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Clear Process or King of Wing? Build your Business Predictably!
Episode 2124th November 2022 • Align Your Practice • Dr. Clifford Fisher
00:00:00 00:19:11

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Do you run your business on emotions or metrics? Do you have a SOP (Standard Operating Procedures), is it the right SOP and is everyone following them?

If you have a process and you have issues these are the three questions to ask yourself: Do you have a written process, is every one following it or do you need to change or improve it? Let’s dive in and see how process impacts you, your team and your business and learn how to grow your team and practice and how it can help you understand and build your aligned life.

This episode will help you understand and fill in those gaps and create the life and practice of your dreams. Join host, Dr. Cliff and co-host, Dr. Joseph Esposito as Align Your Practice helps you understand and create clarity on your leadership and vision.

About the Host:

Dr Clifford J Fisher

Dr Cliff Fisher – Owns several offices all over the US and has a coaching business Dream Leadership Institute to help people find the greatest version of themselves. He will help you get to a foundational understanding to create the business and life that align with your being.  


Dr. Joseph Esposito, CEO

Dr. Joseph Esposito, D.C., C.C.N. C.N.S., C.C.S.P., D.A.B.C.N., F.A.A.I.M. C.T.N., is the Founder and Chief Executive Officer of AlignLife. As such, he is responsible for the direction of AlignLife as it expands further across a dynamic and rapidly changing health care landscape. Dr. Esposito has more than 20 years of experience in a broad range of businesses, including chiropractic, nutrition, technology and internet marketing.

Dr. Esposito has extensive post-graduate academic accomplishments, as well as 15 years of experience managing successful chiropractic clinics in multiple states. He also is founder and CEO of Aceva LLC, a service-based nutritional company providing products and services to the AlignLife clinics. As the former CFO of an internet publishing company, Dr. Esposito understands the power of leveraging the internet to impact the lives of millions of Americans.

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AYP Intro/Outro:

Align Your Practice podcast with Dr. Cliff Fisher where your best practice and life awaits you. Are you tired of running a practice on your own? We want to come alongside you with experts to help you create your dream practice in your dream life. Here is your host

Dr. Cliff Fisher:

Hey, tribe, welcome back to align your practice with Dr. Cliff and Dr. Joe brought to you by align life where we want to give you the tools to find and create your aligned life. And so, today we're going to talk about, do you have clear processes? Are you the king of wing? I know, like I've been on both sides of this where it's everything's a process, and I've been, whereas my king a wing? And there's definitely one's better than the other? What do you think, Joe?

Dr. Joseph Esposito:

Yeah, I agree, I think process is what helps you eliminate the variables in practice, because basically, business is an experiment, just like you're trying to prove something in a laboratory is where you got to minimize variables. That's the way you create predicted outcomes, right?

Dr. Cliff Fisher:

Yeah. So I think from a predictability standpoint, definitely the processes are great. And as you want to scale and grow, you know, the processes are necessary when you first start out, I think people don't feel like they get locked down by like processes or like, I don't, I won't be able to do it my way when I you know. And so there's benefits with both. But you got to definitely have to pick your problems in that.

Dr. Joseph Esposito:

Yeah, I agree. I think this discussion that we're having on procedure, or I'm sorry, I'm process also ties in with the issues because when you have issues in practice, it's usually you don't have a process or process. So we got to look at the two things. One is creation process. So what we call it in a lot of business standard operating procedures is there's ways to operate a business. So when there's adversity, the first thing I do is I say, is there a standard operating procedure? Or is there a process? And if there's no process, then you have to document a process? If there is a process? Next question is, are you following the process? If the file is in process, and you still have an issue? The question is, do you need to improve the process? Right? So first is do you have one second is, are you following it? And the third is do you have to change it? So a lot of the time, there's nothing really documented, three people are doing the process, they all three, do it differently. Outcome is variable, a lot of issues, a lot of poor, service issues with customers, that you don't have it documented, that's usually the issue. If using a consultant or an organization like align life that has refined operational manual of over 400 pages of how to operate a clinic in a very granular sense, then that then you have a process, you just got to work on training on it and mastering the process. So

