Staying in Control of Your Practice When Everything Seems Uncontrollable

Hi, everyone. Thank you for joining us for our third episode of Catch Up with ChiroTouch, our new podcast series where we will talk about the state of chiropractic profession, best practices and recommendations to manage and grow your practice, and share expert advice with a variety of guest speakers. I'm one of your hosts, Dr. Brian Blask.

I am an account executive here with ChiroTouch, where I consult with chiropractors to determine which software solution is best for them. We have Dr. Jeremy Todd with us today to talk about how to stay in control of your practice during these times, when everything feels uncontrollable. Jeremy is a good friend of mine, as we were classmates at NYCC, what seems like years ago.

He's a chiropractor client, a chiropractor specializing in rehabilitation in New York, and a CrossFit gym owner. Great to have you here today. Jeremy, how are you, sir?

I'm doing good. It's great to be here. Good to talk to you.

I want to explain to our listeners kind of why we've got you back on because we had you on in our webinar series about six weeks ago, where we talked about the state of what's going on in New York, what you're doing. So I want to get you back on here, because everything changes here week by week, day by day. So I want to get you back on and kind of talk about what's going on in New York, what's going on with your business, with the gym, with the practice.

So are you currently open?

Sure. So the practice is open on a limited basis. The language that was used here was chiropractors are allowed to remain open for urgent and emergency care.

So I've been qualifying that with people who are having inability to sleep, pain or inability to walk or dress themselves. So really more of the critical ADLs. And if people are having those issues, then we are letting them through the door as long as they are otherwise healthy.

So we're up and running there on a limited basis. I am limiting the number of people that are coming in. And I've changed how much time I allot per patient.

So there's less time in the waiting room. The gym is unfortunately still closed. And we're still waiting on clarity as to when that's going to be open back up.

Gotcha. So how were you able to blast out to your client base, hey, we're open for emergency. What types of communication do you use there to kind of get the word out about what's going on with your practice?

The mass email function on ChiroTouch has been a great way to stay in touch with people and just give them updates, valid information that we're getting, just letting them know where we're at, just keeping an open line of communication. And that's been the best way to do it.

So kind of what's been the vibe with the patient base? Are people more cautious? Are they reluctant?

Are they eager? Kind of what's the flow there for patients?

Really, it's a mixed bag. We'll have people who want to be the first appointment in and avoid going through the waiting room. They'll go out through the gym.

So we have the very over cautious people on that end. And then we have other people who are coming in and then like not wearing a mask and just kind of like, you know, it's business as usual for them and really everything in between. So I'm just trying, I treat everybody like they are overly nervous and over cautious.

And really, for me, it's, yeah, let's be as safe as we can using the common sense that we have and not be too cavalier about it. Great.

So are you practicing with different sanitation standards? Are you wearing a mask? Are you sanitizing everything?

Kind of what's your kind of make of the practice there?

Yeah. So I'm wearing a mask. I started with an N95 and that was just oppressive.

It's hard to communicate for hours at a time wearing that thing. So I'm just wearing a regular basic surgical mask. I'm not wearing gloves because I do a lot of soft tissue work.

So that doesn't really let me do what I need to do. I am wiping down the tables between patients, washing my hands. I'm making sure actually that after the patient leaves, I'll wait to wash my hands and clean the table until the next patient comes in.

So they see me doing that. I just don't want to leave any doubt in people's minds. I was getting some people coming in saying, hey, did you do this?

Did you do that? I'm like, you know what? I'll just have you watch me do it.

So yeah, that's where we're at. We recommend, we ask people to wear masks. Most people do.

Some don't like it and take it off halfway through. But that's where we're at.

That's a great tip right there. That's a great trick. I didn't even think about that where you have you wait till you do your cleaning until somebody sees you do it.

That way they know that what you're doing is safe and it's sanitized, because there's still that fear. Especially in New York. Talk about where you are.

I don't think people really realize how close you are to New York City.

Yeah. We're a 45-minute train ride. I don't even know maybe 20 minutes from New York City.

We've been at the epicenter of a lot of this. We have a lot of people that work in New York City. We've had a couple of gym members lose family members due to this.

We've been at the heart of it. It's been rough going. There's been a lot of fear going on around here, but everything seems to be moving in the right direction.

I know other parts of New York State opened up into phase one today. That's more upstate and western New York. We haven't checked all the boxes to enter phase one just yet, but we are trending in the right direction.

Things are moving well here.

That's great. So you were closed for quite a bit of time there. How long approximately did you have to shut the doors for?

So I chose, again, I didn't have to. I chose to. I know a couple other chiros in town stayed open the whole time.

I chose to close my doors for three weeks. I needed to understand what was going on better with how this was being transmitted and what were best practices. So I made that choice.

And then as things, you know, sorted out, I felt confident opening back up again.

Then you still have the gym as, you know, income and then you do other classes for income as well, right?

Correct. Yeah. The gym membership has been really great.

You know, vast majority of people have stayed on continuing to pay their membership. We are continuing to offer online classes, and it actually spawned a new class where I'm doing basically a low back school live on Zoom. So I've been actually able to add revenue by running a Zoom class doing some low back exercises.

