Where Is Your Joy

What is a day in your office like for you? Is going to the office work, or fun? Where is your joy?

Is it just the thing you do to pay your bills and support your family? Is it what you thought it would be when you were in Chiropractic school? If not, why not?

How much of your time and energy are consumed by administrative chores like paperwork or dealing with and trying to motivate staff? Are you stressed by a high office overhead? Do you feel like a salesman trying to sell your patients on extensive treatment programs? Do you have to beat the bush for new patients? How much time and energy do you spend trying to educate people about Chiropractic? Are you having fun?

THERE ARE ONLY THREE REASONS TO PRACTICE CHIROPRACTIC: SERVE PEOPLE — HAVE FUN — MAKE MONEY

If your focus is on serving people then having fun and making money are inevitable. It really is as simple as that.

The key lies in giving the patient what they want. They all want the same thing — to feel better and be free of pain as fast and inexpensively as possible.

Give them what they want and your patients will love you, trust you and spread the word.

When your patients see that you have no agenda other than helping them, they will trust you. As trust and confidence in you build, they will come to think of you not just as their Chiropractor, but also as a friend and confidant. You may become the doctor they consult first for all manner of health related issues.

Many will check with you about the recommendations of other physicians. They will do this because they respect your opinion and have confidence in your judgment. And because they know you care.

When a visit to see you is something that patients look forward tor as opposed to a time-consuming, expensive chore to be endured, you will be on your way to a practice with minimal stress and a lot of joy.

JOY IS CONTAGIOUS. When patients perceive your joy in helping them, they will be happy and they will want to share the joy. They will want to tell their family and friends about it. Your practice will grow. Your stress will diminish. Your days will be fun. Your work will be your joy. THAT IS SUCCESS.

So How Do You Find Your Joy?

Do What You Love, Do It Well, Have Fun Doing It.
Follow Your Passion, Focus on Your Patients, Find Your Joy.
Live and Work with Passion and Joy and Success and Money Will Follow.

That is How I Find My Joy — and by Being the Best Chiropractor I Can Be.

Do I think that I am the best Chiropractor in the world? HELL NO! But I will die trying to be.

The truth is there is no one who can be called THE BEST. Some arrogant clowns will claim the title, but they are fooling no one but themselves.

I do know some really great chiropractors. They are not only great technicians; they are people with a great depth of knowledge, experience, and above all WISDOM. These are the doctors I would go to if I had a serious health challenge. They are the doctors who not only have holistic practices, but holistic minds. They see big pictures, not microcosms.

This year I agreed to do a series of articles for The American Chiropractor magazine. Each article called for me to interview a chiropractic technique innovator and teacher. It proved to be one of the best things to happen to me in a long time. It introduced me to some of our profession’s rising superstars, some of whom I didn’t even know existed.

What a great experience for me. It has certainly enhanced my personal and professional life, and has increased my level of joy.

Since the year 2000, I had been “Lay’n Low in Abaco,” surfing, sailing and diving, semi-retired in paradise. Problem is — paradise is an intellectual wasteland.

I really needed some intellectual stimulation. Learning about the profession’s latest innovations directly from the people who did the research and development, proved to be just what I wanted.

Then I took it a step further. Instead of just writing about the doctor’s techniques, I took it upon myself to study and become proficient in them, remaining true to the pledge I made to myself and my patients 45 years ago: To always give my patients the benefit of the best state of the art care chiropractic has to offer.

Today, at age 65, practicing in the out islands of the Bahamas, I am more excited and enthusiastic than ever about my work and the constantly evolving art and science of Chiropractic with its expanding role in healthcare.

I am semi-retired and living in “paradise,” but if you really want to know the truth, it often seems I have a lot more fun in the office taking care of people than when I am out “playing.” After almost 43 years in practice, I still really love what I do.

I would like to share with you how I keep my referral-only cash practice fun, exciting, joyful, rewarding and constantly growing.

YOUR MISSION, IF YOU CHOOSE TO ACCEPT IT …

… is to cultivate your healing consciousness, a dedication to excellence, and never say or think the words, “that’s good enough.”

