Do Patients ‘Shop’ online?

When I first contemplated a website for my physiotherapy clinic around 6 or 7 years ago, I was yet to be convinced my potential clients would locate me using an impersonal, electronic, new-fangled gadget.   Much has changed, including my opinion.  Your web page is now the most powerful window into your business for current and future clients.  Let alone referrers and potential employees!

The website for a physio practice is a combined yellow pages ad, practice brochure (indicating hours, people, services, etc), geographical locator, health information site and shop front.  Or at least it could and should be all those things if you want to maximise the value to your business.

Perhaps the most important contribution of your web presence is the contribution to your brand.  The online image should be an authentic reinforcement of the brand of your practice.  Not the logo – the brand.  Those elements of your business that leave clients with a  feeling or emotion associated with doing business with you.  Feelings like ‘professional’, ‘ethical’, ‘trustworthy’, ‘safe’, ‘approachable’, ‘fun’, ‘friendly’ and so on.  If you business brand leaves clients feeling ‘neglected’, ‘unvalued’ or ‘doubtful’ you should probably work on those problems long before investing in a website.

Another valuable contribution is the reducing the fear of ‘the unknown’ for people who have heard of you or better still been recommended to see you but who may be anxious or apprehensive about seeing a physio for the first time.  Your web site can do much to allay their fears and replacing uncertainty with useful information (how they can pay, where they can park, what to wear) and confidence in your professional brand.

So, what should a physio practice website be made up of?  How complex should it be and what role should it play in your business? This will differ from practice to practice, but I believe one element is common to all – get some professional help with design, composition and content.  Being a fabulous physio doesn’t make you a top class web designer or techie.  Trust me, I tried and failed miserably until I put my ego to the side and let a professional take the lead.  Not only with my old clinic website, but also with my current business sites (www.redsok.com for example).

Possible contributions from your web site to business success include accurate descriptions of your team and the services they offer.  A chance to sell them as experts long before the client actually comes in the door.  Creating an expectation of quality is a good start.  You might include health information pages on common problems you treat, or an online store for the products you sell (clients can pre-purchase and simply pick up, or ask you to post it to them).  What ever you decide to include here is the golden rule: do it well and do it soon.  Become the site of choice for physiotherapy in your area and show your brand to the world. 

If you have a web helper already and are happy with them – stay on board.  If not, or if you are yet to start looking, can I suggest the company that helped us completely rejig our website, online store (international workshops and products), newsletter systems and database building.  A small and agile company with extensive design and construction experience in large corporate websites as well as small boutique clients.  Located in Hobart this company served us so well here in Queensland we actually transferred our whole site hosting to them from a much bigger national company who basically took us for granted.

DataFirst IT Services is run by Tim Allingham and we are working together now to provide a more complete service for physiotherapy clients who want a web site that is an extension of their clinical expertise and professionalism.  If you want to know more, click through to DataFirst IT and check out the ‘Site Options for Physios’ tab.

It’s a Shame the Basics aren’t more Exciting

Are you the kind of person who likes to get to the exciting bits quickly?  I don’t mean fast forwarding a DVD or leaping ahead in a book to see what is coming up (or perhaps you like that too), I mean do you get bored doing the basics.  Of anything.  Whether you are learning a musical instrument, acquainting yourself with a new smart phone or building a business or career.

Most physiotherapy clients I work with as a business mentor agree that the basics are really important, and then rush to show me their latest ‘bright shiny object’ – a new piece of equipment, gadgetry or tool. Or a new technique, system or software.  Or a new person, place or whatever.  And that’s the thing: basics are important but not exciting.  Nobody seems in a great rush to boast about their new policy on personal phone use in the business, or how they check the references for potential employees, or a new procedure for handling incoming phone calls and message taking.

Not exciting, but absolutely mission critical.  The examples above may seem minor in the big scheme of things, but when they are compounded by the multiplier of frequency they can make a huge difference to your business outcome.

I am about to embark on a tour of New Zealand to present business workshops for private physiotherapy practitioners and I just know they are hungry for ‘the next big thing’: the one secret of marketing or leadership that will boost their business outcomes. Well let me tell you the one big secret I am about to tell them….FOCUS ON THE BASICS. Especially people, service and cash flow.

