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Hello and welcome to this week. Show of Growth Without Risk. My name is Dr. Janice Hughes, one of the regular hosts, and I’m really excited for our conversation today. Um, for a couple of reasons, I love the topic and then I love the chiropractor that I have here. So today we’re going to talk a lot about associates or building. I’m going to call it your, your team of doctors, you know, not some hierarchy of, you know, one doctor and then somebody else that you always hear those stories about. Oh, we’ll just bring someone in to help a bit like I want to talk about, is it really possible to build an incredible team? And so I’m bringing to someone who has done it. Um, I’m not going to introduce you a lot, Dr. Elise. Um, I would like Elise to talk a little bit about herself, but I have known this woman for probably since, before you graduated. And so Dr. Elise Rigney is our chiropractor and guests today. So welcome. Thank
You for having me. I appreciate it. Well,
It’s exciting. Tell, tell us a little bit about you didn’t start out, obviously in a clinic, you know, with multiple doctors, you know, you had worked, you tell people where you got the idea that multiple doctors was possible, even though you set up a practice originally on your own.
Sure. Um, that’s a great question. So I originally of course, started out solo practice and then it got to a point about a year into practice where my capacity, I guess my volume was at a certain place that I was physically starting to not feel great in my own body. And it was just kind of that intuitive warning of like, all right, you’re going to need help. Your vision is a lot bigger than where you’re at right now in practice. So you can’t do this alone. And so I brought in my first doctor who I actually went to chiropractic school with. He was in my class, he was valedictorian of my class. And he came in and he was with me. He was just a straight adjusting doctor. And he helped me out a ton because I was able, I got pregnant. I had a maternity leave, he covered my maternity leave.
And then we ended or parted ways at the same time that I brought in my now senior associate doctor, Dr. Laura, who has been with us for six years. So at that point, she came in and she was, she interned from Palmer, which was a wonderful experience to have her as an intern because she got to learn everything, but wasn’t able to adjust in our state and then easily transitioned into that point. And then from there on, it was again, like I knew I wanted to make a bigger impact in our community and seeing more and more patients help more and more families. And I knew that that was not going to happen with me alone. So it was just kind of a no brainer to me to continue to bring on phenomenal doctors in the office. So now I’ve grown the office. We have six doctors, six chiropractors, all women chiropractors in our office and it feels so good. We have totally created an impact in our community and we’re, we’re still continuing on.
Well, I love, um, the first words you talked about were your vision. You had a vision bigger than say what you yourself could do. And I think that that’s a really key distinction because part of it, like, I want us to dig into, um, not just, Oh, well, you’ve done it, but how could others do it? And a lot of it starts from that mindset piece. Like this just isn’t Oh, well it sounds great. Or it’s financially a really good thing to have another associate. You talked about the vision. So what kind of a mindset does someone have to have to include others? Like, like you are in a system that you have different docs adjusting at different times in different shifts. So what’s that mindset piece all about Dr. Elise?
Yeah. I think that’s something that comes a lot down to your ego. Um, that’s something from the beginning. I was really cautious of not naming my practice with my name. I’ve always been really mindful of marketing, making sure it was about our practice name is impact chiropractic. So making sure it was impact chiropractic getting out there and not Dr. Elise Rigney. And so that was something from the beginning. I, I work towards, even when I was so low practice, it wasn’t about me. It wasn’t about my face. It wasn’t about my personal branding. It was about branding, the practice and that when people thought of the practice, they thought of it as that’s where the best chiropractors are. And so it’s kind of like any medical facility really, you know, it’s the name of the hospital, the name of the clinic, the name of the specialist, the specialty clinic, but it’s not the doctor’s name in there.
