Dr. Nancy Trimboli: Streamlining Your Business

I've got a killer app for you. It's called Process Street. You know your business lives or dies by its processes. You got to do it right and you have to have the team following it consistently. We know that in house and that's why we implemented Process street. And I encourage you to do the same. Process street is the easiest way to manage your team's workflows and recurring processes. In fact, it even comes with pre made templates for things like client onboarding, employee onboarding, sales processes, marketing processes, content publishing, promotion, customer support processes. You name it, the system has it. And now you'll have a consistent deliverable for your company. Do what we did and implement Process street in your business. Plus, I got a deal for you. If you sign up now at our link, you get 20% off. So go to mikemcalowitz.com processstreet that's mikemicalitz.com processstreet and if you're struggling spelling Michalowicz, you're not alone. Go to mikemotorbike.com processstreet and don't throw that superfluous slash at the end that messes everything up. Go to mikemotorbike.com processstreet and get 20% off today. All right, my friends, it's time to strap on your fluffy bicycle. We're about to discuss how to streamline your business. You're about to hear that and so much more in today's episode of Entrepreneur Elevation. How you doing, cows? Great.

How are you doing?

Good. I'm Mike Michalowitz. I'm the author on a mission to eradicate entrepreneurial poverty. You know what that is? The thing is, you're probably living it too. We gotta fix that. It's the perception of this tremendous success. You have all the time in the world to do what you want and you're making all the money that you want. But none of that's a reality. It's the grind and hustle. Well, we fix that. No more grind and hustle. It's about designing the outcomes you want. I'm joining the studio with Kelsey Ayers.

Hello, friend. Thank you for listening to us. If you feel so inclined, we would love it if you left a review wherever you found us.

I felt like a cliffhanger, like you were gonna say one more thing after that. No, no, no. Also in studio is Jacob.

Hey, what's up, Jacob?

Loan's become quite famous recently.

When I'm for nothing good.

For nothing good? No, no. For your cat liquor, your cat licking. That's a great thing to be famous for now, admittedly. Have you tried it at all? Have you used it at all?

I used it on my hand. I did not put it in my mouth.

Have any of your friends seen it? Like.

No, but the cats don't like it.

How do you know that?

Because they. They get weird.

Did they tell you?

No, because. All right, so they did. They did tell me. So the. The bristles, I thought they would be soft. They're not. They're hard.

Very.

It's like silicone.

Yeah. And they're not even bristles. They're cones almost.

Yeah. So it's like hard plastic. They don't like. They don't like hard plastic. I can use, you know, one of the lint rollers. I roll that on my cats and they love that.

Oh, there you go. And then you roll on your tongue.

Yeah, same style.

I want to thank nextiva. Makes this show a reality. We appreciate nextiva. We'll give you more details on a little bit. But let's get right into the meat and potatoes noise. I try to recover without you making fun of me. Her name is Nancy Triboli and she has built a multi million dollar practice. It's multi location, multi doctor business with over 40 employees and mastered the art of taking complex health issues and breaking them down so others can execute on in a concise and comprehensive way. She shares this knowledge through platforms such as YouTube. You gotta check her out there, Facebook. And in her brand new book, which is Stay, I'm sorry, Stealth Health. And she's transitioned her business now to a solo practitioner. And as a solo practitioner, you can make your business run on automatic too. We're about to discover that in the episode right now. So, Nancy, Dr. Nancy, I should say, with no further ado, welcome to our show.

Welcome, Nancy.

Hello, Mike. Hello, Kelsey. Hi, Jeremy. Hey. Hey. Hey.

You started off, you know, pretty sizable practice, almost 40 employees. There are over 40 employees and today you're a solo practitioner. Is there a reason behind that change? Is one better than the other? Give us the kind of the juxtaposition of the two.