I recall my very first patient when I graduated as a young and enthusiasic physio in Australia.  She had recently suffered a stroke (CVA) and was wheelchair bound with a left hemiparesis.  After months of neuromuscular rehab starting on the floor mat, progressing to four point balance, then to sitting skills and finally standing from sitting she was able to learn how to walk independently.  This was the exciting part made possible by previously focusing on the basics and getting them right with repetition, coaching, practice and feedback.

The basics of business are just that: the base on which everything else is stacked – the exciting bits are the highest, most obvious and premium-priced items, but they are fragile if the basics are shaky. Not only that, but the foundations can shift or fatigue.  Regular management reviews will indicate when repairs or updating of your boring basic systems is due. Which is often more effective at boosting your business than a new ‘bright shiny object’.

Craig Allingham

Is Your Business Stable?

One of my sons, Jon, is completing a bachelor degree in circus.  True.  Swinburne University in Melbourne houses the National Institute of Circus Arts in a fabulous modern training facility.  How fabulous to be able to gain a degree in a performing art as esoteric as Circus.  

Modern circus is full of spectacular physical stunts, acts, theatre and acrobatics.  Which is exactly what young Jon (22 is apparently still young) is learning.  He has a vast repertoire of tumbles, juggles, leaps, catches (other people) and dives through hoops.  Which is what we see at his shows.  Apparently other peoples kids are also doing stuff but I can’t seem to recall them. These flashy, impressive acts are difficult because they challenge the very laws of physics and the performers constantly appear on the brink of failure.  The liklihood of falling, dropping, missing or just stuffing up is what makes the acts so watchable.  The whole business of circus is built on instability – the imminent failure that is so obvious to the audience.

Curiously, they rarely fail.  The obvious instability is underpinned by hours and hours of strength training, agility drills, stretching, skill building, rehearsals and then start again.  The preparation is the stable base that allows controlled risk taking in the name of entertainment.  But of course, the audience never sees the preparation, just the outcome.

Your business is no different from a circus.  Perhaps it even resembles one at times.  The fabulous face your business presents to the client in terms of customer service, clean facilities, quality products or services and so on is only sustainable if it is built on a stable base.  Your staff training, record keeping, inventory management, cash flow management and many other systems and procedures are the foundation on top of which your business can shine.

However, if the base has been cobbled together in a rush to get the business up and running, or maybe a good base has been undermined by staff turnover or complacency, the ‘customer facing’ aspects will be unstable. And the wobbles will be evident to your clients.  They will notice stock shortages, appointment mistakes, failures to follow up or deliver on time. And perhaps worst of all your clients will percieve you are more preoccupied with keeping the good ship afloat rather than look after the passengers. There, I think I have mixed all the metaphors I could think of.

Here is the bottom line: the basics are not the exciting bits.  The hours spent by Jon in the gym building his body and skills is the tough repetitive grind on top of which he embroiders the visible performance skills we pay to see.  Same for you – hours of unseen (and unpaid) work to build strong basics for your business to shine. Yet the whole facade of your professional expertise is anchored by sound basics and a firm base for your business and this time spent on the basics is never time wasted.

The message is obvious – if you are building a business to last, build, sell or franchise, you should spend time, money, resources and effort on getting the basics right.  Seek assistance from advisors, regulators, professional organisations and mentors to ensure your success. In fact, as part of his circus degree, Jon is studying event management, marketing, sports injury care and other business basics to prepare him for managing the back of house not just the onstage presence.

Build your business on a stable foundation and while you might not get a standing ovation like Jon, you will prosper from return business and recommendations.

Craig Allingham
Professional Development Consultant

Survival of the Best Fit

Charles Darwin is often misquoted as saying evolution is the survival of the fittest.  Not quite true.  He actually said ‘It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.’  In other words, the creatures most suited to the current environment will be advantaged and reproduce. 

The same is true in business.  In New Zealand there has been a shift in the operating environment for physiotherapsts and some other health practitioners.  The previous system where the government run accident insurance scheme provided full funding for physiotherapy consultations has now been modified and the agency only partly funds the cost of treatment.  Many practices are now having to ask clients to actually pay some of the fee, for the first time ever.  This is a huge environmental shift.  And like the dinosaurs who couldn’t adapt after the planet was struck by a huge meteor, some practices in New Zealand have also perished. 

Fundamental changes to the operating environment are not common, but change will always be in process.  Some changes will be internal to your business (people, systems, technology), some external (suppliers, tax laws, HR regulations) and some will be environmental (think global financial crisis).  Business that are strong and have systems and procedures often believe they are ‘change proof’.  Just like a dinosaur.

