of those items that you see docs getting started with and then what's kind of the bracket you touched on the process. But what are some of the things where you're like, okay, now this is what I wouldn't recommend and where, you know, so maybe both sides of that coin.

Yeah, great question. You know, what's interesting a newer one for us, but people always grab onto our podcasts, you know, and so something we've done so much of this Jeff, that we have SOPs. We can help owners if they want to have a virtual assistant, handle phones. We can walk you through how to do that, what phone systems are best if you want somebody. If you've got a server and not a cloud based ehr, we can walk you through how to certify them on hipaa and you know, how to get into your server in a way that doesn't disrupt the rest of the office. Podcasts are a new one. You know, we can a lot of, you know, I think every chiropractor should have a podcast and you really architect this out for our team so that, you know, we can walk somebody through how to do a podcast. A lot of times it's podcasts, social media. I think podcasts and your social media channel aren't maybe necessarily direct marketing plays for your practice owners, but boy are they important parts of building a good practice. And you know, your existing people listening to your podcast, watching your Instagram presence, their ongoing value that you're building. The email lists that you provide for us for my clinics, you know, driving people from those emails to the podcast and the Instagram pages helps keep keep people plugged in, helps educate them about the services we offer in the clinics. So those are things that we tried for years to offload off to staff and people just didn't love doing it. You kind of got to be wired a certain way so you know, now I can. And again, you trained this Jeff, when we'd be together, you just. If anybody goes back and looks at, at our Power Matchmakers Instagram page a while back or my Instagram page, Alan Miner, you know, a lot of that is you asking me questions off camera, I'm answering them and then you know, we send them off just that raw footage and they're the ones who, who cut it and edit it into reels. And so it's making that easy for the owner is how we've been able to put it. A lot of produce a lot of content. So those are interesting tech ones that I think just add to the culture and the long term value of clinics that everybody knows they should be doing. But a of people aren't doing the monotonous stuff, the billing. We don't typically find billers, but we find people that have done billing. So they understand EHR, they understand coding, they can help upload EOBs, do follow up calls with insurance Companies, you know, all that support work for the billing is really popular. Also a personal injury we just found you know, having a really solid virtual CA who can send off of course all the notes and everything to the attorneys. But then the follow up, we've really. Personal injuries slowly, like a lot of practice owners become a big part of our practice revenue. Not intentionally for us, but so we had these balances. It just kind of, you know, they'd sit there for one, two, three years and then one day when they're ready, they call us and we hopefully get a check. Now we have a VA who literally calls on our cases every one to two weeks. And we just found being that annoying squeaky wheel, just checking in attorney. How's the case? Any progress? Okay, thanks. It was amazing. Looking at our receivables year after year, how much we, you know, just sped up getting paid because we were, we were bugging people all the time. That's been a big one. Phones, of course, you know, answering hours, you know, if you're doing any kind of SEO spend, Google spend to then miss those calls when they finally come in. Just hurts when you own a practice. And so, you know, a lot of times people start on lunch hours, on weekend hours, on evening hours, on morning hours with phones and then that often expands. We don't have the phone ring in any of my practices because we want people to be present with the people in the clinic. And when that phone rings, we know we've paid three or four hundred dollars to get that phone to ring. We don't want that thing to ring more than twice. Early on I paid for Google Ads and I had a snippet put on the site and at the end of the month, out of 50 calls from Google, we picked the phone up one time and I just thought, well that was dumb, we better answer the phone more often. And then I think the next day I was calling an H Vac guy and they didn't answer. So I called the next one on Google and they didn't answer. And I called the next one until somebody answered. And that's who I hired. And I realized, huh, that same thing's probably happening to me with our clinics that we're paying to promote. So that's a big deal. Answering phones also, not to mention just keeping your clients happy, you know, they want to get a hold of somebody live and then the other one. Now with a lot of the marketing that people are doing inside, go high level. I think you taught me, Jeff. You know, every minute that goes by from when they opt in, you're, you're losing that, the warmth of that lead. So our team gets notified instantly and they're all over that lead. And so we jumped up our schedule rate on marketing by 20, 30%. So there's a lot of different ways to use these people. And then maybe the entry point to answer your question is a lot of people just hire us for projects. They've never. Probably one of the biggest concerns people have coming in is do I have enough work for this person? And so, you know, we structure. If they're doing social media, if they're doing insurance, you can kind of segment the hours that they're doing. If they're doing phones, you'll have them available, you know, the certain hours you want the phone answered. And of course if they're not busy on the phone, it's nice to have them working on something else. But if you're still just trying to get your head around this. We do a lot of project work for people and one example is, is, is we're both members of UAC and there's a big lift. Right now UAC is doing the top 20 most influential chiropractors. And so there is a list that I generated of nominees and then all the UAC membership added people in and, and we didn't know a lot of those people. How, how do we contact them? They're nominated? Well, we hired CMM to simply reach, do outreach to get cell phones and email. So we just start, you know, googling and calling people. Hey, you've been nominated, we'd like to send you the information packet. When people are changing ehrs, when they're uploading data from one system to another and you get this monotonous repetition. A lot of times people will come hire us as one off project work for a 10, 20, 30, 40 hour job. And sometimes that gets them used to using a VA and seeing how it works before they, you know, hire somebody kind of to put on the payroll, if you will.

