He paused, and then replied, “One at a time.” He explained he worked on each patient at the exclusion of everything and everyone else around him, until he was done. Working this way was essential to his success.

I’ve watched leaders in our profession practice and received care from them, as well. The level of concentration they bring to their art has always impressed me. B.J. Palmer, in particular, had this quality. Old films from the 1920’s, showing him adjusting patients, reveal a man who was absolutely centered. One gets the feeling, if the entire world fell around him while working, he would have continued serving his patient.

Why Is Focus So Important?

Where is your mind when you adjust? The old timers called extreme focus, “being one with the bone.” Isn’t this the kind of care you would want?

Patients need focused care. They come to you after having little success with other doctors; they deserve your absolute attention. If you can put everything aside and lend your full attention to them, this may allow them to heal. This amount of caring can be profound and restorative, in and of itself.

In remembering the best adjustments I’ve received, the intense focus, the level of concern, and the precise delivery was life changing. Our patients will recall the same about us. A few moments of laser-beam focus can create a memorable event in patients’ lives. When patients are cared for this way, they will repeat their story, and chiropractic will keep growing. Isn’t this what you want for your practice?

Let Your Life’s Work Become a Work of Art

Something magical happens when we are totally involved in our work. It’s described as “being in the flow” and is one of the aims of the truly successful. Extraordinary people lose themselves in their work. Like great artists, they are in a meditative trance while working, yet they are fully present. The greats in every field love to experience this state: in a chaotic world, they enjoy moments of absolute clarity through focus.

How to Become More Focused

Often, growth in practice is counterintuitive. A close friend urged me to cut back my hours, saying that, if I did, my practice would grow. Although I was convinced he was lying, I finally reduced my hours after he continued to badger me. Suddenly, my practice grew. It grew so much, that I did it repeatedly. This worked because shorter hours demand more focus and higher energy. Allowing too much time to get things done decreases the quality of care by letting distractions into the workplace. If you must focus to get the job done, you get organized and do it.

Another counterintuitive way to develop focus is through rest. People who don’t relax can’t muster the intense focus necessary to build a great practice. These same doctors will protest about the high cost of having someone help them around the house and do it all themselves. By not resting adequately, they lose their clinical edge, and it costs them and their patients dearly. Intense focus demands a recovery period to recharge and perform at higher levels. B.J. Palmer often napped in the afternoon. During the rest of the day, he ran a college, sanitarium, cafeteria, two radio and one television station(s), wrote many books, and developed our great profession. Rest allowed him to be this productive. Are you well-rested? Discipline yourself to nap, meditate, take breaks, and play. Regenerate with regular vacations, seeing friends, and having fun.

Get Organized to Focus More on Patients

Rules for providing a quality service include:

1. Patients Always Come First
2. Doctor’s Time Is Primetime, and
3. Delegate Everything.

Patients Come First

In times past, patients expected to wait for a busy doctor and would tolerate a poorly-run clinic. Years ago, seeing a doctor required hours, but patients waited willingly because it was normal.

Today, this arrogant behavior is not well tolerated. Offices are usually better run, and the best offices provide the finest service. When a patient shows up, everything stops. The assistant hangs up the phone, or at least signals the patient, it won’t be long. The doctor drops his pen. All extraneous conversation stops and patients receive the attention they deserve.

In the best centers, doctors and staff anticipate every question and need patients may have. They are led through a seamless experience and receive appropriate care without much waiting. Ideally, the patient walks away thinking, “Wow, these people care about me. I can’t wait for my next visit.”

Doctor’s Time Is Primetime

Assistants in a busy office maximize a doctor’s time by minimizing interruptions. Experts in efficiency note that, every time someone is interrupted, the time to complete a task doubles. They also say that interruptions multiply the odds of errors dramatically.

In the best offices, phone calls, extraneous conversations, and other interruptions are tactfully limited, so that the doctor can offer his/her best. The staff dutifully runs interference for the doctor, so there are no distractions. Does your practice work this way?

Delegate Everything

Ideally, all work not requiring licensure to perform should be delegated. Assuming they can do everything better, delegating can be the hardest thing for doctors to do. Most doctors would rather do it all themselves than allow any aspect of care to suffer. When doctors won’t delegate, quality eventually suffers.

The greats throughout the centuries received support from qualified staff. Michelangelo and Leonardo had others stretch their canvas, mix their paints, and hand them brushes. They reserved their attention to the details only they were qualified to perform. Working this way, they contributed a vast body of work to the world.

Learn to hire well, train, and delegate. Give aspects of your work to people who can do it, and monitor their work. Manage so that you can focus on what you do best.

Conversation

No discussion of focus would be complete without covering what to say as we attend patients, and when to say it. This is often when we lose our focus.

There should be no conversation immediately before, during, and after the actual adjustment. Conversation should abruptly stop to allow absolute focus on this event.