Being able to recognise change (even before it arrives) and adapt to better suit the new environment will ensure your business survives and thrives.  Being open to ideas, seeking new information, having a agile approach to opportunities and recognising that the old way may no longer be appropriate is a sign of competent leadership and proactive management.

 Late in 2010 I was invited to New Zealand where I had the opportunity to speak to private physiotherapy practitioners in four major cities about the changes and suggest strategies to respond to them.  Under the heading of my “Seven Deadly Sins of Business – and how to avoid them’ I shared my experience in business and the successes and stuff-ups I have generated.  Got to love those stuff-ups – a lesson in every one of them.

Small and medium business is doing it tough globally.  Even in health care we are competing for the discretionary spending of our clients.  Any money they spend on clothes, holidays, skin care, domesting cleaning staff, etc is money they wont’ be bringing through the physiotherapists’ doors.

I like to think I offered value to those attending and helped them identify the current operating environment so they can adapt more quickly and completely.  Each participant received a copy of ‘Book More Clients’ to help educate them and their staff in how to better convert, service and market to their clients in order to build a more resilient business model.

I look forward to returning to New Zealand in March 2011 with more targetted information and strategies to improve the agility, speed, efficiency and responsiveness of their businesses to the changes occurring within and around their businesses. Much of which I will also share with my online readers.

Easing the Pain of Selling

One of the most difficult concepts for health and fitness professionals is to consider themselves as ‘sales people’.  Their training and predisposition to help people achieve recovery, health or new goals is an overwhelming drive.  Selling is completely underwhelming and often seems at odds with the notion of ‘helping people’. 

After struggling with this conflict for most of my physiotherapy career I came up with a strategy that gives an opportunity for the client to initiate the enquiry.  Once over this hump the whole process simply becomes another way to help them. 

Those of you who have attended my Biz Fizz workshop will know the secret already, and I know from your feedback that it is working for you.  For the rest of you: if I could tell you a way to overcome your discomfort with selling, would you want to know it?

There you go.  You now know the secret.  It is the sentence in purple!  Simply adapt it for the situation, for example:

  • If I knew of a product that might improve your recovery would you like to know about it?
  • If I could show you a program that would allow you to achieve your fitness goals more quickly/conveniently/fun would you be interested?
  • If I could show you how the benefits of a higher membership level would improve your outcomes, would you like to know?
  • If I knew of a nutritional supplement that brings more bang for your dollar would you like to hear about it?

So there it is: a simple strategy that invites the client to seek your professional opinion on a product or service that they have given you permission to tell them about.  All you do now is tell them, answer their questions and let them make a purchasing decision based on their perception of  benefits vs costs – also known as VALUE.

One of the most difficult concepts for health and fitness professionals is to consider themselves as ‘sales people’.  Their training and predisposition to help people achieve recovery, health or new goals is an overwhelming drive.  Selling is completely underwhelming and often seems at odds with the notion of ‘helping people’. 

After struggling with this conflict for most of my physiotherapy career I came up with a strategy that gives an opportunity for the client to initiate the enquiry.  Once over this hump the whole process simply becomes another way to help them. 

Those of you who have attended my Biz Fizz workshop will know the secret already, and I know from your feedback that it is working for you.  For the rest of you: if I could tell you a way to overcome your discomfort of selling, would you want to know about it?

There you go.  You now know the secret.  It is the sentence in purple!  Simply adapt it for the situation, for example:

  • If I knew of a product that might improve your recovery would you like to know about it?
  • If I could show you a program that would allow you to achieve your fitness goals more quickly/conveniently/fun would you be interested?
  • If I could show you how the benefits of a higher membership level would improve your outcomes, would you like to know?
  • If I knew of a nutritional supplement that brings more bang for your dollar would you llike to hear about it?

So there it is: a simple strategy that invites the client to seek your professional opinion on a product or service that they have given you permission to tell them about.  All you do now is tell them, answer their questions and let them make a purchasing decision based on their perception of  benefits vs costs – also known as VALUE.

Are You Available?

When I was running a busy physiotherapy clinic, carrying a full clincal load plus admin, plus preparing conference presentations, university lectures and researching/writing academic papers or book chapters my work days were pretty much full on.

