EP 604: Transforming Practice Success: A Conversation with Josh Wagner on Patient Mastery

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Welcome back to the Habit Based Lifestyle Podcast. I'm your host, Jesse Yule. Today we got a very special guest, Mr. Jo or Dr. Josh Wagner. And Josh is the creator of coaching program called Patient Mastery. It's, it's actually an amazing program. I have several clients in it. They love it and they love Josh. But Josh, you're doing amazing things. Can you tell us just a little bit about Patient Mastery and then we'll kind of get into, you know, you and your story.

Yeah. Thanks, Jesse. So Patient Mastery has been around now literally 10 years. It's flown by. We've helped over 700 docs. What we find in chiropractic is that docs are passionate and really smart when it comes to the clinical end and don't know how to be the CEO of their practice. Don't know how to market for new patients, don't know how to get patients to pay cash out of pocket and follow recommendations, especially from what we call a patient centered approach. So rather than trying to sell or close or overeducate patients, we show them a different way to communicate where they feel good about. Like they'd be happy if their own mother was a patient. And practice gets easier. It's more fun. You make more, you help more people and you get seen as the go to doc. So that's what we focus on, just helping really awesome chiropractors do it better.

That's great, man. Ten years, huh? Okay, so that's, that's a good solid amount of time. You're probably one of the first guys who actually started coaching chiropractors because I know it's, it's fairly new, you know.

You know, it's, it's, that's actually something I was going to bring up as a story because I know you're not a chiropractor, Jesse. But chiropractic coaching, that's been around since actually the late 70s. There was just a few that started and then it's actually, I mean we're talking that's 45 years ago, right. It's gone through a bunch of transitions. Like back in the late 70s 80s insurance was huge in chiropractic. It was so easy. And most of the coaching and practice management was catered on how do you sign people up for one year care plans, see them 100 to 125 times, waive the co pay because insurance will pay you a bunch. And there's really famous old coaches that would say you have to be retarded to not be pretty much a millionaire in chiropractic. And back then it was true. But insurance isn't the same now. Most of the doctors we see, they don't even really take insurance. They, but they still struggle with charging cash. So what happened was in the 80s and 90s it was all education based. How do we convince people that they should come three times a week forever or you know, six months and then taper down and once a week forever. And if they're paying $10 copay or let's just not, you know, let's break the rules and not say anything and not charge them anything, just keep coming, it's a lot easier. And then everything changed. Like when insurance started declining and disappearing, chiropractors realized oh my 45 minute recommendations, conversation making the spouse come to a lecture at 7pm at night, that doesn't work as well anymore. And then what changed in the, I would say early 2000s is the coaching field went from education to fear tactics. And that's when I got into the field. Like that's when I started, you know, even before I was a student I was interning in chiropractic practices and ones who are coaches in the field and the fear tactics, whether it was blatant stuff like if you don't address the subluxation it's going to turn into cancer. That's the extreme to the whole let's make a mountain out of a molehill and just like knife like oh, you have three headaches a week, that's, that's 150 a year, how awful is that? And it's like, well you know, most chiropractors didn't get into the profession to be like a fear monger. And then what I've seen, what's changed over the past 10 or 15 years is it's gone from fear tactics to sales tactics. Yet most of the sales tactics that are being taught are the same things that have been from the 80s. And people are hearing it from their mechanic, they're hearing it from the carpet cleaning service. And then to hear it from a doctor and their chiropractor to feel like they're getting closed. You know, sign on the bottom line today and you say 50%. Most chiropractors also didn't get into chiropractic to feel like a salesperson. What I love is I feel like we've evolved the game of showing how you could have three day weekends, you could speak to patients no differently than you'd want your mother to be spoken to if she was a new patient. Get paid really well. Like, you don't have to see 500 people a week to make a great living. And it just ticks the boxes for what chiropractors want who are in it to help more people get well but also get paid well.

Yeah, I mean, I, I think, you know, maybe the coaching side is. It's like anything, right? In the last like four or five years, coaching has really taken off in every industry, you know, and obviously there's, there's obviously like the older coaches. And then things change, times change, focus changes. Let me, let me ask you this, man. Obviously you, you were a chiropractor, right? What made you become a chiropractor and then what made you kind of transition to becoming a coach?

