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TEAM DRIVEN PRACTICE TABLE OF CONTENTS
10 Commandments of Leadership
The Interview: Your First Team Training
o The Proper Flow for an Individual Interview
o Group Interview
o Second and Final Interview Process
o Common Questions
o 14 Traits of Ideal Team Member
Hiring a New Team Member
o New Hire Pay and Benefits
Starting a New Team Member
Raising up CA Zones
o Raising up a Front Desk CA
o Raising up a Financial CA
o Raising up a Tech CA
o Raising up an X-ray CA
o Raising up a Promotions CA
o Raising up an Associate Doctor
o Raising up a Muscle Therapist
Doctor Coverage
One on One Accountability Meetings
o Front Desk CA Responsibilities and Meeting Guidelines
o Financial CA Responsibilities and Meeting Guidelines
o Tech CA Responsibilities and Meeting Guidelines
o Promotions CA Responsibilities and Meeting Guidelines
o Associate Doctor Meeting Guidelines
o One on One Meeting Checklists
Team Trainings
o Weekly Training
o 26 Week Training Manual and Annual Training
o Quarterly Training
o Spontaneous Training
Team Training General Principles
Training on TLC Procedures
o Telephone Procedures
o Reschedule Call Guidelines
o Law of the Call
o Non-patient Related Phone Calls
o Staff Reimbursement at TLC Events
Ongoing Team Development
o Team Member Biannual Reviewo Bonus and Challenges
o Hand Off of a Patient to another Team Member
o Key Results Area (K.R.A.) Study
Common Mistakes
o Mistakes in Practice
o Mistakes in Team Development
Issue Confrontation Script
o Mistakes a CA Makes
30 Second Rule
Gifting Programs
A.D.I.S.
Team’s Healthcare Records and Personal Care
Challenges
o Personal Phone Call Tolerance Letter
o Dismissing a Team Member
o Letter about Associate Doctor Leaving the Practice
Longevity Awards Program
The Passion Drill
10 Commandments of Leadership
● Thou shall build up your team members in front of others
● Thou shall honor boundaries and zones of team members
● Thou shall work as a team and think as a team always
● Thou shall keep “other” people’s business to yourself
● Thou shall talk about important issues – like our philosophy
mission – first and always start with the why.
● Thou celebrate our victories together
● Thou shall set team members and patients up to win
● Thou shall speak honorably of all team members
● Thou shall delegate to team members items that build their
value to their team and its mission
● Thou shall set clear goals with actions to complete them as a
team
The Interview: Your First Team Training
To build your dream team, we suggest you stand out whether done as an individual or in group. The
following pages will lead you through various stages of training from the first interview to giving
you tips of common mistakes to look out for.
Two vital elements in every phase of training are preparation and mindedness. If you are not
prepared and in the proper mindset, chances are, your trainings will not be as successful as they
could be.
Before you even schedule an interview, be clear on what you are looking for in the ideal candidate.
Refer to CA Traits to Zones in Practice for ideas and decide what questions you will ask each
candidate with Doctor Questions for Applicants. Discuss the needs with your team; ask them for
feedback on the specific position. You might give the Front Desk CA the interview schedule and ask
her/him to note the arrival time of each candidate. Brief your team on their roles during the
interviewing process. In other words, be prepared and function like the dream team you are looking
to grow!
You can distribute a Please Help letter when you are looking to grow your team. Please feel free to
modify and use it as your own. Also included for your reference are the words for a newspaper
advertisement for a new CA.
Be sure to slip off to a quiet place for a minute or two to clear your thoughts and focus on the desired
outcome of the upcoming interview(s).
CA Traits to Zones in Practice
Traits Primary Zone Passion Front Desk CA
Extremely social Tech CA
Outgoing Front Desk CA
Takes tasks to completion Financial CA
Comfortable with hands on the patients Tech CA
High confrontation Financial CA
Warm Front Desk CA
High confrontation Front Desk CA
Extremely grounded in chiropractic Tech CA
Comfortable asking for money Financial CA
Sensitive to unspoken messages Tech CA
High understanding in the value of chiropractic Financial CA
High energy Front Desk CA
Quick to communicate Tech CA
Computer comfortable Financial CA
Can complete tasks independently Financial CA
Works diligently on own spinal fitness Tech CA
Leader minded Front Desk CA
Works well alone Financial CA
Doctor Questions for Applicants
1. How was it getting here today?
2. Having gotten here today, do you think there might be any challenges getting here on snow
days or challenging weather days?
3. Will there be any problem refraining from smoking during the hours that you work in the
practice and during brief breaks when you will be quickly returning to patients?
4. If you had to think about what the most critical or important qualities are for a good team
manager to have, what would you think are the most important qualities? (Communication,
organization, teamwork, etc)
5. What is it you believe chiropractic to be?
6. What is an adjustment?
7. Where is it that you believe wounded tissue gets its ability to heal?
8. At what point do you believe it is impossible to help a patient improve their health?
9. What do you believe congruency has to do with how our personal and professional lives are
lived?
10. What thoughts come to mind when you think of what the word “entitlement” means?
11. What responses or thoughts come to mind for this statement? Life is a never ending process
of change, therefore, to seek never ending change is to seek intimacy with a part of what
defines life.
12. Have you had any experience with chiropractic in the past?
13. What do you know a subluxation to be?
14. What are the greatest virtues you experienced in the job you enjoyed the most throughout
your work history?
15. What are some of the most challenging difficulties you experienced at the job you enjoyed
the least?
16. What would you describe as the challenges present in the place you most recently left?
17. What would you describe as the virtues most clearly present in the place you most recently
left?
18. If you could fix something at the job you just left, what would you engage in doing in that
environment?
19. If you could have any hours possible and have the job schedule designed just the way you
want it, what would your ideal hours be now?
20. If this job could be a stepping stone toward preparing you for something else you want five
years from now, how might this team best serve you in preparing for that next step?
21. In what ways do you think your spouse would be most joyful about you taking this position?
22. In what ways do you believe taking this position might challenge or stress your spouse or
family?
23. Are you still interested in this position?
Watch for the nature of how they answer these questions and for the tendency of people to
believe a place of work should exist to employ them and not for them to serve humanity.
Emphasize to them, this is not a job but a career move. View it as a major decision. In a work
community with multiple people and positions, what do you believe is the single most important
quality for a great manager to have?
PLEASE HELP
We value you. We know that you experience our high standard of care from the entire
team at TLC Chiropractic. And you realize that it is not by chance or accident that we
have such a quality group of people who have served our community for decades.
We need your thoughts, prayers and outreach as we are seeking our next team
member. As with all of our positions, this will be a fulltime person who works
Monday through Thursday 32-36 hours, with a few possible Friday or Saturday
mornings available as well. We will train the right person for this position. What is
required is that they are humble and eager to continually learn and serve with
excellence on our team. This particular position will have additional training in the
(select your zone ) of our practice.
You have been given this letter because you know the devotion and quality that your
team at (Name of Practice) exercises in caring for you and your neighbors. Please
think of anyone you know (even if they are employed elsewhere) who may fit with
our team. Your thoughts and prayers will surely help us. If someone specific comes to
your mind, please hand this letter of outreach to them so they can reach out and
connect with us.
Our entire team is part of this search. Please direct people to (Name of Doctor).
Thank you in advance for all your prayers and efforts!
Grateful and blessed regards,
(Name of Doctor and Team Members)
Updated 01/22/2020
Newspaper Ad for New CA
Front desk receptionist for a healthy and active doctor’s office. (Indicate full time or
part time.) Indicate days and hours (optional). Your perfect attributes; naturally high
energy, organized, great communication skills, and some comfort level with computer
function. Call …..
You never put an ad in the paper or list it anywhere else for anything other than the title of
receptionist. All four zones are defined by an initial relationship based upon hiring a receptionist.
The Proper Flow for an Individual Interview
1. Proper greeting and filling out of application in the reception room.
a. Who will greet them and how?
2. Have them sit and read information you believe is important about chiropractic, subluxation,
etc.
a. What will they be given to read and by whom?
3. Upon completion of application, introduce to team members, and give an office tour.
a. Who will collect applications, make introductions, and give tour?
4. Prepare the doctor to meet with the applicant. (It is ideal if at least one team member joins the
doctor.)
5. Doctor remembers to address all the primary rules of inflexible points such as beginning on
time and ending with requirements of seminar attendance, team trainings, intolerance with
gossip, and intolerance with team members discussing pay scales, etc.
6. Doctor should discuss applicant’s need to fully experience the quality of care and steps in care
the patients receive by having their own assessment done.
7. Doctor should thoroughly describe all the zones of employment in the practice. Describe the
intention of placing this person in one particular zone. Make clear this is a career decision; they
are a part of a greater whole, a team and a mission and make clear to the applicants your 5 year
and 10 year picture.
8. Define clearly the rules of cross training and how everyone is responsible to learn all the jobs
in the practice.
9. Upon doctor’s completion of dialogue, he/she should ask the applicant a series of important
questions:
a. What they now believe are the most ideal reasons why this job would be right for
them?
b. If this position were not just right, if there were even a small issue that just seems like
it could be a reason why this is not the ideal position, what might that be?
c. Are you still interested in the position?
d. How quickly are you looking to begin?
10. Escort them out and make sure they have met everyone on the team and promise you will
communicate with them regardless of the results and within seven days.
Note to doctors:
BE SURE YOU ABSOLUTELY COMMUNICATE PROMPTLY AND DIRECTLY WITH
THIS APPLICANT. IF THERE IS A DELAY IN LETTING THEM KNOW WHETHER OR
NOT THEY WILL BE EMPLOYED, HAVE A TEAM MEMBER CALL AND LET THEM
KNOW HOW LONG THE DELAY WILL BE, BUT DO NOT LEAVE APPLICANTS
HANGING. This is one of the worst statements of disrespect to an applicant.
11. Upon leaving, make sure the new patient process is set up for this applicant. If possible, be sure
to complete the new patient process before completing the hiring process.
Equal access to programs, services, and employment is available to all persons. We consider applications for all
positions without regard to race, color, religion, creed, gender national origin, age, disability, marital or veteran
status or any other legally protected status. Those applicants requiring accommodations to the application and/or
interview process should contact a representative of the Personnel Department.
Position Applied For Date of Application
How Did You Learn About Us?
Advertisement Friend Inquiry
Employment Agency Relative Other
Last Name First Name MI
Address Number Street City State Zip Code
Telephone(s) Social Security Number
Best time to contact you AM
____:______PM
If you are less than 18 years of age, can you provide required proof of you eligibility to work? Yes No
Have you ever filed an application with us before?
If yes, give date _________________________________________________________________ Yes No
Have you ever been employed by us before? Yes No
Do any of your friends or relatives, other than spouse work here? Yes No
If yes, please provide name and relation_______________________________________________
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you legally eligible for employment in this country? Yes No
Date available to work? _________________________________
Type of employment desired Full Time Part Time Temporary Educ. Co-op
Are you able to meet the attendance requirements of the position? Yes No
Have you been convicted of a crime in the last seven years? Yes No
SUCH CONVICTION MAY BE RELEVANT IF JOB RELAED, BUT DOES NOT BAR YOU FROM EMPLOYMENT
If yes, please explain _________________________________________________________________________
Driver’s license number if job related ________________________________________________ State ______
APPLICATION FOR
EMPLOYMENT
Employment History List your last three (3) employers. Assignments or volunteer activities, starting with the most recent, including military
experience.
Employer Dates Employed Work Performed
Address From To
Telephone Numbers
Supervisor May we contact?
Reason for leaving
Employer Dates Employed Work Performed
Address From To
Telephone Numbers
Supervisor May we contact?
Reason for leaving
Employer Dates Employed Work Performed
Address From To
Telephone Numbers
Supervisor May we contact?
Reason for leaving
EDUCATION School Name and Address Course of Study Years Completed Diploma /
Degree
High School
Undergraduate
College
Graduate/
Professional
Other (Specify)
ADDITIONAL INFORMATION OR SPECIALIZED SKILLS
APPLICANT’S STATEMENT I certify that answers given herein are true and complete.
This application for employment shall be considered active for a period of time not to exceed 45 days. I hereby understand and acknowledge that, unless otherwise
defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any
written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment,
I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature of Applicant Date
Group Interview
1. Applicants are asked to arrive together, either during the night of a spinal workshop or a
specially scheduled “applicant’s spinal workshop”.
2. All the steps previously discussed about greeting, filling out the application, and having an
office tour remain the same, except for the following details.
3. Upon arriving, each applicant should receive a nametag.
4. Be sure as many team members as possible are present and are circling the group, making
observations of all the traits and characteristics they discover in the applicants.
5. Each applicant should be given a separate sheet to fill out after the application is complete.
The sheet should have no more than 5 – 6 questions on it specifically about chiropractic, and
that will be addressed during the work shop.
a. What do you believe chiropractic to be?
b. What is a subluxation?
c. What is an adjustment?
d. Where is it that you believe wounded tissue gets its ability to heal?
e. At what point do you believe it is impossible to help a patient improve their health?
6. Have each applicant fill out this questionnaire with his or her name at the top, collect them
from everyone and then the doctor performs a spinal workshop (ideally no more than 15
minutes). Determine in advance who will be handing out and collecting question sheets.
7. Upon completion of this class, pass out new copies of that exact questionnaire all over again
and have them now fill out the new form, essentially doing the same questions a second time.
8. Collect those papers as well.
9. Define the position available, in group. Make clear the career mindedness you are looking
for.
10. Define the rules of cross training, in group.
11. Define the rules of immediate termination, in group.
12. Define, in a very passionate way, the most ideal reasons why you love being a chiropractor in
this practice. Allow one or more team members to share why they love working in this
practice.
13. Ask in group if there are any questions about the information shared. Be sure that you have
no more than 3 – 5 minutes each to meet privately with the new applicants. If this is a large
group, make sure that you have team members scheduled to help you.
14. Upon exiting, be sure that every applicant is scheduled to get checked and receives a flower.
15. In group interviews, maintain the same promise as made to the individuals, by letting them
know within how many days you will be communicating with them.
16. If you have asked your team to participate and give feedback, be sure to take the time to
listen to the input provided.
Second and Final Interview Process
1. Candidate is scheduled an appointment time to come and meet privately with the doctor.
2. Doctor asks again, “Are you are still interested in the position? Based on our last meeting,
what do you feel are the ideal reasons why it is the right position for you?”
3. “In our separation time, what are some of the issues you thought may be some challenges as
to why this position may not be the right one for you?”
4. Ask remaining questions you believe are still unresolved or will help you define the greatness
of one applicant above another.
5. Try to resolve making your decision within no more than two scheduled meeting times.
Common Questions
Discussing Hourly Rate
Not in group. When you break out one on one, if you think you have a winner, you can ask "What
range are you hoping for?" This allows you to assess if you are even remotely in a similar area.
Hiring Interns
You should have him/her work primarily as a Tech CA and secondarily as a clean up for anything. If
you have old records in basement to clean up, he/she should get that done while he/she is working
there – anything and everything that you want to clean up while he/she is there.
Pay scale
Pay as close to minimum wage as possible.
14 Traits to the Ideal Team Member
You should start drawing humorous pictures of exactly what this person is going to look like. If
anyone else is related to the practice as close to you such as a part time CA, full time CA, friend
or family members, let them color pictures as well. Have fun, use multiple colors and then hang
them all over the office. Ideally you want someone with multiple ears, seven or eight arms, track
sneakers, etc. Make this a game so you have your 14 character traits and skills listed along with
your drawings.
Make sure you are using the Please Help letter for the first two weeks. If no response comes
from that, then make sure you utilize the newspaper, craigslist, careerbuilder.com, etc. Use the
following charts to help you find the ideal CA
CA Character Traits
TRAITS Is this YOU
Capacity driven
Comfortable w/ hands on patients
Comfortable w/ money
Computer comfortable
Creative
Energized & engaging phone voice
Flow maximizer
Grounded in chiropractic
High confrontation
High energy
Is a “closer”
Numbers savy
Outgoing & social
Outspoken for chiropractic
Passionate
Quick to communicate
Rejection proof
Self motivated
Sensitive to unspoken messages
Takes tasks to completion
Works diligently on own spinal fitness
Works well alone
Ch
ara
cter Tra
its by C
A Z
on
e
Are y
ou
in th
e right zo
ne?
T
RA
ITS
F
ron
t Desk
CA
F
inan
cial C
A
Tech
CA
P
rom
otio
nal C
A
Cap
acity d
riven
Y
es
Yes
Com
fortab
le w/ h
ands o
n p
atients
Yes
Com
fortab
le w/ m
oney
Y
es
Com
puter co
mfo
rtable
Yes
Yes
Creativ
e
Yes
Energ
ized &
engag
ing p
hone v
oice
Y
es
Y
es
Flo
w m
axim
izer Y
es
Yes
Gro
unded
in C
hiro
practic
Yes
Yes
Hig
h co
nfro
ntatio
n
Yes
Yes
Hig
h en
ergy
Yes
Is a “closer”
Y
es
Num
bers sav
vy
Y
es
Outg
oin
g &
social
Yes
Yes
Outsp
oken
for C
hiro
practic
Y
es
Passio
nate
Yes
Quick
to co
mm
unicate
Y
es
Yes
Rejectio
n p
roof
Y
es
Self m
otiv
ated
Y
es
Sen
sitive to
unsp
oken
messag
es Y
es
Yes
Tak
es tasks to
com
pletio
n
Yes
Yes
Work
s dilig
ently
in o
wn sp
inal fitn
ess
Y
es
Work
s well alo
ne
Y
es
Hiring a New Team Member
Offer the position in a face-to-face meeting. At this time, agree on a start date and wages. Have the
Suggested Offer of Employment in writing and give them a copy. Give the new team member a copy
of your Office Policies and Guidelines and have them sign an acknowledgement of receipt. Some of
the key items to point out during this meeting are:
Hours – early arrival
Training policy and schedule – give them your annual training calendar (created annually)
Vacation policy
Health days
Zero tolerance policy
If you do not have Office Policies and Guidelines, it is strongly suggested you create them. Refer to
the TLC website for more information about this customizable guideline available on CD on the
H.O.T. Products page.
Have the new team member fill out the taxation form W-4. Tell them how happy you are to have
them as part of your team, and you look forward to their start on day and date and time.
Suggested Offer of Employment Letter
Date
Dear _____________,
This letter is confirmation of my intent to offer you the ______________ position at ABC
Chiropractic at an hourly rate of $_____________.
Your initial schedule will be:
Monday 7:30- 12:00 and 2:00 – 6:30
Tuesday 2:00 – 7:00
Wednesday 7:30- 12:00 and 2:00 – 6:30
Thursday 7:30- 12:00 and 2:00 – 6:30
Friday 7:30- 12:00
Saturday 6:15 – 8:15
*Remember to make the start time 30 minutes before the practice opens to patients
Upon accepting this position, we will begin an exciting journey of helping others. I look forward to
having you as a member of our team.
__________________________
(DC)
I ________________ accept the above stated position at specified hourly rate. My first day of
employment is to be ________________________.
________________________
(New Team Member)
Suggested Rejection Letter
The night of the interview process, everyone leaves with at least a carnation or inexpensive rose.
Everyone should be given the privilege to get checked if they want to – do not push it at all because
someone could interpret it as though you are interviewing just to get new patients. As for those who
are candidates for hiring, I would strongly urge you to urge them to get checked.