You get an appointment with a doctor anywhere and an attorney or an accountant, there’s multiple attorneys or accountants in a firm and, you know, they’re all great. Or, or, you know, especially if they work together. So that’s kind of the, that shift. And also I’d say there was a lot of, um, yeah, letting go of that ego and it not being about me and not being about me being the best in practice or the best chiropractor in town. It was really, I would actually win awards. Um, we’ve won top for the state of chiropra or the state of Colorado for, I think, six or seven years running now. And they always say, I want it. And I’m like, no, I didn’t want it. My team won it. And I have them change the plaque to say impact chiropractic and not my name on it. So I think it’s a lot about like shifting your mindset to team and not solo and not about yourself. Yeah.
It, that, that huge from my perspective, because I also know, um, I go to multiple schools. I, um, again, teach some business classes, but I do, um, you know, keynotes or, or talks with, with different groups at the schools. And, and that’s one of the big challenges out there is that a lot of people say, well, to be an associate, you go into someone’s practice and it’s their practice and it’s all about them. And, or, you know, again, I’m only being paid. Like they end up if we’re not careful having it feel like a job. So you’re, you’re describing that idea of like, literally, you know, it’s a team, it’s a facility, you know? So, so with that mindset, well then how do you attract the right people? You know, how do you, for example, like talk to a doc, a young doctor or interview someone when you know that there’s that message out there already of, well, a lot of times, Oh, you know, it doesn’t pay to be an associate or why would you be an associate? So how do you find such great people?
That’s a great question. So originally when I was looking at hiring our first, our first associate that was through connections, um, within the pediatric community. And then now I have very regularly students or docs docs who have been in practice, reaching out to me seeing, is there any chance you’re going to be hiring in the future? I’ve actually one of our doctors that we have here, we had this moment where I was going to bring her on. And then she had an opportunity to buy out the practice she was in. And then, um, we were like, okay, that’s meant to be, you know, I want you to, she built that practice. I wanted her to purchase it well, that fell through. And she came back to me and she’s like, is there any way? And I’m like, I already hired a wonderful doctor, but, and she said, well, I just know we’re meant to work together in the future.
And I don’t want to go sign a contract at, you know, another clinic when I know my heart is with impact. So what she did was she worked for the joint for a certain period of time just to keep her hands on people and to keep adjusting, but she knew she wanted to be here. So now we’re at this place where it’s wonderful. Cause we have, uh, like a punch of phenomenal doctors and honestly, students coming out of school because of the reputation that we built. But I, what I would say is originally treating, adding another doctor into your practice. Like you do like the amount of effort you put into trying to get a new patient. You know, we will identify our ideal patient avatar, ideal, ideal client avatar doing the same thing with your associate, identifying your ideal associate. And so I actually, and I have a program called building your team team of doctors.
And that’s one of the exercises is how to identify exactly who you need in your practice and getting it all done on paper. And as you know, as you’ve taught me, manifesting that person into being a reality in your future too. So, um, but really knowing exactly who, because sometimes I think oftentimes doctors are like, Oh, this person is from this, chiropractor’s from my town. So I better hire them. Or I only had one person apply. I better hire them. They make all these exceptions. And they’re like, Oh, I, they’re not a great fit, but circumstantially this’ll work. So they try to make it work. And that’s when problems come along and there’s not retention. And that’s when chiropractors get the reputation of eating their young. And I think it’s just, we don’t have mentors. We don’t have programs. We don’t, you know, now we’re starting to, obviously, that’s what I created because I felt pretty lost in, and I didn’t love the models that were set up.