Great question. So at around 20 years old, I'm a sophomore at NYU in New York City. No direction, constantly thinking, what am I doing here? Like, you know, I got a lot of scholarships, but it was still expensive. And then one day, literally chiropractic popped into my mind. My only reference was my brother and mother both had good experiences with stereotypical stuff. Low back with a chiropractor. But it was enough at that point. Let me go talk to some chiropractors. All the ones I talked to, they loved what they did. They were super generous. They wanted to help me. And one of them I saw was a lot more successful. I started interning with his practice during the summers of undergrad. And that's where he had an associate who was like that. De. I don't know if you know that, Jesse, but just very philosophically based. They connected me with the Pasquale Serrasolis, the docs in New York City, and that's where I learned the philosophy. And that's what hooked me on chiropractic is this understanding of Vitalism and self, self healing and just that humanistic aspect of the field. And I also noticed because the Cairo interning with was a coach in the field, there was this whole industry of chiropractic coaching and I'm just 20, 21, 22 before going to grad school. And I also realized, and this was like the biggest coaching company at the time, I'm 22 and I was like, this stuff is outdated. Like this doesn't make sense. This sucks. I don't want to have to give hour long report of findings for every new patient that comes in and we walk out of the room looking like we were in a wrestling match. That's what it was like. It's like that's not what I want to do. So I realized even before I went to Cairo School, I'm sure I can make a difference in this field. And then what was interesting is by the time I graduated Cairo School, I realized the day to day patient care aspect didn't light me up and fuel my passion nearly as much as I thought it would. And maybe it's because I never had my own chiropractic healing story. So I couldn't relate to the patients as much like I'm happy for them. Your headaches go away, your back is better. But I couldn't relate, however, having failed in the first six months, I'll say that in the first six months of practice and waiting six to nine months after graduating before starting in practice because I just wasn't ready. My head space was a mess. I was in fear mode. Helping a chiropractor get over that hump of feeling like the redheaded stepchild to medicine, of not knowing how to talk about fees, that lights me up, that inspires me a lot more. So where I thought, oh yeah, like later in my career I'll end up helping chiropractors. It really started like five, six years in.

Wow, okay. Did you have your own practice or did you start out as a associate and then you know, open or like kind of. What was your transition from chiropractic school?

So right when I graduated, I thought I was going to open up in Charleston, South Carolina, which was not too far from Life University. I fell in love with the environment, but I wasn't ready to open so I couldn't find office space. It didn't feel right. I spent a couple months driving around and then went back north to New York where I was, where I grew up, where family was with my tail tucked between my legs and still for a few months didn't know what I was going to do. Spent some time in other docs practices, just helping out, trying to get my head on straight. And then I finally found space in Manhattan on the Upper east side. Small space that I started out in and started from scratch. But there was a, there was a delay period and you know, the ticking time bomb was the, I think student loans at that point you got like a one year grace period before you had to start paying back or before the interest or something like that. But then started from scratch and the first six months weren't so great, weren't pretty. And that's where I realized I got to do something different than I was taught in school or the typical coaching at the time.

Nice. Yeah. So I mean I, I think one of the common things that, that we see is, you know, hey, just get, you know, get your license and everything's going to be fine, you know. And I think one of the things you realize really quick is if you open your own business, like, you know, what you learned in school is really just what got you permission to open your own business. And then you got to learn everything else, right?

School makes you safe, it doesn't make you money whatsoever. And most chiropractors also know school doesn't even teach you that much about helping people get well. It teaches you how to not mess up, how to refer out, what to look for in red flags. So that's why so many chiropractors need to go and upgrade their technique or get modalities to feel more confident on patient care. And then of course, when it comes to communicating with patients, I talked about those phases throughout, throughout our profession, from education, fear to sales. And that's the big need right now. Because insurance is just constantly declining, which is understandable. And the majority of patients are coming in with high deductibles or just no insurance. And most chiropractors, given it the old college try of whatever they think they should say doesn't cut it. Most chiropractors also don't know how to value their services. I have this expression in patient mastery. Don't choose your fees based on your own wallet. For a couple reasons. Most chiropractors don't pay for chiropractic care anyway. They get free adjustments. So they don't even have this understanding. Most chiropractors are getting adjustments not because they are getting over an issue like your new patients are. They're getting them just for maintenance and wellness. And that's all good. So then when you have someone come in With a legitimate concern. Let's say a blown disc, chronic headaches, can't sleep through the night. We can't even put ourselves in their position. And. And we end up defaulting to, well, what do my colleagues charge? $40 a visit, $70 a visit, $95 a visit, whatever it may be. Rather than charging what you want to get paid now, again, we're stepping away from, like in network insurance, where you're kind of handcuffed. I'm talking about your network, all cash. What do you want to get paid and when. If you're a chiropractor, we're not talking about Lamborghini fees here. You choose what you want to get paid in exchange for helping someone get back to their life. Like someone with migraines, Whether they're all gone or they're 80 to 90% gone, you've changed that person's life not just for the next month, but for the next decade and decades. That's worth tens and hundreds of thousands perceptually, conceptually, to a person. You can put whatever price tag you want on that, and it's going to be worth it to them. But chiropractors don't think like that. We think, oh, well, insurance reimburses 4,987 for a 98941. So I gotta be in that range. Or my colleague charges this, or my mentor who taught me my technique charges this. I could never charge more than him. So we get stuck. And a lot of what we do in patient mastery is just like, peel away the onion of, let go of all these false stories, and you can get paid what you want to get paid, especially when you communicate in the right way.