Dear __________,
In a day where our nation needs people who are willing to work and find honor and dignity in work,
I am grateful to have interviewed you in your pursuit of work. We stand strong as servants of the
community so that the streets we live in can support people who are less drugged and thereby less
inebriated and ultimately more vibrant, alive, and safe to live next door to. A world less drugged and
medicated is a world of wiser thinking people, wiser acting people, and more peaceful people.
All that being said, it was a privilege to interview you, though we will not be going through with the
hiring of you for this position at this time. Our thoughts, prayers, and hopes for you will be that you
find the place of your dreams as swiftly as possible. If you have any questions or ways that we may
be able to offer guidance to you in the future, feel free to call upon us and in the meantime, here’s to
your immediate success with your search for employment.
Dr. ________________
ANNUAL TEAM CALENDAR
Purpose: to get all your team on the schedule of knowing what the upcoming events are that they
are required to attend together as a team in order to be training and growing together. To not allow
any surprises and to provide as much advanced notice of what is expected from the team members as
possible.
Implementation:
1. Write out on paper all the trainings that will be held throughout the year:
Quarterly trainings
Expansion and renewal cycles
Seminars
Leadership camps
Special team holiday parties/gatherings
2. Quarterly trainings need to be done quarterly, typically January, April, July, and October on
the last Friday of those months.
3. Expansion and renewal cycles need to be outlined so that team members do not try to take
vacations during those months. Typically these cycles will run:
Jan-Feb Expansion
March-April Renewal
April -May Expansion
June -August Renewal
August -October Expansion
November-December Renewal
For more information on this (expansion/renewal cycle), search the TLC website under
Promotions and Marketing.
4. Seminars must be outlined, how many each team member must attend with the team. See the
trainings section for more information.
5. All these trainings are NOT OPTIONAL. Review this BEFORE hiring the team member and
do not hire them if they are reluctant to agree to this policy.
6. If any team member misses a quarterly training or a seminar, TLC would recommend to fire
them on the spot (unless there is a death in their immediate family).
7. Leadership Camps: mandatory every year for the whole team to attend if you want the team
to grow together and to improve their communication and team development skills. If you
want a team of longevity, you must be attending this camp annually, NO QUESTIONS.
8. Team celebrations: schedule annual activities that the team will look forward to spending
time in a relaxed setting together. People who like each other are more productive and more
pleasant to be around.
New Hire Pay and Benefits
In terms of employment and pay scale, there are absolutely no positions in a chiropractic practice
other than dollar per hour pay scale. While the chiropractors, themselves, may be on a salary
basis, all CA and support staff pay scales are on a dollar per hour. It is critical when you are
hiring someone that you define exactly what their hours are, their arrival and departure times are,
and your flexibility with starting pay scale.
As for a time clock, every practice must have a time clock. Frankly, the old days Lathem time
clocks are great. They are the standards set from generations back and they are running, ticking
clocks that you put your card into and it gives you the big “klonk” every time it stamps the card.
What we all use now are the software programs that are active time clocks on your computer.
You should designate one computer as the time clock computer and that is where everyone
clocks in and out. Only one person should have the security access code in which to override the
settings feature, otherwise the security code will stamp out onto everyone’s card. This type of a
program also, flawlessly, calculates hours. In addition to the use of a time clock, you should also
know that anyone who works more than six hours in any given day MUST take out at least a half
hour for break time to recharge their battery. If they do not leave the building, let them know that
they are going to be “docked” the time anyway, so they may as well take at least 30 minutes.
Under the benefits package, you must be able to explain your number of health days per quarter,
sick days per quarter, vacations per year, etc. The second parts of the benefits package you must
describe their acquisition of chiropractic services. The third part you must explain is the care
rendered for the immediate members of their family. The next section of your benefits package is
that covering such issues as health coverage (which is actually sickness coverage) and other
related services. One way to overstep this is to provide a stipend amount for an individual who
requires health coverage. You might allocate $100 per month to the first paycheck every month
for someone which they are allowed to put towards their health benefits.
As for 401K’s, we wait until the team has been up and running for a few years. Once the team is
solid and has all been together for at least two years, we then consider setting up the info
structure for 401K. 401K doesn’t have to cost the doctor a single dime or the doctor is allowed to
incrementally increase what they contribute to the team member’s savings program. In allocation
of 1%, 2% or 3% of their total deposits of pay scale. Look at that with a wise investor.
Pay Scale
It is a very clear, black and white agenda in TLC that employees are celebrated based upon the
date they began employment or their employment anniversary. This then marks the time each
year when they will have a review based on performance and pay scale. In addition, every six
months, they will have a review based strictly on performance without any change to pay scale.
Both reviews are clearly defined within the interview process before each member is hired and
redefined during the hiring process as well as stated to him or her in front of past employees so
that everyone is clear on the subject.
In terms of pay scale, we know that every job description is rated in various different index’s
throughout our nation as being worthy of certain pay scales depending on zip codes. We are
hiring people in chiropractic offices under the title of receptionist. We want someone to receive
other people. We want people who are a blank slate and are here to be trained. We do not want
medical assistants, medical billers, chiropractic CAs from other offices, nor any other type. If
they happen to have any of that within their past, that is all well and good but it has no bearing
upon their pay scale today. They are being hired as a receptionist whether they are Front Desk,
Financial, Tech or PR.
In regards to pay scale changes, once you’ve defined the proper pay scale to start someone at,
you must then address that, ideally, we suggest providing a 3-4% annual raise, based on the cost
of living index. Please understand that this is not guaranteed. Someone isn’t entitled to that pay
raise because they’ve simply showed up for the past year. Therefore you have to go through the
TLC review process, which we teach very clearly at the TLC Leadership Camp. This is the basic
outline of the seven steps of confrontation. In this case, it is slightly modified to strictly be doing
a review. In preparation you, as the doctor, should write down all of the skills and character traits
that you celebrate in this individual. Secondly, write down all of the skills and character trait
issues that challenge or frustrate you relative to your exchanges with this employee. Lastly, write
down whether you wish to still retain the employment of this person’s service. If it is contingent
upon improvement in the second category stated, then so be it. This is how raises are allocated.
There will eventually come a point where a member’s pay scale becomes so high that it is very
difficult to give them dollar per hour raises. Never do we give salaries for anyone defined as a
CA in our Practice. Since there is no such thing as an office manager, unless you have many
different offices and a plethora of employees, everyone is a CA and paid on a dollar per hour
amount. Once they get on the top of the food chain pay, you will then have to get creative with
providing minimal cost of living index’s and more in terms of temporary bonuses.
Starting a New Team Member
On the first day, make it special! Have a sign welcoming the new team member (Mary Smith) and
balloons in the office for the first week. Give them a gift of a composition book on the first day in
order for them to take avid notes. Make them feel welcome.
Start an employee file, which contains the following:
• Original application
• Original W-4
• Original acknowledgement of receipt of guidelines
• Copy of Offer of Employment Letter
• Written position description*
• As time passes, you will add:
o Original signed reviews
o Notations with date and time of any disciplinary talks
A New Team Member Welcome Checklist is provided for your convenience.
• Try to have processed the new team member’s complete new patient exam and report in it’s
entirety, prior to their first day of employment, as though they are not first an employee, but a
patient.
• If subluxations are present, be sure the new employee has already begun experiencing their
adjustments and you are on your way to help check and assess and give care to the rest of their
family.
• Be sure the team member is asked to arrive significantly early on their first day so you are
already setting the trends of how to approach each day.
• Remind the team member what their primary zone of responsibility is. Be aware even when the
CA wears multiple hats, the doctor must make clear which zone is primary.
• Remind the team member it will take at least 3 – 6 months to be fully acquainted with all there is
to know in each position. You must do this in order to safeguard them from overwhelming
themselves in the training process.
• Remind this new applicant regularly, of your 3 – 6 month statement.
• It is suggested a new team member spend their first week of employment, NOT working in their
area of primary planned job description. They should spend at least 1 – 2 days in each of the
other zones of the practice.
o The first day, most critically being alongside and shadowing everything that the
doctor does. If you do not have this luxury of time, you may need to consider
skipping this step, but think carefully about instantaneously thrusting someone into
the position they will be working in.
• Immediately instruct them in how you expect them to have a notebook with them at all times and
this is the permanent training notebook to be brought to all training meetings, all private
meetings and should be written in neatly and organized enough to serve as a reference manual
for them. Every new entry should be dated and members present outlined.
• Upon the first day of arrival for the new team member, immediately give them a copy of the
day’s schedule and train them on day one and how to run the “daily previews” and “P.R.E.S.-on”
patient notations.
• Review clearly with them their scheduled hours and days and give them a team calendar of
annual events already scheduled for them in reference to seminars and all trainings.
• Remind them that they will be responsible for training on all areas of the practice.
• Be clear with them about how to address everyone.
• Immediately give them copies of the NP/NPR flowcharts and 5 primary scripts (provided in the
NP/NPR section) as well as their taxation forms (W-4).
• Immediately show them the outline of your weekly team-training manual and assure them that
they will know all the topics in the book forwards and backwards by the end of the year, but the
entire manual will take at least 12 months to complete. Their particular primary job description
will take at least 3 – 6 months.
• Every time there is a free moment, take the opportunity to train with and describe things to the
new team member.
• Remind them, learning how to add 2+2 and make it 4 is something that you can teach anyone.
The things that you can not teach them, apply to loyalty, commitment, the principles of working
for a mission and a calling, not a job. Therefore, all these other steps can take as long as they
have to take, because you are already on a great road, knowing that you have chosen to work
together on a common calling.
• Remember in training a new team member; do not train on any details without first training on
the reasons why these procedures exist. Our primary focus is looking out for serving our patients
and we can best do so if we know why we are doing a procedure.
• After a new team member has gone through their first week of cross trained orientation, remind
them that you do not believe they know any of the positions that they observed, but they at least
have an overview. Now they will begin training in their specific area.
Ongoing Training
• Doctors should always, keep a small blank note pad right by their adjusting station. Immediately,
as they recognize points they believe require training with the team, write them down so they can
refer to it later. Only by this, can a doctor continually let go of issues and stay focused on patient
care yet also be a thorough facilitator of the team’s progress and development.
• The primary key to building a great lifetime team member is to TRAIN, TRAIN and TRAIN!
• All team members should attend a Leadership Camp within the first 6 months of working in your
office.
• Have the entire team out to a lunch after the new team member passes 3 – 6 months of work.
Share greatest team moments as a theme to the lunch.
New Team Member Welcome Checklist
Items for date of hire:
1. Completion of employee application and W4
2. Review and sign offer letter
3. Review of office policy and guidelines
4. Dress code
5. Office hours Opening and Closing Procedures
6. Confidentially (All issues are to be discussed with the doctor first)
7. Termination red flag: Wages discussed/grievances discussed.
8. Seminars and Quarterly trainings
9. Benefits: Communication for requested time off, Vacations, Holiday, Chiro Care.
Items for first day of employment
1. Time card procedures
2. Tour of office
3. Introduction of staff and their general job descriptions
4. General instructions of office equipment
5. Bin location (procedure for written communications)
6. Dr’s message book
COMMUNITY CALENDAR PLEDGES 2019
PADs
Wednesday, Feb. 20th
Wednesday, Mar. 15th
Wednesday, Nov. 6th
Quarterly Trainings
Friday, Jan. 25th 8:00 AM to 1:00 PM
Friday, Apr. 26th 8:00 AM to 1:00 PM
Friday, Jul. 26th 8:00 AM to 1:00 PM
Friday, Oct. 27th 8:00 AM to 1:00 PM
DCs 8+ ☺ TLC Events / Team’s 3 TLC Events
Jan. 11th-12th PC _______ Team Leadership Camp _______ Collections Camp _______
Apr. 12th-13th TDP_______ Spouse Leadership Camp ______ Regional _______
Sept. 13th-14th ASP ______ Team Scripting Camp _______ Regional _______
Expansion Cycles
1.) Begins: mo:___day:_____ Ends: mo:___day:_____
2.) Begins: mo:___day:_____ Ends: mo:___day:_____
3.) Begins: mo:___day:_____ Ends: mo:___day:_____
Party Times
Summer Barbeque Jun. 2nd
Optimal Evening (B.T.E). Sept.18th
Christmas Brunch Dec.17th
Webinars/Calls Dates &Times DCs CAs Both Spouse
Team Driven Practice 3rd Tuesday at 1:00 PM EST __ ___ X ___
Balance & Prosperity 4th Tuesday at 1:00 PM EST X ___ ___ X
PC or PR 1st & 2nd Tuesday at 1:00 PM EST X ___ ___ ___
Heart Hour Tuesdays at 10 AM EST X ___ ___ ___
26 WTM Calls Thursdays at 1:00 PM EST X ___ ___ ___
Philosophy Calls 2nd Monday at 9:00 PM EST X ___ ___ ___
CA Heart Hour (CA Q&A call) Tuesdays at 12:00 PM EST __ ___ X ___
Women’s ONE Call 3rd Tuesday at 11:30 AM EST X ___ ___ ___
Initials of Team Pledges (once document is agreed upon, and copies are hung/placed in/on: office, employee
folders and home refrigerators):
Dr. ______ Dr. _______ CA _______ CA _______ CA_______ CA _______
Raising up CA Zones
Training CA Recommendations
To utilize the time your CA has to engage the following bullets in the order outlined:
1. The 5 Primary Scripts in flawless execution
2. Reschedule call scripts
3. Conducting a “case study” of the week, showing an improved patient
4. Conducting a “case study” of the week of patients who have dropped out of care and attempt to
calculate what could be happening at home for these individuals now that they are no longer
getting adjusted
5. Memorization of your three most common initial care plans
6. Memorization of your three most common continued care plans
7. Memorization of your wellness, maintenance, and support of care plans
8. Memorization of your fee structures for your second, third and fourth family members in the
midst of any one of those care plans
9. Reassessment in that every patient, under your care, is reexamined every 10-12 visits and how
they are doing with progress
10. Training on every one of the CA aspects of the TLC NP/NPR process, for tech CA and financial
CA
Raising up a Front Desk CA
Training tips for FD/CA on greeting and exit
Front Desk CAs need a sequence of predictable steps by which to have a successful greeting
1. Greeting
a. Upon the patients arrival there should be instantaneous eye contact, even if verbal
communication is restricted due to the FD/CA being on a phone call.
b. Once the patient has been properly greeted visually, when verbal exchange is possible always
engage in greeting a non symptom based exchange with the patient. Such as it’s great to see
you, you’re right on time, we were expecting you, we thought about you this morning before
we started our day, you know I noticed you at the spinal workshop, hello, when was your last
spinal workshop, hi Mrs. Jones, I was thinking do you have a favorite spinal workshop that
you’ve attended, that of all the ones you’ve come to was the most desired, hello Mrs. Jones,
you know I was thinking how every time you come in here it’s like a learning process
starting all over again, do you remember what the first class was that you got to when you
started coming here as a patient of the doctor’s spinal workshops.
c. Reaction regimen also comes into play in this arena such as if a patient says something like
gee, it sure is cold out, this is a moment where a CA could move into the TLC reaction
regimen such as you know something, when it’s cold out we notice that a lot of our patients
who have had years of subluxation and now possess arthritis and deterioration have even
more achiness and restrictions in their joints. Who do you know who ends up suffering from
restriction in their joints, arthritis, and gets affected by the cold even more adversely than the
normal warm weather? So not only do we turn the discussion back into a chiropractic one,
but we segue into referral. Another example would be a patient coming in talking about the
movies that they just went to see. It’s the CA’s responsibility to turn it around and say you
know what Mrs. Jones the first thing I think of when you tell me you went to a movie is how
I make a point to sit in the first few rows of the movie theater so that I can be working on my
neck extension while I see the movies. Do you do this? Reaction regimen is a response or
reaction to a moment where the discussion could go anywhere. Even if a patient brings up
that they are talking about their dog, and how they are taking care of it, you can bring up the
fact that they may or may not understand that many racehorses nowadays get adjusted
because we understand the benefits of a healthy spine absolutely affects performance and not
merely symptom relief.
2. Details and Policy
This pertains to making sure that the patient signs in, prints their name, is addressed in terms of their
arrival time on time, early, or late (O.E.L.). Congratulating them if they’re on time and thanking
them for the fact that they are on time. If they are early congratulating and thanking them for their
enthusiasm and asking them would they like for us to change their appointment time to the earlier
time. And if in fact they are late, thanking them for the fact that they showed up, but let them know
we’re going to get you back with the doctor as soon as we can, but please have a seat out here for a
moment, there are several patients here who were right on time and I’ve got to get them back with
the doctor immediately and then we’ll get you in the flow. Be careful to not make this patient feel
punished, do not make this patient wait more than several minutes, but go through the act of not
allowing them to flow right back to the normal flow of appointments if in fact their arrival time is
significantly off from when they’ve scheduled. And let them know “I don’t ever want to have you
delay or wait any minutes in your day. Is it possible that you would like me to change your
appointment time to a time that’s more conducive for you?” So long as you don’t punish this patient
by waiting too long, if in fact they do need to have a rather flexible arrival time they’ll have no
problem with the fact that they may need to sit down for a few minutes before they go back.
Over the Counter (O.T.C.) Sheet: making sure that the OTC is addressed as TLC protocols
prescribe which is on the 1st or 15th of the month. You always ask the patient, "How would you like
to make your payment today, cash, check or charge?"
There are policy issues such as if someone has fallen out of financial fair exchange, or is out of sorts
with attendance at spinal workshops, these are the times that the prediscussed agendas that the doctor
and other team members agree to is what the greeting FD/CA must address.
3. Educational Exchange
The greeting FD/CA picks up the educational literature for the day, hands it to the patient and with
interactive genuine exchange, asks the patient to read or participate in the letter or questioning
process for the day. In reading the letter or responding to the questioning process of the day and at
that point the CA will send the patient back to meet with the doctor and inform them as to which
patient they follow. The key with this component is to make sure that the process of education is
completely interactive, that you speak with the patient; you engage with the patient and ideally have
some required response that must come from them. The education process does not serve any better
end if it’s not transformational for those involved in it. Personal testimony from the CA will always
help this. It does not necessarily have to be personal testimony about their own story, it can be
testimony of their observations of other patients, testimony of their observations of the doctor,
testimony of their observations of transformation they have gone through.
4. Definitive Action-step hand off to the doctor
The patient is then segued into or handed off to the doctor. At this point giving the patient a
definitive mission plan, as to which patient they are behind, where they should sit, where they should
go, what they should plan for, as much information or directive as possible helps the patient move to
the next step.
The three steps of the Front Desk CA’s ideal adjustment experience for the patient
Step 1: Greeting
Once again use the patients name to stop them. The most profound sound in a person’s life that will
stop them in their tracks is the clear and joyful expression of their name to their ears. If the practice
is run ideally and all financial and detail issues are addressed on the way in, the checkout process
should take no more than seconds.
Step 2: Policy and details
The details may be nonexistent unless there is additional overflow that needs to be addressed about
financial issues, appointment issues, spinal workshop issues and so on. Scheduling of re-exams, re-
reports, other specialty appointments.
Step 3: Binding exiting statement
The FD/ CA’s last words should only be of one nature, they should always be a reiteration of the
patients next appointment, date time and function. Such as, “We will see you Mrs. Jones on
Wednesday at 5:00 for your regularly scheduled adjustment. You are 3 adjustments away from your
re-exam which means by next week we will be doing your reassessment.” That is a very thorough
means of a complete and comprehensive exiting binding statement that has future pacing agendas
within it.