And I've been able to get people who are a little bit more hesitant to come in. We have a couple of people with immunocompromised spouses or people that live with their parents. So we've been able to engage them remotely with that stuff.

That's two things I love there, right? One is you're taking care of everyone, right? You're putting people's fears at ease with sanitation.

My wife has Lyme disease, so she's immunocompromised. And we still have that. We go through a ton of the sanitation protocols and keeping her safe and everything.

So I love that you're doing that for people. That's great to take care of patients like that. But then also adding the revenue side to it.

I think it's very important for other chiropractors to understand there's other ways, right, passive income-wise, that you need to set up for your business, because this could happen again, right? Even within your business, trying to think about other ways that you can continue to generate revenue, right?

Absolutely. I feel like I was lucky, in a sense, that I have a large exercise science and exercise background and had been doing online stuff before. I saw it as a necessity, not only to reach people that might not be able to geographically reach me, but also as follow-up care for the patients who are discharged, but are still experiencing some form of weakness or poor coordination or endurance.

So, it's nice to have that recurring income, even if when the office was closed, I still had income coming through that stream.

Have you found yourself being more active promoting certain parts of the business? Are you using or less active? Like how's your outreach been when it comes to marketing?

Have you switched anything up there? Because it seems like it has to be a fluid plan at this point, right?

It depends on the day. I've been a lot more active in the gym during this time, to be honest with you. As the owner, co-owner there, providing leadership in that regard, and being in front of the camera, and running more classes, and communicating with people, and trying to figure out what the future of fitness looks like.

Because that's a question I don't know a lot of people have answers to. So I've actually been doing more of that. With the chiropractic end of things, I don't do a lot of marketing as it is.

I've found myself having to deny new patients right now, because I'm so busy. So many people want to come in. So I've been expanding my hours accidentally over this time, really without much effort.

But that again, leads to how my practice functions.

That's very fortunate for you. That's a great job that you don't have to do that marketing. And you still get that influx of new patients and staying busy.

You mentioned the fitness industry. So people with gym memberships, like you, you're a co-owner of a gym. Where do you see that going?

I mean, short term, we have to develop some sort of online service. It's hard to expect people to pay their full gym dues. Again, CrossFit gym is a more boutique gym.

So again, I feel lucky that I've had experience with the online realm. We were quickly able to get Zoom classes up and running. But you hear those grumblings, hey, why am I paying this much for something that's less than?

So we're looking at saying, all right, well, let's look at this as an opportunity. Let's maybe we'll drop our price for just online programming and then renting out our equipment. So because right now, if you guys are staying up with fitness, you cannot find a dumbbell or a barbell or a lot of things anywhere online.

As soon as they become available, they're gone within hours. So our equipment is a commodity, so that will kind of offset the cost and really kind of say, if you want to use a barbell or a dumbbell, we're your only option right now. So I think developing that short term, but then being able to not just hold on to the people that we have, but really reaching out to the community at large and locally and starting to advertise and say, hey, for this price, you can join this community of people.

You will get Zoom classes, you will get support, you will get this stuff that a lot of the cookie cutter online programs that might be cheaper won't provide you. There's $20, $30 programs out there. Yeah, and if you're very self-sufficient, healthy, go for it.

But a lot of times people need that support. How do I modify this? This is bothering me, what should I eat, da-da-da-da-da.

So providing them with that in real time will be valuable.

Yeah, that's great because healthcare is not a cookie cutter approach. As chiropractors, it's diagnosis and it's treatment. We're healthcare professionals, we have to diagnose and treat accordingly.

So you can't have that cookie cutter approach for the most part. So I guess what are the thoughts moving forward there on how this quarantine is affecting people's health? Are people coming out of it like you thought they would?

I mean, talk to me about that. I mean, how is quarantine affecting everybody here?

It's interesting because what I'm seeing, at least with the gym population, a certain segment of the fitness population has an unhealthy relationship with exercise and uses exercise as a coping mechanism. So those are the people that we've been focusing on and keeping them from overtraining. So they're stressed out, they have more time, they start working out more, they start to get repetitive use injuries.

So we're trying to head that off. That's one end of things. The other end of things is people just being super stressed out and saying, darn it all, I'm just going to sit on my couch and not do anything, which that's not the answer too.

So we've been reaching out to them, hey, I haven't seen you in class, I haven't seen you log on, let's get you moving. Then in the clinic, we talked a bit about before the psychological component of pain and how that can spike pain and how that can actually, there's some evidence out there that it leads to fascial restriction over time. So the people that have been reaching out for treatment have definitely had a psychological component involved that we've established in the past, that's really spiking their symptoms currently.

Okay. So now moving forward with that, so you see people coming out of this, are they more stressful, less stressful? Are you getting information out to them about the healing process?

What do you think moving forward there for yourself and other chiropractors in the same position?

It's a good question. I mean, I think moving forward, you're going to see one of those three options, people that have been overused, people that have the mental fortitude to be fine through this, that they are adaptable, and then the people that are super worried and super stressed and just shutting down and becoming introverted about it. So I think educating people, at least on the highly stressed ends, so the over-exercisers and under-exercisers in my world.