Remember these words from an old airline advertisement: “WE EARN OUR WINGS EVERY DAY.”

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A Patient Focused Practice

What is a Patient Focused Practice? The answer to this question may help you to enjoy more satisfaction and success as a chiropractor.

I often get questions from chiropractors who have been struggling to define themselves as doctors, to define and shape their practices and to find the success they had hoped for. Many are truly frustrated, distressed and dissatisfied. Some are ready to give up.

I can honestly sympathize with this. I really do know what such struggles are like. I remember my own early years when chiropractic was still less than a generally accepted and respected profession. Back then we were still struggling for legitimacy and licensing in several states. I certainly had my own challenges creating a successful practice. It was not easy, but I did manage to do it.

And now, after 45 years as a chiropractor, and after building 3 separate practices (now working on number 4) I still love what I do. I still get up excited to go to work, excited to discover the new challenges and rewards each day brings.

However, I could not have maintained my love and enthusiasm for my practice for over 45 years if I were just a “backache doctor.” Nor would I be happy if I felt I needed to use fancy pitches and marketing campaigns to “sell” my services.

I am not a salesman, nor do I want to be. That is not how I want to spend my time and energy. I am a doctor, a chiropractic physician. I have a Patient Focused Practice and deliver personalized, Patient Focused Care. That is how I choose to spend my time and energy – and if I do that right, my patients do my marketing for me.

That is not to say that I didn’t play the chiropractic salesmanship game for a while. Over the years I subscribed to a few practice management seminars/programs/services. I was not happy with any of them. I found them to be a waste of time and money. Worst of all they caused me more conflict than clarity. Luckily I recognized that before I got in too deep.

Most of these programs push doctors into trying to build a huge, high overhead practice with several hundred patient visits a week and as many new patients as possible. That is a trap many doctors have gotten into, only to find themselves working long, hard hours just to cover their overhead. The gross numbers may sound impressive.

But what about the bottom line? And even when they are lucky and their net income turns out to be pretty good – most find they don’t have the time and energy to enjoy it. And by the time they can afford to retire, they have so abused their bodies, they can’t enjoy that either.

I do not think the high overhead model of practice, with huge gross numbers dependent on high pressure sales tactics, works for most people. And certainly not for those of us who have the soul of a healer. Nor for those who want to avoid unnecessary stress and be able to sleep well at night without having to worry about how to cover all that overhead. Nor for those of us who just want to have a comfortable, happy, healthy life with time to enjoy our families and the fruits of our labor.

To me being a successful chiropractor means having a practice that is personally and professionally satisfying. One that allows enough time to take good care of all patients, and provides enough financial success to have a comfortable living with enough personal time, energy and health to enjoy it.

The kind of practice that has worked that way for me is what I call a Patient Focused Practice.

In my writing, I frequently use the term Patient Focused Care or Patient Focused Practice. Several of my readers have asked, “What exactly do I mean by that?” And how does it help a practice to grow and thrive?

My personal practice took on new meaning when I adopted the Patient Focused Practice Mindset, and made Patient Focused Care my practice model. To me Patient Focused Care means that every interaction with my patients is totally focused on their concerns. The patients’ needs, fears and worries, no matter how trivial they might seem, are honored and are honestly addressed.

The patient’s primary reason for consulting me is always the first thing I deal with. When I quickly, efficiently and effectively take care of their primary complaint, I rapidly establish their satisfaction with my performance, confidence in my abilities and an important bond of trust with me as their doctor.

This inevitably opens the conversation to other health problems or concerns they have, but might not have associated with chiropractic, or thought of as having a natural solution. People are often amazed and pleasantly surprised to learn that I frequently help my patients with their headaches, digestive problems, high blood pressure, weakened immune systems, allergies and asthma, metabolic disorders, endocrine deficiencies and imbalances and weight loss.

As the conversation progresses, I find that most people would prefer a natural solution to their problems. Many speak of their frustration or even anger over their experiences with medical care. Beyond that, they often voice real fear of the side effects of medications, hospitals and surgery. That means that many are not only willing, but happy to take a natural approach to treatment, and are delighted that they have found a doctor who can help them.