Dr. Cliff Fisher:

yeah, I think, for me, like the nice thing too, about the online life manual is it's shifted from like, it was a it's a 400, page manual, but it's also an LMS system, where now it's like, you can train the doctor, you can train the team, there's different sections for each one. And so with the ability to do that, it really adds a ton of value to who's training on what and that

Dr. Joseph Esposito:

you have over 20 years and align life, you know, we broken it down by attraction, conversion, retention team building, so you can just work on a section of the manual, if you're looking at just attracting new patients, there's a section on there. There's also a practice analysis where you can do an evaluation, your own practice, take kind of a, in a sense of survey questionnaire to see where your gaps are. So you have kind of awareness about what you need to train on, then you go into the manual, you train the team on a piece of it, and you level up the number, it's really interesting for me over the decades long, is that when people are true to the system, and they see a gap, the stat is down on their practice diagnosis, that they can go in and do a practice analysis on a section and say, Oh, we're not doing some of this stuff. They train their team on a process. All of a sudden, the practice changes, the number changes, the KPI changes, like wow. So basically, we just got to keep training on different aspects of the system in order to create the outcomes we're looking for. And that's where companies and clinics start to level up really fast is when they really understand that it's basically having process training on process that trade creates the change and the growth of the business.

Dr. Cliff Fisher:

That's great insights. Joe, I know when I started out that I think the big thing that comes up for me is like when I started out, I went to an office and they're like, Oh, here's all the scripts. I'm like, What do you mean, I'm a doctor, I don't need these scripts. And he says, No, if you want to see patients here, and if you want to do these things, you have to learn the scripts verbatim. So I learned them verbatim. I'm like those, which was a challenge for me. And then when I opened my own practice, I'm like, I threw the baby out with the bathwater. You know, I just threw I'm like, I'm not doing scripts. I'm gonna do it my way. And, you know, three years later Four years later, I started bringing doctors on. And then they're like, Well, what do we say? And I'm I say with, we don't have any scripts, then I had the fall down. And then we started to develop them over the years. But it's just the scripts really help you be able to be present with the patient, rather than trying to think of what to say or what they're going to ask. So you have the answer. The scripts give you the tool. So you go in the room, and you're tooled up. Yeah. So

Dr. Joseph Esposito:

that the difference between process which is, you know, what you're doing and your communication, what will your we call scripts, is what do you actually communicate, and there's so many levels to that, I as well as you as well as most people don't want to follow a communication cycle. And the argument that I had you had others have is, I want to be myself, I don't want to be a robot, I don't want to, there's all these statements. And I was adamantly against following any communication cycle, adamantly, like fought it, tooth and nail. What I would someone challenged me on which I hated, but it was so true, is they listened to me with a new patient. And I said the same thing. So over time, the script occurs organically, you just don't have any intention on it. Because if you do the same cycle over and over, guess what you end up saying the same thing. But there's no intention. It's just whatever comes out, it becomes repetitive. So the the real reality for me, the wind for me was that I learned Wait a minute, we could be intentional on how we're educating our people, our patients, and be more proactive. And once you own a communication cycle, then you use your flair, your personality, you add your your self to it. But where the when I got was not only when they challenged me that I already had a script, whether I liked it or not. The second thing was the length of my communication change with my emotional state. When I was really upbeat and passionate, I was in the new patient room and extra 20 minutes, but I wasn't I was a little tired or not as refined. I was out in six minutes. The six minute one wasn't as educated and but didn't stay as a good patient. 20 minute one I was behind on the next 10 patients. So if the scrip was exactly 10 minutes, why didn't I just follow a process, and that was the circle for me to come to it. And what I realized was I was invalidating my team, because they were staring up patients waiting to get adjusted, because I was long winded, or the patient came out and said, I know the doctor, talk to you about the workshop that we're about the report next time and invited your spouse, oh, no, they didn't say anything about it. Oh, they didn't say it. So you can't carry any continuity of a conversation between your staff and yourself inside and outside the room. If you don't have a set communication cycle. So everything's siloed everything's fragmented, everything's individual, and you lose the continuity of the communication cycle. And in chiropractic, you know, it's, it's an intangible, if you can't touch it, feel it, see it, the subluxation. And you got to be masterful in bringing value to what you do, and clarity on their problem. Or you're going to, you know, if you don't sell them on chiropractic, you're going to, you're selling them on drugs and surgery. So whether you like it or not, we have a mission to give people the opportunity for chiropractic, and we fail that mission, we're only promoting things that we know can create much harm to the human body.

