Academy of Chiropractic’s

Lawyers PI Program


 From the Desk of:


"PI Office Success Checklist"

Delivering what lawyers want versus what they need to prevail


What lawyers need is different from what lawyers want. The former are critical needs of admissibility in order to prevail and the latter, their wants. These are the overt and subliminal issues that can either make or break relationships with lawyers or any other referral sources.

The needs of the lawyers are all of the issues we have discussed range from triage to SOAP notes to narratives to credentials. What goes beyond that is the feedback from their clients, your patients. That is the sum and substance of their wants. They want their clients to be handled, happy and create a "hassle free" environment for them. The last thing they want is negative feedback from their clients and have issues to resolve regarding you and your office. If they do, that becomes a "kiss of death" in your relationship and will be very difficult to overcome in the future.

15 years ago, I took a seminar with an office guru who helped me understand my office and create congruency in what I wanted and what I was portraying to the public. This consultant/lecturer/guru/expert opened my eyes to the congruencies, or lack thereof, in my office and life and illuminated the disconnect I had created, thereby stunting my practice growth. In retrospect, it severely inhibited my ability to create and maintain a personal injury practice as well.

What this consultant did was ask us to write down our purpose in practice and combine that with our purpose in life. The instructions were to make this as expansive as possible in scope, language and words. 2 hours later, I had concluded a 3 page treatise about my vision for chiropractic, my office and how I fit into the plans of changing the world. Upon completion, we got new instructions to boil it down to 1 page. After another hour of editing, I now had a precise document that fit into my vision of changing the world through chiropractic because I had the power to do so in my 2 hands and was able to see it in words!

NOTE: Unfortunately I cannot find that document as I would have liked to share that with you.

The final instructions were to go back to our offices and boil that 1 page down to 2 sentences and use that as our positioning statement for everything from caring for patients to marketing and advertising. It was to be the basis for everything in our offices and our lives and it all had to be congruent with our purpose. Furthermore, we were to have our staff go through the same process in a staff meeting to get everyone pulling in the same direction, thereby creating a powerful tool for the staff to be on the same page, moving in the same direction and not giving mixed signals to patients and each other.

The consultant also gave us one last task which became the most important message of the day for me. We were to go to our offices and start from the outside of the office and work our way in, moving from the front to the back. We were to use the 3 page treatise as a blueprint, as the inspection standard. If we saw anything in our office, either inside or out, that didn't match our purpose, we were to change it. If the physical plant or staff systems were inconsistent with our purpose, then the patients would be getting mixed signals and therefore, the success process would "short-circuit," whether overtly or subliminally.

Here is what I saw that were mixed signals:

External observations:

1. Signage - The name was wrong as I wanted to be a PI office, but my office name was not good, fraught with "family" and "wellness."

2. The blinds on the windows to protect from internal sunlight were dirty on the outside and "crimped," thereby looking unkempt to the outside observer.

3. The office hours posted on the door were wrong.

Internal observations:

1. Magazines were outdated.

2. Magazines were "dog eared" and torn.

3. Pictures on the walls were old and dusty.

4. Pamphlet racks had empty slots.

5. The wallpaper was pulling off in corners.

6. Chairs were soiled in some spots and very worn in other areas.

7. The rug was clean, but stained.

8. Upon entering, the staff often didn't immediately acknowledge the person coming in because they were working on other tasks and didn't take 2 seconds to greet the patient entering.

9. The clipboards that housed the "sign-in sheets" were scratched and looked old.

10. The forms for the "sign-in sheets" were not copied straight; they were crooked.

11. The forms for the "sign-in sheets" were not copied clearly; they were copies of bad copies.

12. Pictures of children under care was very outdated.

13. The staff was not dressed professionally.

14. The entire office was littered with tiny pieces of paper on the floor. With a paper intensive office, every time a chart is pulled or the paper punched with holes to fit in the chart, it creates tiny pieces of litter that is discreetly spread throughout the office.

15. The walls of the reception area and hallways had no message about chiropractic or the expertise of the doctor, me.

16. The treatment room constantly had full garbage pails with headrest paper.

17. The bathroom had "very poor quality" hand towels and toilet paper.

18. X-rays were piled up in individual file folders in the corner of a room and all "dog eared."

19. The doctor and staff offices were a mess. There were piles of paper all over the place with no level of organization.

20. Under the adjusting tables was dust. The tables were clean, but the patients lay face down and in the base of the table was dirt.

21. Below the headrest paper, where they put their faces, was dirty.

22. The doctor, me, was taking too many phone calls in the middle of caring for patients.

23. Recalls and "made up misses" were not done in a timely fashion, with patients not getting their fully prescribed care.

24. More

25. More

26. More, etc.

BUT...I was giving great adjustments and the patients were getting well. In spite of great care, the above items were a tremendous amount of objections to overcome and I was in control of every item on that list. These types of mixed signals are what get back to lawyers and every other referral source, creating a level of work and potential embarrassment for them, for THEM to overcome the objections of your patients, their clients, about you and your practice. The consultant I was with guaranteed that if our purpose was exhibited in our offices both in systems, services and the physical plant, that we would get busier quickly and he was 100% accurate.

Upon returning to the office the next day, I had an office meeting and had every staff member write his/her purpose on paper. I then had them boil it down to 1 paragraph and share with the entire office the vision. I then shared my vision for the practice and discussed each person's idea, incorporating theirs into mine, as I felt appropriate, and came up with 1 statement. I was very careful to make sure that every voice was heard and gave the entire staff ownership of the final document.

My next step was to get the physical plant in line with our purpose, involving simple tasks like vacuuming every hour. I remember going to Disney World for my honeymoon 35 years ago (it was all we could afford!) and what impressed me the most was the level of cleanliness. Upon speaking to employees during the many repeat visits with my wife and children, I came to learn Walt Disney's motto of cleanliness, "We clean clean windows." His vision was that if you clean something that is not dirty, it will always stay clean because you get the little things so they don't become or look big.

The office agreed to have a rotation of vacuuming and emptying garbage pails. Each person had the same hour during the day. Jennifer had 10 AM, Natalie had 11 AM, Diane had noon and so forth. If 1 person had to repeat twice the same day, it was arranged so that as a team we made sure that our physical office reflected our purpose and no matter the condition of the office, we cleaned our clean office.

On a side note, pay careful attention to bathrooms in restaurants. The restaurant industry has found through their market research that bathrooms matter greatly and they are spending large sums of money to ensure a great "bathroom experience." I am not saying you need to redo your bathrooms for $50,000, but make sure it is an overwhelming positive experience and not a negative one in your office.

I changed the window blinds, magazine racks, carpeting, and wallpaper. Wall decor was taken down and replaced with doctors' diplomas. Adjusting tables were cleaned with Q-Tips. X-rays were boxed and stored in shelves. Everyone had to purge their offices and we purchased extra file cabinets. The entire staff was given an allowance for scrubs that were color coordinated for days of the week and new systems were put in place for greeting patients and made up missed appointments, and with the exception of my wife and children, unless it was a true emergency, I was not to be interrupted when I was with patients.

As for the systems, we created a written office manual for every facet of the office with scripting. This process took 3 years to complete, but after each chapter, an office meeting was held to discuss the current chapter. Every staff member participated in the process even if it wasn't in his/her department. The insurance staff had to participate in the front desk systems and vice-versa. Everyone had to be familiar with everyone else's jobs, as there were times coverage was needed, but more importantly, it created a scenario where everyone was pulling in the same direction.

I will be creating an actual checklist for your office and have it posted shortly. In the meantime, please use my experience and create the office of your dreams PURPOSE.