Raising up a Financial CA
Tools needed: Team Training videos
This must be a person who hungers for chiropractic and totally values the care your office
provides. This CA must be good with numbers but much more importantly, this CA must
VALUE chiropractic care. Above all else, this must be the person who always gets adjusted,
comes in when she/he is sick, and is committed to their care.
Raising up a Financial CA must be under the guidelines of finances, which at our office, are
simple, easy, and fun. Even if your finances are not currently simple, easy, or fun, they need to
become that.
The Financial CA needs time to observe. Observation first of the team training videos with the
doctor. The Financial CA needs a notebook to jot down all the questions and observations during
these training sessions. Next, the Financial CA needs to observe actual financial meetings with
existing patients as well as financial closes with new patients. Then the Financial CA must be
observed doing his/her own financial meeting with patients and observations/comments need to
be shared to help complete the training.
The Financial CA needs to contact TLC Member Services and engage with other CAs through
our TLC community. The most important thing is to welcome him/her to your team and embrace
that the training will take months.
Raising up a Tech CA
Spinal Workshop 26 week outline required tools – TLC brochure and TLC Referral Brochure.
The most important part of raising up a Tech CA is a hunger to be involved – hands on in patient
care and partnering with the doctor. This CA must love teaching and being able to switch focuses
and keep communication direct and to the point.
This CA needs lots of time observing the doctor. The CA must jot down notes in a notebook of
how the doctor engages the 4 Steps of an Ideal Adjustment. The CA must observe many new
patient reports and understand the care recommended and must understand the seriousness of
chiropractic care.
This CA must come to at least four spinal workshops in a row as education is this CA’s primary
job. Even if this CA has been a patient, the spinal workshop requirement is non-negotiable.
The TLC TIC brochures are great starting blocks for the Tech CA to utilize immediately. The
more quickly the Tech CA learns to converse with a chiropractic dialogue, the better the CA will
do.
Introducing new Tech CA
Be careful not to suggest a tone of self-serving in the agenda. While some of this is real, we
know that people tend to want to search out, seek and destroy the lowest common denominator
of why anyone would ever do anything, and in turn make it as negative as possible in their
minds. It is unfortunate, but this is just the human nature with information; particularly
information surrounding change.
Therefore, you should give them as little opportunity for that as possible in your verbiage.
Consider the following:
"When John begins taking part in your exam process, it will increase the standards of our
evaluation, as now you will have the opinions of two people watching over and assessing your
findings; both John, as well as Dr. Gibson's review of the findings. This will also make sure that
when it is adjusting time, Dr. Gibson remains focused exclusively on delivering the greatest
adjustment, and not on any other details at that moment. Then when it is time for him to assess
your exam, he will be 100% immersed in considering your findings."
Engaging the patients in the written word regarding the "benefits and upgrades" surrounding a
Tech CA’s participation in their care. Refer to the sample letter of introducing a new Tech CA.
Sample Letter Introducing a New Tech CA
Dear _________,
Our relentless pursuit in caring for you is to never rest regarding our abilities to forever upgrade the
care we render to you as well as maintain the parts that are already so well provided. We are forever
grateful in your deliberateness to not merely seek to be out of pain, but to truly be pursuing ideal
health. We as a team have labored and succeeded at upgrading our health as a team and therefore
our ability to better serve you.
You have probably met John already. He is our newest team member and serves the Chiropractic
Assistant position of "Tech-CA". He is here to serve you. With his presence we are going to be able
to provide significantly upgraded attention to detail and thorough follow through on all the things
which help support an ideal adjustment. We already know we are providing your spine and nervous
system the greatest chiropractic adjustments and care that exists. Now we will be able to
compliment those adjustments more successfully by Johns engagement with reviewing your
homework from time to time, helping administer your re-exams along side me, helping prepare our
consideration of your reports following your re-exams, and much more.
Please welcome John into your process here as his commitment to your excellence in true health is
genuine and skilled.
Other than more content data on his times, tasks and long term check list for issues, it is the
"SPIRIT" of the letter which is most important. The spirit should be "benefits to them", upgrades
and hopefulness
Sincerely,
Dr. ______ and Team at _______
Raising up an X-ray CA
(This is a T-CA who is a State Licensed or Certified in X-ray Tech Work. Not all states permit such
certification. To utilize this information you must confirm through experts in your state board of
examiners, if this is at all possible. It should also be noted that this investment is most wisely
considered on someone who is also trained on how to back you up with OPQRST, The Traumas,
The NP Exam and the Re-Exams.)
1. Call your state board of examiners and find out:
a. when the upcoming exams for X-ray tech CA licensure are held
b. what study courses are available
c. are there any manuals and guidelines which may be purchased in efforts to properly
train and prepare your CAs
2. Establish with the team a rallied support for the ambition to be an X-ray Certified T-CA and
designate the goal date for the most ideal exam to all participate in
3. Be prepared, as the doctor to be the facilitator for a total team training process
4. Schedule an in house training process such
a. Put aside 3-6 different days, usually either Fridays or Saturdays, where you (the
doctor), are going to prepare and deliver individual trainings that range anywhere
from 2-4 hours long each
5. Go to a book store and purchase an anatomical coloring book and a medical terminology
book for each of the CAs who are going to be doing each of the trainings. If they are
challenging to find, then be prepared to search and order them. These are classical training
books for most Bachelor of Science programs and doctorial programs, they are out there, find
them.
6. Ideally designate two CAs to take the state licensure even if you know one of them will never
really work as the X-ray tech. It is always best to make sure that any skill sets in the office
have back up training by additional team members. It is that guarantee of making sure we
are all backed up and all dispensable.
7. Designate the primary territories for your training. The following is my personal example for
you to draw from
a. Medical Terminology
b. Anatomy Terminology
c. Palpation and land mark identification
d. X-ray terminology
e. X-ray mechanics and equipment
f. X-ray set up and guidelines
g. Examination trials, written and practical
8. Establish policies for the process based on your preference and team leadership style. The
following are a few examples from the TLC perspective
a. Doctor pays for all costs of training, purchasing learning materials, paying for classes
and training, and paying dollar per hour for in office training time
b. TLC suggests that they train on their own at home at their own investment of time
with no dollar per pay
c. Doctor pays for the exam fees, travel, lodging, meals but not for the hours involved in
taking it.
d. Team member receives a bonus for passing the exam not merely for taking it
Raising up a Promotions CA
Relative to a Promotions CA, he/she should work two separate days per week for no more than three
to four hours per day, ideally in the first half of the day. Before they are set loose on doing things
like that, they must be a well established patient, they must have attended a series of spinal
workshops, and they must have shadowed the doctor as well as each of the other team members for
several days so that they understand the entire degree of intensity, accuracy, and morality that
defines the whole practice.
Once that is done, you must put in place a weekly meeting that is held by you with the marketing CA
with a definitive checklist such that there are things you want them to go over. They should begin by
being the sergeant at arms relative to how:
SWS details are filled out every week
The NP policy sheet is reviewed by the FA-CA (financial) in the execution of scheduling
workshops
The tech CA on the first inflow adjustment fills up the rest of the workshops.
He/she is checking on the fact that the next 12 months of workshops are written, printed
and posted around the office
He/she is checking in on the fact that the tech CA should be calling everyone listed on the
SWS sheet the Thursday before the next Tuesday’s SWS
He/she is checking in after the SWS is completed to see how many people were on the
list versus how many showed up and what was done about the ones that didn’t show up
He/she is doing statistics to assess how many visitors came to each SWS and what
happened with them
He/she is the one purchasing and placing the referral brochures throughout the office and
is helping to train with the team on how to ask for referrals and how to use the brochure
Once you really squeeze your in-house process and under your tutelage these proclamations of
authority, leadership, and consistency will raise them up even amongst the existing CAs. Then once
this is in place, we can then send them out into the exterior world and watch them do their
stuff. Other than if we include hours for being at screenings and being at talks and traveling with you
to such events, there would be little other reason to have a PR CA working 20 hours per week.
I. Ideal Hours for an Individual Practice
The PR CA is to work two days per week, anywhere from two to four hours per day. While more
than this is possible, it is actually not necessary in an individual doctor’s practice. These hours
however do represent hours for developing the promotions and marketing program and are not
inclusive of going out personally on screenings, lectures and other PR events.
II. Days
Ideally the days should be scattered between the beginning and end of the week. For instance, if
it’s a Monday through Thursday work week, choose Monday and Thursday. If it is a Monday
through Friday work week, it would be Monday and Thursday as well or Monday and Friday. In
terms of the part of the day it is best to always set up such activities for the first half of the day,
ideally anywhere between 9:00 and 2:00. Later than 2:00 is rarely as productive a time to be
engaged in promotions and marketing phone calls and set up.
III. Multi-tasking
Some doctors have PR CAs who also serve as front desk CA’s, financial CA’s or otherwise. If
this is the case, you must obey the following law:
Never allow promotions and marketing to be mixed in the middle of hours that define their other
job descriptions.
You must make sure that their job description for promotions and marketing has completely
separate hours on separate times of the week and that at least one of those times, if not both of
those times, is exercised when the practice is closed. This is the case, if in fact you are requiring
a CA with a previous job description under other headings of the office to then take on the hat of
PR CA.
IV. Pay Scale
Since most promotions and marketing people in the outside world are used to a rather ambitious
income level, it is necessary to start them at a pay scale that is usually different than regular CAs.
Start the PR CA at a high rate and make perfectly clear that this will only last for three months
and that they will then be lowered to a more conservative base pay scale so that their true income
is developed by their pursuit of making sure they are scheduling events. Both of these rules
change if in fact you are trying to take an existing CA who is already accustomed to one pay
scale and work them into the promotions position. This would be carried out for three months
and then after three months, they too would have a lowering of their base pay scale so that their
incentives for promotions and marketing are based on successfully accomplishing setting up
outside talks and the like.
V. Attendance at Marketing Events
1. Attendance at marketing events is an entirely different component of being a good PR
CA. Some PR CAs have nothing to do with taking the show on the road, while others do.
2. It should always be the PR CA’s responsibility to prepare the materials that are going to
go on any event, whether it is an outside talk, screening or otherwise. This means they
should have their boxes packed, their give-aways prepared and all the details arranged for
the doctor.
3. The PR CA should be responsible to make sure the dates are placed in the appointment
book, the front desk team is made aware of it and directions have been laid out and
prepared so that the doctor needs nothing to do other than to basically get in the car and
drive to where the event is. This is the same if it is the doctor’s team that is doing the PR
event as well.
4. The PR CA should prepare everything.
If the PR CA is a part of the road crew, then there must be standards of income for this as well.
Again, we would prefer to set the standards up where they are receiving their base pay per hour
of attendance and they are provided a bonus based on success in the field. It is important at this
point that you check with your laws for each individual state relative to what you are allowed to
pay people for, but it is my understanding that in most states you are allowed to bonus people for
their ability to share the information and schedule people who want to get checked. It is our
understanding that you are not allowed to bonus people for whether or not they agree to sign on
for care or whether or not they spend dollars in your practice, etc. Therefore, we would consider
setting up the ability to bonus them for setting up appointments that people actually show up for
to simply get checked. This is true whether it is outside talks or screenings. We would not
recommend setting up a second or variable bonus based on whether or not the patient signs up
for care, as it is our understanding this is the territory that is inappropriate for payment.
VI. Reviews
In all of the regards, this employee operates under the same standards that your regular team
members do. Relative to reviews, they are checked every 6 months. Once is for performance and
the other is for performance and pay scale.
VII. Team Training
This is something that possesses a great deal of variability, depending upon the practice and the
age of the PR CA relative to years of employment. Initially we would suggest that the following
criteria are critical:
They must be a patient in your practice
They must have attended at least six spinal workshops before they are allowed to go on
the road
They must seem to have a very strong grip on the principles and philosophy that define
chiropractic
They should have their own set of Truth CDs or Philosophical Fundamentals CD’s so
they are listening to these on a regular basis
They should be listening to whatever audios from the TLC agenda you’re plugged into,
and certainly the first Cornerstone which is on Promotions and Marketing
In terms of ongoing training, these team members may not necessarily be required to attend
weekly trainings. However, they must engage in at least one team attended seminar per year and
one leadership camp per year.
Like all positions in a well-oiled team, this is one that requires development and evolution
together in order to create the greatest solutions. The framework contained in this document
gives us a tremendous degree of structure, but from this point we now need to have our regular
weekly meetings in order to engage it properly. This calls for our final recommendation to
have a deliberate meeting every week with doctor and PR CA. Along with this meeting, there
must be the preceding checklist the PR CA must fill out weekly and leave on the doctor’s desk
by the end of their week so that the doctor can prepare for the next week’s meeting. PR CA
meetings should take no more than anywhere form 5-15 minutes per week, once the momentum
of training has evolved.
TLC recommended tools for Promotions CA
The audios from Promotions and Marketing Boot Camps
The Teach to Testify audio series. This is an especially rich tool for the vast array of
promotions and marketing actions steps that are available to you.
The Words of Wisdom CD that should be printed out and placed on your front desk in the
practice on a regular basis.
The Volumes I and II of the Spinal Workshop series.
o Volume I: Packed House Workshops
o Volume II: Rock the House Workshops
Speak OUT and be sure they listen to the audios contained inside
Referral brochures
MD referral program – Building Alliances
Optimal Healer program
Stump the Team program
Any additional tools that have been created by our vast array of successful TLC members
by the time this document has been read by you…
Emphasize with the PR CA that you promote not in efforts to get patients in the front door, but to
get chiropractic on the streets. Since chiropractic represents truth, truth will always prevail at
attracting people so long as it is put out there. We want to keep clear stats and prove the
worthiness of continuing to employ this person, but remember the fundamental issues and that is
that putting truth on the streets will always bring prosperity into our house.
Raising up an Associate Doctor
While an independent contractor has its place with someone paying your rent, we should stay
away from such a structure and define with clarity, what type of an associate doctor you want.
Q: Do you want someone with ambition they will be with you forever?
Q: Are you open to seeking associate doctors who will be with you anywhere from one to three
years, in cycles, and then move on to their own set up?
The reality is, even if you believe you are looking for a long term doctor, you must approach it
one step at a time. In this design plan, there are 4 – 7 different levels that you can choose to
design your graduation process by, in order to give your new associate doctor clarity in their
position. You have to be extremely careful to not give away the farm in your early discussions
with them about providing vision and expectation for your future together. You can let them
know your hopes are that you will be working with them forever and they will reach all the
highest levels of engagement that are possible at your practice, but the first step is a tech doctor.
The tech doctor is basically support staff for your tech CA. For their first period of work they do
nothing other than follow, support and clean up after your tech CA while learning the details of
how the tech CA works in your practice. This period can be as short as two weeks; it can be as
long as several months. From there, we gradually work their way up through 4 to 7 different
levels. Incremental pay scale changes and introduction into percentages all hinge upon their
articulate and very well discussed graduation from one level to the next. It provides for a huge
developmental period of humility, clarity, cross training and the strength for them to be a 100%
team player in your facility. They would then be well groomed to move out on their own and feel
nothing but the generosity with which you trained them.
A suggested homework assignment for now is to start writing down your dream picture of an
associate relationship and how it would look within the first – 6 months, 1 year, 3 years and 10
years together. Write your story exactly the way you want it, so we can then begin to work
backward in creating the steps that would be necessary to manifest that.
Refer to the Associate Driven Practice (ADP) H.O.T. product to learn more.
Raising up a Muscle Therapist
There are series of details we have got to be clear about with muscle therapists. No matter who
they are, what their skills are, or how old they are, they have to fit the disciplines:
1. The CA has to become a patient under your care.
2. The CA has to attend several spinal workshops before he/she is allowed to engage in
anything with your patients.
3. The CA is an employee that is paid per hour for the services rendered and not for any
peripheral hours.
4. He/she must be getting adjusted by you, in your house or by your in-house associate.
5. The CA is immediately terminated and informed of this in advance if he/she were to ever
communicate with or see patients outside of your practice.
6. The CA does not schedule the appointments nor change the appointments; he/she does
everything through the front desk CA.
7. The CA is to provide you blocks of hours available that are consistent, set, scheduled hours
that you are available to fill and if you arrange one hour and skip the next and fill the third
hour, you do not pay for the hour in between on any level.
8. You commit to doing your best to fill the CA blocks of time, but until the first several
months unfold, he/she is going to have to be patient with doing straggler appointments here
and there.
9. You provide the room, the space, the heating, the sheets, the oils, and he/she simply shows
up to do the sessions.
The issue of choosing to have a muscle therapist within a practice is one that we recommend you
engage a process of thinking and assessment on the part of the doctor and the overall team
present. This person must be seen as an employee of the team and someone who has direct and
repetitious long term contact with the patient. Therefore, all the parameters of training and
discipline of conduct that apply to the front desk, financial and tech CA’s apply to a muscle
therapist. They should never be given any extreme variances in required diligence towards
training, attendance at seminars, and participation in workshops and so on. The following is an
outline of steps we believe you should address to engage clarity with muscle therapists.
I. Why would I consider having a muscle therapist?
One must understand that muscle therapy compared to potential revenue extremes available by
providing chiropractic care to patients is not a means of enhancing the financial stability or
fluency of the practice. You hire a muscle therapist because it provides a great service for the
patients. We had a muscle therapist because we believed working the soft tissue truly enhances
the process by which someone surrenders subluxation.
II. Selecting a muscle therapist
If you are interviewing for muscle therapists, it is easy to contact local schools for muscle
therapy and hire from there. However, one must realize that you are usually getting a muscle
therapist who does not have thousands of hours of experience, which is not ideal in terms of
application of technique. There are some individuals right out of school who deliver greater
muscle therapy sessions than those who have done thousands of hours of work already.
Understanding the type of technique work they apply is critical to the process. It is my personal
opinion as a chiropractor focusing on motion and biostructural work that I prefer to have muscle
therapists that are able to do deep friction work, more in line with shiatsu and neuromuscular
therapy. However, it has been my experience when these techniques are applied to people who
are fibromyalgic in nature that this technique work is far too intensive for their types of bodies.
In cases of fibromyalgia, extremely soft approaches are necessary, such as Swedish massage.
However, we do not usually recommend this technique. Muscle therapy is not a “feel good”
experience. It is a definitive attribute towards allowing people to gain greater reeducation of the
systems and processes surrounding subluxation correction.
III. Gender
There should be no issues regarding gender preference in a well-run, professionally operated,
methodically executed practice. However, there have been problems in the past that have
revealed challenges with male muscle therapists. You need to run your process thoughtfully and
thoroughly enough that gender never provokes challenges with scheduling appointments.
IV. Personal Experience
Make sure you have at least one muscle therapy session done on yourself as the doctor to
understand the nature of the person’s approach. It should demonstrate an authoritative and
confident touch, and a well demonstrated knowledge of the anatomy inherent to Golgi tendon
apparatus function, trigger point work, and global perspectives on body tone. If afterwards you
feel comfortable enough with this person, the next issue is to assess their overall knowledge of
chiropractic. If they do not have a comprehensive knowledge base about chiropractic, then they
need to demonstrate a willingness to be a humble student.
V. SOAP Notes
Muscle therapists need to create well-articulated SOAP notes and to communicate well with the
staff in the practice. It is usually the doctor who spends a great deal of time training muscle
therapists in proper documentation, since this type of knowledge is not provided in muscle
therapy schools or not up to the standards necessary for a doctor’s office.