This opens the scope of chiropractic practice to one of true health care, reaching far beyond the treatment of back and neck pain.

Being patient focused means developing real, honest, trust-based patient/doctor relationships. It means really seeing, hearing and responding to your patients as unique individuals.

No cookie-cutter, same for everyone, wrack’em and crack’em, assembly line adjustments in my office! I focus on each patient, one at a time, and always consider their unique situations and needs.

By inviting patients to discuss all their health issues and concerns, by taking the time to really listen and have a personal conversation, by discussing the possible alternatives I offer as an alternative to the usual medical approach, I create a natural, relaxed opportunity to inform them of the natural, safe options I can provide. In this way I teach them about options they did not know existed.

I believe this is the right way for chiropractors to let people know what we do, without subjecting them to the transparent marketing of patient education and orientation programs that are promoted by many practice management gurus as the way to build our practices.

Patient Focused Care in a Patient Focused Practice is the approach to practice building I prefer. It is natural and comfortable for the doctor and patients. And it has worked very well for me.

Good, honest, competent patient focused care sells itself. Happy patients do your marketing for you.

Dr. Bill

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Stay Off the Injured List

Chiropractors: Stay Off the Injured List

(Originally posted on May 20, 2012 by Dr. Bill)

We are all conscious of the need to conserve natural resources. But how conscious are you of the need to conserve and protect your own personal physical resources?

Most of us, especially when we are young and enthusiastic, think that we are invulnerable, that we are ten feet tall and bulletproof. We work hard as we strive to build a practice and a life.

I personally worked crazy hours seeing a ridiculous number of patients per day with no thought of the toll it was taking on my own body. I was not alone — most of my friends were doing the same thing. We were hooked on the ego trip of being able to attract a high volume of patients. We were making a lot of money and most of us were living up to it, buying expensive toys, working hard and playing hard.

It was a rude awakening when one morning my body staged a revolution. I suddenly found myself on the floor in excruciating pain as I was adjusting a 120 lb. woman. I had heard of this sort of thing happening to other Chiropractors, but of course never thought it would happen to me.

The fact is that traditional full spine adjusting, or as I have come to call it — Full Contact Chiropractic — is indeed a rough game.

I was amazed when my friend Ed Miller, owner of Impac Inc®, told me that the Chiropractic profession has an attrition rate similar to professional football – and for the same reason — injuries. Tragically, many disabling injuries apparently occur during
Chiropractic school, well before the DC degree can even be awarded. That is very sad and unnecessary.

Being a Chiropractor shouldn’t mean that we have to sacrifice our own health or live in pain to help others. That is not a fair exchange. I live with pain every day because of my past excesses, thinking I was superman.

The good news is that if you are a young DC, you won’t have to hurt yourself to help your patients. I can still enjoy practicing today because of advanced Chiropractic technology. If I had to practice the way I did for my first 30 years, I simply could not do it.

In the past several years I have interviewed some of the contemporary masters of Chiropractic Technique. Each of the techniques I discuss are “doctor friendly” in that they
are easy on the doctor’s body. The articles I wrote following these interviews have appeared in The American Chiropractor Magazine, and I am currently planning more interviews and articles.

I am also working on a soon to be completed book called Conversations with Chiropractic Technique Masters. It is a collection of those articles with additional material and commentary on my personal experience using those techniques in my practice.

Conversations with Chiropractic Technique Masters will soon be published and available as an e-book from Amazon Kindle. BOLO, I think you will like it.

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TSA and X-ray Physics

TSA and X-ray Physics

(Originally posted on November 29, 2010 by Dr. Bill)

The biggest travel days of the entire year are upon us, and the hottest subject of media attention is the controversial airport security screening practices that are being carried out by the Transportation Security Authority (TSA).

Anyone traveling by commercial airlines flying out of most airports is faced with the choice of two screening procedures. They can either submit to full body X-ray imaging, showing the individuals anatomy in intimate detail, or they can “opt out” and thus have to submit to a very personal “pat down” which includes the manual exploration of everything including breasts and genitalia.

Many people take exception to the idea of both practices as being an extreme invasion of privacy and a health hazard. Others justify the procedures as necessary to protect the public from terror threats.

Others express concerns over the dangers of radiation exposure, and consequent cancer risk caused by the screening machines. This charge is summarily dismissed by TSA officials who claim that their screening machines create minimal or “low level” radiation exposure. They go on to claim it causes little if any public risk. They say that the X-ray exposure is comparable to that which passengers are exposed to in an hour or so when flying, and that is supposed to make it acceptable.

Nowhere in this debate have I heard any discussion of the physics of X-rays and how it effects the human body. As a chiropractor with extensive education and experience in the use and effects of X-ray, I can assure you that they are indeed dangerous. I take exception to the TSA’s claim that the ‘low level” of X-rays generated by their machines are not in any way harmful.

My opinion is based on my knowledge of the physics of x-rays. There are three factors involved in the production of x-rays. They are miliamperage, kilovoltage, and time.

Milliamperage is the measure of the actual amount of X-rays produced.

Kilovoltage is the measure of the electrical power propelling the X-rays.

Time is the duration of X-ray production or exposure.

The characteristics of the image produced by X-rays are dependent upon the combination of the above factors adjusted to produce the desired quality of image.

The cleanest X-rays are produced by a combination of low milliamperage or a small amount of X-rays, powered by high kilovoltage for the least amount of time, dependent upon the thickness or density of the subject to be imaged. This is known as a high Kvp, low Mas technique.

This is the kind of x-ray technique chiropractors use to get finely detailed images of the spine for bio-mechanical analysis. The benefit to the patient is a minimal amount of time exposure to a minimal amount of ionizing radiation.

X-rays penetrating human tissue under high power for a short duration of time are the least damaging. The image produced in this manner comes from a small amount , but high percentage of the X-rays produced, reaching the imaging material. This minimizes what is known as scatter radiation.

Scatter radiation does not penetrate the tissue, but is absorbed by it , damaging it, effecting it’s cellular structure and DNA. This causes it’s carcinogenic effect.

X-ray images such as those produced by the airport screening machines can only be produced by a low kilovoltage (power), high milliamperage (a lot of X-rays), and a long exposure time.

The length of exposure time is the major factor in determining how much damaging radiation a person is subjected to. The other factor is that the minimal penetration by Xrays necessary to produce the detailed full body image coincidentally produce a maximal amount of scatter radiation, due to the fact that a relatively few of the X-rays pass through the body and most are absorbed and are therefore damaging.

A properly exposed spinal X-ray is taken in a fraction of a second. The X-ray beam is collimated or limited to expose only the part to be imaged.

The airport screening X-rays expose the whole body for as much as 30 or more seconds. That is an unacceptable amount of radiation to expose people to. Read more about the damaging effects of X-rays, in an article, Protect Your DNA from CT Scans and X-rays, by Robert Klein published in the August 2010 issue of Life Extension.

In summary, it is the multiple levels of X-ray penetration of body parts that produce the intimately detailed full body image. This can only be done by a long “dirty” exposure to damaging radiation.

It is important to note that x-ray exposure is cumulative, making it a real health liability to frequent flyers and airline personnel. However the health liability to the occasional flyer should not be overlooked and must be considered in the context of other sources of radiation exposure, such as medical X-rays and CAT scans.

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Back To Basics – A Great Success

Back To Basics – A Great Success

(Originally posted on August 30, 2014 by Dr. Bill)

My class at the FCA National Convention last weekend—Back to Basics: Practice from Above Down/Inside Out—was a great success!

The FCA National Convention which was held in Orlando last weekend was a class act, as usual. The folks at FCA really know how to put on a party. This one was special for me because I was honored to be on the program for the first time.

The title of my class was Back to Basics: Practice From Above Down / Inside Out.
Based on the idea of excellence in patient care with the focus on each patient’s individual needs, I called for a return to the philosophy of patient care that made our profession great in the first place.

The Patient Focused Practice

I believe in a patient focused, patient centered practice in which we slow down enough to give each patient the individualized attention and exceptional care that he deserves. This creates a real “WOW’ experience that makes people want to refer friends and family and helps you grow your practice organically, from the inside out.

A Hands-on Demonstration of Examination and Treatment Protocols and Techniques

The class was much more than a lecture on philosophy of practice, however. More than half the class was a hands-on demonstration of my unique approach to the new patient’s first visit, including the consultation, interactive examination and treatment protocols using instrument adjusting techniques.

I showed the patient exam protocol I have developed over several decades, which includes aspects of many well known and accepted technique methodologies. I have put them together in a way that gives me the best, most complete picture of what is going on with the patient, and utilize muscle testing to make the exam truly interactive so the patient can see/feel his own weak areas.

After the treatment she can see and feel the way the muscle tests strengthen to indicate improvement. Patients always love to get this kind of immediate feedback, which reassures them that something good has happened.

After doing a complete exam of a real patient and announcing and recording my findings, I continued to demonstrate my treatment protocol based on my specific findings. Again, I used a combination of techniques that I have studied and used over almost 5 decades of practice. Some of them are traditional and involve manual adjusting techniques, but these days I use more instrument adjusting.

I shared with the attendees an x-ray of my own damaged spine:

Dr. Bill's back injury x-ray

Dr. Bill’s back injury x-ray

Note collapse of the body of L3.

The instruments and adjusting technique style I use today saved my career after four years on disability. Learning to do this kind of instrument adjusting has allowed me, not only to get back into practice, but to do the best work of my career.

The icing on the cake is that the patients love it. It is comfortable, effective and eliminates most of the snap crackle and pop adjustments that can be a turn off to patients, and which sometimes prevents prospective patients from ever seeking chiropractic care. Those noisy and forceful adjustments that scare many patients are also the high impact, full contact chiropractic moves that injured me and so many others.

Did you know that the chiropractic profession has an attrition rate due to injuries that is comparable to that of professional football players?

Using the instrument adjusting techniques I teach can help you protect yourself from injuries like mine, allow you to work more comfortably and effectively with a technique that patients love and that gives consistent, superior results.

The techniques I use can help you extend your career while giving you some of the most patient friendly and effective methods you can use to help you grow your practice organically: “from above down and inside out.” They certainly have helped me to remain active and enthusiastic about practice after 47 years. I really love what I do and the results I get never cease to excite me. There is nothing routine or boring in the way I practice.

There was one other aspect to the course that I want to be sure to tell you about.
In addition to demonstrating technique, I also showed how I and my wife Kiana work together as a team. Our team approach is unique. She acts as my assistant in a very active and interactive manner. She records every detail of my examination findings and treatment procedures which I communicate to her in an ongoing dialog. This serves multiple purposes:

  1. The dialog between Kiana and me tells the patient that everything I do has meaning, a name and importance. It lets the patient know that what I am doing is very exacting and that we take their care very seriously. It is a different kind of patient education which I find to be very effective.
  2. It provides excellent documentation of each and every visit, and shows that every single treatment procedure I do is justified by an objective exam finding. This puts me in a very strong and defensible medical-legal position.

Kiana and I both enjoyed presenting this class. It was a lot of fun to do. And I got great feedback from the doctors who attended my class: “Excellent presentation, we need more classes like this!”

My goal for the remainder of my career is to share with the next generation of chiropractors, the experience and expertise that I have acquired over a half century in chiropractic.

If you are interested in attending my upcoming seminars, please contact me with your name and email address and indicate what your interest is. We will be sure to let you know when I will be teaching my next classes.

Dr. Bill

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Chiropractice Made Perfect

Chiropractice Made Perfect – Part 2

(Originally posted July 16, 2014 by Dr. Bill)

It has been a long time since I have written here. A lot has been happening. It has been a busy time with big changes. And I have some exciting announcements to make.

