Subscribe
Share
Share
Embed
Welcome to Business School for the Rehab Chiropractor where we coach you on how to run the practice and business of your dreams. Your host is Justin Rabinowitz - a multiple Rehab Chiropractic practice business owner and investor. In addition to running his own locations, Justin works with Rehab Chiropractors across the US talking about everything from sales to marketing, and creating the business systems necessary to succeed.
Dr. Benjamin Stevens:
If they come back in a second or a third time with the same kind of injury over and over again, if your job as a clinician is only to get them out of pain, you're actually doing them a disservice.
Dr. Justin Rabinowitz:
That's Dr. Benjamin Stevens. He's a clinician and educator who spent years helping chiros and physical therapists in Canada and the US improve their clinical skills and communicate better. In today's episode, Ben and I talk about why so many chiros struggle to translate their good clinical skills into more patients. We also talk about why getting someone out of pain quickly is not the same as helping them, and why poor communication could be at the root of your patient not returning. We had a great talk today, so much so that we've even split this interview into two. So look out for part two of my interview with Ben over the next few weeks. It went so well that we're having him over to host an entire mastermind with our community.
If you want to hear more about joining that community and accessing Ben's talk and loads of other material to help your practice, head over to the link in the show notes and find out how to join. If you're new to the podcast, every episode we share the stories of chiros who are learning how to build their businesses and along the way, learning the lessons they won't teach you in chiro school. I'm Dr. Justin Rabinowitz and this is Business School for the Rehab Chiropractor. You have worked with, have a list of hundreds and hundreds of clinicians all over North America, I'd imagine worldwide. What patterns are you seeing over and over again?
Dr. Benjamin Stevens:
A lot of people, they don't have really good systems in place and they don't have very good guidance on what to do in business when they want to practice in a more modern way or when they want to practice more of a rehab or movement-based or strength and conditioning approach. A lot of the things that are out there are designed for more high volume practice. They're more designed for old school practice, they're more designed for a way that just doesn't really kind of vibe with a lot of the current generation and the way a lot of people like to do things, myself included. And so what people end up doing is kind of slapping together their own systems and figuring out their own way to do it and they struggle.
And I've had a lot of these conversations just in the last, I'm going to say maybe two months or something of that sort, just because I'm in the process of trying to create some more systems for myself and some of the people I work with, is that it's very, very common that people are excited about the service that they're offering, but they don't feel like they have a very good idea of how to present it in kind of one cohesive package both clinically and business-wise, and they're kind of struggling and they're flailing and they're spending a lot of time feeling very not confident as a result.
Dr. Justin Rabinowitz:
And so kind of getting into that a little bit, if we take it to the end result, you work with clinicians who are coming to you to get better at delivering the service, which at the end result of that, is they have patients who get better outcomes. But the challenge becomes when patients don't follow through with their plans or they don't have a plan set, or any of the other things that happen other than them getting the outcome they came in for. Why do you think that happens even when a well-meaning clinician knows what that person needs when they sit in front of them?
Dr. Benjamin Stevens:
I'm firmly of the belief that so many people that practice like we do want so strongly not to be like a high volume doc. They want so strongly not to be an x-ray everyone, take out these giant care plans. They want so badly not to be that, that they're actually afraid to sell. And maybe not sell as the right word, but they're afraid to actually express some conviction to the person sitting in front of them of like, "This is what you need, this is where we're going to go," and to gain that trust. In a strange way, because I think we're so afraid of betraying the patient's trust, we're so afraid of seeming too much like what we don't want to be and we want to be purely us, that we're really afraid to sound like them when the fact of the matter is we're actually doing a lot of patients a disservice.