Got it. Yeah, we. We kind of call that, you know, where we are is like, get paid for the results that you help people get versus the amount of sessions you give them. You know, because ultimately what people want is they want results. They want their problem solved. They don't really care how many sessions it takes to do it.

100.

So, you know, it's like changing the focus of. It's not about the sessions or the adjustments. It's about the person getting the results they ultimately want. And that's the focus that most people come in with, right? Is like, hey, can you solve my problem? And that's all they really care about 100%.

And that gives, you know, another form of communication we teach is what chiropractors think they have to say to a patient. Oftentimes sabotages a patient from starting and paying and following and referring and all that. And an example is, you know, a common new patient recommendations in the Cairo field is, well, it used to be a year and a lot of visits. Then some of the coaches started getting a little savvy and realized humans don't like that anymore, especially when they have to pay. So they went down to three months, 36 visits, and a Cairo. To a typical Cairo to be like 36 visits over three months. That's not so much at all. Like, that's how many times I get adjusted. But to a patient, 36 times is a lot. Like, that's, you know, people have lives and. And so think about it like this. If you tell someone we're going to work together for three months, it's going to be 36 visits and it costs whatever. Immediately they hear 36 and they're like, I wonder where I can get the same result in less time or less effort. So what if you just said, we're going to work together for three months, we're going to start at three times a week. As you're getting better, you're not going to have to come in as often. And it's going to be this. Now, you might have to see the person 36 times, but guess what? I want to be gentle on how I'm seeking this. If you have to see the person 36 times, it's probably from an old model of you need to get reimbursed for 36 rather than it clinically needs 36. Right. So instead of, let's just hypothetically, for sake of numbers, say your visit's 100 bucks. So 36 visits gets you paid 3,600 bucks. What if you can get that person well over three months in 16 visits? Well, instead of only charging 1600, why not still charge the 3600? Person's playing the same, but they're actually happier because they're coming in less. You're not taking them away from their kids and their errands and their dogs and their work and all that. And it's actually more attractive. You do less work. Now, I'm not saying give less care if that's going to compromise the results, but a lot of recommendations and care plans in the field has come from a place of what can we get reimbursed by insurance, not what does it need to get the patient? Well, and when you separate those two and decide to charge what you want for just doing what gets a patient well, it's actually more attractive to a patient. And more of them will start Pay, refer, and follow your wrecks, for sure.

And a lot of, you know, I don't want to go somewhere where I got to go three times a week. Like, I don't have three times a week to go somewhere. And most people don't. So, like, I think kind of your point in this is like, look, don't just sell the model that everybody else is selling. Sell the model that's actually going to be the most beneficial for the client, you and the practice, and everybody wins. And that's the model that it really sounds like you're trying to help people see.

And, you know, it's not even selling the model, it's selling getting their life back, which is really what chiropractors are doing, right? The model. Hey, a lot more people are going to be attracted to less visits than more visits, even if they're paying the same amount. And it's crazy because, Jesse, you're not a chiropractor, so that makes complete sense to you. But for chiropractors listening to this, a lot of them, their mind is fried right now. They're like, wait, how do I charge the same amount for half the amount of visits? And they know they can get the same result, but they're fried because there's been so much mind sabotage going through chiropractic school and coaching, and it's so antiquated and so outdated. They don't realize that they can work four day weeks, have three day weekends every week, charge what they want to charge, get paid cash, not have to see 500 visits a week. You know, I know so many more chiropractors who see 100 visits a week and make so much more than 500 a week practices. It's, it's insane. And that's not because of crazy insurance billing. We're talking cash.

Let me ask you this, man. So, so most of the people you work with, are they brand new, coming out of school, or are they kind of already established.

