Welcome to Part Three of our opening series introducing key foundational concepts of the ADIO Chiropractic Coaching system. I hope you got a lot out of my previous two articles, Pillar One: Your Core Identity in Practice and Pillar Two: Adjusting and Clinical Excellence. Let’s jump right into it and continue to build on the ideas we discussed in the last two articles.
Here’s a quick reminder of the top-level model we’re working from.
The Four Pillars of Sustained Success In Practice
Again, think of this model as the operating system of our approach to practice management and coaching Chiropractors.
Pillar Three: Your Systems, Procedures, and Operations
Let’s move on to the Third Pillar of the Four Pillars of Sustained Success in Practice model. This Pillar is composed of the Systems, Procedures, and Operations of your practice. For ease of communication, I’ll simply refer to this Pillar as your Operations.
Pillar Three is the crucial how of your practice. Meaning how you operate the processes of your practice. The what of your practice is the specific brand of Chiropractic care you provide. The why is your Core Identity.
The unique way you integrate and synthesize your why, what, and how in your professional life is as individual to you as your fingerprints. Your Systems, Procedures, and Operations are how you express your adjusting artistry and your Core Identity. This synergy is embodied by the execution of your practice Operations and ultimately, defined by your patient outcomes (how well you serve the people you take care of) and the level of success present in your professional life (the quality of your life).
Introducing the Four Domains of Practice Operations
You may be struggling to define and build-out your practice Operations. Or maybe you want to take your practice execution to a higher level, serve more people, and make a greater impact. Wherever you are in your professional trajectory, I recommend that you adopt the following organizational structure as you work to develop and strengthen your overall practice Operations.
Within ADIO Chiropractic Coaching this framework is known as the Four Domains of Practice Operations. This is a critically important model to apply to your practice.
Consider the Four Domains below:
The Four Domains of Practice Operations
Everything you do in your practice needs to serve at least one of these Domains of Operations:
- Your Marketing and Promotional efforts
- Your Conversion process
- Your Retention process
- Your Team Development and Leadership efforts
Collectively, how well you execute each one of these Domains defines what your practice is and determines how successful you are.
A Tried and True Framework
This organizational structure is not unique to Chiropractic practice management or the practice of Chiropractic in particular. Every service-oriented business will follow a similar framework. In general, any business that aims to survive will need to: generate first-time prospects (Marketing and Promotions); exchange some type of service to those prospects for money (Conversion); deliver value via the service and nurture long-term relationships (Retention); and have a well-trained and motivated team of people to execute the processes that deliver the service (Team Leadership).
Let’s look at how to apply the Four Domains of Practice Operations in your practice.
Constructing Your Domains of Operations
What is the first step in building-out each of your Domains of Operation? In order to apply this framework to your practice and understand how to effectively construct each Domain, it is important to understand the functional levels of each of your Domains of Operation.
There is a hierarchy or organizational framework within each Domain of Operation. Let’s zoom in and get more granular to understand how each Domain works. Essentially, we are distilling each Domain down to its constituent parts.
Imagine three functional levels to each Domain of Operations.
Each Domain is Made Up of:
A System
The System is the main driver of each Domain. The System Level exists to generate the Overarching Outcome of that Domain. More on this in the next section.
Each System Comprises:
Named Procedures
Named Procedures are the individual named appointments or individual named events that patients/ people experience within the System.
Each Named Procedure Comprises:
Procedural Units
Procedural Units are the discrete steps that make up each Named Procedures.
The diagram below may help you visualize the relationship among the three levels.
Domains of Operations
*A quick note on the diagram above: not every System will have three Named Procedures and not every Named Procedure will have eight Procedural Units as depicted in the diagram. The diagram aims to show the process of distilling your Domains of Operations down into smaller functional units or levels.
Define Your Overarching Outcome for Each System
Once you have an understanding of how each Domain is organized, it is important to define what you are trying to accomplish with each Domain of Operation. Ask yourself, what is the primary result you are trying to accomplish? What is the purpose of each Domain of Operation? What is the Domain trying to generate through its System?
This is known as the Overarching Outcome of each System.
It is critical that you explicitly define this for yourself and your team. Here are some examples. Your practice may have different Overarching Outcomes, but they are probably at least similar to the ones below.