Well, I will tell you this to encapsulate it. When I downsize from two locations, four doctors, 40 employees, and I downsized over the course of a year or so to one location, just me. I was able to. Well, actually what happened is I decreased our income by a half, but I decreased our expenses by two thirds and I got my life back because I decreased our stress, my stress level by 90%. And I go through the specifics of that on Dr. Sabrina Starling's podcast, Profit by Design. And I go through everything that happened, like the bleed out, but what was good? And the bleed out happened because I was riding a wave and I knew the wave would crash. And it had to do with insurance companies. I knew at some point changes were going to trickle down to me in the Midwest, and they did. Luckily, I had $100,000 in reserves in my checking account. But after slashing expenses and things were spiraling out of control, I ended up with panic attacks. I didn't pay myself for a year. And I was looking around and I saw employees that were had a bad attitude. They were gossiping, they were running patients off. And I thought to myself, I'm paying you every two weeks like clockwork, on time, and I'm not getting paid. Something's wrong with this picture. Around the same time, I stumbled upon Profit First. That was my entry into the Mike Michalowicz world, was Profit First. And I read that, and it wasn't like it was a totally new concept to me because my mom had taught me how to allocate funds towards groceries, clothing, housing. She taught me that when I was a kid. And that's why I had $100,000 in reserve, which saved me. But it made me look at things in a different way, like, where is your money going and does it deserve to go there? And so I set up my accounts right away, and I was allocating my money, still not paying myself. And then, of course, I read Profit first. So I had to read the pumpkin plan. I get halfway through the pumpkin plan, and I thought, this is brilliant, because I knew I had to downsize my business. The wish list interviews is where I knew the brilliance was, because as a sole practitioner, I could not see 100 people a day with only me. It was going to be less. And I had to hone in on that. But I stumbled. I couldn't make it through. I couldn't decide, well, who are my top earning patients and the cringe factor and all of that. So I reached out to Donna Lyons and she set me up with Dr. Sabrina Starling. And that was really the game changer for me in the transformation of my office. She looked at the health of my business at that point, and she saw a risk. And the risk was with just me as the sole money earner. That was a problem because if, you know, if somehow something happens to me, in the past with multiple doctors, they would just cover for me, but now it was just me.

I want to explore that in A second, I just want to rewind back to the 40, down to currently 10 employees. So you cut your. Your number of people into. By. By 75%. You.

You.

But you said your income dropped only by half.

Yes.

So that's remarkable. So you had multiple doctors providing services. Now, for a while at least, you've been the only doctor providing services, is that correct?

For the very early on, I've been in practice for 24 years in my own practice. So very early on, I think it was year five, I started to bring on associate doctors.

Okay.

So I.

But. But you went up to 40. 40 people, right?

Right.

And then you went down to 10. Give me the context. Who are those 10 people? Are they all administrators or some doctors?

No, I'm the only doctor. I have four massage therapists and I have two assistants that help me with patients. One at the front desk, one in billing. Let's see.

Okay. Yeah, well, that's enough. So tell me, with the 40 people, how many doctors were there?

Four, and we had 50.

So you went from four doctors down to one doctor, and you went from 100% income to 50% of the income. So one quarter of the number of doctors, yet the income only went by by half. Did you start taking on, like, were you working 24 by 7 now?

Aren't you proud of me? No, we work less.

Yeah, I'm proud of you.

We work.

Why? Why? This doesn't compute. You work less, more income. How does that work?

Yeah, because when we looked at the wish list of our patients and what they liked, well, get rid of the crap that they don't like, because it's just taking more mental energy from us, more, you know, stocking of stuff, expensive people we don't need. And then, okay, who are people that love us? Who are patients that show up, do what we tell them to do, they get better. They refer others. Who are those people? Let's get more people like that. And so that's the brilliance, that's the jewel, is like really focusing on that and then knowing that, okay, I'll let this person in the door, but let's all say this out loud right now. They are not an ideal patient. And if we stick to our guns and not accept the rigmarole we know they're going to put us through, just let them walk. Because they're just stealing our energy. They're stealing our joy. They're stealing our. Our ability to serve our ideal patients better.

Okay, so when it came to streamlining, bringing systems to your business, did it start with the the clarity on what a good customer is versus a bad customer.

It started with that. We did our wish list interviews with our best patients. I think we did 20, I think we had 21 people, maybe more, maybe 26. And we had 20 something questions we asked them. And one of the things they said that we asked them, what did we do in the past that you like that we don't do anymore? One of those things was in office workshops. I had been doing weekly workshops in my office just teaching people some hands on methods they could do to help themselves with their back pain or their headaches or their foot pain or whatever. It was simple hands on things they could do called trigger point therapy. And they liked that. And we kind of got away from doing those because people started to cocoon. You know what I mean by that? Like they're not coming out after 7 o' clock anymore. They're staying home, they're watching Netflix. So getting them out of the house was hard. So we were doing those less and less. But in these wish list interviews, that was this theme that kept showing up. Let me dovetail into Dr. Sabrina Starling. I'm holding up her book Now Hire the Best, because this was key, how to hire the Best. And she, in her interview with me and talking about mitigating risks, I just happened to say, I feel like I want to write a book. I feel people need to learn things and I want to teach them and I need an avenue to teach them. So she focused in on that along with our wish list interviews where people are saying they wanted me to teach them more. And now what I'm doing is I've just finished writing a book with another one of your fans, AJ Harper, and I'm creating online content in the way of courses to bring in income.