Are 10 to 30 PL years in and it had success, Burned out. And then they're burned out and realize insurance doesn't cut it anymore. And now they're declining because 80% of their patients are cash rather than 10%. So yeah, we cater to docs who have a level of maturity in the profession. Like know what they're doing clinically, they're not super wet behind the ears. Yeah, we, it's funny, we find docs right out of school oftentimes are the hardest to teach because they think they know everything.

This is like, that's like any industry.

Get your bruises for three years and we're here when you, when you're stuck below 20.

Yeah. Let me ask you two questions. So number one, new guys coming out of school.

Yeah.

What would you recommend as maybe the number one thing that they need to focus on with what we've just talked about?

Well, if they're open to learn, they've got to learn how. Like what we call patient centered communication, which is, hey, most patients coming in, you're not respected like the md. You are the redhead stepchild of medicine. Now the fact that they've come in, they've let go of a certain barrier if they're willing to give it a chance. But you've got to perform in that consult, you've got to show them that you've heard them, you understand how they feel, you understand what they want and you want what they want. That's very different than a new grad thinking, I've got to get them to understand subluxation. I've got to get them to agree with chiropractic. I've got to get them to accept chiropractic. It's like, no they don't. They just need to feel heard. Understood. And you want what they want. And there's a way to do it. We call it the six question consult. The five step Rex. Super simple. A five year old can understand our fees structure. Where most chiropractors, you look at their fee sheet and it's either looks like it's from 1987 or it takes a college degree to understand. So that's some short answers. And then the next one is we get into a lot of headspace. I love personal growth and I've introduced a concept into the field based on most chiropractors get stuck for how much money they can make, how many people they can see the success of their practice because they don't truly believe they deserve having practice success. And that could come from parent upbringing, it could come from most chiropractors grew up in a middle to lower socioeconomic class where their parents maybe the one vacation a year was a strain. They saw the cars their parents drove and that gets imprinted on us. Then you have insurance companies hate us. MDs don't refer to us redheaded. You know, you, you know, you learn practically nothing in Cairo school and there's a huge lack of confidence. And we show them how to create and grow a deserving belief muscle for being the go to doc in the area. Seeing the amount of new patients they want to see Getting paid and ultimately making the money they want to make to give their family the life they want to give them. So deserving.

So what's, what's. Let me, let me kind of bring this back into, you know, have a base lifestyle, right. Is like, what would you say is your number one habit that maybe you teach chiropractors when it comes to their headspace and, and mindset.

So I have a meditative process called the deserving process, which helps least and let go and clear out undeserving beliefs and then replace them and build a muscle of deserving beliefs. So it's my book and actually that was one of the things I was going to share at the end, but I give it away on my website, patientmastery.com at the top it says book, you could get a free downloadable copy of you deserve it. And it teaches you the process. You know, you don't have to pay anything. You don't have to pay anything to do the process, you just do it. You will see shifts internally within the first one, two or three times you do it. And then as the weeks roll on, if you keep doing it, you will see life start to change, I promise you.

So tell me like, give me a little backstory on where you learned this because obviously you had to have some breakthrough in this, which you know, is the whole reason why you brought it into your, your program, right?

Totally. Okay, so most people are, especially chiropractors, very personal growth oriented, you know, like law of attraction and visualization and all of, all of those components of manifestation of clarity and vision and seeing it and feeling it and writing it down. And all of that is great and all of it is validity. However, what I found is and what I see oftentimes you see the people with the biggest crowds in that space. It's always the same people and their life isn't changing. That says something. I've been going to this guy for 10 years and I still beat my cat. What happens is when you focus on what I call the second half, which is the vision with clarity and emotion. It's like trying to build a mansion on top of a swamp. You can have the best architects, the best materials, all of that, but if it's on a faulty structure, that beautiful house is just going to sink in. And we don't look at because it's uncomfortable and it doesn't sell as well and it's not sexy. We don't look at all of the undeserving beliefs that we all have in some way shape or form, whether it's our health, whether it's relationships, whether it's self love, whether it's financial ability. And so for instance, if we don't believe we deserve, if I don't believe I don't, I deserve to be financially independent or abundant. It doesn't matter. All the affirmations, the goal setting, the visualization of the million dollar income, I'm going to be sabotaging myself from that.

Right.

One of the biggest parts, and I learned this, it was actually a client's mother who, who teaches this very significant technique called the clearing process for clearing out blockages. And I actually used it in my relationship with my mom because I grew up with a very combative relationship with my mom. By the time I got to be like 30, I was like, hey, this doesn't work. Like I'm a grown, grown man, I need to have a, a better relationship.

Yeah. You still kind of show up like that. Seven or eight year old.

Exactly.

Yeah.