It's funny that you phrased it the way you did, because I actually have had that specific conversation two or three times just in the last week with a clinician who went like, "Yeah, I feel like I'm doing really great. I knock it out of the park on the initial exam and then they're back for maybe two visits and I never see them again." And I'm going, "Okay, well, either you're a phenomenal clinician and you're getting people better in two or three visits every single time, or you have a huge communication gap." There's something about the way that you are structuring your initial visit and communicating the value of what you do that's just missing. And so I feel like you probably know this about me, but a huge amount of what I'm going to say to almost every question about where the problems come from is it's communication. And there's some underlying stuff beneath that, I think as well.
I want to touch on one really quick. I think one of the things that has happened with a lot of people who want to be very evidence informed and evidence based and very forward is that they are trying to be comfortable with not knowing the answer all the time. They're trying to be comfortable with saying, "I don't know." They're trying to be comfortable with the evidence changing their mind. They're trying to be comfortable with evolving and living in that space of having to execute really, really well for a patient and be sure for the patient, but then have the humility as a clinician behind the scenes to let the evidence influence them, to let the way that things evolve change how they practice. I think what a lot of people are doing is they're letting the kind of unsureness seep into the way that they communicate with patients, because sometimes the evidence isn't perfectly clear.
If someone comes in with something that is just kind of obscure, like one of the things they give as an example all the time is a cuboid syndrome or something like that, good luck finding evidence, good luck finding anything out there. Because I've searched for it myself, it doesn't really exist. I think a lot of the time if people know that what we do is kind of vague and loose from an evidence or from a scientific perspective, they're afraid to commit to an answer and then that transmits a lot of the time, to the patient sitting in front of them. When what will actually help the patient a lot of the time is committing to a path and auditing as we go, but people just won't communicate that.
Dr. Justin Rabinowitz:
This is something we see all the time in our mastermind group. So many people are excellent clinicians, but they really, really struggle to communicate. That means that treatment plans fall through and even worse, your patients don't get the help they need. If communication is something that you're struggling with, head over to the link in the show notes. We have a great team here at Rehab Chiro who can help you translate your clinical skills into full treatment plans and revenue for your practice. And in case you're wondering if it'll work in your area or town, just know that Ben works all over the US and Canada.
You said something earlier that I want to touch on, what you and I have talked about in the past of they see the client twice or the patient twice and it's like you either must be a really good clinician to get them the result or something else is going on. But then again, the disconnect is I look on your website and you have strength and conditioning stuff and DNS stuff and all the things that have nothing to do with pain. And so I'm just curious on your take on the whole idea of, "Well, I got them better in two visits." And then I'm always saying, "Well, how do you define better? Because we just studied all these things that have nothing to do with pain, but then you're saying they're out of pain." So I'm curious on your take on that.
Dr. Benjamin Stevens:
I think a big part of it, you and I have talked about this a little bit, is that we focus purely and only on the pain in front of us. And I think a lot of that is, again, because we're trying to get away from sounding like someone who's very evangelical or trying to talk about the innate. And so we go really, really far to being like, "Pain is all that matters. We get people out of pain, we send them on their way." And there's actually really nothing with that model, but one of the things that people are getting better and better at doing is using a lot of the systems and a lot of the kind of tools that we have to get rid of pain very, very quickly.
And by that, I mean, if you establish someone's directional preference really quick, you phenotype them really quick and you get really good at inflammatory control and you get really good at stabilization strategies and you do these things, people can come in with something really acute and really flared up and you can have them calm down really quick a lot of the time, depending on the patient population. And so there's this kind of amorphous place whereby we don't want to get so far out into left field where we claim to know the why behind every single pain that comes in and that we're going to address that every time, but we do need some other form of kind of objective measure or some kind of gold standard that we want to hold people to, where especially if they come back in a second or a third time with the same kind of injury over and over again, if your job as a clinician is only to get them out of pain, you're actually doing them a disservice.
If three times in a year, someone comes in with a completely flared up low back and every time you've seen them two visits and you've gotten them out of pain and then you send them on their way, you probably actually haven't done a great job of addressing lifestyle factors of addressing movement quality, of addressing strength or functional capacity and all these other ways that are actually serving that patient in the long run. And so I think a lot of the time we are getting better and better at getting people out of pain quickly, but we want so badly not to make it about subluxations and spinal curves that we're actually afraid to talk about, "Hey, strength and conditioning matters, movement quality matters, lifestyle matters, nutrition matters." All these other things that we could do to really impact patients' health, we're kind of afraid to touch on them a lot of the time. And so we end up in this weird, obscure space where people feel enough better in a short timeframe and then we kind of leave them alone and hope that they're going to send friends our way.
Dr. Justin Rabinowitz:
You've said before and just hitting on it now that communication is everything. And you gave us great ideas of strength and conditioning and, essentially, I call it reentry into movement, strength and conditioning in that case. And if communication is everything and that is important, how would you or how have you gone about teaching other clinicians about how to do this best?
Dr. Benjamin Stevens:
A few ways. First I want to tell a story that's going to sound really strange. It was when I was in a preceptorship, I was working with a doc in one of the bigger cities in Canada, and I won't mention him by name in case he doesn't want that, but in the first day that I was shadowing in this preceptorship, I watched this doc go around. And one of the things he did... And he was what I would consider an evidence-based doc. He was a sports doc, lots of strength and conditioning, been to the Olympics over and over again, was doing the full gamut of care that all of us like to do. A little bit of exercise, a little bit of soft tissue, a little bit of nutrition, a little bit of everything. But I watched him go from patient to patient and he had wait list weeks long, and everything he did was very structured.
And so he actually, believe it or not, had a list of jokes that he would pull from on a daily basis and he would cycle through these jokes, knowing fully well that just building rapport really quickly with the person in the room was something that was really, really important to him. And so he had a list of jokes that he would find a natural way to bring up. And I heard him tell the same joke about 12 times in a day at one point. And I remember thinking at the time, "Seem so inauthentic. It seems kind of weird to just tell the same joke to a bunch of people." But that was a really immature way to look at it because he had really tapped into this thing that was really about planning what you're going to do, planning how you're going to communicate, planning what you're going to say, and then executing on it every single time.
I think we're generally kind of afraid of scripts. We're kind of afraid to sound like we're selling. We're afraid to sound like a car salesman or someone on the phone, and so we're afraid to actually plan what we say. And I don't think you have to plan down to the word what you say, but I do think going into every patient interaction, especially a new patient visit, with a structure of the points that you need to hit to make sure that they fully understand what they have going on, they fully understand the solution that you're going to bring them, they fully understand the full extent of how it's going to extend into the future and how that's going to help everyone, I think that's really important.
Dr. Justin Rabinowitz:
Do you remember the joke?
Dr. Benjamin Stevens:
I don't. It was really perverse, I'll tell you that. I know that for sure, because he just absolutely loved just a stupid dick joke. And it didn't matter if it was a guy or a girl, he would tell the same joke every single time.
Dr. Justin Rabinowitz:
This episode is brought to you by Jaen, a practice management software and EMR built to support you in the day-to-day work of running your business. If you're a health or wellness practitioner, you already know. The care you provide starts well before your patient arrives and extends far beyond the treatment room. Jaen is here to support every part of that experience. With online booking, your clients can book at a time that works for them. And with features like wait list notifications, they'll even be able to grab last minute openings when they pop up.
It's an easy way to keep your schedule full while getting your patients the care they need. During your appointment, Jaen's AI powered documentation feature can help you thoughtfully take notes so you can stay present with the person in front of you. And after appointments, you can end your time together on a healing note, not a transactional one, by charging the card on file. So guys, when Jaen reached out to me to become an ambassador for them, it was a no-brainer. In my community Slack channel, we have 140 chiros, PTs, US, Canada and all over the world. And this is the one piece of equipment software that consistently gets a 10 out of 10 rating. They talk about it all the time, they absolutely love it. And so when Jaen reached out to me to help them and be an ambassador for their brand, it was an absolute no-brainer and I am so excited to be able to work with them.
To learn more about Jaen, how they could support you and your patients, head to jaen.app/demo. And one last thing. If you're ready to get started with Jane, you can use my code, RehabChiro1MO, for a on month grace period on your new account. What I really love about Ben is that he teaches clinical skills, but he's also focused on running a really great business. He's not just focused on theory. I wanted to find out what other clinicians are struggling with and how he finds the time to help them. So when you are teaching clinicians or you are working with people in the vast amount at the volume that you do, what's the number one question that people ask you?
Dr. Benjamin Stevens:
There is no one specific question that a lot of people ask me, but there is a spirit behind a lot of the common questions, and that spirit is that they are looking for the thing a lot of the time. They're looking for the one thing and it's going to depend on what I'm teaching on. So a lot of the time they will look for keywords or phrases if it has to do with communication. They'll look for a certification if it's something clinical. They'll look for a modality, whether they have a question about shockwave and it's really important to them that they understand it fully. Or they have a question about a kettlebell, or they have a question about a book, or they have a question about these things.
And a lot of the time, the reason I say the spirit behind it is the same is because a lot of people kind of come up to ask questions flailing a little bit, kind of looking for something that's going to make it all make sense or looking for the magical cure. And that's the thing that I have a hard time answering because I can usually answer the question relatively well from kind of a logical or just scientific perspective, depending on what it is. But a lot of the time what I want to say is, "Yeah, you can understand this inside and out, but like you need a framework to hang this all on." You need kind of a greater system, an operating system both business-wise and clinically because there's no one ingredient that's going to make the meal. You got to figure out how to actually cook this whole thing and present it as one really good meal.
And so a lot of the questions have that spirit behind them of like, "Oh, here's this one little thing and I know if I get this right, this is going to blow everything up for me." And I go, "Yeah, sometimes." And that can be true, but it's usually only true for one patient. If you get really, really good at that one technique or really, really good at answering this one question, there's a good chance you're going to go back and you're going to have one patient, they're going to go, "Hell yeah, that helped so much." And then the next 10 patients that are going to come in, it didn't answer their question and you go back to struggling.
Dr. Justin Rabinowitz:
It's funny you say that because not vague, but I immediately thought of when I first got into practice, I was working as a chiro in a strength and conditioning facility and I remember sitting there during these meetings. And the first thing was they were doing FMS screening for the New York Giants. And they were like, "This is the thing that's going to transform our gym business." And they did it and it was good, but nothing that much changed. And then a few years later, this was 2012 and the timeline matters, so I graduated July. And in September they're like, "We're going to do a back to school thing where we're going to do this, that and the other." And they sent out postcards and all of that. And it happened to be Hurricane Sandy and basically our state was shut down for two weeks, no power, no nothing and that ended.
And I remember thinking to myself, "There is no one thing." It's a series of activities done over time. And if you keep waiting for the one thing that's going to change your business, change your life, change your clinical practice, you're probably going to be in for it. Which I think for me, as I reflect back since graduating in 2012, having a business now 11 years, the number one thing that I would say if someone asked me, why have I had any success, it's because of consistency, not because I sort of hit it out of the park. So that actually resonates with me a lot. The next question I have is one I wish people would ask me, is what question do you rarely get asked that you wish they would?
Dr. Benjamin Stevens:
Yeah, that's a big question. Usually the context matters. A lot of the time I get approached more often by people in their first five years of practice than anything. And I think people get to a certain point where they go, "Oh man, I thought I'd have it figured out by now," and they don't have it figured out. And that comes out behind their eyes a little bit where they're just kind of flailing. And it's not as if they're actually failing in practice, but they feel like they're chasing a million shiny objects and they're kind of looking for the cure to all that. And so the question, I don't know if there's a specific question I wish they would ask. I more wish they would look at me and say, "What do I not know that is holding me back?"