VI. Setting House Rules
A muscle therapist is an employee and not an independent contractor. They are paid per
service delivered and not for any cancelled appointments. They work according to the
schedule we provide at the hours we require muscle therapists present, which is usually not
during prime time. At DePice Chiropractic, the restricted hours were 8-9am and 5-6:30pm.
All other hours are open to muscle therapists.
Muscle therapists must be patients at the facility for their own chiropractic care.
They must attend spinal workshops. They need to attend three workshops in three weeks
before they begin working on any of the patients. Then they must attend one workshop per
month for their entire first year of employment. At any point if they do not successfully
attend one workshop per month, they can be immediately removed from the schedule.
They are paid a conservative amount per hour for their first three months of employment.
However, their appointments are scheduled by the facility and the table, sheets, ointments,
and so on are provided by us.
The muscle therapist is responsible to call in at the beginning of each day to check on the
next day’s schedule or that evening’s schedule. If they have a block of hours and there is an
empty slot in the middle of it, they are still required to be present for their blocked hours
but will not receive pay for that empty slot.
The muscle therapist will not be paid for any sessions that do not demonstrate successfully
written SOAP notes afterwards.
A muscle therapist must support the principles and philosophies defined by your practice.
We teach patients that while an adjustment may only take minutes, a muscle therapy
session may take an hour and does not address issues with bulk magnitude that an
adjustment does. A muscle therapy session is to support the benefits of the adjustment and
not to substitute it. This requires that the muscle therapist is profoundly articulate in stating
and defending the same position on these issues.
A muscle therapist is never entitled to see patients outside of the office. They are not
allowed to call or contact patients at home, unless they are at the practice and checking in
with them after a first appointment.
Muscle therapists must introduce themselves to all new patients by having a sit down
discussion in a consultation room and present the letter outlining patient policies for muscle
therapy sessions. They must introduce all the points in the letter and have the patient initial
each point.
A muscle therapist is never paid for a missed appointment. However, if the patient did not
give 24 hours notice, the patient is responsible to pay what is stated in the policy letter as
the agreed amount for canceling within 24 hours. If they do not pay this fee, the patient is
not entitled to receive their next muscle therapy session. This policy must be defended by
the front desk CA, as they are the person who is responsible for scheduling muscle therapy
appointments.
The front desk CA runs the muscle therapy schedule and makes the appointments based on
the doctor’s request.
The patient is prescribed for as many muscle therapy sessions as the doctor prescribes. The
muscle therapist is never allowed to intercede on the doctor’s recommendations and change
them without first talking to the doctor and letting the patient know that they will be
consulting the doctor regarding changes in muscle therapy.
Muscle therapists must print out SOAP notes and deliver them to the doctor for the first two
months of employment.
Muscle therapists will be considered for a raise in pay scale after their 2-3 month evaluation
period, but it will still be a flat rate per hour.
VII. Scheduling
Muscle therapy appointments should not be given to patients who are not at least
through their initial intensive care.
Muscle therapy appointments should only be scheduled during slower times of
the day.
Muscle therapy appointments should not be scheduled at any time when the
doctor is not present in the office.
Appointments are understood to be less than the time allotted. A one hour
session will only provide 50 minutes of contact time.
VIII. Legality
One must clarify the legality of having a muscle therapist deliver services in your practice.
Doctors must check their state and their third part billing carriers’ requirements about whether or
not muscle therapists are licensed to practice in office or licensed to provide services that are
billed to third party carriers. These issues are unique and specialized for each stated board. This
information can be obtained through a coding and compliance officer or directly from state
licensure facilities or third party carrier facilities.
IX. Performance Reviews
Muscle therapists should be reviewed just like very other employee every six months. On their
semiannual review, it is strictly a review of performance. On their annual review, they would be
considered for possible pay scale changes.
X. Continuing Education
Muscle therapists are required to attend leadership camps, just like the rest of your team
Muscle therapists are required to attend at least one TLC seminar per year
Muscle therapists are required to regularly attend spinal workshops
Doctor Coverage
In selecting a good coverage doctor for your office, the first thing you must do is conduct a
private, one on one meeting with him or her. Have him/her observe you adjusting for
approximately thirty minutes of your prime time. Then you must have a rather candid and private
conversation with him or her to see where they stand.
Next, you must definitely allow him or her to adjust you, as well as you adjusting him or her too.
In this, you will have mutual dialogue regarding technique work. The following are some details
you can require of yourself on a private checklist during the meeting:
1. The overall energy and presence of the person is congruent with that of the tone of your
office and your team members.
2. Your CAs felt good about the visiting doctor and favorable of his or her presence.
3. If your CAs are up to it, they become adjusted by that doctor.
4. You are clear that you are not inviting a new technique work to your office.
5. The technique work is congruent.
6. Train on the 4 steps of the ideal adjustment and that he or she is willing to engage those steps
with accuracy and consistency without discontent.
7. Adherence to the hours you defined.
8. You may want to review how this individual will meet with a patient in terms of day 1
gathering, but never train them on day 2 or NPR skill sets. If you are going to be away for an
extended amount of time, you would want to work with his or her willingness to meet with
new patients according to your 6 steps of day 1. In this, you can see how he or she would
support your new patient volume even in the midst of your absence from the practice.
9. Pay scale – depending upon the zip code you are in and the amount of travel involved, pay
scales can range anywhere from $250-450 per day. For a half day, you would usually pay the
individual a little more than what the half of the total day amount would be. In terms of
travel, there is no extra pay for travel for up to an hour in distance. Travel time of over an
hour includes travel logs for validation. You can provide anywhere from an extra $50-75 per
day for travel. If your office sees more than 100 visits per day, you may want to provide a
high volume premium which may be an extra $50 per day.
Q: What do most 400+/week Chiropractors usually do for vacation coverage?
You should have open hours during the week that you’re away and all of your greatest CAs must
absolutely be on a full time schedule that week. You should schedule cleanup projects that they
are going to take care of on the days that your practice is not open, but for the days that it is, they
should see themselves as personally responsible for the practice, more so than the coverage
doctor.
If you work from Monday through Thursday with Monday, Wednesday and Thursday being full
days and you go on a one week vacation, hire a coverage doctor for Monday and Thursday in
their entirety. Arrange for a half day of coverage either Tuesday or Wednesday evening and the
rest of the time, have telephone access to friends of yours that are local who would take care of
the patients. That way, you are only paying for two full days and one half day of associate
coverage, at a pay scale of no more than $400 per day. You would save yourself from spending
$2400 on coverage. However, you do have to be in a circle where you have regular doctors who
can perform at such a level.
You may want to call some of our other brothers who even have associates in their practice and
see if you could borrow their associate for one of the days. Obviously, these have to be doctors
that are comfortable with a significant amount of volume, but if your CAs are there in full force,
it should work out well.
Ideal Q&A for meeting and introducing practice to coverage doctor
In TLC, we recommend to have no contract with coverage doctors who show up. If they are
going to show up, one of the things we do is make sure they are in training with us on their visit
to the office. They have to observe me in prime time for at least an hour and we have to have at
least a half hour of chat time with them or we are not interested in them. Then we would like to
build a long term relationship. We teach them how we like to document, and what not to adjust.
We exchange adjustments so we teach them how to hopefully make their adjustments in my
office feel more like mine rather than mine in theirs feeling so vastly different. I am more
concerned with the details of communication and having clarity. After each of the points, say,
“So tell me what you heard me say? “
“So tell me what you feel is unique about what I do? “
“Tell me what you noticed I do in my adjustment sequence that is different from yours? “
“Tell me what parts you will have to do differently to surrender some of the things you do
so you do not do things that my patients are not used to?”
“What are some of the things you are going to have to add in that you don’t commonly do
so my patients get what they are used to?”
One on One Accountability Meetings
Goal: To allow for scheduled meeting times privately with doctor to discuss specific tasks that
are in the team members’ primary job description and need to be performed daily and weekly.
Implementation:
Log on to www.tlc4superteams.com (core member log in)
Under Member Tools, Listen, Recordings, click on "Back by Popular Demand"
Locate "1 on 1 Meetings" under the appropriate core proficiency category
Listen to it three times (twice listening only, third time taking notes)
1. Schedule 15-20 minutes weekly with doctor and CA and write in the appointment book.
2. Print CA weekly checklist from TLC manual for your zone of work in the office.
3. Review the jobs listed and modify the tasks to reflect your specific practice’s jobs.
4. Print a new modified CA checklist to be used daily and turn in the on the last day worked in
the week (this should be printed and left on doctor’s desk and you might also want to email it
to this doctor as well).
5. If using Outlook to manage office tasks, print a task report update for each of the tasks you
are responsible for and print these along with your weekly checklist.
6. Pay particular attention to the bottom section of comments/challenges and write additional
comments so the doctor can be aware of concerns you have.
7. Regard this time as time devoted to building your team member and investing in him/her
with your time, energy, and money in doing this meeting regularly.
8. Results need to come from this meeting, and you need to check back the next week on tasks
that were discussed from the last week.
9. New tasks assigned should be added to Outlook for each team member and doctor as need be
from each team member’s one on one meeting.
Individually, the doctor should meet with each team member for no less than 5 minutes,
no more than 15 minutes, addressing their specific primary zone of job description, at a
separate designated time per week. While there can be some flexibility in establishing
those times, once established they must meet every week.
These separate individual meetings can be informal, dialoguing about how the team
member is doing, what they feel are some of their strengths right now, what are some of
the things they need to improve upon. These meetings can also address specific issues
that the doctor knows that CA needs to work on relative to their primary zone of function.
You can choose to create a weekly meeting agenda for each zone by utilizing the
responsibilities and meeting guidelines
o Front Desk CA Responsibilities and Meeting Guidelines
o Financial CA Responsibilities and Meeting Guidelines
o Tech CA Responsibilities and Meeting Guidelines
o Promotions CA Responsibilities and Meeting Guidelines
o Associate Doctor Meeting Guidelines
o One on One Meeting Checklists
Related Video: TLC Weekly Accountability Checklist
Front Desk CA Responsibilities
1. Support and uplift the doctor
2. Raise value experience for the patients
3. New Patients
4. Payments
5. Scheduling and Patient flow
6. Patient Education
7. Accountability
PRIMARY
CHECK IN
Greet patients
Patient flow
Answering telephones
Over the Counter Collections (OTC)
Special appointments
All NP procedures
Reschedule calls
Patient education
CHECK OUT
Check travel card
Confirm or change next appointment
Address loose papers
Schedule SWS
Keep up daily count (sign in sheet, computer and travel cards)
Schedule special reports and other appointments
Ensure a connected exit
SECONDARY
Maintain surplus NP files
Ensure no piles at front desk
Keep all bins empty
Pre-call next day’s NP’s and once a month visits
Pre-view next day’s schedule for flow patterns and special reports
Update team calendar and patient calendar
Prepare report folders and exam paperwork
Cross communicate with FA/CA on policy patients
Cross communicate with T/CA on patients requiring special doctor meetings
Update TV screen announcements
Keep all patient areas neat and clean
**This is a suggested guideline of some of the questions the team can check on at any given meeting.
It would be impossible to address all of these issues in every single meeting. It would be the team
leader or doctor’s responsibility to select the ones most important to go over at each weekly
gathering.
Front Desk (FD) CA 1 on 1 Meeting Guidelines
New Patients
1. Assess all the most recent new patients since the last 1 on 1 meeting.
a. How efficiently and effectively the CA feels each new patient was processed in terms of time,
accuracy of paperwork, and completion of questions answered.
2. Snoop through all the bins at the front desk and review all piles.
3. Specifically notice new patient files that are in transition between NP & NPR and completion:
a. Is all paperwork completed?
b. Have the financials been called, checked on, and established?
c. Are checklists to completion?
4. Are all new patients having their reports of findings and their NPR's performed within one to two
days of their NP Day 1?
Payments
5. Is the OTC being written up newly every month?
a. Followed up on at the first and fifteenth of the month?
b. Are you successful at making sure the majority of all payments come in on the 1st and 15th of the
month?
c. How well are we addressing people who miss payments?
6. Snoop through all upcoming re-exams and complete files?
a. Snoop though all upcoming Anniversary report and check x-rays, attendance at SWS’s,
balances and engagement.
Scheduling and Patient Flow
7. When was the last time you did a timing flow study to assess that no patient takes more than eight
minutes to get onto an adjustment table & that no appointment takes more than twenty-five minutes
from in the door to out the door?
8. How are you doing at following up on patients' requests for information or financial questions to be
answered?
9. Are you utilizing the financial questionnaire pad so that the financial (FA) CA is not interrupted in
the middle of their day?
10. Is the front desk team doing well at protecting the FA CA from scatter and distractions/questions?
11. How would you rate the overall flow? (think coordination between the FD and the Tech CA)
12. How efficient is your wrap up and on-time closing?
13. How long after the last patient is seen does the team find themselves going home?
14. At what point are the lights dimmed, the blinds pulled, and the doors locked at the end of the morning
session? At the evening session?
15. How articulately are you separating time flow from adjusting hours to report hours?
Patient Education
16. How would you rate the ability to keep FD dialogue on chiropractic and the patient's health care?
17. How efficiently are you making sure that every single patient who comes in is reading the article or
letter of the day?
18. How functional are you at interrupting moments of silence or prolonged waiting by activating
moments of education on the pre and post x-ray box and other table talk?
Accountability
19. Have you calculated the percentage of missed appointments?
20. How well are you doing with reschedules?
21. How articulately are you catching people on their first missed appointment and making sure that upon
their return after the missed appointment, the doctor is informed and has a private one-on-one with
the patient during the course of that adjustment?
22. What number of thank you notes have been written or acknowledged to patients weekly?
23. What part of your last TLC seminar attended do you still feel the most attached to following up on?
24. Have you called your accountability partner from the last TLC seminar on the prescribed 30 day post
seminar check-up?
25. How is your attendance on TLC TDP training calls on the 3rd Tuesday of each month at 1:00 P.M.
EST?
26. When was the last cross training week in your practice? (This is where each team member has to
perform at least one day in another team member's job description)
27. Review the two seminars and one leadership camp in your past year of employment and what our best
improvements were from them.
28. How many additional patients per week are you scheduling for spinal workshops?
29. How many guests are you scheduling for spinal workshops?
30. How are you in some way initiating a procedure that enhances practice efficiency/profitability or
decreases practice overhead? (There should be at least one statement in this area per week per team
member.)
Training
31. Review the front desk primary five NP scripts:
a. NP phone script
b. NP greeting
c. NP exit
d. NPR greeting
e. NPR exit
Financial CA Responsibilities
1. Support and uplift the doctor
2. Accountability
3. Finances
4. New Patient, Re-Exam & Anniversary Reports
Take day’s schedule and do preview (P.R.E.S.- on)
Special projects (flyers, filing, etc.)
Work the front desk on (Monday) nights
Review current day’s upcoming financial agreements (AR’s and NPR’s)
Insurance billing
Cash billing
Create follow up on OTC’s on the 1st and 15th of the month
Stats
Generate monthly itemized statements
Insurance follow up calls
Discharge process
Check out at front desk when needed
Enter insurance payments from the mail
NP/Re-exams (when needed)
Update NP checklist
**This is a suggested guideline of some of the questions the team can check on at any given meeting.
It would be impossible to address all of these issues in every single meeting. It would be the team
leader or doctor’s responsibility to select the ones most important to go over at each weekly
gathering.
Financial (F) CA 1 on 1 Meeting Guidelines
New Patients
1. Spot check lifetime care all mapped out from NP’s 1-2 weeks ago
2. Spot check SWS scheduled in book on same NP from 1-2 weeks ago
3. Spot check any NP folders filed and NP checklists are completed (ie: FHH completed)
4. Spot check monthly swipes for entirely of care plan for any NP 2 weeks ago
Accountability
5. How many heart touch notes have you written out this week to patients & secretaries and
members of third party billing companies spoken to on the phone?
6. What part of the last seminar attended did you still feel the most fresh or diligent in following
up on?
7. Have you called your accountability partner from the last TLC seminar on the prescribed 30
day post seminar check up?
8. How is your attendance on TLC CA training calls on the second Tuesday of every month at
1:00 P.M. EST?
9. When was the last cross training week where each team member had to perform at least one
day in another team member's job description?
10. Have you engaged in at least two seminars and one leadership camp in your past year of
employment?
11. How are you in some way initiating a procedure that enhances practice
efficiency/profitability or decreases practice overhead? There should be at least one
statement in this area per week per team member.
12. Spot check bins on financials CA’s desk
13. Spot check copies of their P.R.E.S. sheets
14. What is our percent on continued care conversions?
15. What is our percent of new patient conversions?
16. What is our PVA? (Patient Visit Average = total office visits for the month divided by total
NP's for the month)
17. What is our DVA? (Dollar Visit Average = total collections for the month divided by total
office visits for the month)
18. What is our case average? (Case Avg = total collections for the month divided by total NP's
for the month)
19. What are our average services per visit?
20. What percentage of patients are on wellness care? (% wellness care = total office visits
divided by wellness office visits.)
Re-Exams
21. For each patient's re-exam, are you utilizing these times to reassess their status with keeping
up on their financial agreements as well as their attendance in SWS's?
Finances
22. Are you reading and reviewing the print out of this month’s OTC sheet?
23. How are we doing updating the follow up assessment of last month’s OTC sheet?
24. How have you reviewed the OTC for accuracy and success? (Review the scripts of how the
financial CA finishes an NPR by doing all parts of the financial CA NPR script and how a
CA addresses resigns for continued care as well as patients who have missed a payment.)
25. How many follow up calls to insurance companies are being done per day? (Minimum of x
times per week and get clear on this.)
26. Spot check notes entered on someone whose insurance promised to pay in computer- read
notes
27. See alarms set for date and monies promised
28. Spot check on rejected credit card swipes
29. Review a printout of the 30, 60, and 90 day accounts receivable report.
Anniversary Reports
30. Spot check AR box and pull out cards from 2 months out
31. Open and inspect the Anniversary Report (AR) box.
a. See that a paper is filled out that states who has their anniversaries coming up in three
months, two months, within this month and who is past due.
b. For the three month people – Have you already gone through and reviewed the status
of their finances?
c. How up to date are they and do any changes need to be made?
d. Have note cards gone out from each of the team members to stagger and write
acknowledgement notes to these people three months from their anniversary? (the
note cards are acknowledging something genuinely virtuous about the nature of how
they have engaged in their care)
e. Assess the participants in SWS's. (3 in 1st month + 1x/week there on...)
Patient Education
32. How many additional patients per week are you scheduling for spinal workshops?
33. How many guests are you scheduling for spinal workshops?
34. How likely are you, when out of the financial office, in the midst of patients to stop and
speak with patients and initiate warm dialogue?
Tech CA Responsibilities
1. Support and uplift the doctor
2. Patient Flow
3. New Patient/ Re-Exam
4. Patient Education
Take day’s schedule and preview (P.R.E.S.-on)
Note taking
Patient flow
Exams – scheduling and doing; scheduling reports following exams
X-ray write-ups
Highlighting exams and reports
Scheduling and confirming spinal workshops schedules
Teaching spinal exercises/ rehab/ tech
Back power/ball class
Muscle therapy
Update article of the week, whiteboard, SWS topics, office tours & posture checks
**This is a suggested guideline of some of the questions the team can check on at any given meeting.
It would be impossible to address all of these issues in every single meeting. It would be the team
leader or doctor’s responsibility to select the ones most important to go over at each weekly
gathering.