Like if you don't do anything to change it, it's not going to change. It's just gonna get worse or cemented under stuff and it'll come out when it's, when it's itched and provoked. And I did so many different types of, whether it's modalities, therapies, things like that in that for that relationship. And it wasn't until I did a clearing that there was a really tangible shift. And so clearing, I'm not going to go into it, but essentially it's filling in those swamps, filling in those sinkholes. It's like on the old computers, what is it? Not the Max, but the ones before IBM. What is Steve Jobs? Not Steve Jobs, Apple, Bill Gates. Computers. What are those?

I did Microsoft.

Microsoft. It was like clearing your recycling, like emptying your recycling bin.

Got it.

We all have some type of, a lot of people call limiting beliefs. I'll call it undeserving. And if you don't address those and really move through them, you're building a mansion on top of a sinkhole. So the first part of the deserving process is you've got to move through those to then have your vision, have your goals, have that clarity, actually have something to stand on. And that's what I see is mostly missing in most of the self improvement and self help is it's all about just putting a card course and all the good stuff. But we don't address the trauma.

Yeah.

And it doesn't mean you were physically or psychologically abused. Literally stuff happens. Like you're six Years old, and you ask your mom for a cookie before dinner, and she says no, because she doesn't want you to ruin your appetite. And you think mom thinks I'm fat? Like, it happens like that. You didn't have to be hit, you know?

Yeah, I mean, I think, you know, what's the saying, if you don't change the root, you don't change the fruit, you know, and. And that's like, if you don't change the root of the problem, you know, you just kind of changing. You're not really changing the fruit, you're just kind of trimming the branches. And unfortunately, that doesn't usually produce new fruit. And that's kind of the personal development space is.

I like that. I've never heard that term before.

Yeah, so, I mean, I've got really heavy into it probably since like 2011, 12. But, you know, it's like you said, you see the same people at every event, and they. They're still. They still have the same beliefs. Yeah, most people, you know, they teach you what you need to change. They just don't teach you how to change it, you know, and they get you kind of high on hopium and motivation, and then you're left after you leave, and you get even more depressed because you're still not fixing it. Yeah.

And that's a lot of the Cairo seminars also. It's a lot of rah rah. And people's practice goes up for the next week after because they're on a high of meeting all these colleagues and hearing an awesome speaker or charismatic. But they're not actually being taught. I used to think. I used to go to these seminars, and the preoperation in the front would be like, you gotta be a leader. You gotta lead your patients. That's 100% correct. But shouting that from a stage is not having anyone in the audience go back and be a leader. Like, you've gotta actually clear out why you're not a leader and install new beliefs, new understandings, new communication to show up as a leader. And that's what I'm proud of in patient mastery.

That's awesome, man.

Just continually grown and evolved and developed and gotten better and stronger. And we don't teach new things every year or every season, depending on which way the wind blows. When Covid hit, all you saw was like, you know, change to this model. This model. When Covid hit, we dive deeper into. These are the foundations. These are the principles. Every single client had their best year in 2020, even if their clinic was closed. For two months because of their state, whatever. Like everyone had compromised stuff in 2020. Everyone had their best year, 2021. Even better. No one would have thought that in March, April, May of 2020.

Yeah, that's amazing. All right, so, you know, I know one of the big things that it sounds like you really focus on is helping that chiropractor who's kind of burned out. He's done it one way and he's now like, okay, Josh, show me a different way to do this. One of the things that I find is that guys have a really hard time trusting. That's one of the biggest things I see in chiropractic is they've been burnt so many. I always say this. They've been burnt so many times by so many different people. They don't know who to trust or how to trust people. But I really, you know, can you speak into that a little bit? Because that's a big thing that I see.

Oh, 100%. I mean, my first coach was, I love the. I was in grad school and I would get his emails and they were so philosophical and inspiring and beautiful. And then, I mean, it was low cost. It was like 3,$325 a month for coaching with him. And really quickly into it I realized, wow, this guy probably never really had a practice or was never very successful. I mean, there was a, there was like some crazy fee structure he set up. And I don't think it was new patients. I think it was like care continuation. It was so ridiculously complicated. Like there was like algorithms involved. I was like, this would never fly in real life. Like, this is so stupid. Ultimately, I forget it was, I think it was like a year long commitment. And at six months I was like, hey, this isn't working. Let's just go our separate ways. And I paid in advance because that was the only way, you know, can I get the remainder? Like, I'm not using the calls with you. Can I get the remainder back? And he actually said, yeah, I'll send you the remainder back. And then for the next six months, it was the stereotypical. It's in the mail. Oh, it's on my dashboard. I said, I ended up just giving up. But that is so common in our field. And I'll tell you, when we started patient mastery, we used to do year long commitments purely from the standpoint of, you're not going to change your life at a seminar, you're not going to change the trajectory of your career in 30, 60, 90 days from learning from someone can you get a bunch of good value? Sure. But real long term growth is not going to happen in days and weeks. And we've switched over the last couple years to allowing month to month purely because, hey, you know what? Some people just aren't a fit. Some people aren't, you know, they drive my team nuts and my coaches nuts.

