Ivan Delman, DC offers tips on how to create a strong and cohesive staff for your practice.

by Ivan Delman, DC 

Twinkies for Teamwork

I read that the Saturn Corporation had placed the largest Twinkies order in the history of Continental Bakery. What was a carmaker doing with all those Twinkies? Well, it seems that Saturn management handed them out to employees to celebrate company events.In this case, it was the launch of a new car model.

Before you dismiss the above news while mumbling to yourself, “That’s as dumb as failing a blood test,” remember that the Saturn Corp. is one of the few car companies that actually make a profit from their operations.

Besides new car launchings, Saturn management also hands out Twinkies during meetings. This is to reward the exceptional efforts of an outstanding production team.

Let’s look at the reasoning behind Saturn’s efforts to cause periodic sugar-rushes in their employees.

Twinkie “attaboys” are just one of Saturn’s ways to build teamwork within their Spring Hill, Tennessee, plant. The reason it caught my eye was because it was a good example of how even a large corporation recognizes the dollar value of strong teams in their plant.

Chiropractic Twinkies?

I’m not sure if Twinkie distribution is your answer to building a strong staff. However, I do know for a fact that the concept of a strong team is directly applicable to the operation of any successful chiropractic practice. I also know that well-planned staff meetings are even better than Twinkies for strengthening your office team. The following ideas will help you plan and manage effective and productive staff meetings.


During office hours, we are usually busy. Our hours are filled with numerous activities. Thanks to hectic schedules, some of us tend to make staff meetings a second or third priority. If you are in this category, you’re missing a super opportunity to strengthen your staff.

Although well-planned staff meetings are not the only answer to building strong staff members, they are an excellent tool that will produce almost immediate dividends.

Boring Meetings

If you love to stand up and pontificate for endless hours about your favorite topic du jour, you may want to change that inclination.

Meetings are a total drag to the staff when one person dominates them. The staff will feel stressed (Because they can’t stand up and holler, ‘SHUT UP!”) The members attending will be uncomfortable when they are forced to listen to Dr. Yakkydack drone on for an hour.

As a rule of thumb, at least 50 percent of your staff should have something to say during any staff meeting (unless you have a guest speaker).

Many experts indicate that if you have a relatively small staff (less than 10), the meeting frequency should be once a month. I favor a meeting every two weeks. A two-week interim provides enough time between meetings to get assigned projects researched and accomplished. That time period is also close enough to address the results of those assignments in a more timely fashion.

A Few Basic Rules

Below are some points that’ll help you run an effective meeting:

Start on Time

Don’t penalize those who are on time by making the group wait for a latecomer. This is not only unfair, but if the meeting has started, it suspends the meeting until that person gets seated. If the lateness becomes habitual, it’s time to have a private talk with that person.

Have an Agenda

Make certain everyone has a copy of the agenda prior to the meeting, especially if there are some people who have been assigned to report on a task. That’ll remind those who have to make a presentation to be prepared.

On items discussed at each meeting, make certain that they are followed through to conclusion.

All staff should have the follow-up and final information on that discussed subject. This has to be done in a consistent manner, or your staff will eventually feel that they are wasting their time debating and discussing issues at the meetings. At the very least, it’s demotivating.

Keep on Track

Meetings will have a tendency to wander off subject if allowed. The job of the facilitator is to keep that meeting on subject and as close to the agenda as possible. If an important off-agenda matter has been brought up, then assign someone to get further details, place it on the next meeting’s agenda, then have that person report on it. Also, get a volunteer to take notes at every meeting.

End on Time

Let everyone know the length of the meeting and stick to it. We used to either set a timer or have our minutes-taker let us know when it was time to wrap up the meeting.

Running Your Meeting

The basic activity of a staff meeting is to discuss mutual problems and share mutual successes. When the majority of your staff members participate, it will strengthen the working bonds between team members. Here are a few guidelines to help that meeting be productive and smooth running:

• One of the key elements of any good staff meeting is to have interaction from as many attendees as possible. To help make this happen, there should be minutes of the prior meeting and an agenda passed out to all staff prior to the meeting.

• The minutes should also remind attendees that if they have something to present at the next meeting, they should contact the person making up the agenda. By doing so, that presenter will be listed on the next meeting’s agenda.

• The agenda should be handed out a day or two prior to the next meeting. The agenda names people who have been given assignments and indicates that they have a report to give at the next meeting regarding the progress of that assignment. It’ll also state any new subjects that will be brought up at the upcoming meeting.

A quick comment on the form of the agenda: You can find both complex and simple agenda forms on the Internet. I prefer the simple form.

If you don’t want to look around the Internet, send an e-mail message to Ivan@BusinessofChiropractic.com. Ask for the “Agenda Form.” I’ll email you back with an attachment of that simple form.

• There also should be someone who will be writing ideas and items onto a blackboard as they are discussed. The facilitator of that meeting should handle the blackboard.

Something Extra

To add a different flavor to your staff meetings, it helps to occasionally bring in an outside speaker. That speaker should be someone who will speak for fewer than 30 minutes on subjects that should be useful to the operation of your practice.

The reason I mention 30 minutes is so that there is time to cover any urgent office business.

The speaker could present a training session for such items as HIPPA, office organization or patient processing. It could also be someone trying to sell you some type of service or office equipment.

During the Meeting

The blackboard should be set up along with comfortable chairs. The phones should be placed on “answer” and there should be no interruptions to the meeting.

When we first started our meetings, we had a problem with interruptions. This was because they were held in the reception area, which had glass doors.

When patients walking by spotted us sitting around, they would sometimes knock on the door to ask a question or do some sort of business. This usually shut down our meeting.

We moved our meetings to the rear of our office and were not again interrupted.

Starting the Meeting

Usually the meeting started off with a short update statement or announcement of an upcoming event. If there were no assigned tasks to be discussed by staff, we would go around the room to see if there were any problems or successes to discuss.

In the first few meetings, the staff members usually said there was nothing to discuss. So, I placed myself on the agenda and brought up a problem and a success story to give them an idea of what we wanted. I then asked staff to help with the problem and comment on the success story.

Also, after our first meeting, I handed out pens and notepads to all the staff members; each staff member now had a pad with their name on it. I told them to have the notepad with them whenever they were in the office. When they ran across a problem or a success story, they were to make a note and bring it to the next meeting.

It still took several meetings before they got into the swing of things. Whenever I roamed around the office, I asked if they had the notepad. If we were talking about a problem, I asked them to write it down for the next meeting.

By the third or fourth meeting, pretty much everyone was participating. If they didn’t have any problems, at least they mentioned some of the success stories. This kept most of the staff involved during the meeting.


Here’s an example of the four steps we followed during the problem-solving portion of our meeting:

Identify the Problem

We made certain that we were describing the problem rather than the symptoms. Then, we wrote it on the blackboard.

For example, if patients were complaining to staff about waiting too long to see the doc, we didn’t try to figure out how to ease their waiting time. Instead, we tried to identify why they were waiting.

Identify the Cause

In this case, after going over many suggestions, we discovered I was the cause of the problem. It was my excessive socializing with my racing buddies who were patients.

Discuss Possible Solutions

We would brainstorm as many possible solutions as we could dredge up. Items such as duct-taping my mouth or giving a warning note to my buddies were eventually discarded.

We ended up with two possible solutions:

• Schedule my closest friends during the last appointments of the day. That way, if we visited too long, we wouldn’t hold up other patients. It wouldn’t be a bother to the staff since they would be busy doing their day-end chores.

• Work out a system to warn the doc that he was taking too much time during that patient visit.

Test Each Solution

This is when you take each feasible solution and test it separately. By doing this, you can easily determine the one that works best.

As we tried each solution, we kept track of the time patients spent waiting for treatment. The procedure that best reduced the patient’s waiting time would be the winner.

First we tried scheduling my buddies at the end of the day. This proved too difficult.

Our eventual solution was that the staff bought me a timer, which I kept in my pocket. I reset it each time I entered a treatment room. If I talked too long, it quietly vibrated, indicating that I had better start wrapping up that visit.

The system trained me well and after a period of time, I kept within our schedule without needing mechanical reminders.

In Summary

We found out that if the majority of our staff participated in our meetings, their involvement would carry over into their work after that meeting. This led to us solving a lot of little and big problems as a result of staff participation.

Many times I’ve heard staff discussing some problem they were working on or some success they were proud of accomplishing. They appeared to be interested and enthusiastic. The big story is that they were involving each other in the operation process of our practice.

Now that’s the sign of a winning team!

by Ivan Delman, DC. Reprinted with permission from Do Write Publishing.  

Dr. Delman is the author of the book The Business of Chiropractic: How to Prosper AFTER Startup. He has degrees in both business and chiropractic. After 38 years of enjoyable, productive work in both fields, he and his wife have retired to travel and write. He can be contacted at:  Ivan@BusinessofChiropractic.com.

Dr. Chris Clark, a chiropractor and consultant, purchased Do Write Publishing and Business of Chiropractic Publications in 2007. For more ways to improve your practice, visit  www.businessofchiropractic.com.