Lawyers PI Program


#65

From the Desk of:

Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

INFRASTRUCTURE

 

The most important word in your success

 

This was taken from: http://www.groupprofessionals.com/consulting/infrastructure.htm

Today's business success comes as a result of careful planning. You must have a detailed written business plan that clearly defines what the ultimate goal is business to business, e-business, b2b b2c, the reason you are pursuing the goal, and each milestone that must be passed in order to reach your goal.

It is an operational plan for achieving your goal. A complete success story is required to define your basic product, income objectives and specific operating procedures. To attract investors, obtain financing and hold onto the confidence of your creditors, particularly in times of cash flow shortages, a business plan is imperative.

It provides an overall directional policy for the production, sales effort and profit goals of your product. It will be the basis or foundation of any financial proposals you submit. It is a long range "map" to guide your company to the goal you've set. The details the what, why, where, how and when, of your company.

Writing a "winning" idea takes research and time. Don't try to do it all in just one or two days. Once you start, thousands of thoughts concerning it will begin racing through your mind. It's a good idea when you aren't actually working on your idea, to carry a pocket notebook and jot ideas down as they come -- for sales promotion, recruiting distributors, channel distribution, and other thoughts on how to operate and/or build your company. Later, evaluate your ideas, refine them, and integrate them into the overall picture.

Idea's for even the smallest businesses run 25 to 30 pages. Title each page and arrange the different aspects into "chapters." The format should pretty much run as follows:

- Title Page

- Statement of Purpose

- Table of Contents

- Description

- Market Analysis

- Competition

- Primary Location and Satellite Offices

- Management

- Current Financial Records

- Explanation For Growth

- Projected Profit & Loss/Operating Figures

- Explanation of Financing for Growth

- Documentation

- Summary

- Future Outlook and / or Exit Strategies

- Listing of amp; Personal References

This is a logical organization of information every plan should cover. Take an objective and critical look at your ideas. Putting it all down on paper (a word processing program) allows you to change and refine it to function in the manner of a smoothly oiled machine. You'll spot weaknesses and strengthen them before they develop into problems. This will become an operating manual and valuable tool to keep on track, and guide you into a profitable, well-managed operation.

Because it's your idea, it's important that you are directly involved in the work. Seek out the advice of other people; talk with, listen to, and observe other people running similar businesses. Enlist the advice of consultants, accountants and attorneys -- but don't ever forget it has to be your idea! Statistics prove the greatest cause of failure is poor management and lack of foresight. Without direction by which to operate, no one can manage. Without a direction in which to aim its efforts, no company can attain any real success.

 

This is the basic policy for every successful major business in the world. They first develop a plan and then…put that plan into action. If you are a business going into a bank for a loan or any type of funding, they will want your business plan to ensure they are making a safe bet in lending you the money.

 

McDonald’s, IBM, Ford, Verizon, Tiffany’s, JP Morgan, Disney, etc. all have business plans. It’s like getting into an airplane and not having a map; where will you go? We know how to get there, we have the vehicle to take us, but unless there is a map or blueprint outlining the direction, we will fail.

 

A chiropractic practice is no different than an airline, McDonald’s or IBM. We go to school, are highly educated and know so much about so little, and then are let loose in the business world. What do we know when we graduate about coding-marketing-managing-admissibility-billing-collectitions-writing reports? Let’s take it one step further. We are in practice for 10 years and what do we know about coding-marketing-managing-admissibility-billing-collectitions-writing reports? Sadly, after reviewing 1000’s of documents worldwide, the answer is not much more than we knew immediately after we graduated. The difference is our line of rhetoric (bullcrap) has gotten better over time and we speak with authority to justify what we have been doing for the last decade.

 

I know this sounds harsh…sorry…because I had the best line of crap on the planet and said it with more conviction than anyone you know. My line of crap ended as I entered the medical-legal world and had to testify. A good defense lawyer will call you on it, as they are trained in ferreting out facts from make-believe, no matter your depth of conviction with a non-truth!

 

A very dear friend of mine was the Mexican National Manager of a worldwide corporation that had sales in the billions. When he was in his 30’s and single, he was offered the opportunity to become the worldwide CEO of this household name company. They offered him $3 million per year with incentives, plus houses in the US, Europe and Asia, with a corporate jet, etc. He turned it down. He went on to explain that the reason he was offered the job was because he re-created the infrastructure of the Mexican operations and at the same time, the net profit, to the point that the company wanted it duplicated worldwide. He further explained that if he did it for this global company, he could do it for himself…so he declined the offer and left.