Marketing and Promotional System:
Overarching Outcome: Prospects schedule and show up to first visit appointments.
(These appointments may also be known as checkup appointments or New Patient appointments.)
Conversion System:
Overarching Outcome: Patients start programs of care.
Retention System:
Overarching Outcome: Patients complete their recommended programs of care and graduate into the next program of care.
Team Leadership System:
Overarching Outcome: Your team is dedicated, effective, accountable, and inspired by providing extraordinary Chiropractic Care to their community.
On a related side-note, your Team Leadership System is the steward of your Team’s Culture.
Putting it All Together
Now that we understand that Procedural Units form Named Procedures, which then constitute the Systems that deliver an Overarching Outcome, let’s look at an example to make these concepts more concrete. Please consider the Conversion Domain of the following hypothetical practice, Practice XYZ.
Practice XYZ’s Conversion Domain is driven by the practice’s Conversion System.
The Overarching Outcome of Practice XYZ’s Conversion System is to lead people to start programs of care, i.e., commit to recommendations of care.
Practice XYZ’s Conversion System is made up of the following Named Procedures:
- Initial Consultation and Examination appointments (Checkups)
- Report of Findings appointments
Practice XYZ’s Named Procedure of Initial Consultation and Examination appointments are composed of the following Procedural Units:
- Confirmation Call/ email/ text
- Greeting and Check-in
- Escort the patient into the Consultation Room
- DC Greeting
- Pre-Consultation
- History of Complaint(s)
- Trauma History
- Physical Examination
- X-ray Examination
- Checkout
These ten Procedural Units above define the Named Procedure of Initial Consultation and Examination appointments of Practice XYZ. You can imagine that each Procedural Unit is rich with detail. Defining the individual Procedural Units entails formulating ‘What is to be said’ and ‘What is to be done’ in totality within a specific Named Procedure. The same process would apply to Practice XYZ’s Named Procedure of Report of Findings appointments.
Each level of the Domain of Operation should contribute to causing the Overarching Outcome of that Domain. Systems are the workhorses of each Domain. They are the main drivers of the top-level Domains.
The Retention Domain: A Quick Detour
The Retention Domain holds a very special place within a Chiropractic practice. For many of us, Retention outcomes are particularly important because excellent Retention results can lead to very durable and healthy practices. Retention outcomes are often seen as the gold standard of effective patient leadership and conversely, Retention leadership skills are a major focus of my coaching methodology.
To that end, I have a special gift for you. I have developed a Free Essential Guide: The Ultimate Retention Toolkit. You can learn more and download the free toolkit here.
This free toolkit also provides a number of examples that illustrate the concepts presented in this article. You won’t be disappointed. And it’s free!
Clarity is Power
On the surface, organizing your Domains of Operations into levels like this may seem a bit overcomplicated. So, why do this? What is the point of having this degree of detail in your Systems, Procedures, and Operations?
I believe that distilling each of your Domains down to their constituent parts as detailed above will help you gain valuable insight into how you want to function in your practice. From there, it is about applying these insights to your on-the-ground operations, so you can be a more effective leader in your practice. The point of introducing this framework is to improve the execution in your practice, so you can help more people and experience more success.
It also gives you access points to make the necessary changes in your processes if your results are not up to your desired standards. For example, if you are not happy with your Conversion results and you feel there is something that needs to improve at your Reports of Findings, then a smart place to start is to analyze the individual Procedural Units of your Report of Findings appointments. Maybe you need to revamp specific steps or simplify what you are doing. Always ask yourself, ‘does this Procedural Unit drive our Overarching Outcome?’ Was anything missing in the Named Procedure that needs to be present? Is there anything that needs to be cut?
In general, when you approach a large task and try to understand how best to make progress in the task, I think it is valuable to break the larger entity down into smaller units. ‘Chunk it down’ to get your arms around the broad concept. Then it will be easier to attack and flesh out those smaller units as you work to gain mastery over the larger process.
The overall task we are trying to accomplish here is to construct effective Domains of Operations so your practice will thrive. It is important to begin by defining the Overarching Outcomes you are trying to achieve in your Domains.