A bit like the analogy of time management where you consider your day is an empty bucket and you ‘fill’ it with rocks (rocks are the big jobs).  Your day now looks full, but then you tip in some smaller pebbles (smaller jobs) which seek out the small gaps between the rocks.  Now your day is very full.  But if you pour in sand it will filter through the rocks and pebbles and fill the crevices with even smaller jobs – surely now your day is as  full as your bucket.  You wish.  If you now pour in water it will flow down between the rocks and pebbles, through the sand and fill all remaining microgaps until your bucket is now brim full of tasks, jobs, meetings and chores of all shapes and sizes.

Nothing else can now be fitted into your busy day.  You are operating at maximum time efficiency.  These were my typical days – patients (rocks), admin tasks (pebbles), reading, writing, preparing lessons, reviewing papers (sand and water).  Until one day my practice administrator mentioned that she often wanted to speak to me during the day, to bring important matters to me about our business, our employees or even just to chat but she didn’t because I seemed to always be so busy that her interruptions would not be welcome. 

My days were full.  But I was no longer operating with any measure of time efficiency.  Not if important things, including social contact, were unable to be accommodated. 

So I changed my attitude and freed some time for ‘soft meetings’.  I set aside 30 minutes a day when I would be in my office and welcome any visitors who had need of me for quadrant one or two activities – those that were important irrespective of urgency.  Sitting blankly for 30 minutes waiting for contact scared the bejillikers out of me, so I made sure I had a simple task to do that was easily halted and resumed as necessary.  I mastered the art of putting it aside as soon as someone arrived, leaving a blank desk space in front of me: simultaneously removing distractions and inviting interaction.

Team members now had both permission and opportunity to drop in and keep me informed, let me help or direct them, tell me about their weekend, check some procedural matters, say Hi, share information about their families, report progress on our projects and so on.  They loved it, more importantly I loved it.  Most importantly the business ran better and I noticed less interruptions during other times of my day as they knew they would receive my focussed attention during the soft meeting time.

However, even good ideas need tweaking……

I noticed after a while that people were coming in to my office anytime they noticed I was at my desk.  Perhaps interpretting my physical presence as permission to approach!  Despite a pile of paperwork and my frantic keyboard clicking.  Not wishing to undo any good will I might have engendered with the soft meeting system, I sought an answer in the management wisdom literature. 

One boss used a flag system on his desk to indicate his availability.  If the green flag was up he was 100% available (my soft meeting time); if the yellow flag was up staff were free to approach with caution (it better be important); if the red flag was up he was most definitely NOT available.  I didn’t have any flags but I did have a red cap in the office.

Company Policy #42 – If Craig is wearing his red cap he must not be interrupted for anything less than emergency evacuation for fire or flood.

Simple, effective but not stylish.

Quanto è Sicuro Il Cialis 100mg e quando non deve essere assunto, è sempre indispensabile ricorrere al parere di un medico specialista, che è dovuto al pieno afflusso di emicranie nella regione pelvica. I test medici non hanno rivelato anomalie causate da un uso regolare del farmaco. Per ottenere più portata nella loro efficacia e voluminosamente rapido assorbimento, anche presunta naturale.

Seven Deadly Sins

While in London recently, I was asked to make a business presentation to a group of private practice physiotherapists who are part of the Physio First network.  I was happy to share with them, as I believe the stronger our profession becomes in business the better it will be for clients, employees and owners.

This opportunity allowed me to unveil a new presentation titled ‘The Seven Deadly Sins for Physiotherapy Business’.  A two hour overview of common errors, over-sights and missed opportunities with specific application to any service or health business.

The Seven Deadly Sins are-

  1. Secrecy
  2. Chaos
  3. Sciolism
  4. Neglect
  5. Naivety
  6. Sabotage
  7. Deference

I love this presentation – it allows me to dig deep or skim over each sin as determined by the needs of the audience.  It can be customised to suit the occasion.  This presenation can be a keynote for a large event, or a workshop for a small group.  It can be platform or interactive.

Anyway, the presentation went down very well in London and the feedback was overwhelmingly positive.   So much so that I used it again in New Zealand with private practitioners looking for strategies to adapt to a new operating environment.  A feature article on the Seven Deadly Sins appears in the December 2010 edition of ‘Business in Practice’ an Australian physiotherapy publication. 

If your organisation is interested in more information with a view to booking me for a workshop, please let me know.