Right? Yeah.

You know what? There's such trust issues and resistance that, hey, you can stop at any time. And we know people who are committed and learning and growing, they want to keep doing what's working. So I've seen it from every, every, every side and it is a really big issue. And we, we have a ton of docs who reach out to us and are like, I really want to do what I'm doing with you, but I still owe this other company three years worth of fees and I don't even use them anymore. And I'm like, you know, they really.

Like collections, do that.

They're not coming after you. Collections doesn't work. You can just tell them they're not going to ruin your credit score. Like, it's all big baloney. But it's sad. It really is sad what's happened in our profession. Yeah, that's, that's the shortage, you know.

You know what's funny is I had a guy, a buddy of mine today, I was a trainer obviously, for 20 some years. He says, hey, what do you do when somebody doesn't show up? Like, what do you say to him? And I said, well, you know, I'm like, dude, if they don't show up once or twice, like we're having a conversation about how serious they are about changing their life and changing their health and, and I thought about it for a second and I was like, you know what? That's the difference between an amateur and pro. And this guy's not really a trainer. But I said, that's the difference online today is that you got a bunch of amateurs trying to be coaches that have never actually had the experience of what it takes to be a coach. Allowing people to live at a standard that that person hasn't even set for themselves. So no wonder they can't hold people to the standard. But as I thought about it, it's like, listen, we have, there's a lot of coaches in the coaching space, personal development, all these things. But like, how do you, what would you say to someone who needs to really decide, like, hey, who do I pick as a coach or how do I pick? What's the criteria of that? Because I think that's really important for people to understand, too.

Yeah, good question. Three things come to mind. So the first is. The first is the most important, and that is, does this person, what I'm hearing them say, their tone, their energy, and what they're teaching, just, you know, YouTube videos for free, all of that, Is it congruent? And does it resonate with me? And especially in a field like Cairo, there's so many different philosophies. There's so many different approaches. You know, for instance, someone might teach PI work. That's not wrong. That's not bad. It's not what I do. So, like, hey, if you're wanting to increase your PI, go to them. You know, if so. And. But then there was also people that are just like. That feels like bad energy, like all that. So the first is you gotta feel congruent, inspired by them, resonate with what they're actually teaching, especially in Cairo, because there's many different angles. Hey, if you want to educate people to death, like, find someone who does that. If you want to do scare tactics, you'll find groups. If you want to feel like a salesperson, you can find groups. And that. That may be your jam. So that's the first find what resonates. Second is do your homework. Like, most people have testimonials, whether they're Facebook written video, but, like, how many do they have? What are the people saying?

Do? Like, are they over 30 seconds or 60 seconds?

Like, are there four testimonials? Or do you have 100? So that's an aspect. You know, we have over 100. And our Facebook reviews as well as we. We take a lot down because they're like, old, and we just replace them with new ones. But tons of case studies. So that's. The second one is, you know. Yeah, it's crazy how many people ask me for input on, like, say, maybe a new marketing program, and I'm like, well, have you talked to anyone that's done it? No. It's like, well, talk to someone who's done it. And then the third one is, what we were talking about before is, is there some type of guarantee? And, you know, there's two sides of this. There may not be a guarantee, but there may be. You're not locked in if it's not working. And that's where we got to like, well, do you have to do a year or three years? Or there's Cairo groups that. It's five years from the start. Like, you got to sign for five years.

Wow.

Or is it month? To month. Not from the standpoint of, you know, you're just trying to get all you can in 30 to 60 days, but from a standpoint of they've got to prove that you're either having a good experience and hopefully growing and it's worth continuing. So those are the three components. Like, you resonate with them. There's colleague proof and the terms make you feel safe and doesn't feel like you're going to get trapped into something that isn't right.

That's good, man. That's good. So, all right, I'm going to go through a little rapid fire for you. Number one. Like, what would you say is the most important lifestyle, like, kind of personal habit that you do every day is outside of business?