I didn’t love like the low base plus commission because I’m thinking if they’re going to have to build this practice up, why wouldn’t they just go build their own office? And if they’re really good at building their practice up, they’re going to figure it out. Pretty soon they should go open their own office. You know? So if they’re making money just off of commission making their salary and not much of a salary, that’s um, just also creates a, in my mind mechanistic model, it’s not vitalistic. It’s very, like, it’s not a team. If you have to go, you know, market for your own patients and see your own patients in this person’s mind. So I get commission off of this person, but not this person. It’s not a collaborative effort within an office. And it also puts your mind in a focus that’s about probably your paycheck. I would assume if you have a low base and not on the patients or the people in front of you. Right. I don’t know if I really answered your question with that, but
No, you, you actually, you’ve answered several questions that I have. You know, number one is that, um, that attraction like of right people, you know, I think that what that really speaks to is many docs listening. You may need to do some cleanup. You may need to do some cleanup of like your own office and the systems that you have so that they are reproducible. The other thing is, I think it takes some cleanup of the mindset. You know, you, you said that, you know, not just hiring someone out of convenience, Oh, they’re coming back to this area. I made that huge mistake years ago. And so everyone listening, like I kind of did the opposite. I was actually on maternity leave when someone was coming back to town that needed to precept. Um, another situation felt through fell through. One of my CAS, knew his family.
So out of convenience, we ended up having him come in. I wasn’t there to guide him. I wasn’t there to be the leader while I was on maternity leave. And very long story short, a lot of accidents, you know, ended up happening. It just, it, it was completely wrong because it was out of convenience. So it doesn’t mean like that. That’s an easy thing, but I think you’re speaking to, like, you have to have this vision, you have to attract great people. And then I heard you say the word retention. So, so tell everybody listing a little bit about, you know, do you just have them come in and everybody does their own thing or do you have a system? And then how often do you train? Because I know you retain these doctors and you’re attracting more because you have this great facility, but talk a little bit about the training and how that leads to retention.
Sure. That’s a great question. We train a lot. So I saw someone just asked this question about if we have contracts, we absolutely have contracts. Um, and then I also set them up on different periods. So if they’re coming from a student, you know, maybe if they’re not doing their peak or internship with us, but they’re a fresh doctor out of school, then they go through a 90 day, probationary period onto at least a six month training period. And then they’ll sign a contract. So they’re not officially employed until after nine months. And that’s because there’s such intensive training to get them to that point. Um, where I, I’m not going to say that there’s like a return on investment, but where the numbers and projections do make sense. And also just to get them to the level of care that we require within our office before providing care for our patients.
So that doesn’t mean they’re not adjusting until nine months or anything like that, but it’s right now, my senior associate, Dr. Laura is training our newest doctor who just graduated this fall. So they’re here trading before shift. Um, and then we do a full doctor’s training, 90 minutes every single week. And we train on everything, everything I want us, that’s the beauty in having a bunch of doctors too, is we can collaborate on certain cases. So on Mondays we meet, we meet after the morning shift and we go through every single doctor’s report, every patient who just started care, their case, their x-rays or scans. And we make sure we all know about this patient special adjusting information that we need, any information we need about that patient’s life. And then also the training that we do on Wednesdays is for 90 minutes. And mostly that pans on communication role-playing, um, anything because we do, we sh we share patients, we share all of our patients, and that is something to be very mindful of.
If you’re going from solo practice to bringing on another doctor is you are going to have to there’s communication. And there’s steps in the process that you need to change with your patients, especially the ones who’ve been seeing you for years, because you have to retrain them. You know, he needs to have the proper communication on how to build confidence in your, in your patients in order that they trust the new doctor. And I go through all of that with building your team of chiropractors, but there are so many steps that I know we miss. I’ve been an associate before. Um, and so I know what that can feel like when you’re just kind of shoved into it. And it’s like, I don’t know, just figure it out. So I’d say before you even consider bringing another doctor in, um, making sure that you have the time in the next year to know you need to put that time into that doctor and to come at it from a mentorship standpoint, you are their mentor.