Over my 12 years of being an author devoted to the small business entrepreneur, I've discovered the biggest challenge. And you know what it is? It's profitability. That's why I wrote Profit first and that's why I'm now hosting a two day workshop here at my offices in Boonton, New Jersey where I will teach you and my team will teach you how to become permanently profitable. Go to profitfirstlive.com right now to get details again. Profitfirstlive.com find the dates that work for you and I'll see you here at my office. Okay, so now, now I was about to get to that because your, your income isn't just from doing chiropractic services, it's now you have other revenue Streams. That sounds like it's not dependent upon you, but maybe it's not even dependent upon any employee doing work.

That's very possible. This is new to us, so we are.

It's early stage. Okay.

Yeah, we're forging. We're forging a new path for ourselves. Our first course drops in fe. It's a jet Lag no More course. Then we will be developing courses around Stealth Health, the book, this year. Well, my ultimate goal is that in three years, our income from the content will match our income from the office. That's my goal.

Okay. How are you going to measure that? You're marching in that direction. And how do you adjust if you need to?

So if in three years we want to be collecting that amount, my projection is by the end of 2020, December 2020, I want to collect $25,000 a month. So I In this.

On. On this ongoing.

In this content, with the book and with the jet Lag no More course and the other Stealth Health courses we're going to create. And we just sent. I had a beta reader group for the Stealth Health, and we just sent out some questionnaires to them about what they would like to see specifically as far as courses and what they need help with, because that's the real deal. Mike is not. What do I want to do, Dr. Nancy? What does the office want to do? What do our people want? What do they need? Because it's in service to your audience. Always. AJ Taught me that with the book. When I wrote my first draft, it was 30,000 words of drivel about me. And it's not about me. It's about my reader. It's about them. What are they looking for, where they are in their journey, where do they need help? And that's my job to deliver that. So I was able to.

That's very. That's very Don Miller esque. He talks about the client being the hero, we the guides. But I gotta ask you this jet lag no more. That's a very specific community. Travelers, did you find from your wish list, which is a process to identify your best customers and learn from them. Did you learn from your wish list that this is your community, the travelers, or why are you writing that content?

This is the weirdest thing. I was at the Breakthroughs on the Bayou last year at Dr. Sabrina's house. You were there, and Dr. Sabrina asked.

We may have had a bourbon together yesterday.

Yes, we did. Yes, we did.

So did everyone.

So did everyone. We had a few people. People imbibing. So Dr. Sabrina asked me to take the participants through some little stretches a couple times during the day, which I did. And I don't know why the jet lag idea came out of my head. I think somebody was traveling internationally. I said, oh, check with me later. I'll show you how to not experience jet lag. And you, you know, you. At the retreat, you know, your mind is, like, full of ideas. You're looking at your phone, you're looking off into the distance. And I said that. And you're like, like, like immediately, like, zoned in. Like, what did you say? And I. And I didn't even think of it as a course until I had so many of those business people coming to me and reaching out to me, saying, where? Where is that? How. How do I do that? And. And it's something that. It's not my original idea. It's something that is based on acupuncture points, but I have simplified it and also made it super, super effective so that it is great for the business traveler. That has to be, you know, a keynote speaker like you. You got to be on your game when you get to where you're going. Or it could be somebody that's a recruiter and has to, like, interface with people as soon as they land. They're interfacing with people to bring them to offer them a job. Or it could be a family that's been looking forward to a trip with the kids to Hawaii or to Europe. Months, if not years. And what. And the fact that jet lag can ruin days of the experience, that's not acceptable to me. When there's a simple, easy fix. I mean, this. It's super simple. Even a child could do it under direction.

So. So we got to start wrapping up soon as flying.

Darn it.

I know, I know. So I got to ask you more about streamlining. So it sounds like the first stage to streamlining your business was to remove. To make some hard decisions. Removing staff, it sounds like removing clients, that's the hardest. Is that the first.

Okay, yeah, that's the hardest part is, is really taking a hard look at who your A team players are and who your B and C team players are.

Okay.

And I was in a great situation because I was. I was downsizing. I didn't have to say. I didn't have to just do a clean sweep. I mean, I was. I just told people, I don't have a place for you. I literally don't have a desk for you to sit at, or I know you don't want to Travel to that other location. So it was still really hard. That was the hardest thing to look people in the eye and say, I don't have a place for you. But hiring or firing faster is really the key.