It's got to be morning routine. I mean, like, morning routine is everyone should have one. Everyone's is going to look different and everyone's is going to change and evolve over time. But just, man, I put my phone on airplane mode before I go to bed. So when the alarm goes off and I turned off, I'm not seeing any notifications. I'm not looking at social media, email, texts, anything that's outside of me or who's in my home, you know, for the first two hours of the day. And there's exercise, there's meditation, there's reading, there's writing. Just how you start your day is how your day goes. And that's cool.

What would you say is your most important business habit that you do every day?

Every day. That's a good one. You know, I think that ties in. I was planning on actually doing a little teach on this and I'll. I'll go for it, man. So most chiropractors are horrendous when it comes to knowing numbers and stats. And just, just hearing me say that, a lot of them, like, tensed up because there are certain groups that are like, you've got to know these 65 stats and there's graphs over the wall and it's overwhelming and it's scary. And you know what? Most of them aren't moving the needle. And so the chiropractors go to the other end. Like, if you talk to 10 chiropractors right now and you ask them what were your collections last month? 9 out of 10 would probably know what their collections are. But you know what's really scary? 2 to 3 out of 10 would know what their profits were the months before. And we got like, I don't know how this came into the field. It's kind of like the volume stat. Like volume actually doesn't matter unless you're in network. If you want to get paid what you want to get paid, volume doesn't matter. There's a lot of false metrics in Cairo. Volume, pva, patient visit average, not patient vision average. Like how many number visits, not what you get paid per visit collections. Hey, if you collected 500,000 last year, but you profited 67,000, that's not so great. Whereas you could have collected 400,000 and profited 300,000. Big difference.

Yeah.

Profits are what give you your future. They were giving you your life. They're what, to an extent, allow you to knock out debts. Collections is a very ambiguous step. So that's one thing where I'm going to show you a quick exercise we do in patient mastery. And like a challenge we have a few times a year, which gets everyone motivated and just knowing their numbers better. And on a daily basis, knowing what your collections both for the day and ongoing through the month, where you're at and then knowing also what that translates into. Profits. Assuming you know your typical monthly overhead. I'll show you what it looks like.

Yeah, draw your thing up, man. I know it's super simple and we call it.

I learned this from one of my coaches of how to teach it. We call it out running overhead on a monthly basis and we're talking about practice office overhead, not your life overhead. This triangle. And I'll talk it out because I know some people are just listening to this audio. We've got a triangle. The bottom left corner is one that stands for the first day of the month. The top Corner stands for 15, that's the 15th of the month. And the bottom right corner is 30. That's like day 30. Even if there's 31 days in a month, just keeping it simple and out running overhead is the concept of first, you should know what your typical office overhead is. Of course things will fluctuate month to month. Not every cost is fixed. But the point is, most chiropractors, or if you're not a good small business owner.

Yeah. When you keep saying most chiropractors. I'm going to say most business owners, man, in my experience have this exact same problem.

So I want you to think of, you should know what your overhead is. Let's say it's 20k a month and as quickly as possible you want your collections. Think about there's a. Whether it's the people you pay your rent, your utilities, like you owe that every single month, not just when you Want to pay it right. You think about it as if you know what your overhead is when you're making collections every day. And as a month like the first, let's say for a 20,000 person, the first 20,000 is going not to you. The goal is how quickly in the month can I get over the hump of my overhead? So the rest of the month is all profit. Now a lot of bad business owners, it may take 70 to 80% of the month to just copy your overhead. And then you only have the last week of this is your profits. And guess what, those profits, you're still going to have taxes taken out. So it's not even like all yours anyway. And the goal, and of course this shifts based on your business size. A smaller practice is going to have a less percentage of overhead. A much bigger practice is going to have more than 50%. But most practices are between the $250,000 a year collections to million dollar practice. And in that range, the 50% line is a really good, strong, healthy margin to shoot for. That 50% of your collections is going to go to overhead. Not your salary, not your profits, other things that are not you. And that would be approximately the 15th of the month. So the goal is every single day at the end of the day of practice, you're getting either on your screen or on a post it from your ca. This is how much came in today and this is the running total for the month. So on day seven, you know, hey, we're about 25% of the way through. At day 10, we're about 30% of the way through. At Day 15, we're 50% of the way through. And if you fall within, let's say a quarter of a million to a million dollar total annual practice, your goal is getting over that hump of paying the office overhead. So the rest of the month it's all profit. And you know, if you're on track for that or not based on every day seeing this stuff. And it causes you to just think differently and focus differently. It's like, do we need to have more team meetings? Do I need to look at my marketing? Do I need to upgrade my fees, my recommendations, like where do I need to get stronger if we're consistently not doing it? So the goal is to, if you're spending a lot more than 50% and you have an under a million dollar practice, move that line of getting from overhead to profit, ideally to around the 15th. Now it's not about how short you could do it. There's some Aspects where chiropractors get in trouble, where if you're not spending enough, it most likely means you're not spending enough on marketing or you're not spending enough on team, and then you're doing way too much on your own. But the bigger issue is spending a lot more that isn't moving the needle of increasing profits. So this is a quick, easy understanding. We call out running overhead of how quickly can you pay off your overhead each month? And then the rest is all yours.