They want to learn from you. They’re working for you because they maybe admire you admire your practice. And so not this place where they’re less than you. I learned so much from all of our doctors. I love it because they go to different seminars, we’re able to truly collaborate. It doesn’t matter that I’ve been in practice longer. Um, there’s certain standards for our practice that everyone follows or certain communication. We follow their certain technique. We follow, you know, we don’t just have pull our own things out of nowhere. If there’s a new adjustment, let’s say that someone wants to, you know, thinks could benefit a patient or a few patients. And it’s like, all right, let’s go through that at doctor’s training. And let’s all learn it. Let’s make sure our touches the same on it. Let’s make sure communication is the same on it. Let’s make sure we’re noting it the same. Um, and so we will still, if there’s something that another chiropractor in here knows that I haven’t ever learned, I want to learn it. I’m excited to learn it, but I want to make sure we all know it. And they don’t, you know, no one pulls it out in the middle of shift. And then the next time someone sees that patient, they’re like, Oh, Dr. So-and-so did this. And you’re like, Oh, that makes you look incompetent. You’re like, I don’t know what that adjustment is.
So yeah, that, that really brings up this key piece. Like I described this like with my years and looking at a lot of practices or coaching and guiding a lot of people, um, there’s a real misconstrued or a misconception. A lot of people has set, have set things up to be an independent contractor. They’re calling it an associate chef, but it’s actually that independence. And, and like you, I was an associate originally, and I can still remember like coming in for us a Friday afternoon shift. And everybody on the team would look at me and say, you have to do these numbers because then we all hit our goal. But, but like, no, like no, like collaboration or we all adjust the same way. And, and I think that’s what happens in a lot of practices. Like why there’s all of a sudden this, any quality because somebody will adjust different and then a patient wants that versus this.
So you’re describing a lot in what you just said, like clear systems, consistent training, you mentioned it. And I want people that, that, you know, we’re listening to understand like Dutch release is saying, if you don’t have the time to train, then why are you bringing this person in? You know, like that, that mess that I created, I wasn’t even there. And so there was no new leadership when one of my associates, like when somebody went from a preset to an associate, it was out of convenience. It was the complete opposite of everything that Dr is describing. So I think it’s really important that people really understand that and, and share a little bit, cause I know this is so jam packed. Um, we will make sure that people know how to get ahold of you. Um, but share a little bit about, well then how do you hold people accountable? Like how do you ensure that there’s this consistency and the training, but then how do you hold people accountable? Like, you know, if they’re not performing the way that you expect.
Yeah. That’s a great question. So the wonderful thing about the way we set up our general terms is I have nine months to really figure out like I, thankfully I’ve never had to let anyone go at that time or anything like that, but I have nine months to say, we got to pick it up here. This is an area we can really improve. You’re killing it here, but, you know, go through and really have reviews throughout that time. Um, but we have a lot of accountability. So every Monday meeting our doctors report, how many new patients they saw, how many doctors reports they saw, how, what their conversion rate was for closing. So they’re reporting numbers there and then they also have their KPIs. So I meet with each team member monthly to go through their quarterly KPIs. So key performance indicators. And that’s something I go through too in the program.
Just if anyone’s wondering how to find out more about that. Um, but there’s a lot of accountability there. And then we, uh, really have kind of this open, we’re all in one room for our office, all the doctors, we have a large office, obviously because it fits six desks in there. Um, but we’re able to, if a situation happens with a patient or if a doctor is like, Oh, I messed up in this certain point. I said, this, I shouldn’t have said that. Maybe I should have said this. They can come right into the office and talk to one of us about it. And we can say, Oh, here’s how we could repair that. Or maybe next time, here’s a suggestion on how you could communicate it in this way. So it’s like we can do onsite training right there, um, within the day if there’s questions or anything.
But then, um, it’s pretty obvious if someone isn’t pulling their weight because we, because we depend on each other so much. So we have permission, we give each other permission to be able to have those conversations too. And when we’re, you know, asking, you know, do, do I have your permission to tell you something I saw that maybe could be improved or was maybe problematic for this patient or whatever it is then it just releases that wall or that barrier. And they know, no one’s in trouble. Like we just want what’s best for the care of our patients and for our community. So, um, I think just being able to have those open conversations, but then also accountability with statistics is really important too.