Dr. Cliff Fisher:

Yeah, that's great points. And I think as I processed everything you were saying, the things that came up for me was like this is if you want to be again, scalable and durable. Or you want to have a consistent product like these, that's the reason to do if you want to just if you just want it to be you and one team member, you guys are always gonna do the same because just like Joe said, you're gonna have an unconscious script, automatically. Do you want to have a conscious or intentional script or the opposite so

Dr. Joseph Esposito:

and it's really high, we say to people, you know, line life we want to have, we want it to be disney world level experience. We don't want it to be the town fair experience. If you go to your town fair, no one has a communication. They don't have process you get on the ride. I'm not going to greet you give me your damn ticket. And I hope that I hope you know your seat doesn't come flying off during the ride because we don't have quality control. When you go to Disney World. I always say you know, I remember going across the turnstile with my son first time we went and you hear the music playing in the turnstile that set the mood and you walk across turnstile and around the corner came Mickey Mouse ready with the arms wide open with music playing and they experienced that child was like wow, oh my goodness. And then Mickey went around the planter and then came around again for the next group of kids it was this experience the same music the same experience because they wanted to create an outcome of an experience for a child. And then when you go through the park you see that there are cycles of the way they operate. Have process and communication to guide the experience. And that's a Disney World level experience. It's trained, and it's communicated with mastery. And that's what we want in the clinic, we want people to come back and refer just merely based on the energy and experience, forget the doctor's care, you add great care to it, it's even better. But we want to experience so refined that they feel loved cared for understood, with direction and clarity, without the doctor service yet. And that's when you really win the game and providing the highest level of chiropractic experience, from my point of view, process and communication.

Dr. Cliff Fisher:

Yeah, so as you're talking about that, the thing that comes up for me with process, why is it so important? So you know, doesn't matter if I have a clear process or king of weighing. And so I think for me wrapping this up, this part of it is, the reason I have it is to make it better experience for the patient better experience for the team, because we're, I always found things go sideways as well, I thought you were doing that, oh, no, I'm doing this. And it's like the telephone game. It's like, you know, you say one word, you know, a phrase. And by the time it gets in, it's butchered by, you know, two or three people. And that's what happens with training. So that's why this, you know, SOP, or these core processes are so crucial to scale and be durable.

Dr. Joseph Esposito:

Yes, so you have to decide, you know, in business, if you're a student, you have to decide, you're going to need process. So you either build it or pay for it. You can use consulting groups, you can use the company like align life and national franchise, that's refined process, you could create it yourself. But no matter how you approach it, you need process, you need documented, written proven process. Now, it may take you 10 years to prove your own process. And, you know, grueling journey, a lot of scar tissue. But you'll have to create process that's documented, and communication cycles that really work over a period of time. But either way, at the end of the day, to get the outcome you're looking for, you're gonna need process and communication to have a really effective chiropractic, chiropractic offering. Well, let's go into the second part, the opposite of process, or the the concern with lack of process would be issues. Yeah. And in the end, they talk about issues.

Dr. Cliff Fisher:

Yeah, so my question on that, are you addressing them? Are you pushing these under the rug, and I think, so many offices, they just they don't address them, they don't have a place to address them. And some of them aren't even aware that they have them or some people, well, this is just the way it is. And so what we want to do is have a process a way that we have a collision, where we meet, you know, once a week at least, talking about what our issues are, so that we can address them so that they have the smallest impact on our business, on our practice and on our team on the doctor.