 

He spent 10 years and opened 15 imaging/treatment facilities, involving full-service general and advanced imaging, and radiation oncology. His 1 center in New Jersey treated over 1000 cancer patients per week. His net income was $14 million per year and he answered to no one. I spent a significant amount of time with him and asked him the secret to his success. His answer never changed…Infrastructure. It is the same answer as the business consultant gives in the opening paragraphs.

 

McDonald’s, the #1 small business in the world, is also the largest employer of 15-year-old employees…The secret to their success…franchise format, or a business that is system-dependant and not people-dependant. The key is that the McDonald’s corporation built an infrastructure around systems that work, and if done properly, can be duplicated worldwide with the same predictability of product outcome. McDonald’s has an infrastructure that is consistent, therefore ensuring their success anywhere.

 

Whether it is my friend and his imaging centers or McDonald’s, we have the same requirements for success. You need a solid infrastructure that will allow your business to double, triple and grow exponentially, or you are doomed for failure. Remember the adage, “The definition of insanity is to do the same thing again and again and expect different results.”

 

When I practiced, I personally owned 4 practices and helped create an infrastructure for 22 other offices, for which I worked with 3 other doctors. We spent 3 years developing an infrastructure or business system that allowed our offices to be automated, no different than McDonald’s. We created written manuals and procedure systems, with pictures for every facet of our office. We had separate manuals for every department: front desk, providers-doctors, providers-support staff, insurance-billing, insurance-collections, marketing and management.

 

The rule in the office, once the infrastructure manuals were completed, was that staff was trained to the exact standard of the manual and had no leeway for artistic freedom. That artistic freedom was a staff’s way to do things in their own way, which was the shortest way to ensure failure, given time. If the staff found a better way to do a job, they wrote it up, the 4 of us reviewed it and if correct, we changed the policy for every office and re-trained everyone to that standard.

 

Sound complicated or top heavy with beaurocracy? Too bad…for every delay in the beaurocratic procedure, it meant that we stayed extremely busy and got busier. Something I reminded myself every time I went to the bank to make a deposit…Get the picture?

 

Ohhh…for those staff members who wouldn’t conform…my favorite word was…NEXT! We found the next staff member who would. Sound cold?…Too bad. My staff worked for me, not the other way around. I made those mistakes as a rookie…I am smarter now.

 

As for our relationship, I am not going to teach you business systems. If you want to learn about them, buy the book E-Myth Revisited, by Michael Gerber, as this is the single-best source to learn how to create a concise business plan for your practice. You can hire me to help you create one for your office, but it is far less expensive to buy the book, although I can be bought.

 

My purpose of creating an infrastructure with you is focused on the personal injury (PI) portion of your practice. Your PI infrastructure is quite simple; you must be solid and have a written plan on the following, that also must be executed:

  1. Curriculum Vitae
  2. Narrative
  3. Educational Binders
  4. Medical-Legal Communication System
  5. Medial to the Organs of Hearing

 

Please note: These consultations are your written plan.

 

Your CV…I have talked about that until I am “blue in the face.” This is simple. Poor CV...no referrals...non-negotiable. This is the hard truth and as important as your narrative. However, you must remember that a CV is a living document that grows as your credentials grow.

 

A survey of personal injury lawyers in numerous states have confirmed that the credentials from the PI Bootcamp are acceptable to confirm expert status on those topics. You need the credentials on advanced imaging, neurodiagnostics, crash dynamics, triaging, evaluating and documenting of the injured. Without those specific credentials, you will be considered a “second class citizen” in the eyes of the medical-legal community and often will have your testimony disallowed on critical issues. It is one of the most undeniable reasons for a lawyer to by-pass you for another DC or MD that is better credentialed. This is a very bad place to be and one of the compelling reasons that I created the PI Bootcamp.

 

Does continuing education make you a radiologist or neurologist? Of course not. It does, however, allow you to build on the current credential of your DC and formally allow your opinion to be considered in testimony. The credential unlocks that door.

 

Your Narrative…Simply put, if your narrative is not admissible, a lawyer will never willingly work with you again. The lawyers are being squeezed as much or more than the doctor in today’s economy. Therefore, if your work is sub-par, they probably will not even want your referral for a new client. Why would they want a client where they can’t prevail due to the poor quality of your documentation? Simply put, if your narrative “sucks,” they want nothing to do with you!