Tech (T) CA 1 on 1 Meeting Guidelines
Patient Flow
1. With what level of efficiency would you rate your practice's implementation of NMT (neuro
muscular therapy) work or massage work?
2. How well would you rate the flow of patients and their time spent in the office?
3. Have you been a part of running a time trial process and assessing the time flow of how
efficiently the patients are brought back for adjustments?
New Patient
4. What is the quality of scripting for the tech CA's NP exam?
5. How would you rate the quality of x-rays being taken at the facility?
6. What is the quality of x-ray markings and lines being done by you?
7. How quick is the turnaround of post NP completion of paperwork?
Re-Exam/AR’s
8. Are you catching and noticing that all additional services are noted and articulated in the
billing process, such as extremity adjusting/application of appliances/rehab/low tech
work/etc.?
Patient Education
9. How quickly do you turn all dialogue with patients back around to chiropractic and their
health issues?
10. How likely is the tech CA to implement dialogue with patients on the pre and post x-ray view
box?
11. How quickly are you answering questions posed by patients?
12. How many additional patients per week are you scheduling for SWS's?
Accountability
13. How do you do at reordering inventory, such as x-ray films, face paper, and any tech support
or appliance items?
14. How do you rate the cleanliness of all areas of patient care? Are the head pieces wiped down
on a daily basis?
15. Have you called your accountability partner from the last TLC seminar on the prescribed 30
day post seminar check-up?
16. How many guests are you scheduling for SWS's?
17. What number of thank you notes have been written or acknowledged to patients?
18. How are you in some way initiating a procedure that enhances practice
efficiency/profitability or decreases practice overhead? There should be at least one
statement in this area per week per team member.
Training
19. Are there presently any issues with patient "backwash"?
20. What part of the last seminar attended did you still feel the most fresh or diligent in following
up on?
21. How is your attendance on TLC CA training calls on the third Tuesday of every month at
1:00 P.M. EST?
22. When was the last cross training week where each team member had to perform at least one
day in another team member's job description?
23. Have you engaged in at least two seminars and one retreat in your past year of employment?
Divisions of tasks with 2 Tech CA’s
NP/ Re-Exam Tech CA
1. With Dr. for all new patients exams
2. Does all Re-Exams and Anniversary exams
3. Enters all exam notations
4. Makes sure Dr completes all new patient, Re-
Exam & AR records
5. Teaches exercises/ rehab tech when doing exams
6. Back up to front desk
a. Confirms appointments
b. Re-capture calls
7. Engagement connection form completed for all
NPs and up to date for all existing patients
DR Tech CA
1. By Drs. side at ALL times
2. Notes – Drs. and supernatural listening
3. Flow of patients
4. Patient education – answering questions
5. Scheduling and connecting on SWS
6. Back up to input NP and Re-Exams
findings
7. SWS confirmation/ post SWS
PR CA Responsibilities
1. Support and uplift the doctor
2. Promotions
3. Accountability
SWS attendance patients and guests
Patient reactivation letters send weekly
Outside talks set up
Community interactions – individual and whole practice
Website updates
Social media – Facebook, LinkedIn, Twitter, posts 2x/week
Articles to post on blog weekly
Constant contact newsletter updates – practice
Groupon or coupons
Relationship network building
Expansion cycles planned and tasks detailed with timelines
Daily, weekly, monthly, quarterly, annual promotional activities
Weekly meeting with doctor to review PR
ROI stats on all promotional actives – monthly report
**This is a suggested guideline of some of the questions the team can check on at any given meeting.
It would be impossible to address all of these issues in every single meeting. It would be the team
leader or doctor’s responsibility to select the ones most important to go over at each weekly
gathering.
PR CA 1 on 1 Meeting Guidelines
Can be inputted as tasks in your electronic calendar to be reviewed weekly in one on one meetings.
Promotions
1. Update team's individual marketing tool boxes – spot check & engage TIC on this
Accountability
2. How many NPs last week
a. Referrals __________
b. Outside sources ____________
3. How many new talks/screenings scheduled? _________________________
4. What are our new leads for outside talks or screenings?
___________________________________________________________________________
___________________________________________________________________________
5. Rate quality of team's
a. Efficiency in processing NPs _______
b. Energy to attract NPs _______
c. Follow through on everyone getting checked _______
Training
6. Review scripts for Setting Up Outside Events at least once a month. Review doctors spinal
workshop and outside events closing scripts at least once a month.
**This is a suggested guideline of some of the questions the team can check on at any given meeting.
It would be impossible to address all of these issues in every single meeting. It would be the team
leader or doctor’s responsibility to select the ones most important to go over at each weekly
gathering.
Associate Doctor Meeting Guidelines 1. How are their skill sets in the graduated levels of training associates they are supposed to go
through?
2. How is their timing and effectiveness on paperwork for doing re-exams?
3. Are they taking and marking x-rays?
4. Are they preparing the patient’s folders for the doctor for re-reports and NP’s?
5. Do they back up the tech CA?
6. Do they continually train on cross training skill sets in all areas of the office?
7. Have they been improving their skills at duplicating the experience of the adjustment such
that every team member would have a difficult time when face down understanding whether
it is the primary or associate doctor adjusting them?
8. How are they doing on door to door surveys?
9. Are they scheduling outside talks and screenings?
10. Do they participate in outside talks and screenings?
11. How many additional patients per week are they scheduling for SWS’s?
12. How many guests do they have scheduled for SWS’s?
13. How well are they demonstrating their abilities to proceed with humility in the presence of
all CAs and the doctor?
14. What number of thank you notes have been written or acknowledged to patients?
15. What part of the last seminar attended did they still feel the most fresh or diligent in
following up on?
16. Have they called their accountability partner from the last TLC seminar on the prescribed 30
day post seminar check up?
17. When was the last cross training week where each team member had to perform at least one
day in another team member’s job description?
18. Have they engaged in at least two seminars and one retreat in their past year of employment?
19. How are they in some way initiating a procedure that enhances practice
efficiency/profitability or decreases practice overhead? There should be at least one
statement in this area per week per team member.
Contact TLC headquarters for more information on the ADP product
One on One Meeting Checklists
One on One Meeting Checklists are designed to be living documents so
that each team member is always being lifted up to be more. Checklists
should have only 3 to 7 tasks the team member is learning to master. As
a task is mastered, it is removed from the checklist and a new task is added.
We recommend setting 90 day goals to accomplish a task. Some tasks such
as “recalls” should never be removed as this is something that we always
want to be aware this task is being completed.
One on One Meeting Checklists
Front Desk Primary CA 1 on 1 Checklist
Team Member: ___________________ Week of: _________________________
My WHY: _____________________________________________________________________
My Target #: ______________________
# of 14 day rule family members checked: _________ or # of drop in’s: _________________
Support and uplift the Doctor
Tasks M T W Th F/S Details
Greet all patients
Answers phones
Call patients to confirm special
Call all missed appointments within 8 min.
Confirm all patients next appointments
Make sure all patients notes are entered in
computer and charges are entered
Check email am/pm and respond
Check messages and return calls
Text reminders for next day adjustments
Update Dropout List
Schedule, enter all new patients in computer &
complete the file
3 Heart touch notes sent
Warm Fuzzy cards to doctor
Text NPR call for Doc
NPR/AR Checkouts
Deliberately engaged 30 sec. rule
Got adjusted during prime time
Gave Personal Testimonial
Collect monies & review OTC transactions
sheet
Team Training Monday 1:15
Made one on one weekly meeting happen
PRES
Front Desk Assistant Checklist Team Member: _____________________________ Week of: _________________________
My WHY: _____________________________________________________________________
My Target #: _______ % of Kept Appts: _________ % of Patients w/ future Appts: ________
Support and uplift the Doctor
Daily: M T W TH F/S Details
Call missed appointments within 8 min
Confirm Special apt/ text reminders
Answer Phone
Turn on-off Computer/Music
Greet Patients
Check IN/OUT Patients
Pull Re-Exam Files
Direct Patients in office
Adj Rooms - Open/Close/Between
Shift
First Inflow Tour
Break down/Set up SWS Room
PRES
Clean Kids Area
Print PRES Schedule for next shift
Warm Fuzzy to Drs
Mail out by 11 am
Shred Paper
Enter Re-Exam & NP info into comp.
New Patient Checkouts
NP Welcome to Office Postcards
Change NP Names on Chalk Board
NPR checkout/Take home phone#
Gifting AR Patients
Give Chiropractic Testimonial
TIC Talk
Weekly:
Change SWS Board (Wed AM)
One on One Meeting with Dr
Team Training (Mon 1:15)
Listen to Philosophy clips on TLC
Website
Change Referral Board
Inventory of Stock
OTC Sheet up to date
New Patient folders made (25+)
Monthly:
TDP Call (Third Tues)
Input Supplement Order
1. Ways I improved my ability to be finished and gone within thirty minutes of closing:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
2. Ways I helped lower my practice’s overhead:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
3. Ways I built up my team members in front of patients (be specific):
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Financial CA - Weekly Checklist
Team Member: ___________________ Week of: _________________________
My WHY: _____________________________________________________________________
My Target #: ______________________ Dollars collected weekly: _________________
Support and uplift the Doctor
Task M T W TH F/S Details
Enter all New Patient Care Plans
Prepare & enter care plans for NPR and AR
Enter Monthly Swipes
Review all NPR with Finances done before NPR
Add Alerts to Software/Stop Manager
Check Re-Exam folder for # of visit & financial Re-exam
Pull Re-Exam & AR files
Review AR finances and engagement
Give Chiropractic Testimonial
1 on 1 Meeting with Dr
Team Training Mon 1:15
Listen to Philosophy Clips on TLC Website
Update Referral board
AR Letters mailed
Prepare and Print any necessary patient ledgers for review
Deposit (every Thursday)
Give all AR Letters to Dr one month prior for personal
message
Display Product/ Supplement of the Month
Order Supplements and Products
Cross Check Previous Month AR list and form list for Dr.
Birthday Post Cards/ Letters
Review Financial Patient hardship
Review WC/IP cases
Wellness Care Letters & Alerts
Continued Care letters & Alerts
Review patient aging report
Review insurance aging report
Review AR log
Review discharge patients
Resolve any denials from monthly swipes
Consult and Send Collection Letters
Enter TLC Stats
Listen to monthly TDP call (3rd Tues)
D
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W
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L
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M
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H
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1. Ways I improved my ability to be finished and gone within thirty minutes of closing:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. Ways I helped lower my practice’s overhead:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Ways I built up my team members in front of patients (be specific):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
TECH CA - Weekly Checklist
Team Member: ___________________ Week of: _________________________
My WHY: _____________________________________________________________________
My Target #: ______________________ People added to SWS Weekly: _________________
Support and uplift the Doctor
Task M T W TH F S Details
Be with Dr at ALL times
NP Exams: completed & notes entered
Input NP info into computer
NPR greeting/Day 2 greeting
NPR checkout/Take home phone#
First Inflow Tour
Turn on and off X-Ray Room
Input NP info into computer
Re-exams / AR exams: completed &
notes entered
Pull Files for Re-exams
Photos for Family Wall
Give Chiropractic Testimony
Clean Kids Area
Breakdown and Set up SWS room
Warm Fuzzy
Print Scans (if applicable)
Prepare NP/AR Files for Doctor
Listen to philosophy clips
Team Training (Mon @ 1:15)
Trash on Monday
CA Training (Wed @ 11:15)
Fill Water Cooler
Weekly 1 on 1 with Dr.
Listen to TDP Call (3rd Tues/month)
D
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W
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M
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H
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1. Ways I improved my ability to be finished and gone within thirty minutes of closing:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. Ways I helped lower my practice’s overhead:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Ways I built up my team members in front of patients (be specific):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
PR CA - Weekly Checklist
Team Member: _____________________________ Week of: _________________________
My WHY: _____________________________________________________________________
My Target #: ______________________ Number of outside talks scheduled this week: _____
Support and uplift the Doctor
Task M T W TH F/S Details
Print articles of the week
One on One Meeting Monday @ 12:30-
1:00pm
Team Training Mon 1:15
Update Constant Contact Emails
Create Facebook Events for SWS
Promote Weekly SWS through email
Post AOW to FB and blog
Schedule Outside Talks
Schedule Outside Screenings/Health Fairs
Manage Facebook
Post promotions on Website & Facebook
Patient Reactivation letters & calls
Review Expansion/ Renewal Cycles Actions
# of new likes on Facebook
# Reviews on Health grade, Facebook &
Yelp
Attends every SWS
Update Marketing Binder
Share Monthly newsletter on Facebook
Share monthly calendar on Facebook
Update SWS Schedule and Handout
Create Monthly Newsletter
Patient of the month
Update Website
Community Connections
Relationship Building connections
TLC Philosophy Call
Discuss current monthly internal promotions
with Dr.
Discuss outside monthly marketing options
with Dr.
Check constant contact email bounces
Create Monthly Office Calendar
W
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1. Ways I improved my ability to be finished and gone within thirty minutes of closing:
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
2. Ways I helped lower my practice’s overhead:
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
3. Ways I built up my team members in front of patients (be specific):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Associate Doctor Weekly Checklist
Week of: _________________________ Team Member: ___________________________
Task M T W R F S Details One hour of philosophy reading/listening
done
Written one page response to the above (attached) Schedule 3 patients for SWS’s (who & when) Read one research article and wrote synopsis (attached) Added a synopsis page to patient education
weekly materials
Practiced adjusting team blindfolded with Dr. Did 20 more surveys daily Did screening site (2 hours) (when, where) Watched NP/NPR training video daily (when, how long) Read NP/NPR notes 10 minutes per day Spoke NP/NPR notes 10 minutes per day Did spontaneous 10 minute training with
CA’s on 5 primary scripts at least once daily (when)
Arrived ½ hour before opening AM session Arrived ½ hour before opening PM session
Strictly adhered to 30 second rule
(specific examples)
(who & when)
Did 2 minute adjusting drill 2x/day
1. Ways I improved my ability to be finished and gone within thirty minutes of closing:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Ways I helped lower my practice’s overhead:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. Ways I built up my team members in front of patients (be specific):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Team Trainings
From minute to minute, to annually, all the ways to train with your team Weekly Training
On a weekly basis, all teams require frequent and varied forms of training.
The Seven Rules for Weekly Training:
1. Trainings take place weekly, in the beginning of the week with all team members present
2. Never optional for anyone, even part time members
3. Be on time – start on time, end on time, and keep the total time to 45 minutes
4. Be prepared:
a. Assign someone to keep notes each week
b. Assign someone as timer – keep track and enforce
c. Make copies in advance
5. Listen to TLC 26 WTM Conference Call (Live or Recorded)
6. Rehearse physic ownership in advance and Socratic openings
7. Close with accountability
Goal: If improvement is sought in any area of life, a schedule and commitment to consistent daily
and weekly training is a must. Whether it is a golf or tennis game and students in organized sports, if
new capabilities and outcomes are wished for, scheduled consistent training is your right of passage.
Your commitment to consistent training determines your success in every aspect of your practice.
Implementation:
1. Listen to audio on “An Introduction to Team Trainings” audio on the TLC website.
a. Log on to www.tlc4superteams.com
b. Member Tools>Listen>Recordings>26 WTM Calls
c. Listen to the audio three times (twice listening only, third time taking notes)
2. Understand the difference between trainings and meetings and accept that you are beginning
with trainings not meetings. It will take at least three to six months of total implementation with
successful weekly trainings before beginning one on one meetings, though you should
understand the reason and design of both.
3. Determine your time that the trainings will be weekly held and put it in writing permanently, in
your patient schedule. Define that all team members must be present. It is strongly suggested that
all weekly trainings occur on Monday (Tuesday at the latest).
4. Parameters of the training: allocate an hour and do your best to be done in 45 minutes. It does not
begin until all team members are present with their personal notebook and pen in hand. Assign
one team member to be the secretary of the 26 WTM.
5. Prepare for each weekly training by engaging in the weekly TLC 26 WTM conference call the
PRIOR THURSDAY at 1 PM EST. Always select your training bullets based on your core
proficiency. Never select more than two to three bullets for a weekly training, ideally one or two.
Plan to train with plenty of time for interactive role play.
6. During your first 12 months of trainings, it is strongly suggested to do a 15 minute separate
training per week on the same training with interactive role playing on the subject.
7. Jump into the workbook on the week TLC is currently training on, not at the beginning of the
book. The 26 WTM should be used completely and all team members should sign off on the
training on the provided initial spots weekly. When one manual is completed after 26 weeks of
use, you should purchase a new 26 WTM so these serve as an ongoing journal of motivation of
your team’s advancing skill sets.
8. As a primer to this 26 WTM process, always begin with introducing your team to TLC by a
group training on the 5 Primary Scripts. (For the 5 Primary Scripts, which are in the TLC
Scripting Manual, contact TLC headquarters.)
EXECUTION FROM TEAM TRAININGS
1. Ask the staff what it looks like in the practice, when this is completed (the task or skill set you
want to complete).
2. What determines or defines when this task or skill set is done? Is there a numerical value to
determine when it’s done or is it more of an ongoing measurement?
3. What team member is responsible to keep a log sheet on daily workings of this task or skill set?
4. How long do we want to work on this? For the week, two weeks, month, quarter?
5. Post huddle every day you want to work on this task or skill set.
26 Week Training Manual
The 26 Week Training Manual has note pages in it, and you should be writing in it. If you look at it,
the last questions ask you, “What are the things you are going to implement? Who’s in charge of
each implementation? What is the deadline date for the implementation of each of those things?” So
you should come out of each training with that paper filled out; you do not have to wonder about
how to do it. Every single sliver of what needs to be done to raise a million dollar a year plus
practice is in there. The challenge is settling into the idea it is going to take years to get all the pieces
in place and being peaceful, joyful, gracious, kind, and willing to work on it. Simply put, it is by
working the pages and the questions.
Annual Training
In the ideal practices, teams hold annual planning and goal setting meetings, usually held in
November, December, or January. The outline for this meeting must be unique and
specialized for each individual practice, depending upon the size of the team, the number of
years together, and the comfort level of the doctor in how to run such trainings. It is not
commonly suggested that doctors do this with their staff members when in their first year in
practice.
Annually, doctors should outline the specific seminars they expect team members to attend,
providing dates and times at least 6 – 12 months in advance.
A good practice would be for first year team members to attend three seminars plus one
Leadership Camp during the first year. After completing the first year, team members must
then attend two seminars and one leadership camp annually.
Quarterly Training
1. Assessment
a. Accumulate statements from cockpit observations in day to day moments where we
realize weaknesses or vulnerabilities in the team’s scripting, responsiveness, defense of
policies, and overall engagement with patients for at least two weeks.
b. Executed a statistical analysis of both static and dynamic stats enough to come up with a
clear agenda about the parts of the practice that need to be strengthened.
c. Executed a review of previous issues defined by our most recent in-office evaluation and
once again scoured back through those details in order to apply them to our ongoing
growth and improvement.
d. Assessed our most recent seminar top 10 list and selected the items that have already
been identified but have not yet been followed through on.
e. Identified ongoing items from our one on one weekly checklist meeting notes and
selected the ones that are most likely appropriate to consider for quarterly training
agenda.
f. Assessed dynamics of team energy and which individuals seem to be the most supportive
of maintaining ideal team momentum and which individuals tend to present the potential
to drain team energy. Consider the dynamics of how to deal with it.
g. Overall balancing of individual team skill sets.
h. Balancing considerations of each individual’s zones to ideal traits considerations.
i. Consideration of topics relative to the primary nuggets and courses of study that you have
selected with your TLC accountability coach.