Dr. Joseph Esposito:

And I think the way to do issues is it's your framing into a question. So you're trying to come out with an outcome. So the question is, why are we not retaining our patients? That's a potential issue. Why is are we running 45 minutes behind at the end of the day? Why our over the counter collections dropped? 25% like these are, take your issue and frame it into question. So there's three parts identify, there is an issue. And in the identification process, you asked the group in your meeting, and it could be a group of to you and your staff member or group of five, but it doesn't matter. It could be even a group of you, you and your staff. And the question is you ask if you have any clarifying questions, like you said, over the counter collections dropped 25%. Was it just last week or last month? Was it the auto pay? Or was it actual dollars across the counter? Like you're asking questions to get clarity, and then you open it up once there's clarity on the true issue that we're trying to solve? Because you want to know what the question really is. So that question may be modified, once you know what you're trying to solve, then you open it up for discussion. And then finally, you're looking you create a solution, you solve it. That's the last part. And the idea of an effective Office meeting, or leadership meeting is how much how many issues can you solve and in the period of time that you have allocated, right? You solve and make decisions, the more the quicker your business will grow.

Dr. Cliff Fisher:

And like you said, it's to solve it like sometimes we will, like it's more important to get go through one issue deep and solve it than it is to surface over three to five. And so it's not like part of it is how many can we solve but the the next part of it is like make sure you solve the most important one first, and if there's time in the meeting, because there is that time restraint that you saw you, you don't go just right past it, you get you nail it and you get the solution. Yeah, that's

Dr. Joseph Esposito:

a good point, because I've caught ourselves even 30 years later that sometimes we have a great discussion, but we never state what the solution is, but we feel good we're like, oh, that was right. Should Oh, that's the next point is like we know, but we don't know what we're doing. Like, it was a great discussion, but there was no solution. So yeah, have someone on your team, if it's you and your staff, you may ask your staff member to say, Listen, don't let us walk away from the issue until there's a documented solution like we are going to do X. And that's the juice of the discussion is that the solution? You got to make decisions in business? And a lot of us were scared to make a decision. And sometimes the wrong decision is a better decision than no decision, because you're going to learn from decision making. Lack of decision making is the downfall of a business. It really truly is. Yeah,

Dr. Cliff Fisher:

100%. Like the best decisions, right decisions, the next best decisions, the wrong decisions, the worst decision is no decision.

Dr. Joseph Esposito:

That's huge. Yeah, I love that analogy. And so cliff, putting these together, we know issues can be caused from lack of process, from not following the process or having the wrong process we mentioned earlier. So we have the issues can be solved by creating more process, or following and training on the process or changing process. So when you have the issue, my recommendation is, as much as you can go back to your standard operating procedures or your office process and see and see if you could solve it by reviewing the actual documented process. Yeah,

Dr. Cliff Fisher:

I love that. And then, you know, some of them are processed. Some of it's like, a vision, like, do they know what it looks like? So you have to ask those questions. So that's where like, Joe, you're saying all the clarifying questions like, you know, is this a vision? You know, what success looks like? Is this a leadership? You know, do you know who owns it? Or who's running this? And then or is this a process issue? Or is it a people issue is the wrong person in charge of it? I don't know how many times I've done that I put the wrong person in charge of a project. And it didn't get done. And I was frustrated. They were frustrated, and nothing got done. And so and then, or is it a training issue? Yep. You know, I have clear vision. Yep. I'm the right person to own it. Yep, we have the right process, but I don't know how to do it. So is it a training issue? Or is it an energy issue? Is there enough energy to get this done. So those are the kinds of the, as you identify, discuss, and solve those are some of the points that I got,

Dr. Joseph Esposito:

you made a good point, click that it's either, it could be the wrong person doing the actual process itself. So that's where it's good to have that awareness. You know, everyone has their KPIs in their scorecard. So we know what kind of outcome we're trying to achieve. If it's not been achieved, then we can look at the process and maybe alter different people on different seats on the bus, you may have the right team members in the wrong seats of the bus that need to be altered based on their the way they're wired, their personality, or their work ethic, or their their ability to the ability to communicate and get the outcome for that particular job detail. So that is issues and process which kind of work together, hand in glove, that process when trying to solve your issues in the business. And don't be afraid of continuing to build your issues list every week. And you're doing your best to solve as many issues during your office meeting as possible. That sums it up. So we hope that you learn a little about process and I think if you want to finish some homework, it's look at your operating procedures. If you have the process, where are the gaps, what what areas need to be documented that you don't have documented, what processes inside your business right now you need to train on that you can dive in and do the training. And then lastly, what areas or process of your business need to be actually changed and updated. Okay, that concludes this particular podcast sorry, we lost Cliff towards the tail end here. We will see you on the next session, which should be about people.