Before and after the adjustment, the doctor should focus and talk about the patient’s needs, issues, and benefits of care; answer a question; explain his/her progress, results, how he/she adjusted, how he/she might feel; and give instructions and suggestions for self-care. As a rule, the focus of the conversation is on him/her. Is your “table talk” like this? If it gets off track, does it always come back to the patient?

Focus to Build Your Practice

The chiropractic champions have one thing in common: uncommon focus. They offer exceptional care and enjoy extraordinary results through this discipline. This is why patients flock to them. In the end, doctor and patient benefit. The patient enjoys wellness and the doctor his/her art. Do whatever it takes to center yourself on your patients needs. Retrain staff, rest more, and lead productive conversations. Lead your practice forward by managing your attention.

Dr. Steven Visentin, D.C., is a solo practitioner and clinic director for Care Chiropractic in Denver, CO. He authored an e-book entitled “Blow Your Head Off Practice Building Secrets” for the chiropractic profession.

As an accomplished public speaker, he is available for corporate events, training seminars, and other group functions as well as private consultations on a limited basis. For additional information, visit www.practicesecrets.com.

by Claude Cote

There is no doubt that one of the most popular trends in chiropractic is going paperless.  Software companies have never been so active at programming all kinds of paperless office systems.  Most chiropractic offices are already using computers for front desk tasks such as billing, appointments, etc. For most chiropractors, going paperless is the elimination of the health record paper file or travel-card.  The chiropractor would use a keyboard instead of a pen to take notes.  This is all nice, but not that big of an improvement for the overall practice.  Although doctors will not have to search for a lost file, the benefits are very limited and the productivity and efficiency will remain basically the same.  Fortunately for the chiropractic profession, the growing trend of going paperless has made Health IT companies surpass themselves with automated systems that, 10 years ago, none would have thought possible.  The key word in these systems is "Automation."  Going paperless is great, but going fully automated paperless is impressive.  Lets say you are in a situation where your CA is wanting to go on vacation next week because of a family emergency.   You want to do everything you can for them and let them off, but you are expecting 250 patients next week.  Then you start to think, “I can’t do everything by myself.”
Instead, what if your answer to your CA would be:  "No problem, take next week, and then take an extra week to take care of your family."  Believe it or not, a new fully automated system will let you do this very easily, and with no stress at all.  Many doctors that I know are handling these kinds of situations regularly.  

The concept, a very logic one:
This fully automated concept was invented in 2001, and was available for all chiropractors in March 2003.  Basically, you need three computers in your office.  One installed for patients to signin electronically.  This Sign-in computer will be installed near the entrance door or near the waiting room area.  The patients sign in by themselves and then sit in the waiting area.  This eliminates the need for the patient to go and see the busy CA to tell her "I am here...." By signing in, the entire system is aware that the patient is in and is presently sitting in the waiting area.  Another computer is in the treatment room for the doctor.  At a glance, the doctor sees who is in already and who will come during the day.  When the doctor is ready, he presses one key to release the room for the  patient to come in.  This single key press will activate a calling system where speakers in the waiting area will call the next patient and invite them into the room number one,  as an example.  You could have two or multiple rooms with a computer in each and just do the same thing.  What is really impressive is that the system will use the CA’s (or doctor’s) voice to call the patient.  At the first visit, the CA will record the patient’s name and everything is done for all subsequent visits.  Having been witness to thousands of patients being called this way, I can tell you they are very impressed and excited.  Then, the patient shows up in the treatment room.  The Health Record file comes up on the screen instantly, including X-Rays, posture images, and everything the doctor needs to know about the patient.  You may also want the patients to answer a few questions on the Touch Screen to build the subjective note themselves before the treatment.  As the normal routine goes, the doctor will build the SOAP note on a Touch Screen or electronic Touch Pad (no keyboard needed) and the system will automatically generate all the billing required for this patient.  When the treatment is finished and the patient leaves the room, the doctor will close the Electronic Health Record by pressing one key again. This final action will close the file and, believe it or not, the system will call the next patient in line and direct him to this new available room without any human action needed.  In fact, if the patients have prepaid for a few treatments and have a few appointments already scheduled, they can leave the clinic without stopping at the front desk at all—unless they want to ask your CA how her last vacation was?  
The reactions of patients using these automated processes are incredible. You need to go and visit an automated clinic for yourself to realize how impressed the patients are. Also these systems give your CA a lot of free time so, instead of managing an arrival sheet and entering data for billing, they can walk around educating your patients, reminding people about marketing promotions or can actually be a Chiropractic Assistant instead of a Chiropractic Administrator.  
So, if your CA needs a week or two of vacation, tell her to “Have fun….”

M. Claude Cote  is an expert in EHR systems, insurance billing and chiropractic clinic management for 22 years.  He has installed EHR system in 17 countries over 5 continents and nationwide in USA.  He is the President and Founder of Platinum System C.R. Corp (www.platinumsystem.com).  For comments or questions please email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .