Ivan Delman, DC offers tips on how to develop and maintain a strong practice through management.

by Ivan Delman, DC

You’re Normal!

Have you recently been in front of a mirror, tugging and jumping up and down while trying to zip up a pair of pants or get into last year’s dress? If you’re like most of us, several minutes of huffing and puffing later, you glared at your reflection loudly and proclaimed to no one in particular, “I have to get on a diet!”

Congratulations! You’re part of the “normal” majority. Every day, we’re seduced by television shows, newspaper ads and magazine articles. They all display pictures of beautiful people who have been skinny their entire lives. These lean actors tell us that if we gulp down their “Special Miracle” diet, we’ll also look beautiful, other beautiful people will be chasing us down the street and we’ll have beautiful, enchanted lives forever after…


As a lifelong chunko, I’ve tried hundreds of fad diets. They all went down screaming and kicking to failure. The only losses I experienced were from my bank account.

Where Am I Going With All This?

Most fad diets, like most tax refunds, don’t last very long. There is no one magic diet, just as there is no one mystic answer to managing a successful practice. There are many answers. They all can be found in the proper management of your operating details.

Just as thousands of computer screen pixels constitute the total screen image, the many management details, when put together, will constitute your total practice picture. As your career progresses, you’ll discover additional personnel can be of great assistance in handling those important details.

For example, when we start a new practice, we wear many hats. As we grow, staff is added to help cope with the expanding practice. The supposed purpose of the added personnel is to help you handle the additional work created by your growing practice. Remember, I said, “supposed purpose.”

To know whether you’re really getting power productivity from your personnel, you have to be aware of what they’re accomplishing.

Knowledge of Your Practice Is Power

The best way to monitor the work quality of your staff is to have an overall understanding of how your practice functions. That doesn’t mean you have to do it all yourself, you just have to have to understand how all the facets of your practice function. The most practical way to manage your practice is to delegate responsibility for selected jobs.

You must be certain that whomever you assign a task to has been given sufficient control to complete that task or job. Otherwise you might as well send an employee to catch fish without a hook. You, however, cannot give up the overall authority for the job’s satisfactory completion. That procedure is called delegation.

Delegate Not Relegate

Successful managers delegate job responsibilities to their staff. The key word here is delegate, not relegate. In other words, you hand out job responsibilities but not job authority. Your staff now has the responsibility to accomplish those delegated tasks. As manager, you have the authority to determine if that delegated task was performed to your satisfaction.

Being able to delegate responsibility without relegating authority requires building a winning team. Building that winning team is not accomplished by paying them high wages, giving them free hot dogs or providing wide-screen monitors.

Three Team-Building Principles

1. Develop a strong channel of communication between you and your team.

Of course, don’t make this strictly a negative system. It should be balanced. A congratulatory pat on an employee’s back will have twice the impact of a punch to their arm telling them they messed up.

At your weekly staff meetings, make certain all team members have been assigned projects to report on so that everyone at the meeting participates. This responsibility will help them grow to be strong and useful employees.

2. Be truthful when making statements to your employees.

The flow of honest information and suggestions should go in both directions; otherwise, it’s not healthy, it’s dictatorial.

For example, we’ve all seen the doctor/manager who continually complains to staff about low new patient intake, poor collections or too many appointment cancellations. There should be a higher proportion of sharing with your staff when the numbers are great or your collections are up from the previous quarter. These positive statements are essential for building staff receptive to your comments.

Share both the good and the bad. Sharing financial and patient statistics during staff meetings isn’t giving away trade secrets. If your numbers are strong, good. If your numbers are weak, your staff can help.

Discuss production figures at your weekly staff meeting, then ask for suggestions. You’ll get good ideas from this information exchange as long as your staff feels you are being truthful with them.

When you share information with your staff, it’s a fact of life that employees will talk to each other about your practice. They will talk about both the good and not-so-good parts of the practice. To avoid interoffice conflicts between staff and management, it’s extremely important to maintain honesty in your discussions with them. Try to con one of your staff, and it’ll come back to bite you.

A Con Story

The butcher had only one pot roast left in his display case when a little, white-haired lady walked in and quietly asked for a pot roast. The butcher pulled the remaining one from the cooler and said, “Here’s a good one for $13.” She said, “Too small.” The crafty butcher carried the $13 roast to the back room, waited a few minutes, then returned, carrying the same piece of meat. He said, “Here’s a better one for $15.” The wise woman looked at the butcher and said, “That’s great! I’ll take both.”

The butcher’s dishonesty came back to bite him. He was wrong and tried to treat one customer unfairly. Which leads us to the third and final principle…

3. Be Impartial

This means equal and consistent treatment for all members of your practice. These days, this is a complex issue in the increasingly complicated world of personnel relations. In order to be able to offer impartial treatment to your employees, and remain within current legal boundaries, it is imperative to have expert help.

Most of our practices do not have enough personnel to justify a position in Human Resources; however, we all need a well-crafted personnel manual. We hired an independent HR contractor to put together a manual. (The components are outlined in our book, The Business of Chiropractic.) She also updated it yearly with the latest rules and regulations.

All new staff members were allowed time during their workday to sit down and read the manual. After they finished, together we reviewed several sections of the manual such as the various disciplinary steps, raises, vacations and reviews. When the new employee indicated they had no more questions, they signed a form that indicated they had read, discussed and basically understood our personnel manual. The manual was kept in an accessible place for reference.

The personnel manual helped us prevail during several labor hearings and precluded countless other problems by delineating our office policies. A personnel manual is another example of how managing details (in this case, regarding personnel) will simplify your work. This will give you more time to concentrate on directing your practice toward accomplishing your goals.

In summary

Please remember there’s no one magic pill to make your practice the wonderful thing you desire it to be. A great practice is built on the solid foundation of competently managed details. An integral part of that foundation’s strength is empowering your personnel through your knowledge of the big picture.

As you and your staff work in harmony to handle those important details, your practice will begin performing a symphony of wonderful chiropractic music.

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