Kristin Neff is a really good psychologist. She's kind of hit the pop culture scene recently, and she does a lot on self-compassion and recognizing you're struggling and realizing everybody's struggling and having better self-talk. So that's the kind of dissemination that I've been doing with that information and really getting people to understand, yeah, you're suffering.

Yes, we're all suffering. She has the clinical research to back that there's something curative in that, but being able to step outside of yourself and say, okay, a friend is coming to you with this set of problems. What would you say to them?

Because what she's found is people will speak more kindly and more constructively to someone else than they will themselves, at least 90 percent of people. So that's the angle I'm taking with it, is being a little bit more compassionate with yourself and then asking yourself what you can control at the end of the day.

That's amazing. That's great stuff. We covered a lot of the psychological component last time, which I advise other chiropractors that are listening to this, that may not have listened to the webinar that we did a few weeks ago, to go to chirotouch.com/resources, where you'll be able to find our taped webinars that we've been doing during this quarantine.

So go to chirotouch.com/resources. We cover a lot of that there. Jeremy gives a lot of good information on that as well.

If you are a younger practitioner, because you're established, you're late 30s, you've got your businesses, you're rolling, you've got the new patients, you're busy. There's a lot of younger practitioners now that are graduating or a few years into practice that are struggling because of this. What ideas do you have there for other businesses, younger practitioners?

That's a good question. I would say, first thing is find some continuing education on practice building right now. I know I'm doing that right now.

Again, I'm later in the game, but I'm always trying to improve my practice. This has really given me a time to understand my efficiencies and my inefficiencies, not only in my office, but in my communication. Really self-reflecting on the experience that you're giving people and how you're talking to them.

I think also if you're inexperienced and you're rather new, maybe taking the time to understand social media and marketing better and really clarifying your message to get out there. It starts with refining your message and knowing who you are. I think that's something that I wish I did earlier on and saying like, listen, no, this is me.

This is who I am. This is what I believe and really expressing that because the more you express it, the more you're going to attract the patient you want to see. The more patients you attract that you want to see, the more success you have and the more people that they send in.

I didn't really have that early on. It was just kind of read and react and try and give people what they want. Again, we were in Croatia, so I was trying to do this all in a foreign language too.

But that's what I would say. Define your message and then start getting it out there as much as possible.

Yeah, that's great. Look at yourself, figuring out who you are, how you want to practice, and then educating, getting that message out there. You mentioned social media there.

We're going to touch on Croatia, by the way, what you mentioned. The social media component, I think, is also very important. You can use Facebook, Instagram, Twitter, whatever you need to, to get your message out there about who you are and engage with your patients.

We've been talking to so many chiropractors about this. Engage with your patient base. You do a great job of that.

I think that's a great point to give to other practitioners, is use those services. Social media is a billion-dollar business. It's not going anywhere, people.

You might as well use it.

Absolutely. It's great to just put those ideas out in the ether. You're going to fire a lot of blanks out there.

It might be 15 people seeing it, but eventually, you're going to say stuff that sticks with people. Like I said, you're going to start attracting the right person to your practice, which is what you want to do.

That's exactly it. I love that. Go into real quick detail.

You started over in Croatia and then came over here to the States, right?

Yeah. After my wife graduated, we moved over to Croatia and that was the first practice that we opened up. I had never really worked in another practice.

My experience in chiropractic college was at the BA, so that was a very different experience than being in a clinic. It was really interesting. There's no very vast differences over there, but yeah, we were over there for five years.

That's awesome. As we wrap things up here, how about you? What are you doing during this time to stay healthy?

I guess I had the benefit of, I coach a class at 6 AM, three days a week. I'm in front of the camera doing my best Richard Simmons, impersonation. So I'll do that and then I'll run the low back class.

So I'm getting a solid hour and a half of exercise those days. Then I'm taking this time to do more continuing ed on different exercise or movement systems. So I've been really working on gait and running cycles.

So I've been getting to experiment with myself two times a week, just going for doing some running intervals, half hour, 45 minutes.

Oh, that's awesome. Where can people find out more about you, your practice? Where can they find you online?

So you can find me on the website is vatra, V-A-T-R-A, spine and sport.com. And that is also my Instagram handle, vatra, spine and sport. And that's where you can find me.

Awesome. Thanks, Jeremy. I really appreciate taking the time to help us in this new reality, right?

I mean, it's nice to hear from somebody that's established that has both feet on the ground, multiple businesses, the passive streams of income. We covered a lot that's going to help a lot of chiropractors.

Thanks for having me. I love talking shop.

Thank you again to our listeners here at Catch up with ChiroTouch. This is our third week we're doing this podcast series. We'd love to hear from everyone.

So we set up an inbox. Just email us at podcast at chirotouch.com. You can send us questions, feedback, comments.

So again, that is podcast at chirotouch.com. Next week, we're going to be discussing how to navigate the recently available COVID-19 financing options for small businesses. So tune in and listen at chirotouch.com/podcast or wherever you like to listen to your podcasts.

Thank you again for listening to Catch up with ChiroTouch.

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