That's good, man. I, I, I like that because I think the number one thing and all business owners is they just don't pay attention to their numbers, you know, so it's like, hey, what is your overhead every month? What's the bare minimum you gotta make? And they don't even know the number. And you're like, dude, like, yeah.

And this doesn't take algebra, this doesn't take fancy equations. We're talking about two numbers. Yeah, profits like every Cairo could do that. And if you choose to open up your own practice, it should be almost a responsibility that, yeah, for sure. At least those numbers.

That's awesome.

So, yeah, we'll do a challenge of who you know a few months of the year in patient mastery of who outruns their overhead quickest, you know, based on their collections level. And docs at different levels learn different strategies. You know, it's that saying what got you where you are isn't going to get you to where you are. Docs who are stuck below 20,000amonth collections need to do things and learn different strategies or drop certain habits that are different from the docs stuck below 60,000.

Yeah, for sure.

We have different levels of if you're below 20, stuck below 20, stuck below 40, stuck below 60, or stuck below 80. $4,000 million dollars practice we've identified over years. Here are the nine things that most likely are missing in your practice or some of them are missing keeping you under that threshold. And that's a really cool part of our coaching is that diagnosis part. And it's, you know, it's not a cookie cutter. Everyone is supposed to have the same practice or get the same exact learning because someone at 70,000amonth needs different strategy and coaching than someone at 10,000amonth.

For sure. Cool, man. Well, let's wrap this up. I know you got, you got some appointments coming up, but like maybe like one last word on kind of everything we touched on today. What would you say is maybe one last thing you want to leave on here?

Yeah. So you know We've touched on communication, patient centered, we've touched on CEO money mindset and we've talked on talked on deserving belief, which is overall headspace and mindset. We have a saying in patient mastery called tone over bone. Tone meaning it's your intention, it's your headspace, it's your mindset is always more important than the bone, which is the action, the words you say, the strategy. And that came from a chiropractic mentor over mine mentor of mine, which is related to even just the chiropractic adjustment. The intention of the chiropractor is far more important than which technique you do, what bone you line up on what line of drive. It's your healing. Intention always matters most. So when it comes to everything we've talked about thinking about tone, dive into that deserving belief first. And I mentioned it before. Go to patientmastery.com There's a little tab at the top that says book. You enter your name and email and you will get it in your inbox and you could read it in probably 90 minutes. You can get the audible online and listen to my voice more. And it will, I promise you. If you're a chiropractor, you've been plagued with sabotaging beliefs from our profession. There's so many of them. And we will like this book is catered to chiropractors. We will address them and we'll show you how to work through them in that book. So go to patientmastery.com get that book. If you want to talk to one of my coaches, you can book a call on the website too. But just start with the book and watch what happens.

And if you guys are, you know, listening to this, you can go to the show notes and it'll take you directly to Josh's website. So if you do want the book, you can also just hit the show notes. It'll take you directly there. I would highly recommend number one. Obviously Josh has been doing this 10 years. I don't know a lot of people that, you know, stick around with coaching for more than 10 years. Unless they're evolving constantly, they usually wash away after a few years. So, you know, Josh has obviously learned how to kind of navigate these things, but also how to evolve. And I think that's really important. Plus I know a lot of guys in my program are currently in his and they do amazing. So. And they speak very highly of them. So if you guys are looking for someone to help you take your business to that next level, especially in the chiropractic space. Just go to the Show Notes. Click on Josh's stuff. Josh, I want to thank you for being on the show today. We appreciate you man, and we appreciate what you're doing in the industry. If you guys want to be part of our habit based lifestyle community, we do have a Facebook group. Go ahead and go to the Show Notes. You can click on the link and go to that. If you have any questions, you can always email me jesseaveabaselifestyle.com until next episode. Have a great day.

The purpose of this show is to guide you to realign with habits that get you to live the life. Live the life you've always dreamed of. This is the Habit Based Lifestyle Podcast with Jesse.

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