2. Development
a. From the list of items above, take the items you have identified and cluster them into
common categories whereby you could create individual subject headings that sweep the
greatest number of these issues all under 1-4 (or at most 5) headings of training agendas
that could be addressed.
b. Example: If we have a challenge with consistency of new patient conversions, we may
need to work on scripting in terms of
i. the 5 primary scripts
ii. financial CA’s clarity with the financial close during the NPR
iii. science and philosophy of understanding that our CAs have
iv. CAs themselves are adjusted on a regular basis
v. CAs themselves are reexamined and they understand their own findings and
ongoing process towards improved health
c. We must identify all the possible directions of action steps we can engage and sweep
them into as narrowed a heading of subjects as possible. This process of development is
most commonly where you are going to need to engage with your accountability coach in
order to have an outside voice listen in on your discoveries of assessment and help you
narrow down the number of items you are going to work on during your quarterly
training.
d. You must look at the overall flow of the hours and design the flow of the classes.
Generally speaking, the first class should be longer then the remaining 2nd, 3rd and
possible 4th class during the five hours. Therefore, you must also choose the component
of training that is going to take the greatest energy to be done somewhere early on in the
five hours.
e. You must also plan in advance the types of games and interruptions which can recharge
the energy if it happens that the team is working on tedious or challenging issues.
f. During the flow of the five hours, we want to end on something that is uplifting, unifying
and presents hope. Remember, in any delivery of a training process the most matured and
successful of leaders always goes through the three steps of values, truth and hope and
make sure they end on hope. Therefore, you would be wise to end on something where
each team member has to think about the positives of the other team members or
somehow recall ideal breakthroughs of times past such as road trips to seminars, time
spent at seminars, time spent at retreats, etc. It is wisest for you to help people laugh and
have a good time recalling the things they do in training rather than strictly things they
may do outside of the practice.
3. Implementation
a. The first step of implementation is to make sure that the team knows a year in advance
exactly when all the quarterly trainings will be held. If ths is your first quarterly training,
this one should be announced at least 1-2 months in advance and a sheet should be
handed out to each individual as well as one taped up on the wall, dated and signed by
everyone so that everyone is aware. They should understand the timing schedule so that
they know in advance exactly when it starts and ends.
b. A strict adherence to time flow should be respected and the doctor should not run over on
anything.
c. You must become a master at recognizing when the team’s energy is great and when it is
drained. Know how to take breaks and bring people back together.
d. You must be sure you are a master of giving the team true ownership (psychic
ownership) such that the meeting is run in a way where you facilitate their engagement
with them speaking about their solutions just as much as you are bringing up yours.
e. Assign a secretary to the process so that in the midst of the meeting someone is taking
notes and you have one log book which represents your quarterly training notes from all
the quarterly trainings you’ve done in years past.
f. If there is a possible segment within the five hours that it would be wise to allow one
team member to contribute their own prepared training for 15-20 minutes, it would be
honorable to let the team engage in the process alongside you.
4. Squeeze
a. Be sure that in the midst of the training you are having fun in ways that deliberately
challenge the skill sets of the individuals present. You could create cue cards that present
challenging situations which are unique to those situations (remember not to train on
objections and challenges until they are at least good at the fundamentals). You could
create games where people stand in a circle holding the same script and you go around
and read every other word in the script so you are breaking up and making play out of the
work that has to be done while still sticking to doing the work.
b. Following the quarterly training, you must be a wise enough leader to keep revisiting the
seeds that have been planted during the training and helping people remember what it is
that you worked on by playing games that bring them back into state with the quarterly
training.
c. Upon closing, make sure that one of the things you speak about is what you will be doing
in preparing for the next quarterly training and you all mark the date, agree to the time
and plan to start all over again as all of life is a process and not an outcome.
d. Make sure to send notes reviewing all items covered and homework assigned.
Please refer to “Quarterly Training Action Step” on the TLC website
Spontaneous Training
Goal: The purpose of the spontaneous training is to let everyone on the team realize that we are all
in a constant process of training and that we are never, never, never done training. We are all seeking
to improve the quality of our communication, and we are all doing this training together.
Implementation:
1. Spontaneous trainings may be called by anyone on the team.
2. Spontaneous trainings are a maximum of 15 minutes, NO LONGER.
3. Spontaneous trainings must include everyone.
4. Spontaneous trainings should be FUN.
5. They should be on a specific script or procedure and it is OKAY to read the script until you
memorize that script.
6. There should be no pressure in a spontaneous training to be the best at the training. Everyone has
their own style of communication, and the purpose is to bring out the best in everyone and to
increase all the team members’ confidence.
7. Suggested topics for spontaneous trainings are:
New patient phone call scripts
Exiting of new patient on Day 1
Greeting of new patient on Day 2
Recall for missed appointments phone script
TLC – keeping dialogues focused on chiropractic and turning around dialogues
Signing up patients for Spinal Workshops
Greeting and exiting of patients by the doctor and CAs
Assuming we run a “cluster booked” prime time vs. report time scheduling process, when there
is down time, the doctor and CAs’ first response in use of that down time should be for
“spontaneous training”.
Rule for Spontaneous Training: Must cover a topic specific to the time of schedule you are in
Examples:
Adjusting time – train on greeting for adjustment, check-in, check-out, reschedule calls, patient
flow, etc.
Report time – train on NP 1st phone calls through exiting NPR’s and everything in between
o Pull everyone together to do it
Be so consistent with this habit that everyone knows to do it immediately and constantly.
Team Training General Principles
Always remember to train on the process and procedure and never train on an individual,
especially not in front of other team members.
If in fact an individual team member has been part of group trainings on a specific topic several
times, and this team member continues to have a problem with that topic, be sure to have a time
in your private meeting with that team member to find out what they are challenged with.
Private clean up one-on-one suggested questions:
o How they think they are doing?
o Are there any issues they feel particularly good about?
o Are there any issues they feel they need my help on?
o What do they feel are their strongest points?
o What do they feel might be their challenges?
o Is there anything, which is creating even a shred of stress for them?
o Try to facilitate the team member bringing up the issue before you, as the doctor, need to
point it out. If they bring up an issue and state they feel they need training on it, you have
now given them the blessing of cultivating their own wisdom and maturity in recognizing
things that need work. Now they take ownership of the process, you get to help them process
their way out of it. And, “people will protect that which they have created”. So watch and
enjoy.
o It is one of the most empowering, stabilizing and enriching ways to create a doctor/CA team
relationship that will endure the ages.
If an individual team member is new and requires training in a certain area and it is the first time
they are learning on it as a new team member, then it is ok to bring up a new training topic
(outside the flow of the ongoing 26 WTM process), and specifically jump into the flow of
training on the spot relative to a new members need.
Allow more seasoned team members the privilege of giving trainings on certain topics in general
or open training sessions.
When it comes to training a new team member, they jump into weekly trainings and meetings
just like the rest of the team. Special points for new team members:
o Remind them daily it is going to take a minimum of three to six months to begin to really
“get it” relative to how to excel at their job. Therefore, if they ever feel stress about not
getting something, it is stress they are placing upon themselves.
o Try to not allow a new team member to work within their job description for their first week
of employment.
o Try to have them sit in every weekly spinal workshop for the next two months.
o Have them complete their own NP/NPR process before they ever begin working.
o Have them shadow the doctor the entire first week, and then shadow each of the other job
zones for one to two days.
After a new team member has gone through their first week of “cross trained” orientation, we
remind them that you don’t believe they “know” any of the positions that they saw, but they at
least have an overview. By week two, they will begin training in their specific area.
Whether it is Front Desk (FD-CA), Tech CA (T-CA) or Financial CA (FA-CA), remember to
begin with the most basic training issues first, and never add more than one major skill set per
day, (especially if they are ones that involve memorized scripting.)
We send all scripts home with a new team member day one and assure them that within two
weeks they will be held accountable to have totally memorized everything on these pages. This
way they have time to study and memorize scripts.
Photo copy and immediately give them:
o TLC NP and NPR flow sheets (beginning of NP/NPR section)
o 5 Primary Scripts (in the Scripting Book)
From this point forward, every day should involve some minutes of training on the new patient
process.
o Every day should involve some aspect of reviewing the scripting and necessary memorized
work for processing a new patient, from the phone call through the closing of the new patient
financial NPR, no matter who that CA is or what their position is. All team members must be
able to complete all aspects of NP care. The new patient process must be memorized by all!
Time-Out Session
Should happen on at least a weekly basis. It is time to rescue a seeming “crash and burn”
moment
All team members stop
Retreat to a closed-door area
Have the answering machine get the phone
All openly address what they think is happening
Agree on a plan of action to clean it up
Pray and move out
Should take only minutes
Post Huddles
Should happen after every AM and PM session
Again, only three minutes, not an entire training session
Suggestions:
o When was each of the team members most “on fire”?
o What did we love about the past several hours?
o What could we improve upon?
o Move on
Training on TLC Procedures
Telephone Procedures
One of the most immediate areas to train all team members on is how to answer the phone.
Formulate your own opening statement of power and optimism. Be sure they always have a point
where they state their name and end the greeting by stating, “they can be of help” or service to the
person on the other end.
Example greetings:
“It’s a great day at _____________ Chiropractic. This is Sue. I can help you. Or How can I
make your day better?”
“It’s a marvelous Monday at _____________ Chiropractic. This is Sue; I can help you.”
Change it for the days of the week: tremendous Tuesday, wonderful Wednesday, terrific Thursday
and fabulous Friday.
The majority of all phone calls within a chiropractic practice fall into two primary categories:
1. New patients – you must always assume, all phone calls, every time the phone rings, “it’s a
new patient”.
2. Existing patients wanting to change, modify, or add additional appointments (not cancel. In
the NPR, you educate patients that no canceled appointments exist at your clinic, we only
change or reschedule so the quality of their care is kept high.)
More information is provided in the Patient Care – NP/NPR section of the TLC Manual (NP
1st Phone Call Scripts)
Reschedule Call Guidelines
Place reschedule calls within 10 minutes of a patient not showing up and refer to the
Reschedule Call List
Always take responsibility. i.e. “Mrs. Jones, I don’t know if we made a mistake, but I had you
down for an adjustment at 11:00, is that correct?”
Remember to get on the phone knowing a patient’s schedule! Is it 1 time per week, 2 times
per week or 3 times per week?
Remember showing up for the next scheduled appointment does not equal a successful
reschedule.
You must inform the doctor when:
o A patient misses an adjustment for the first time
o A patient does not reschedule
o A patient says odd things like
“It’s ok, I feel fine.”
“I can’t come in because I feel sick.”
“I can’t come in because my cat is home alone.”
Get the big picture about why we do reschedule calls before we do them. You (DC & CA) are
life raft captains. These people have employed your team to get help in breaking their old sick
habits, which have put them into the broken health they have. Calling them is a loving rescue
moment to help them from returning to living a life as they were before they first sought you;
a life where feeling okay, means it is okay to abuse their health. Love them, call them and let
them know why you care enough to make that call.
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Law of the Call
The law of the call applies to what is appropriate and inappropriate in terms of how persistently a
practice should end up calling a patient who may be out of balance with their appointments. It has
been our discovery that if a patient is over called for appointments that they have missed, they begin
to take offense to the fact that they are being called even though you may feel like you would not
have to call them if they merely called and addressed their appointments properly to begin with.
However, such judgment and poor positioning on the part of the doctor or the CAs tends to not fair
well in the interpretation of a patient, who to begin with, demonstrated that they are not in the mood
for being clear with their communication. It is important for us to be willing to let go at the right
time. It has been our policy that we never place more than two calls on the day they missed the
appointment. If we have made two calls either as leaving a message on a machine or with someone
and we do not get a call back, then we call the patient once a day for the next three days. If there is
no response, the doctor must call the patient on the fourth day. The law of the call pertains to what
we do in each of these delicate phone instances. That is why in some cases, CAs who call a house
and receive the answering machine do not even leave a message on the machine because they do not
want to inconvenience the patient with having more messages on their machine until they get to
speak with them personally.
1. When a front desk CA is making a reschedule call, we know it is important to call all the
numbers present.
2. If you call three different numbers, you should only leave a message on one of them, the one that
the patient is known to most frequently check, so that they do not feel overrun with
communications from the practice.
“Hello Mr./Mrs./Ms _________________. This is _______________from (Clinic Name). Dr.
__________ has asked me to call, as he/she was very concerned about the quality and sequence of
your care. We could be mistaken; our records show you had an appointment today at _________.”
(Pause to receive response)
“Dr. _____________ has asked that I do everything possible to try and reschedule your adjustment
for the remaining hours of today so that the quality and sequence of your recovery is in no way
affected. We are here until 6:45 PM. What time will be most effective for us to help you today:
__________ or __________?”
Receiving a (R/S) communication:
For patients who have not been in for an adjustment in some time (four weeks), that is a call that is
directly for the doctor and should be a call purely of love, outreach, and concern to let them know
you are checking in on them to see how they are doing because you simply realized that you have
not seen them in some time.
“Thank you for calling Mr/Mrs/Ms _____________. I appreciate that you called us to reschedule
your adjustment for the remaining hours of today, so the quality and sequence of your recovery is in
no way affected. We are here until 6:45 PM. What time will be most effective for us to help you
today: ________ or _______?”
If additional communication is needed, grab the tech CA for specific information on patient’s
subluxations.
“Mr/Mrs/Ms _________ your (lumbar, cervical, dorsal, headache, shoulder, degenerative, nerve
compression) problems and the subluxations surrounding them are our primary concern. It is
critical we do everything possible to stay on schedule in order to counter this problem. Please let me
do something to try to help you hold onto the excellent results we have been making.”
1. There should be no more than overall two messages that they receive.
2. If a patient chooses not to communicate after four clearly defined messages that have been left,
then they are deciding in some way that they no longer wish to communicate at the present time.
This is the time where CAs turn the phone call over to the doctor on something called the
warm/fuzzy card. Now the doctor can choose to place only one phone call and in our advice, no
more than one phone call that would sound something like this:
“Mrs. Jones, this is Dr. ______. I feel terrible that I haven’t seen you for (certain number of days). I
don’t know if we made a mistake with your schedule or somehow something bad has happened, but
please know my first and foremost concern was for your ideal results and outcome and that such
progress for you is only possible if we stick to your agenda. If there is anything I can do to help you
stay on top of your process or resume your adjustments, please let me know. I will not leave you
another phone message but I want you to know that I do care about how you are doing and I only
want for your very best. Here is the number I am calling from, here is my cell number, here is my
home number. If you can at least give me a call back such that even if you are deciding to
discontinue care for now, we at least have clear communication about that. I will be here for you.”
We believe the biggest issue for you to prepare for upon getting on the phone is what you wish to
have as the end result.
1. Let them know that you have concern for them and that you feel badly that you have not
taken care of them.
2. It is not our suggestion to follow through with not caring for them
3. Make sure they understand that the doors of communication are open on our end and we will
always be here for them.
Once those issues are clearly communicated, there is really nothing more that we can do. If the
patient still does not call back, the law of the phone call is that we are completed. There are no other
efforts we need to make other than possibly a closing letter that might be sent to them again,
emphasizing the same feelings of concern and that the door remains open for them.
Non-patient Related Phone Calls
No sales calls or non-patient related calls make it to the doctor whatsoever – NONE! If it is
important, tell them the doctor returns all non-patient related calls once per week on
Wednesday at 12:15 PM (for example)
All social calls are put on a message sheet. These calls should not be returned until patient
hours are completed.
The doctor must make a clear statement with the CAs if there are any people who are
supposed to be immediately routed to them; otherwise, the doctor receives no phone calls
during the day other than spouse and children, and then only if emergency or when doctor is
not adjusting or in reports.
When should the doctor, absolutely be interrupted?
o When a patient who is under care, announces that they are stopping care. Politely and
calmly ask the patient to hold one moment, do not explain anything to the patient, get
the doctor, inform him/her about the call, and ask the doctor to pick up the line –
immediately.
o New patient has questions on scheduling an appointment you feel unprepared to
answer, such as: specialties in technique or simply things you have not been trained on
yet and you are early in your development, immediately get the doctor.
o If a TLC doctor is returning a call or making a call to your doctor. The only time they
would ask you to get the doctor is if they know the call will be brief.
o TLC coaching response calls from Dr. Dean, other coaches, and TLC team members
should get through quickly.
Staff Reimbursement at TLC Events
For advice on how to address staff pay at seminars, you are responsible to make sure all your
actions are reviewed by the guidelines of an employment attorney or those licensed and
credentialed in employee law. Any information that we are sharing with you here has absolutely
no legal substantiation; they are just the experiences of the doctors who have brought their
stories to the TLC community and have felt the desire to place them on roster. Here are the
things that have been shared with us. You are responsible to read them, address them and double
check them with the appropriate legal authorities who are proficient in the guidelines – not only
the federal but your state’s requirements for compliancy.
Doctors are responsible to pay employees who attend seminars.
The laws today are different than they were 20 years ago and we must make sure that we
double check our actions with compliancy standards at our state and federal levels.
Some states adhere to the guidelines that the employees must be paid per hour for the
hours they sit in classes.
Some states allow you to have a seminar hourly rate that is different from the day to day
hourly rate while some states require that they are paid the same hourly rate.
If an employee is a passenger in the transportation to and from seminars, they do not need
to be paid for the hours in transportation.
If the employee is the active director of driving, such as they are the driver of an
automobile, then they are to be paid for those hours as well.
If the employee is using their own vehicle, they should be paid the appropriate value per
mile for the vehicle being used.
If the employee requires rental car, train tickets, airline tickets, and other related payment
for travel, all such expenses should be paid.
It is customary for the doctor to pay for all meals involved in on the road nourishment;
yet the doctor is allowed to define an appropriate allocation for each meal’s value and
require that the employee stay within those guidelines and if the employee spends more
than that on any meal, they can be held responsible to pay the secondary amounts.
You are not responsible to pay employees for hours spent out of class, such as during
break time, lunch time and sleep time.
We have experienced that it is most effective to give employees envelopes with cash
defining the dollar amounts you will pay for each meal such that even if you have meals
together, they have to pay their portion with their dollars and it constricts or controls the
amount they spend per meal. You can define certain meals that you will have together
and as long as they sit down with the doctor, it may not be necessary that they have
allocated cash for those meals.
In terms of TLC gatherings, we suggest that on the evening sessions of Friday afternoon
between 3 and 6, you make it customary for you to take your CAs out and treat them to
meal time experiences that they might not normally enjoy on their own and therefore
allow them to feel the joy that you are celebrating their employment with giftedness in
the nature of where and how you are dining.
It is also best to have as many meals as possible together so that you can continue to
converse about the things most appreciated in the times you have been sharing together.
During travel time, it is great to bring games and engage in the laughter and
understanding of each other relative to our personal lives in a framework that is more
appropriate than doing any of this in the day to day hours of practice.
If, in fact, for an employee to be at a seminar, or if they are losing pay for which they
would have been paid in other venues, my personal custom is that I like to pay them
whatever amount they would have been paid at the other job within reason.