Yeah. It really reminds me like where we started your, your first wording was a lot about like the vision, um, the vision to have the kind of impact in the community, the vision to, you know, help a lot of people, like if we can stay connected to that, um, create that kind of collaboration, you know? So, so the things you’re describing, we, I mean, this is, this is a quick and dirty interview, you know, we’re, we’re hitting on a lot of quick key points. Um, we will definitely make sure, um, that people have your contact. Um, there’s also, um, the transcript, you know, as Cairo secure puts these interviews on puts these shows on you definitely have the, to get a copy of the transcript. So please by all means, reach out to get that, you know, really start to dissect some of the things that Dr. Elise is talking about. So, you know, just because it’s, it’s basically in closing, like any last words you can share with people, Dr. Elise, because that’s the key, like, how do we share this? How do we have people see that this is possible?
Sure. Um, I will say that, think about when you first opened your practice or maybe you first got into practice and how the nerves that were happening, the fears, the unknown, like, will I succeed? Will I be able to pay rent? Well, I, you know, all those questions, it’s the same thing. You’re just moving into a different phase in your journey, especially if you are a business owner at different phase in your business owner journey. So it’s normal to have all these unknown questions. I would recommend that you reach out for support. I created building your team of chiropractors program because of how many people were reaching out to me. And I just, it’s not a phone call. It’s, it’s a process because there is the mindset. There is a lot of housecleaning. So I’d say the next tangible step for anyone. Who’s bringing it.
Even if you already have chiropractors. Cause I have chiropractors who haven’t retained doctors within their practice reaching out to me. I have, I have doctors in this program who have been practicing over 20 years. Um, and so they, and then Dr. Sue, this is going to be their first associate and they just, maybe they’ve experienced the not being treated well when they were an associate or just wanting to do it differently. And they’re looking for something else. Um, so I’d say the one tangible thing to do right now though, is to start cleaning house and your clinic. If there’s something, I’ll say one thing I used to do when I’d convert patients from their original care plan to wellness care, I didn’t really have that documented how I did it. I just closed everyone. I had a relationship with them. It was simple. It was easy. It was quick, you know, it was natural. And then when you bring in other doctors, you need to remember, especially if they’re coming from school, that’s not natural. They don’t know. They want to know exactly
Like, what should I say? How do I say, what if they
Ask this question? You know, is there a system for this? So if there’s anything, a lot of chiropractors invest in these programs that it’s like, how do you know marketing programs of how to get more new patients? How do you do your day one day two and close closing, all that sort of stuff. But they’re not actually thinking about how do I take care of my team? How do I nurture my team? How do I retain my team? Because when you have a happy team, you retain your patients too, and your practice continues to grow. And you know, what’s happening. You have your hand on the pulse. So I’d say anything. That’s kind of messy in your practice right now. Hey, you’ve done what you’ve needed to do to get where you’re at, but it might not be intuitive for someone else coming into your practice to do exactly what you do.
So start recording yourself. We create a Facebook group. So a private Facebook group that we record every training in there. So we go live on Facebook, but it’s a private group where just our team is at. And then we have a private group for just the doctors. So if the doctors need to go back and they want to, you know, some people learn from watching the video, again, some learn from listening to it on their drive home, you know, whatever it is, they can go back and watch old trainings to make sure they are up to par in a certain area. So I’d say starting to record yourself and getting some of the things that you naturally do into a system right now is one of the best things. And then making sure that you don’t have any like drama or any issues on your team, too, whether it’s with CAS or doctor, whoever, um, making sure who is when you bring in another doctor that they’re coming into, like a loving, respectful environment is incredibly important. Right? Well, thank you. This is completely jam packed. Um, by all means, please get the transcript. Um, I’d be remiss if I didn’t also say thank you to ChiroSecure. ChiroSecure is who creates this platform for us to be able to do these kinds of things. So thank you so much, Dr. Elise, um, please, everyone listening, stay tuned next week. Um, Mike Miscoe is the host for Growth Without Risk. So thank you and have a wonderful weekend.