 

This is a label that can follow you for the rest of your career. It is called your reputation. To this day, there are still lawyers who think I am a “moron.” I am not being inflammatory; that is what they told me to my face and will never, ever, ever work with me again because in the beginning…well not so beginning, in my 10th year of practice, I was still in my “bullcrap days” and tried to pawn myself off as the best thing since “sliced cheese.” That didn’t bold well in court, as some lawyers lost very sizable cases. Needless to say, my picture with devil horns and mustache drawn on it, 18 years later, is still on many dartboards. Get the picture? Oh…I had a forked tail, as well!

 

Your Educational Binders…This is the vehicle, or in legal terms, the demonstrative evidence that you are the best-of-the-best through clinical evidence, as you will overwhelm the lawyer with the depth of your knowledge. The best part, it’s not rhetoric; it is tangible and is backed up with research. This will enable them to prevail at a higher level and as I have said before, you can grow hair on a cue ball or cure cancer, but if you are the reason the lawyer makes more money, they will consider you the best doctor in the world and refer to you for the rest of your career. It is about your reputation and these documents will set the foundation for that reputation.

 

Your Medical-Legal Communication Systems…We have talked extensively about calling the lawyer in the beginning, sharing with them the findings of the new patient, and at the 6-8 week period of care, packaging the entire case and getting them to have breakfast with you. Do not send piecemeal reports…It will drive them crazy and 90% prefer to get everything at once, to see the whole picture, as long as it is timely.

 

If you want to destroy a relationship, then make them wait to get the information, as that will potentially harm their cases and frustrate them. You also need to keep your word about delivering timely reports; without your word being good, you have nothing!

 

Your Medial to the Organs of Hearing…Simply put…what’s medial between your ears? It’s your brain! This is the most important part of your infrastructure. You need to be the best-of-the-best. Not in a notebook or on paper, but through credentials. You need to be the “real deal!” In order to compete in this Internet savvy, medical-legal, spine specialist economy, you have to be “The Expert.“

 

The lawyers are knowledgeable and sometimes more than us. That is a simple fact. The orthopedists, neurologists and neurosurgeons cannot know more about spine than we do. We need to know the same as it relates to trauma, as we are all spine specialists in the eyes of those who are judging us. They are the same people that will refer to us. Guess what?…They are right! We are spine specialists and need to be as educated and articulate in our specialty as our counterparts. This is non-negotiable!

 

I have said many times before that lawyers prefer MD’s over DC’s because on the witness stand the MD can stand the scrutiny of cross examination of spinal related issues and the DC often fails. Subjects like spinal syrinx, herniated vs. bulging vs. extruded discs, hemangiomas, punctuate opacities and the like. You need to be the best and the lawyer will know it immediately. This is where the PI Bootcamp starts. Please notice that I didn’t say it is the whole picture. It is where it starts, because it takes you from the very basics and gives you a solid foundation to build on. I am currently creating courses in head trauma with brain injury, and mild traumatic brain injury with the utilization parameters, and understanding and diagnosing of advanced brain imaging. Additional courses are being worked on in cognitive disorders, spinal osseous disorders and carpal tunnel, cubital tunnel and tarsal tunnel syndromes.

 

You never stop striving towards being the best-of-the-best. This is the single-most important part of your success and you cannot abdicate this responsibility to your staff. When you are with a lawyer, they will know, and it is the surest and shortest path towards your success.

 

If you have not taken the PI Bootcamp, do so now, and as more courses are added, do not stop getting better at what you do and who you are. Go on-line or travel to take additional courses. I do not know of one orthopedist, neurologist or neurosurgeon that does not continually take continuing education courses throughout their entire careers. It is required for them to stay on the “cutting edge” of excellence and we are held to the same standard, as we should be.

 

As the months pass, I speak have spoken to many of you nationwide, and many have followed the plan by building all 5 components of the infrastructure. In the past 2 weeks, I have spoken to doctors in the following states who are putting this into action and succeeding at transforming their practices and their reputations:

 

  1. New York
  2. New Jersey
  3. Florida
  4. Texas
  5. Washington
  6. Massachusetts
  7. Michigan
  8. Minnesota
  9. Delaware
  10. California
  11. Illinois
  12. Pennsylvania
  13. Arizona
  14. Oregon
  15. Maryland
  16. Connecticut

 

This is not an isolated instance, nor is it dependent upon your state, county, city or town. These doctors live in urban areas and rural areas and have one thing in common…They made a commitment toward their excellence and followed that plan. It works, and these are only doctors I have spoken to in the last 2 weeks.

 

I welcome your calls and e-mails to help you meet your goals…the only thing I ask is that you be ready to be challenged and to work. No one can do it for you; not your staff, not me, not your mom or dad…Tag…You are it!