If, in fact, attending the seminar means that they are losing hours they would have
worked at our practice, but in fact they are being paid for being at the seminar, and they
wouldn’t have been paid for those hours, I have to take those situations into consideration
and assess whether or not to provide additional payment since they are losing hours
against the fact that they are gaining hours, etc
On a personal note, I make it customary that the week preceding the seminar, we play
games, sometimes I take the team out to get their nails done and do other things to build
up the excitement and celebration that these are the things we do that surround the joy of
seminar week..
Bottom line – aside from all the legal stuff – the issues and matters of the heart are more
important than those of the pragmatic desires. In a team of employees who feels loved,
appreciated and looked out for, tends to supersede any nit-picking of the details just as we
observe human nature.
(Once again we want to remind you of the compliancy from the opening paragraph…)
For advice on how to address staff pay at seminars, you are responsible to make sure all your
actions are reviewed by the guidelines of an employment attorney or those licensed and
credentialed in employee law. Any information that we are sharing with you here has absolutely
no legal substantiation; they are just the experiences of the doctors who have brought their
stories to the TLC community and have felt the desire to place them on roster. Here are the
things that have been shared with us. You are responsible to read them, address them and double
check them with the appropriate legal authorities who are proficient in the guidelines – not only
the federal but your state’s requirements for compliancy.
Ongoing Team Development
Team Member Biannual Review
The member review is a time for accountability in the most productive and honorable way. These are
scheduled in advance based upon when the employee was hired, every six months with one review
per year being purely based upon performance and a second review per year on performance and
possible changes to the benefits package.
Steps of Preparation:
Person in charge of bookkeeping, payroll, wages, and hours should have already prepared (four to
six weeks in advance) a print out for the doctor. This print out should state: the date of hire, their
present pay scale, the day of their last review, a copy of the notes from all previous reviews, and a
blank review page readied for the doctor’s notations to be placed upon ahead of time.
1. The doctor should carefully observe over those four to six weeks the things that he or she
perceives as most important to give attention to during this review. The more time taken to make
observations in the midst of not feeling the pressure of time demands the more genuine our
observations will be about this team member.
2. The doctor should consider in advance the present levels of benefits for that team member if in
fact this is the review which involves discussion of the benefits package.
3. The doctor should inform the team member in advance that the review is coming up. Let them
know the exact date and time they will be met with. We recommend a half hour block of time
that has no chance of being interrupted, such as on a Tuesday morning before office hours open,
or on an afternoon.
4. Never do a review at the end of a day or week. If a team member ends a review feeling confusion
or any unexpressed feelings of discontent and is separate from the doctor for two to three days,
they have the opportunity to deepen their confusion and invite other people’s dialogue rather
than simply communicating with the doctor. If in fact the review is done Monday or Tuesday of
a practice week, then the doctor and the team member are going to continue to cross paths for the
immediate days following the review. It will allow a stronger likelihood for more complete
resolution and follow up for any accidentally unresolved issues. The doctor must be particularly
skilled in being sure that all issues of communication are brought to the highest levels of
resolution before leaving that review.
5. The following outline of questioning is suggested for a healthy review once the previous steps
have been completed.
a. So what is it that you feel most joyful about in your position at this practice? What is it
that you know when you put the key in the door; you are most excited about engaging in
relative to your work here?
b. If you had to think of some little piece or sliver of what it is you engage in at work that
sometime could have you feeling a sense of stress or something less then ideal joy at the
beginning of a work day or at the end of a work day upon leaving, what might come to
mind?
c. When do you feel in the course of a week, that you are most lit up, illuminated, or joyful
about your function and performance within the duties of your position?
d. What qualities of the other team members do you most appreciate while working along
side of them?
e. How do you most feel that you take deliberate part in increasing the prosperity and long
term success of this practice?
f. If you could improve something in the midst of how the practice functions, what might it
be?
g. If you had a 10 year dream, how could this practice be somehow better in its process of
service?
h. Do you still want this job?
i. Optional: What is it you believe you are most entitled to right now based upon your
performance and contributions to the practice if we were to change some aspect of what
your benefits package is?
If however, you are not comfortable with the idea of letting the team member dialogue in
such a matter, the doctor may have to choose to take the position of proclaiming what
benefits will be issued without any dialogue requested from the employee. These are all
factors of mindedness and delivery that should be exercised in advance of sitting down to
have this meeting.
6. Closing this meeting should be marked by writing down exactly what you have as the notes from
the outcome of this meeting. If in fact there has been a resolution to make a change in the
benefits package, then very careful articulation must be made of what it is the practice is capable
of providing and what it is that you have agreed upon providing. This particular component
should be well thought out in advance; what is the maximum possible benefits enhancement that
the practice is capable of delivering, is this particular team member worthy.
Please take seriously all the preparation and mindedness that should be invested in the doctor’s
participation in employee reviews. This is as critical to the employee as a new patient report of
findings is to a new patient. It is a very definitive proclamation of investment and genuine concern
from the doctor toward that team member. At some point in closing the review, it is critical to review
what that doctor’s policies are for immediate termination, not as an act of threat but only as an act of
enhancing our closeness and clarity which can ensure our success and ability to spend a long life
together and retire happily. By engaging in team member reviews in such a manner, you enhance the
likelihood of having a stress reduced and far more fun practice.
TLC Team Member Biannual Performance Review Outline
Team Member _______________________ Date __________
Date began employment _________ Performance, Pay-scale, Both
Job Title Primary (1) Secondary (2) Tertiary (3) etc…
FD-CA 1, 2, 3, 4, 5
FA-CA 1, 2, 3, 4, 5
T-CA 1, 2, 3, 4, 5
PR-CA 1, 2, 3, 4, 5
DC 1, 2, 3, 4, 5
Define as Part Time or Full Time
Define exact hours and days
Monday Tuesday Wednesday Thursday Friday Saturday
Defined Lunch Hours (must clock out)
Seminar requirements
Team Leadership Camp requirements
Attendance at;
Weekly trainings
Weekly meetings
Quarterly 5 hour trainings (4)
Seminars (2)
One Team Leadership Camp
Success with zero tolerance items
-zero talk about others that is ever anything but positive
-zero gossip about pay scale with anyone other than doctor
-zero misses of seminars, leadership cams and quarterly trainings
Benefits review:
Sick days, one paid per quarter per year after 3 months employment
Vacation after one year, one paid week per year
Health days, 1 per quarter 2nd year onward
Vacation after two years, 2 weeks per year
Responsibilities/skill sets
Duties defined which are at successful execution:
-
-
-
Expanding responsibilities/skills sets
Duties which have been taught to some degree but not yet mastered:
-
-
-
Future responsibilities/skills yet
These are expectations for the future and are totally subject to change:
-
-
-
Ideal joys of work:
-
-
-
Challenges at work:
-
-
-
Does she still want the position?
Our ideal joys in team member (character and skill sets):
-
-
-
Our challenges with the team member’s work or character:
-
-
-
How we feel about their continued employment:
Please tell me what you heard me say?
Bonus and Challenges
Goal: It is a great idea to set up the bonus system for team members. Bonuses are never given to
people for doing their job. They are only given as a courtesy from the doctor when we are seeking to
get the team’s skills at advancing their ability to do something. You do not need to bonus someone
for that as it is part of their employment responsibility to be ever improving.
Implementation:
Bonuses are something CAs are responsible to automatically write into their timecard or to add to
the electronic time sheet. It is then printed out on their pay stub as a separate entry for bonuses of
NP’s and Talks. For example, by doing this, it is a constant reminder that this is available to them at
all times. Keep a year to date total for ongoing bonuses. If it continues to be marked off as zero, it is
a demonstration that they are choosing to not participate in the process but that there are plenty of
ways to beef up their income based on enhanced participation.
Examples:
Bonusing CAs $50 for every outside talk they set up
Bonusing Front Desk CAs for kept appointments over 90% – 95% (if that is actually higher
than your usual kept figure).
o Look back at your numbers and figure out what your standard percentage of kept
appointments have been for the past three months as well as your most likely daily
run on the rescheduled pluses, minuses and drop-ins. If you feel like you have got a
reasonably accurate average of the past three months, a 10%-20% direction above can
give your CAs a safe standard to run to, particularly the fact that the CAs can knock
off one or two on certain days with a fairly consistent effort.
Bonusing Financial CAs for collections above your average monthly collections the year
prior (only offer this for one to two months and it must be calculated based upon the amount
over your average collections the year prior)
Bonusing a certified Tech CA for x-rays taken ($2 per NP exam and x-rays taken)
Bonusing CAs $20 per new patient they refer in, regardless of whether they have care or not
Consider a bonus for CAs that allows for a prospective $20 per day bonus
o For instance: $5 for 95% kept or better
o $5 for a reschedule number plus what is tolerable for you as well as a reschedule
minus number and drop-in number. If we attach a $5 bonus to each of those, coupling
the idea that anytime the CA gets at least three in one day, the CA automatically pops
to $20 and if the CA gets four of them in one day, it is $20.
o You may want to periodically bonus team members on exceptional accomplishments
in their zone
o Overhead bonus
It will show that you are really levying things so she can win. Pick numbers that are at least 10%-
20% greater than what your present standards are. That is usually a safe way to set people up to win
and yet make it something they have to reach for.
o Beat sheet bonus
Time frame for bonuses:
Use very short term bonus structures that address certain specific areas of the office that need
improvement and they should never last for more than three months.
Hand Off of a Patient to another Team Member
When someone is handing off a patient to another team member, he/she should constantly build up
the perceived value of that team member in the patient's eyes before passing them off. In other
words, if one was passing a patient off to you, one would say, "Now Dr. Jeff is going to take care of
you. He has been in practice for years. He lives the chiropractic life, exercises regularly, and you
could not be in better hands than to have him take care of you." That is how we do the hand off
properly. The hand off is strengthened by the circles of confidence drill, which is a piggyback to this.
Key Results Area (K.R.A.) Study
Goal: To clearly define the main “zone” responsibilities that each team member has and to define
the lines of boundaries between job descriptions and what is expected from each zone in the office
Implementation:
1. Have each team member write out individually all the tasks that they believe are within their
primary job responsibilities.
2. Put a 1, 2, or 3 next to each line item to designate if they believe that particular task is a primary
or secondary or tertiary in the importance scale.
3. Separately on new paper, ask each team member to write out what they believe other team
members’ job duties are. After doing so, they can place a 1, 2, or 3 in front of the tasks.
4. Have each team member review the list of his/her own tasks and have them write next to each
task how they know when that task has been accomplished. In other words, what objective
means do they use to determine if the task has been accomplished?
5. Doctor, write out your own list of what you believe each team member’s duties are in order of
primary vs. secondary vs. tertiary in scales of importance.
6. Prepare how to present to the team the outcomes and discoveries of the findings. Usually, this
addresses how much “understanding” resulted from you reading all of these.
7. Meet privately with each team member to review where you have fallen short on emphasizing
with clarity, what is totally expected of the team member and how we can improve on upgrading
these steps.
8. Each team member should submit his/her K.R.A. to you at least annually to be reviewed and to
make sure that there are not better means of objectively quantifying that their tasks are being
accomplished.
9. K.R.A.’s should give the team member a clear outline of the tasks and should help the team
member know by which criteria you will be evaluating their performance. There would be no
surprises in an annual review if the K.R.A.’s are continually being looked at, by printing them
and having both you and the team member review it prior to the annual review.
10. K.R.A. should be done annually. This should be done with team members working with your
team for over one year. The team members under one year of employment should be continuing
their training process and would not be involved with looking at these objective measures yet.
11. Retain copies of the results of these K.R.A. studies so you can all review them by placing them
in each team member’s 3-ring binder of one on one weekly accountability meeting checklists.
This is critically important material to learn from and grow more EFFICIENT AND
EFFECTIVE.
12. Ultimately, the results of the K.R.A. must have impact upon:
a. What each team member does
b. The primary zones of their function
c. The efficiency of how they are doing it
13. The results and steps within the K.R.A. process should be discussed with either your AC or heart
coach.
Common Mistakes
Mistakes in Practice
Overloaded amounts of paperwork
Too many paper trails
Lack of clarity in opening and closing times with patients
Team trainings that run on incessantly beyond their agreed upon time frame
Playing so much with every patient it becomes a social atmosphere, more so than a
chiropractic environment that is friendly and social
Continuing with a procedure just because you have always done it that way
Continuing with doing an external or internal new patient event without receiving back new
patients
Forgetting that subluxations kill people and they are no different than cancer or heart disease,
whose grip takes people long before the impending crisis is evident
Being controlled by fear
Being timid or reluctant to speak the truth or to act on the truth with a patient or team
member
Being unwilling to acknowledge and confront an issue when faced with a dilemma
Mistakes in Team Development
Most common mistakes a DOCTOR makes in team development:
Doctor points out team members who are making mistakes in front of other team members, while the
doctor is negatively, emotionally charged. Remember it is not the individual that is the problem but
the behavior. Mistakes recognized are ideal tools for future group trainings when no one feels
singled out.
Hiring
Hires too inexpensively
Hires too many part timers
Lays down the laws of the practice too vaguely upon hiring
Does not clearly define the rules of the practice upon hiring
Training
Trains inconsistently and/or too little
Trains with little preparation
Trains without consistent cross training
Trains with monologues and does not focus on facilitating team interaction
Trains without respect to starting and ending on time
Preparation
Does not keep a watchful eye over all the things going on
Does not arrive everyday, at least 30 minutes before every session begins
Huddles are not clearly prepared
Does not set enough of an example as a team member. I.e. Give all out, arrive early, staying
late if necessary, sacrifice yourself for your patients, occasionally doing house calls – Be the
team member you want others to be!
Team Development Issues
Throws too many issues upon a CA at one time
During down times, does not use all moments to stay in the required mindedness of the duties
Doctor places him/herself outside from the CAs during down time, disappears and does
personal phone calls or other personal duties
Does not abide by the rules of first reflex for downtime “Spontaneous Training”
o First reflex for down time is:
Train with team
Offer to help team
Stay in primary area and do patient related tasks
Doctor and CAs should always be within eye and ear proximity to each other all day long.
o Ex #1: If all prime time and patient care run from 8 PM – 10 PM and there happens to
be a quiet moment while everyone is caught up, the first reflex for everyone on the
team should be to train on issues of patient care.
o Ex #2: If 10 AM – 11:30 AM is NPR (New Patient Report) time and there are no
NPRs scheduled, the entire team, whether many individuals or one solitary person
should utilize that idle time for training and duties which embrace the quality of care.
Does not constantly find things to compliment about the team, patients and practice
Forgets to celebrate team members’ birthdays
Does not play enough or have fun in the practice while staying focused on the principles and
appropriate conduct of a great leader
Doctor flirts or plays too much with staff
Doctor jokes or plays too much about the patients with the staff
Forgets the boundaries in being a good team leader yet not their psychoanalyst
Allows dialogue to become too scattered on tangents and does not keep the team on track
Does not instantaneously address moments with a “sense of something that is not right with a
team member”
Does not take team member aside privately often enough to address issues that belong in
private
Doctor has one place in office where they always scurry away to, to deal with stressful issues
with CAs, thus all team members tend to fear being called to that one room
Does not have weekly meetings with every individual team member even if it is just for
several minutes
Forgets that team members are individuals who will leave when they feel like leaving, even if
they are very nice and honorable
Doctor positions themselves as emotionally dependent upon a team member staying
Team Benefits
Does not initiate semiannual and annual reviews for employees prior to them asking for them
Knows the time to do their reviews before they bring it up
Does not engage in spontaneous gifting to the CAs
Has not created a spontaneous gifting list for each CA
To help you avoid some of the mistakes listed above, TLC has provided the following for your
reference and use as needed within your practice:
Team Member Review Form
Team Daily Hour Log
Issue Confrontation Script
Request for Time Off
Team Member Review Form
Name ___________________________________________
Address ___________________________________________
Address 2 ___________________________________________
City, State, Zip ___________________________________________
Phone _______________________
Date of birth __________________________
SS# ______________________
Date of hire ______________________
Starting salary ______________________
Current salary ______________________
Work schedule Mon Tue Wed Thu Fri Sat Total Hours per week
____ ____ ____ ____ ____ ____ __________________
Medical insurance Yes or No
Health days (2 earned per quarter)
2 to be paid at _____ hours per day (subject to change based on previous quarter worked)
Health days taken YTD 6 ______________________
Vacation earned (2 weeks after 1 year)
2 weeks to be paid at _____ hours per week (subject to change based on previous quarter worked)
Vacation taken ______________________
Longevity Yes or No
401K Yes or No Employer match pd. 20__ $_______
Last review date ______________________
Next review date ______________________
Doctor’s comments
Team member’s comments
Doctor’s signature _________________________________ Date __________________
Team member’s signature _________________________________ Date __________________
Tea
m D
aily
Ho
ur L
og
This em
plo
yee h
our lo
g sh
ould
be u
pdated
semi an
nually
. This lo
g sh
ould
be k
ept in
payro
ll file. The em
plo
yee's d
aily n
um
ber o
f
hours is av
eraged
and calcu
lated fo
r paym
ent fo
r time o
ff. This sim
plifies th
e pay
roll p
rocess fo
r the p
ayro
ll perso
n w
ho calcu
lates
how
much
is due to
the em
plo
yee w
hen
time is tak
en. T
he em
plo
yee w
ill also k
now
what to
expect fo
r paid
time o
ff. Holid
ay p
ay is
paid
at the actu
al amount o
f hours th
at would
hav
e been
work
ed o
n th
e Holid
ay.
Mon
day
T
uesd
ay
Wed
nesd
ay
T
hu
rsday
Frid
ay
S
atu
rday
Week
ly
tota
l hrs.
Daily
avera
ge
Em
p.
initia
ls
Em
plo
yee 1
9:0
0 - 2
:30
4:0
0 - 9
:00
9:0
0 -
2:3
0
6:3
0 -
11:0
0
20.5
20.5
/4=
5.2
5
Em
plo
yee 2
7:3
0 - 8
:30**
10:0
0 -
6:3
0
7:3
0 -
3:3
0**
9:1
5 -
3:3
0
38.7
5
38.7
5/4
= 9
.68
= 1
0
Em
plo
yee 3
7:3
0 - 5
:00
1:3
0 -
6:3
0
7:3
0 - 6
:30
7:3
0 -
6:3
0
34.5
34.5
/4=
8.6
2 =
9
Em
plo
yee 4
7:3
0 - 8
:00**
1:0
0 -
7:0
0
7:3
0 -
8:0
0**
7:3
0-8
:00
**
40.5
40/4
= 1
0
Em
plo
yee 5
4:3
0 - 8
:30
4:3
0 - 8
:30
8
8/2
= 4
(NO
TE
: ** m
inus 1
hour
for lu
nch
)
Total
hours
164.7
5
Issue Confrontation Script
There come times within the development of a practice that previously existing soft points in a team
member’s skill sets, which were acceptable in the early stages of development of the practice, are no
longer acceptable. Over time, you hope each team member will evolve and develop enough to
surrender their weaknesses and enhance their strengths, but is not always the case. There comes a
time with certain issues when you can no longer be forgiving with the absence of these skill sets.
When this happens, a serious sit down meeting is necessary in order to consider the continued
employment of the team member or possibly the need for them to change zones within the practice.
It is always ideal to try and work on how to retain employment of someone who has been loyal to
your practice for some period of time, rather than to end the relationship and seek to hire a new
person. However, when repeated efforts have been made and attempts to train and develop have
been put forth, time, money, and all forms of energy have been engaged, and you still do not see the
rewards of that transformed individual, then you must move on and begin with putting the
responsibility for these changes upon the employee and not you.