Right. So instead of dragging this out over months and stuff, you met with people and said, here's the new plan I have for my business. And you made the hard decisions, I guess, all within a day or two.

Oh, no, it took months. It took months.

Took months.

It took months.

Okay. Which is better than years.

Which is better than years. Yeah. But still, that's hard. And then also looking at your statistics, make sure you have a good statistical person on staff to every quarter look to see, okay, what's selling and what's not, where's our most lucrative service or most lucrative item? And whatever is at the bottom of the list, just get rid of it.

Did you identify that prior to letting people go or is that an ongoing.

Thing or both on? Ongoing thing, yeah. With the services. Yeah. My team right now is so amazing. They're so with me. They so support our vision and every aspect of it. And they. And I see now with these. With these staff members, I have this team that I have, and our new vision of bringing this content to audience is this is now a pathway for them in their career. They can grow and expand their knowledge and their careers. Because I'm not anymore just a solo person working out of an office in Cedar Lake, Indiana. We are growing, so they're so excited about that, too.

So I got to ask you one more question. The most you put in the notes they sent over to me said I had the most embarrassing question I've ever asked. That I asked is asked of Mike. I. I am willing to relive the shame. I don't remember.

Thank God.

Yeah. But maybe one bourbon and I'm done, though.

So it's in the middle of the day.

I don't remember. Well, that was two bourbons.

Then. It was two. So we had gone for that walk. Dr. Sabrina likes to do that walk on. I think it's on Friday. So we had come back and she. She has her photos she likes to take. And somewhere during that day, you had been talking about how your vest on, it's your anchor for when you speak.

Right.

And in my mind, I'm thinking about my online personality and, you know, the photos you have to take. And I have 110 videos on YouTube and, like, making sure that, you know, I'm not going to look perfect every day, but making sure I have a standard look, so me a gal, you a guy. I said to hey, do you have a stylist? And. And then I thought to myself, that sounded so fanboy. I am so sorry.

I just.

It was nothing. It's just.

That's so funny.

I think that's valid.

And I do a stylist. It's Kelsey. It's Kelsey. And she's totally critical of whatever I wear. Oh, not that vest again. Mike. Always slamming me, always slamming that vest. It's a. You know what?

Slamming a little. I'm just noticing a little bit.

Hey, Dr. Nancy, how's the future look for your business? Are you ultimately planning to pull yourself out fully as you build this online content?

No, I really love what I do. I really love seeing people helping, helping people. You know, I was put on this earth to assist people with their pains and issues so they could live their best lives. So, no, I see myself practicing for a long time, but maybe less hours taking some time off once we get that additional income in. But chiropractic as a career is an excellent choice because this is. It's just really about to, like, go to the tipping point. My generation. My generation.

Dr. Nancy, before we let you go, where can our listeners find out more about you?

The easiest way and a way to get some freebies. Freebie downloads, either on the jet lag points or on five minute fixes to DE stress is go to DrNancy Health. That's D, R, N, C Y Health.

Fantastic. We'll have that in the show notes. And Dr. Nancy, thank you for joining us.

Bye. Take care.

Bye. Bye. I like to end interviews with a big. In a second, we're going to recap what we learned. Are you two ready?

Ready.

Ready.

Jason's gonna steal whatever, so it doesn't matter. Yeah, I'm ready.

Yeah, she does steal everything. First, I want to thank nextiva voice over IP phone system. Oh, I need a new nextiva. I put it in the Monday system, submitted it to Amy. Boom.

Beautiful.

Yeah, I'm following our system. And nextiva is a voiceover IP phone system plus CRM all integrated into one. It's what we rely on and we suggest you consider doing the same. All right, what'd you learn today, Kels?

How important that Wishlist interview is. So I love this. I think it works either way, whether you're trying to scale down or scale up. But interviewing your ideal customers, the ones who show up, who do what you ask them to do and refer other people, I feel like that's so critical but often overlooked and it was clearly effective for her, which I love, and gave her insights.

Awesome. Rock and roll. Jay Kablone.

I think I like the most that she hit the point of most people focus on making more money in their business and she focused on reducing expenditure, which is essentially the same. I mean, it's just as good if not better if you do it properly.

So, yeah, that's a great point. I'm just surprised that with one quarter the number of people, four doctors, down to one doctor, that revenue increase cut in half. So therefore profitability must increase.

Right.

I liked the concept of fit and unfit customers. I called them good and bad customers. And I shouldn't have used those words. It's really who's fit for you now? She didn't use those words either. I just made a note. Fit versus unfit. Maybe she did. I didn't hear it. I also liked.