This structure also forces you to define and clarify what the Systems, Named Procedures, and Procedural Units of each of your Four Domains are to be in your practice. You are eliminating guesswork from your practice. This will lead to more consistent and reproducible results as well.
Having a high degree of clarity will make it much more likely that your Systems will be executed well by your team. By clearly defining each level of your Domains of Operations, you are communicating your standards to your team. You are telling them: this is what success looks like. Your work from there, is to uphold your standards, measure your outcomes, and improve and refine your processes as your practice grows.
It all starts with extreme clarity of your HOW.
If this discussion feels a little daunting, and you’re having difficulty grasping the terminology, or understanding how to apply these ideas to your professional life—know that you’re not alone. We are talking about the critical work of building your practice’s operations from the ground up. It can be a bit complicated at first. I certainly didn’t have all the answers when I started out and I sought out help.
I’m here to be that help for you. If you have any thoughts, comments, or questions send me an email. You can also book a free consultation with me on my website. Let’s continue the conversation and see if ADIO Chiropractic Coaching can help unlock your potential in practice. I’d love to hear from you!
Lasting Success Can Only Come From Within
In closing, let’s start to integrate these ideas. Let’s briefly discuss how the three pillars presented so far relate and interact with each other.
Please refer back to the diagram that represents the Four Pillars of Sustained Success in Practice at the beginning of this article.
Pillar One: Your Core Identity is the central hub of the model. In order for you to experience lasting fulfillment in your practice, your Core Identity needs to be expressed through your Adjusting and Clinical approach (Pillar Two) as well as through the execution of your Systems, Procedures and Operations (Pillar Three). There needs to be alignment and coherence among the three pillars. Your Core Identity should fuel Pillar Two and Pillar Three. As your abilities and results in Pillars Two and Three improve, your Core Identity will also be further strengthened. The Pillars feed off of each other.
Too many Chiropractors have it exactly backwards. They want to be told what to do and what to say by a practice management guru. They look for the ‘right’ scripts, written procedures, systems, or the PowerPoint slides that once worked for someone else. They think, ‘If only I had the right words, then my practice would finally work.’ They search for an outside-in solution to an inside-out problem.
I’ll let you in on a secret: there is no ‘one right way’ to practice. There is the best way for You to practice. Your best way needs to come from inside of you. You need to develop your own voice; your own system for how your practice is to operate. It needs to flow from the inside out.
Don’t get me wrong, it is usually very helpful to be coached, to access proven procedures, and to find inspiration from examples that have worked for other people. This is often an important part of my coaching process, and I provide a ton of resources, procedures, and protocols for you to model after. Every elite professional on the planet has a coach. But the role of a coach is not to force a rigid framework on their clients, trying to replicate past success that worked for someone else.
A great coach individually mentors and develops their clients to become the best versions of themselves. A great coach leverages the unique strengths of their clients and guides them to become authentic leaders in their practices, pursuing their Strategic Vision of success.
Ultimately, you need to do the work to uncover who you are, what you stand for, what you believe, what matters to you. From there, you can source the building blocks of how your practice should operate.
How you operate your practice needs to be an authentic expression of your Core Identity. Without your how being deeply rooted in your Core Identity you won’t be able to sustain long-term success. You may experience fleeting growth for a while, but you will not thrive over time. You will end up going through the motions, spinning your wheels, maybe temporarily gaining traction at times, but you won’t be able to sustain momentum. And you definitely won’t experience deep fulfillment. You need to develop a practice model that reflects who you are.
To make it more concrete to our current discussion in this article, your Domains of Operations—your Systems, Named Procedures, and Procedural Units—exist to cause your Overarching Outcomes. Your Overarching Outcomes need to be aligned with your Strategic Vision for your practice. The details of how your Domains of Operations function are determined by your Principles, Beliefs, and Values. Your adjusting and clinical approach are also driven by your Principles, Beliefs, and Values.
Your Purpose—your WHY—is the beating heart of your practice. It is the motive force of your professional life.
Gaining more clarity, conviction, and certainty of who you truly are, will allow you to create a practice that is deeply aligned with your authentic self—a practice that you are in love with. A practice that profoundly impacts the people of your community. This is why ADIO Chiropractic Coaching exists—for You.
Here’s to your future success!
-DZ