Following is a sample script which may help you deliver such a statement in the midst of a one-on-
one meeting. Read it, digest it, and apply it to your particular situation before you meet one-on-one
with an employee over a difficult situation for transformation. Realize the nature of this is to set it up
as the team member’s +responsibility to engage in the process alongside you and ahead of you, so
he/she is in fact responsible for taking on the duties, tasks, and agendas necessary to grow to the next
level. It is not your job to keep people employed. It is your job to look out for the process and path
of this team so the community in which you thrive is able to continue to receive ever-increasing
exposure to chiropractic services.
Contact TLC for more information on the 7 Steps of Conversation
“(Team member’s name), I need your help. Our practice is in a tremendous place of
transformation and growth. We are moving onto the next level of development in this practice,
and I am so thrilled to include you in on this and to share in this with you because of your many
skills in the areas of (name skill sets). Your true richness in your ability to do ______ is
inspiring and encouraging. With those issues embraced, we are able to look upon the next level
of skill sets that have to be present. We are moving on in a way that requires that your position
include a higher standard of taking issues to completion, a readiness to confront people in the
midst of what could be a stressful situation, and to do it without having stress but merely clarity,
love, and embrace, and even a gentle hand with the bold definintion of the lines of boundaries in
the midst of addressing issues of patients. The reality is while you have plenty of strengths, these
particular items have not been your strengths but they must become strengths. We must move
on, we will move on, and I would like to move on with you remaining a part of the team that’s
able to take on these next standards of function. However, I recognize that these have been
areas of challenge for you and it is not something new or that has just come up recently. These
have been issues that have echoed repeatedly throughout our time together and now their time
has come to be completely dealt with. I love you, I support you, and I want you as a team
member. However, I have to clearly defined the issues that must be brought to resolution. My
idea is they are brought to resolution in a way where you are able to be the person who
continues to deliver the service in that zone of our practice. That means I have to understand
from you what you believe are the ideas and solutions by which to help you develop these skill
sets to the next level beyond where they presently are. This is not something I can take
responsibility to change within you. These are skill sets you must develop. What do you think
has to be done in order for us to move forward with this?”
REQUEST FOR TIME OFF
TEAM MEMBER: ______________________ DATE: _________________
DATE (S) REQUESTED: NORMAL HOURS WORKED TEAM MEMBER COVERING
____________, ___/___/___ _________________ _____________________
____________, ___/___/___ _________________ _____________________
____________, ___/___/___ _________________ _____________________
____________, ___/___/___ _________________ _____________________
1º RESPONSIBILITIES: __________________________________________________
______________________________________________________________
______________________________________________________________
NORMAL DUTIES OF COVERING TEAM MEMBER IF HOURS OVERLAP: ______________
______________________________________________________________
______________________________________________________________
SIGNATURES: _____________________________________
_____________________________________
DATE GIVEN TO TEAM LEADER: _____/_____/_____
OKAYED BY TEAM LEADER: ___________________________
Mistakes a CA Makes
Team Development
Forgets to approach their work as a mission to serve others and rather as a “job”
Forgets to perceive their doctor as a co-team member and not a boss
Does not protect the doctor from habits that squander time such as: unnecessary phone calls,
opening their mail before the end of the week, social calls during prime time, patients
wanting the doctor involved in chatter, etc
Forgets to give supportive encouragement to other team members on a regular basis
Forgets that all their actions are meter sticks for newer team members to understand how
closely to adhere to the rules
Communication
Forgets to bring issues of distress to the doctor immediately
Forgets to protect themselves from ever being involved in gossip
Forgets to help keep the doctor on the pulse beat of patient statements that the doctor may not
hear
Does not immediately get the doctor involved in the patient’s first missed appointment
Does not always address challenges in the practice as an opportunity of a procedure that
needs to be trained on instead of a co-team member that needs to be beaten up
Forgets to stop small talk with patients within 30 seconds (30 Second Rule) and be redirected
100% back to chiropractic
Gives too much personal advice to patients
Becomes too much of a social visit director for patients than the leader of an appointment to
help improve their optimal healing, first and foremost
Preparation
Forgets to take the annual calendar and place it upon their home calendar so all family
members are sensitive to scheduling of seminars and other important issues to the team
Flies by seat of their pants on issues that need to be scripted
Will forget to be several steps ahead of patient flow issues so that prime time never gets
backed up needlessly
Training
Forgets to look back to the purest, surest, simplest but most articulate means of scripting with
patients
CA’s check in procedures are starting to leave too many things pile up for check out
Allows too many piles to appear at the front desk, where patients should perceive order and
direction
Will ask other team members openly in front of patients, “Do you know where their records
are?”
Forgets to have good, clean fun while working
Forgets to keep doors locked until it is opening time
Forgets to close and lock the door at the right closing times
30 Second Rule
Goal: Each team member needs to respect each other’s zone and the 30 second rule gives a time
frame to get in and out of each other’s work areas.
Implementation:
Front desk CAs, in particular, tend to have other team members and the doctors congregating in
their areas more so than any other area of the practice. The 30 Second Rule was created to honor
that some topics do need to be addressed by a fellow team member or doctor but once that topic
is brought up, there is NO NEED for that team member or doctor to remain in the front desk or
other area of the office, hanging around.
1. In a team training, the 30 Second Rule should be announced and explained to all team
members, stating immediately that everyone will have 30 seconds maximum to state their
question or concern and then to leave the work area of another team member.
2. ALL team members need to abide by this rule and it is definitely for the benefit of the
entire team to enforce this.
3. It is the CA’s responsibility to remind people when they have exceeded the max 30
seconds and that they need to leave the front desk zone or other work zone.
4. The purpose of this rule is to reinforce that each zone has their particular location in the
office and the only things the doctor should be doing are one of these four things:
a. Adjusting patients: Completing doctor recommendations, notes, and x-rays for
only 3-8 minutes
b. Meeting with new patients: 3-8 minutes
c. Training: with team 3-8 minutes
d. Promotions: Get out of the building 38 minutes max (first time in the day, get out
of the building. If there is a second time in the day, you can get out of the building
via the phone calling to set up an outside talk, screening, or calling a referral
Gifting Programs
Goal: To recognize and express appreciation for referrals and to encourage more goodwill which
leads to referrals
Cost estimate: $9-20 per patient
How deeply do you celebrate in the moments when patients do profoundly good things, especially
referring others in? Believe that instead of creating a gifting program for patients who refer others in,
which starts small and ends up large, it should be that they actually make it to referring many people
in. Believe that the opposite is the best approach. Upon someone making his or her first referral into
your office, even if the patient does not stay for care, always make sure that you over thank the
person who referred someone in.
Personal handwritten letters from several of your team members should be sent out
A verbal statement of thanks from each of the team is given when the patients come into your
office
Their first name will be posted on the referral thank you board in the office and you all focus
on expressing gratitude to them
Doctors have given gifts of dollar value such as muscle therapy sessions, brunch certificates,
and tickets to a special event. However, now the law on gifting states that you cannot gift a
patient over $20. You could significantly thank your patients in ways that have no obvious
cash value or measurable dollar value attached to them. If you get them a meal someplace,
the meal is prepaid or it is a brunch that is all-inclusive and there is no dollar value placed
upon the certificate.
In terms of giving gifts to patients, be sure that you understand you must be in accordance
with the rules and regulations of your local and state guidelines and laws. Gifting is
something that can never be done too often or in too big a way. Remember that “behavior
recognized, tends to repeat itself” and “what you put out is what you get back”.
Thank you cards are mandatory. You want to give big in the beginning. Technically, medical
guidelines state that you are not allowed to give a gift of more than $10-20 per referral or $50 for
referrals aggregate for a year.
Go big; give certificates for a brunch at a beautiful place near you. It can be between $50-70 for two
people, with no amount printed on the certificate and does not include liquor, with a beautiful
handwritten card. They will always remember that first referral. After that, do not do that big again.
Give them shirts, caps, and things that promote your practice as well.
A.D.I.S.
Assess
Develop
Implement
Squeeze
When growth occurs and new found minutes and money show up, how we allocate them can define
the end of our breakthroughs and the beginning of continued ruin or it can define accelerated
breakthrough and an ambition to further the success. It all depends upon how it is played out as to
whether or not one level of breakthrough fuels the next. If breakthrough is not handled properly, it
will end immediately. Breakthrough comes in the forms of increased efficiency, increased output,
increased income, and increased passion for what we are doing. In this case, we are talking about
money in minutes. This can be considered the final touch in the Financial Mastery Program, as it
handles money after all other issues have been put into place.
In engaging the TLC process of A.D.I.S., we position ourselves to have the greatest breakthrough on
how to handle increased revenues properly.
Assess
Assess what happened, study the exact outcomes, and determine if it is what you want or if there is
something else that you want. We must know exactly what the status of the procedure/challenge is,
what our weekly or biweekly revenue check is, and therefore we must have a fixed check. We
cannot be paying ourselves after bills; that is no way to thoroughly squeeze our enhancements on
improvements of production. Bonus checks are allowable after we receive our weekly paychecks,
but we must always be riding our weekly paycheck to the maximum amount possible. TLC suggests
bi-weekly paychecks.
Develop
Develop a plan that will move you closer towards your ideal result rather than the one you have. In
developing a plan, the following ideas must be written out, thought out, discussed, and reviewed in
terms of its ideals or pitfalls for options.
Implement
Implementation, which means you take specific action steps that are measurable and predictable to
engage in over and over again. The issue with implementation is to finalize that plan, put it in
writing and hang it up on the wall, in a public place for all family members to read and agree upon.
A plan cannot go into implementation unless all parties involved have been informed and concede to
its application. We must define the people who execute the steps. We must also be clear about how
we will implement the checking up on things, monitoring of statistics, what date we will begin, and
how frequently we will do the checkup.
Squeeze
Squeeze the behavior by either compressing time or compressing the intensity in order to see just
how you do when the heat is turned on. In the Squeeze process, we are now going to work it and
push it. Here is where we must study the statistics/procedures.
Then you begin all over again and assess again. The A.D.I.S. process has worked for years and was
designed specifically with our chiropractic practices in mind.
Team’s Healthcare Records and Personal Care
Purpose: Providing for your team’s healthcare needs is fundamental and shows them you value
them and that they are deserving of your attention and care
Implementation:
All team members get examined before being hired and must go through the NPR process and
agree to spinal workshop attendance. The team member must have patient records with notes and
exam sheets.
Re-exam and R-ROF need to be performed on 10-12th appointment intervals
Scheduled adjustments in the appointment book need to be written in for all team
members
Your team must strive to be the example of what you teach – to do homework or rehab
Your team must regularly attend spinal workshops at least once every two months for
team members over one year of employment. Team members less than one year need to
go once a month within the first two months.
Challenges
Personal Phone Call Tolerance Letter to Team Member
Dear Team Member,
I am putting it in writing as from this point forward, there will be a ZERO TOLERANCE
to the breaking of this rule defined. Unless there is a physical injury or crisis that
endangers your family that you must be on the phone about, there is to be zero cell phone
use or personal phone call engagement from landlines.
This letter serves as advance notice that if this is discovered (use of cell phone or landline
for personal phone calls), you will be asked to immediately leave the practice for the
remaining hours of that day’s practice without pay. You will be welcomed to come back
the next day with clear understanding that that is behind us and will simply never happen
again. If it does happen a second time, our relationship of employment will be
immediately terminated.
While I do not want this to happen and it saddens me that it has deteriorated to this point,
I feel you have left me no other choice. However you and I can grow well past this if you
choose. You are a great contributor to the process of helping others gain greater health.
Clearly & Sincerely,
Your Employer
Dismissing a Team Member
“All I want from you is your total success to be the best you can be. I feel like something
here is holding you back and I am not willing to hold you back any longer. I sense you
think things around here should be done differently than they are and this somehow
stresses you. I am not willing to have you here stressed, nor am I willing to hold you
back. I am going to let you go effective immediately.”
Note: Pennsylvania as well as many other states are “Fire at will”. You will need to
check the laws of your particular state. Your payroll company should be able to
quote this legal information for you.
Be prepared: Immediately change computer access codes, change locks, and move on.
Letter about Associate Doctor Leaving the Practice
Dear Mrs. Jones,
You have been here long enough to know that the single most important thing to every one of us
at Total Life Chiropractic is that your greatest results and attentive care are what you experience
on each one of your appointments here with us. This is why we celebrate the fact that we have
equipped our practice with so many fantastic team members. One in particular is Dr. John. While
he has been a profound contributor to our team and our practice, the fact is we must celebrate
that he is moving on to develop his working relationship more closely with his wife, a fellow
chiropractor. As a result, we will be embracing him with congratulations and best wishes as he
moves onward.
In preparation for your continued care, we will be doing individual re-exams and re-reports to
evaluate exactly how you are doing and what we need to address to make sure that nothing alters
your quality of care in the process of his movement. We will be meeting with you today to
schedule a time for that reassessment and we will be doing your re-report within days of that
evaluation. There is great news, we will be paying even greater attention to looking out for how
you have been doing and what we can do to even further enhance your care from here forward.
Warmest Regards,
Longevity Awards Program
Team Eligibility: You design it the way you wish, in compliance with your own states labor
laws, and you are recommended to always check on these before administering bonuses. Anyone
on the team who has been CONTINUOUSLY employed by your practice for two years (part
time and full timers) is included in the celebrations annually from that time onward in their
contiguous employment.
Purpose: To appreciate and promote loyalty and encourage the newer team members to want to
strive to remain on the team forever, certainly beyond two years, so they can achieve such
greatness as the longevity award. This award program needs to be “over the top”, fun, and
catering to the characteristic of your particular team. Go play and shower them in provision,
celebration, playfulness, and an EXPERIENCE they will remember forever. Obvious emphasis
on the word EXPERIENCE. (This is more important than dollars and stuff – though that can
have its place as well).
Plan: Doctors, you need to plan the event, do not give the team a choice, and do not delegate the
execution of this, it is your gift based upon a celebration you want them to experience.
Remember that whatever you plan, make it over the top. They should be talking about this event
for a long time after it has occurred.
Budget: Expect to spend between $200-$500 per team member on this award and celebration.
When to hold it: Within one of your promotions and marketing “Renewal Cycles”. It MUST be
set in the annual calendar in order for the team to plan for this annual event.
Examples of Longevity Awards: the following ideas are meant to spark your own creativity
within the balance of your own rules for celebration and keeping things morally intact.
1. Rent a limo and pick up team members at their homes and take them to a very fancy
restaurant for dinner. Have roses to give each team member, make sure there are snacks
in the limo, and really make it a fun trip.
2. Rent a limo and take your teams to a “Broadway” show or a similar such play in your
nearby city, as well as finishing the night with dessert at a profoundly special place.
3. Take your team out to a “night on the town” to a hip restaurant and then to a hot dance
club for dancing until late in the evening/morning and then go out for breakfast at a diner
and do something that is way out of the ordinary for all the team members.
4. Take your team to a fancy shopping mall and give each an envelope of cash money and
tell them they have 45 minutes to spend ALL the money in their envelope. The rule is
that it must be spent solely on them; they may not purchase ANYTHING for any family
member or friend. They must meet back at the allocated time. What they did not get to
spend in the 45 minutes must be returned. They must produce all the receipts and give
them to the doctor so there is no chance for later exchanges. Upon all team members’
return – have fun, compare how little each has left of their money (the money can be
allocated based upon full timers receiving more and the part timers get a lesser amount).
5. IF your entire team is of a particular faith or recreational “favor” like camping, you may
plan an entire weekend at a “retreat” of your spiritual preference, or an all-taken-care-of
camping trip along with canoeing, hiking and some prizes…
Bottom line, celebrate in a way which thoroughly immerses your team in how much you are
willing to go out of your way for, spend on, and look out for THEM!
The Passion Drill
Purpose: To enlarge our grasp of how to make sure we “get a life” and enjoy things personal to
us in efforts to balance our professional and personal pursuits.
Process: This is a conversational and written exercise and if married or with a significant other,
it should be done first privately, then mutually come together (even in the midst of the very
moments the exercise is engaged). Answer the propositional questions for yourself first and then
listen to your spouse’s answers after he/she has formulated them.
Rules – “The Set Up”
Imagine the following before answering the questions:
1. You are off from all work for three weeks
2. You have unlimited money to do what you want with and you are allowed to do whatever
you want
3. Your practice/business will be handed back to you bigger than when you took off for the
three weeks, ensuring you have absolutely nothing to worry about
4. You must spend the entire three weeks at home with no work, residing daily in your own
home for sleep. During the day you can go wherever and spend whatever you wish, but
when it is time for bed, you must be home. You could fly anywhere so long as you are
back home for sleep. Special exception is allowed one time in terms of spending one
night away from home. We will allow your dream to include one overnight somewhere
(once only).
Write everything you could imagine doing every day. The pursuit is to open your mind and
creativity to “how would you design the ideal days of your life, lived out of your own home
life”? What would you do every day upon going to bed, waking up, having lunch, exercising,
prayer, intellectual growth, family time, social time, recreational and entertainment time,
physical fitness and dining, etc.
Once you have written many versions of your ideal days lived over the 21 days, days without
work but full with provision, and once you have defined how you would live, go back through
the entire list to circle the top seven you wanted to do the most of all which is mentioned.
Once you have defined your top seven items, ask yourself the following question: how many
times in the past 30 days have I done each of these things? Example: if having a world class chef
prepare your meals daily for you is one of your fantasy “ideals” during your time off – ask
yourself, “How many times in the past 30 days have you either
1. Had a chef in your house to prepare a meal
2. Taken a cooking class with a professional chef
3. Engaged a world class dining experience at a famous chef’s restaurant?
If in the past 30 days, you did none of those or even anything like it, then we are beginning to
understand a missing source of personal advance, joy, playfulness and more.
You must take your time and seriously consider each of your seven items with this process of
clear, exact, and lucid questioning. If we are not regularly doing some version of these things AT
LEAST ONCE A MONTH and AT LEAST FOR SEVERAL OF THEM PER MONTH, then
there is no way we are living up to our desired expression and engagement with what drives our
passion. Please note, a man or woman whom is not living a fully passionate expression of their
lives in their chosen way at least a few times a month can never truly grow their practice in an
ideal way.
Take serious and careful note of these facts:
YOU ARE ATTRACTIVE
YOU ARE ATTRACTIVE EVERY SINGLE MOMENT OF YOUR LIFE
THEREFORE THE ONLY QUESTION IS – WHAT ARE YOU ATTRACTING???
AND REST ASSURED
IT IS EXACTLY WHAT YOU ARE PUTTING OUT THERE
POTENTIALLY PAINFUL REALIZATIONS
BUT TRUE NONE THE LESS
Our primary dominant energy is attracting to us exactly what it is. If we are constantly living
concerned or worried about stuff, then we attract fear based energy outcomes towards us. If we
are living with so many injections of moments that make us smile, feel wowed, laughter, tears of
joy, etc then we attract such passage.
Construct a way that you can have some of the items on your Passion Drill begin to become real
parts of your life, to the degree that your life is able to accommodate. For instance, if one of your
desires is long walks along the beaches of the Caribbean every day, then ask yourself, “Can we
arrange to walk daily or at least a few times a week at the local river or lake (if you happen to
live inland that is)? Everything you touch is stimulating. What one or three things could you start
doing that could bring some of these passion elements into fruition? Have fun with this.
