Are You Drifting Through Life and Practice?

The other day I was floating on my back in a hotel swimming pool.  My wife was at a continuing education seminar and the kids and I were killing time by relaxing in the hotel pool.  I decided to lay back and just float for awhile since the kids were all wearing floaties.  A funny thing happened.  I stood up to check to see how the kids were doing, and I couldn’t touch bottom.  I panicked and sank for a moment before I calmly started to tread water.

It wasn’t that big of a deal.  It just illustrates an important point about life.  We can set out to have our life look one way, but if we aren’t careful about avoiding drift, we may wake up one day to find that our life looks nothing life we thought it would.

In his book “Living Forward,” Michael Hyatt talks about drift.  He says that when you allow your life to drift it results in:  confusion, expense, lost opportunities, pain, and regrets.

If you don’t pay attention to the changing healthcare landscape, you will have confusion about where to take your practice strategically.

If you don’t pay attention to the level of oil in your car, or how often you should be changing the oil you will have to deal with the expense of a new engine.

If you don’t pay attention your goals (if you even have goals) you could miss out on a great opportunity because you are doing too many other things that don’t really matter.

If you don’t work on your marriage and if you aren’t intentional about nurturing your marriage eventually you will have to deal with the pain of an awful marriage or divorce.


As you can see, we want to avoid drifting through life.  Especially when it comes to our practice.  So how do we prevent the drift?  You have to know where you are, where you want to be, and how you are going to get from point A to B.  Today, we will focus on where you are now.

In practice were are you?  What is the score so to speak?  If you don’t know the score how can you ever hope to set realistic, actionable goals?  In my practice, I get a report from my biller at least twice a week.  The report tells me how many office visits we had, how many missed appointments we had, what we billed, what we collected, how many new patients we had, how many reactivated patients we had, even how many of each therapeutic procedure we performed.  Numbers don’t lie, and knowing your numbers is the only way to know how you are doing in life, and especially in practice.

If that all sounds too overwhelming, then focus on keeping four key stats.

  1. New patients.  This one needs no explanation.  We even track how they heard about us and how they flow through our clinic’s procedures.
  2. PVA.  This stands for patient visit average.  You take your total office visits and divide that by the total new patients you had that month.  A high PVA means that you retain your patients.  A lower PVA means that your patients only stick around for a few visits.  We can have a philosophical debate about the merits of a lower PVA, but as far as I see it, why do we focus so much on getting new patients in the front door and just let them walk right out the back door never to return?  Take good care of people and they will take good care of you.
  3. $VA.  This stands for dollar visit average.  You take your total collections (not what you billed, we want to focus on what you collected) and divide that by the total number of office visits for the month.  This gives you an idea of how much a visit to your office costs on average.  A low $VA typically reflects a lack of services offered or a poverty mindset.  (I can raise two hands for having had a poverty mindset early in practice.  In fact, I still have to battle this every so often.)  I am not saying to offer services and to bill services only to make more money and drive this stat up.  My cardinal rule in practice is only to do what the patient needs, nothing more, nothing less.  At the same time, a lot of chiropractors could be doing more to help their patients than they are now.
  4. No show rate.  This an important stat because it tells you a lot about your staff and your communication style.  With most practice management programs, this is an easy stat to keep.  You total all the now shows, missed appointments, canceled appointments, and rescheduled appointments.  You divide that number by the total scheduled visits, and that gives you your no-show rate.  Ideally, this should be around 13% or less.  A higher number means that too many patients aren’t keeping their appointments, and you and your staff need to work on communicating with patients the benefits of keeping their appointments.

So there you have it.  I just gave you some homework to do before my next post next week.  So get after it and start keeping score.  Are you experiencing drift right now?  Have you in the past?  Do you regularly keep stats on your practice?

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