The Ultimate Time Saver in the Clinic

 

Whether you are a physiotherapist, massage therapist, chiropractor or naturopath I have a foolproof system to gain you up to 30 minutes extra free time per day!  That’s two and half hours per week or almost an extra week per year!  An extra week to do the things you want to do.  To fill with whatever floats your boat.

This secret system is based on my long-term observation of practitioners filling a 20 minute, thirty minute or 60 minute consultation with, well consulting.  In other words using the full allocated time for an appointment to deliver the service.  Which is great value for the client but means the paperwork (record keeping, filing, phone calls, thank you letters, etc.) gets done after the client leaves.

In other words, you continue to work for the client after the client has left the building!  You use your own personal time to complete the outstanding client-related tasks that should be incorporated in the appointment time: the time your client is paying for you to work on their behalf.

Two issues here, firstly there is a legal obligation to complete medical or procedure records in a contemporaneous manner.  Meaning: at the time of delivery.  This maximises the chances of accuracy and adequacy in the eyes of the law, and gives you the best chance of delivering an effective program based on quality record keeping.
Second issue is theft: you are stealing time from you.  You are donating unpaid time to the business.  The habit in my profession is often to make basic notes or prompts at the time of the consultation and to complete the rest of the record when the working session is completed.  Instead of using that time to read a good book over lunch, to go home to loved ones, to go the beach for a surf or cycle home before dark.

To receive this extra bonus time in your life involves a simple shift in your procedures.  Whatever your appointment duration might be, complete the service delivery with a few minutes to spare and (this is really important) stay with the client as you complete their paperwork.  Tell them how important it is to document the intervention immediately and with great accuracy and this is in their best interest.  Sure they might chat on but you can nod and grunt as you write and finish with a great flourish.  You must ensure your work area has all you need on site to complete the paperwork because as soon as you leave the client they have no idea you are still working for them.  If you walk out at minute 26 of a thirty minute appointment they may feel short-changed or not valued.  Stay with them till done or time is up.

Now all you need to do is work out the best way to use this extra week per year in your best interest.

The Danger of Knowing

I wonder if we ever really know as much as we think we do.   A recent article in Spine (1)  looked at GPs with a self described special interest in musculoskeletal or occupational health medicine and their management of patients with low back pain.  The conclusion drawn by the Australian investigators was, ‘A special interest in back pain is associated with back pain management beliefs contrary to the best available evidence. This has serious implications for management of back pain in the community.’  In other words, those GPs who believed they were more ‘expert’ were actually the opposite!

It got me wondering about the risk of ‘knowing’ something so well that we cease to refresh or challenge our knowledge base.
For example, I have a special interest  in shoulders.  I have written and taught about shoulders for over twenty years.  Yet, how many shoulder workshops have I attended that I didn’t actually lead?  Maybe one every couple of years.  Post-graduate university teaching and delivering at large conferences have obliged me to try and keep up with other work, but I am only human.  And one of our human limitations is the ability to blind ourselves to new information when it suits us.  To hold a strong position and then avoid, disregard, mis-interpret or bend new information so as not to rock the conviction already held.  I love finding research articles that support my clinical observations and the foundations on which I treat patients.  I share these papers,  use them in my reference lists and acknowledge the wisdom of the researchers.  Upon reflection I suspect I treat papers that don’t resonate with my beliefs and practices somewhat more cursorily.   Beyond that, I am sure many colleagues jump on the very papers I underestimate and embrace them enthusiastically because they experience a  resonance with them.  Academic rigor in research demands a review of relevant published work even those not supporting hypothesis.  To keep an open mind pending the outcome. Outside of the research environment there is no such imposed balance.

Knowing stuff can be dangerous.  You can retreat to a comfort zone of ‘well that’s that, I understand it now’ and cease to be open to new, different, complementary or even opposing views.

Knowing stuff is cognition.  Knowing that your knowing is incomplete and is subject to your attitudes, prejudices, bias, expectations and experience is meta-cognition –  the ability to rise above your ‘knowing’ and perceive that your knowledge base is a mere speck of sand on the wide beach of what you do not yet understand.  Maybe this is the difference between knowledge and wisdom.

Just like the GPs who believed their ‘special interest’ afforded their patients an advantage, I suspect any complacency in our information quest will impact on our patient care.

That said, I am now going to register for a shoulder workshop…

 

1.Buchbinder et al, Spine: 15 May 2009 – Volume 34 – Issue 11 – pp 1218-1226