In 2012, Kiana and I decided we really needed to spend more time with family and friends in the States. We still love living and practicing in the Bahamas and do not want to give it up completely. So we decided to find a way to have both.

We spent almost two years searching for the right home. Although it was a joyful thing, the actual logistics of making the move, establishing a new practice, and adjusting to life back in the USA after over a decade of island living has not been easy.

I will now be splitting my time between my new home in Mount Dora and my beloved Abaco islands. I have established a new practice, the Koch Wellness Center, in Mount Dora, Florida, and will continue to see patients in both places. But I want to do more and having a home in Florida will make it easier for me to pursue the next phase of my career.

Chiropractic has been my love and passion for 50 years. I love being a DC and feel blessed to have had this great profession that has given me such a wonderful, fulfilling life with material success and the joy and satisfaction of not just helping people, but of changing lives.

Now I want to give back to my profession. I have a deep desire to share what I have learned during my half century of experience. So I will now be spending more time on my other two passions: writing and teaching.

While I plan to keep doing what I do, to continue to take care of my patients as long as I can still move, I want to be able to reach more people — to help more patients than I can possibly take care of myself. Helping other DCs to learn and grow professionally will allow me to have a positive impact on so many, not only the doctors but also their patients.

I now want to share my expertise and experience with the younger generation of DCs, to help them help more people and enjoy the kind of success I have experienced.

I would especially like to be able to help young chiropractors, new to the profession or students about to graduate and enter the profession for the first time. I want to help them become the very best doctors they can be. I would like to be able to help them with the transition into their new career, to mentor them in a way that will help clarify any confusion, focus their career goals and to teach them some of the technique secrets that I have acquired and perfected over almost 50 years of practice.

Many of these young docs will be starting their careers with a huge debt burden in the form of college loans. And if they want to start their own practice, they face all the expenses of starting a new business, which could mean taking on a lot more debt. It can be daunting to get out in the world with the desire to start a practice when the costs involved in doing so can be so high.

Getting deeper in debt is never a good idea, but in today’s economic climate it is especially scary. The politics of healthcare and the new and constantly changing state of the insurance industry create more and more uncertainty, and make it harder and harder to plan and to know how to proceed.

I want to share my personal philosophy of practice and my own business model, which I think, could really help with many of these issues. I do not believe starting a practice needs to be exorbitantly expensive.

I am a strong advocate of getting back to the basics – to what made our profession succeed and grow in the first place: great technique practiced by a skilled and “patient focused” doctor in a very personalized way with the goal of getting great results quickly. And I believe this kind of practice can be successfully established with very little overhead and without taking on a huge debt load.

I have done this myself, having started 4 unique practices, all of them successful. I want to share my experience so that others may benefit and in the hope that it will shorten their learning curve and eliminate a lot of the “trial and error” aspects of starting a new business. Especially the errors part.

During my long career I certainly have made my share of mistakes. I have learned a lot along the way. It was a bumpy road. I want to help pave the way for new docs, smoothing the road they travel, helping them avoid the bumps, potholes and pitfalls by sharing my own experience, my mistakes and my solutions for success.

Spending more time in Florida will allow me to do this more easily.

Which brings me to my next announcement: I am pleased to announce that I have been chosen by the Florida Chiropractic Association to be on the program at their National Convention August 21-24 in Orlando, Florida. (http://www.fcachiro.org/index.php?option=com_content&task=view&id=433&Itemid=62)

My presentation is scheduled for Friday the 22nd from 10:20 AM to noon and is titled, “Back to Basics: Practice from Above Down/Inside Out.” I will be discussing the importance of the initial consultation in establishing the doctor/patient relationship; and will then demonstrate the way I examine and treat a new patient using an interactive, multi-technique approach that actively engages them in every step.

My sponsor for the event is Impac, Inc. (http://www.impacinc.net/) and I will be spending a lot of time at their booth answering questions, doing demonstrations and signing copies of my new book Conversations with Chiropractic Technique Masters.

I look forward to meeting many of you at this fantastic annual event.

Dr. William H. Koch, DC

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