So your takeaway was your own?

My takeaway was from me.

I really like this idea that I just came up with.

I didn't like what I said.

No, you're brilliant.

I'm a genius. My takeaway is that I was present. You guys are real dicks. And I also liked this jet lag. No more concept in that she's narrowed down or pinpointed a very specific community with a very specific need and providing a very specific wellness type of solution, meaning a non medicine, no medicine involved. I thought that was just a very cool example of how you can targeted community and make some additional revenue.

Yeah, I love that. But at the same time, it's a broader community because it's virtual. So it's. You know, you can really niche down because you're. You're opening the net up so much broader.

Right. But you know. Yeah, it. Yes, yes. Jay Cablone. Anything else you want to share, bro?

No, I'm good.

Okay. All right, guys, I got a game for us.

Oh, well, I did.

It's all dead or alive. Dr. Nancy, are you still with us?

Yes, I am.

Okay, Jerry has to go first because I suspect you may have some insider access because you're female. Both you, Kelsey, and. Yes, we are, Dr. Nancy. Yeah, okay. I presume. I don't know. Nowadays you gotta be careful. I don't know. So here's the deal. I'm gonna read off three entrepreneurs. Two of these people are alive. One person, sadly, may have passed. You've identified the one that's passed. All right, so let me read them off and in no particular order. And then, Jeremy, you're gonna go first. The co, Reid Hoffman, who's the co founder of LinkedIn. Use LinkedIn a lot. Jeremy. And Reid Hoffman is one of the co founders.

Reed. Okay.

R E I D. Kate Spade, who really her full name is Catherine Noel Valentine. Valentine Boshnaham, the founder of Kate Spade is the product line, but she also goes by Kate Spade. And then Travis Kalanick, who is the co founder of Uber. So we have Reid Hoffman, co founder of LinkedIn, Kate Spade, who's the founder of the Kate Spade, you know, bags and so forth. And then Travis Kalanick, who is the co founder of Uber. Jaybone, you first.

I 100% know that Kate Spade unfortunately is no longer with us.

Okay, that's one for Kate Spade. Kels.

Yeah, she passed away.

And Dr. Nancy.

So the question is, who's not with us anymore?

Who's deceased?

Oh, that's so easy because I was just thinking of Kate's day today.

Where are you? I guess it's tragic.

It is.

I'm so, so here's the funny thing. Like I am so not. I wasn't even aware. I know my wife has Kate Spade bags. I like no idea.

Well, there was multiple suicides at the.

Same time because the guy from the show. What show is that? The traveling. Traveling, yeah.

Anthony Bourdain.

Oh, is that recent?

Yeah.

So all I do is. I do, do I know these people are alive or dead? Like that's the whole qualification. So I'm like, no, all these people are probably alive. And then when one person's deceased, I'm like, there we go. No one will know this.

It blows my mind how your lack of pop culture, like you really have no pulse, dude.

But my, my knowledge of 80s culture is like shy, dude.

Oh, see, and I missed that too. You're probably going to do that next week. So. Damn.

You know what's funny is so when I was in business school we, we had a entrepreneur growth strategies with one of the classes and one of the case studies we did was Kate Spade. And I was just blown away by how they started and how they grew. And so I became like a huge fan of just watching them.

Yeah. Sadly she passed away June 5, 2018. So relatively recently, Travis Kalanick, the co founder of Uber is only age 4, according to my notes, probably 40 something because he was born in 1976. So we'll go age 40 something and Reid Hoffman is alive and well, age 52, born in 1967. So there you go. Okay, that was not as fun. It's too recent.

Yeah.

Too depressing. Yeah. Some of these are like, it's hysterical. One guy dies by falling off a cliff and you two are like wetting your pants.

That was so funny.

Yeah, that was. I don't know why that's funny that.

Because it's ironic and it was like.

The cross country segue.

I know, I know. All right, cows, take us out.

Thank you guys for listening and again, if you feel inclined, please leave us.

A review and we'd love for you to visit mikemicalowitz.com if you don't know how to spell that. I got a shortcut to get there. It's mikemotorbike.com that was my nickname in high school. Never drove a motorcycle in my life. Actually, once my brother in law made me take it down the driveway. I was like, I'm done. I almost tipped over going two miles an hour. I did have a helmet on, knee guards, elbow pads and so forth. So go to mikemotorbike.com and click on get the tools. I got tons of free stuff waiting for you there right now. Thanks for joining us and we'll see you guys next week. Bye.

Sa.