Yeah, that makes a lot of sense. I'm going to encourage everybody listening and watching. We've dropped a link down below so you can connect with Alan and the team at Cairo Matchmaker makers Complimentary call and just discover, ask questions, discover how you can utilize a virtual CA in your practice. One thing I can speak into is I think everybody listening has tasks that they either aren't getting done, they know they should things that are getting done late, things that you avoided the whole host of items that co in to running a chiropractic practice and being able to utilize a virtual CA is one way easier than you think. So schedule a call, have a conversation, walk through the process, and two, it's super affordable. And to get affordable help that is ultra professional is just so nice. And that's been something over the last year and a half, two years for myself, I've really discovered, wow, this is way easier than I thought. And the quality of the work is so high that it's great. And, and guess what, it's one of those things where as you start to utilize the services of somebody who might be, as I'd say, beyond the four walls of your practice, you start to then uncover and discover other areas of opportunity as well. And that's all leverage for you as a business owner. So, Alan, I really want to say thank you so much for coming on and chatting today. Again, everybody listening and watching. Connect down below with Alan and the team. Alan, any closing thoughts as we wrap here?

You know, simply Jeff, as you're talking there, I was reflecting, thinking this really has brought stability to our businesses to get really high quality people. But even more importantly, I was looking at our offices and we don't have the CA turnover we used to have in office CAs, the live people. And I think what used to happen is, you know, we'd hire a CA and they'd have to do everything and now they're much more specialized. We hire people who are people, people in the office. They. So all they're doing is greeting people and checking people in and checking people out and all that. You know, insurance work, KPI, data accounting, all the stuff we talked about, editing of reels, social media, they don't have to do that. So now when somebody leaves either side from a virtual assistant leaves, or in an office CA leaves, we're not so vulnerable. There was a time there when a CA left, we were screwed. Like they did everything. I didn't even know everything they did did. And now you know that our, our work is much better divided. So somebody leaves. It's a little uncomfortable, but it's not difficult to find somebody replace them because they're not such a jack of all trades that know every corner of the business. And I think that has really brought stability. And the fancy word we use is operationalized our practices so they're a lot more stable. And quite frankly, what that all comes back to is I sleep a lot better at night. I'm not so exposed when somebody leaves our team.

I love to hear it. If you are listening and have not experienced utilizing a virtual CA in your practice. Click down in the show notes Connect.

With Alan and the team at Cairo Matchmakers have a conversation.

Now is the time to do so. It's time to get set up over the summer so that you can ensure Q4 is your best quarter yet. Alan, thanks so much for coming on and chatting today.

Thank you, Jack. Appreciate you.

Thank you for joining us on this episode of the Evidence Based Chiropractor. If you want to grow your practice, come back for next week's episode. If you want to grow faster, Visit the evidence basedchiropractor.com and join our MD Marketing membership today.