Because a lot of the time people come to you with a presupposed answer to their question or their question has an answer hidden inside of it. In a really stupid, basic sense, it would be like, "Well, what if I adjusted every patient at C3 on the left?" And you go, "Well, great. You hid the answer in the question where you just want me to validate something for you. You're not actually asking me to help you, you're asking me to validate whether or not you already have the answer." And I think the question I want a lot of people to ask is like, "What do I not know? What's going wrong here?" But it takes so much vulnerability for us to ask that of our mentors and the people in our world because we're afraid to find out that the answer's pretty immense, that most people don't ask that.
Dr. Justin Rabinowitz:
The false belief in practice or in business is that there's going to be one thing, one technique, one business thing that you're going to do that's going to revolutionize your practice. And I remember when I graduated chiro school in 2012, I was a chiro who was working out of a gym facility and that gym happened to do work with the New York Giants. I had heard through the grapevine that when they got that Giants contract previously, they thought that was the thing that that recognition was going to get them all the business they needed because they had this prestige of working with the Giants. And it probably helped a little bit, but it wasn't the boon that they thought it would be. And then I graduated in July of 2012 and the date is relevant because a couple months later in September, we had Hurricane Sandy in New Jersey.
Well, leading up to that, this gym was going to run a special. It was going to run a back to school special and they really thought the same thing, that, "We're going to run this one special and it's a back to school and it's going to completely change the course of our business." And so they send out the flyers and they set this all up and then we were closed for over two or three weeks and the state was completely wrecked by this hurricane. I always remember that as a lesson because in both instances we thought that there was going to be one thing that was going to completely revolutionize what we did in the gym and in the business and it just didn't happen. And it's always been something for me where I've looked at the business, whether it's a clinician or whether it's a business skill, that even more important than finding the one thing is to be consistently doing the important things over and over.
And I think that for me, it's been a great thing because if nothing else, I've been consistent in what I've done and the businesses that are the most successful, they don't find the one thing, they find the one, two, three, five, six, seven, eight, 10 things and they just consistently do them for years and then decades. With all the things that you teach or that you bring clinicians in to teach within your company, it can almost be overwhelming in the sense of there's so many different techniques that number one, they have to apply clinically, but then it needs to be communicated, which I think is a huge part of it.
My guess is that most of the time the people that you and I work with don't want to even have a script to be able to follow, which you've sort of alluded to. But how would you suggest someone that is like, "Yeah, I really want to have some version of a script to communicate on, but I don't want to feel overly scripted?" How do you even coach someone on taking all the stuff that they learn from you and then being able to implement it in a non-salesy, non-scripted way?
Dr. Benjamin Stevens:
Yeah. I'm going to give an unpopular answer here as a guy that makes a living off of guiding people. I wish people would just create it themselves. I wish people would have the humility to sit down and go, "What am I comfortable communicating? What is important for every single patient to know? What will actually help them and help me help them and put it all on paper and just hammer through creating your own?" I don't think that's the most efficient way to do it. I think the most efficient way to do it is to find someone that you trust, a good business coach, a good mentor, and kind of take notes and see what the patterns are that emerge and use that. But I think... Not I think, I mean, when I graduated from school, I went right into private practice in a brand new town where I knew zero people. And I started my own business and I hired people and I went right away and I was fully booked within months.
And a lot of that was not because of my business systems, it was because of my ability to do a really good job of communicating. And I wish I could say that that was all natural. It really wasn't at all. I mean, I had a speech impediment as a child and was deathly afraid of the spotlight for most of my life, but I was intentional about it. I knew what points I had to hit every single time. So I think the way that most people are going to feel good about scripting or feel good about planning their communication is if they start internally, inside their own selves as a human and kind of build it out from there.
I think that's a really, really easy way to do it. With that being said, you need to have a deep understanding of the anatomy, the physiology and the causes of everything that you could do, every test that you're doing on someone, every outcome you're looking for, every intervention and how they work, because you need to be able to be masterful at understanding all of them, boiling them down to a communication that's meaningful to the layperson really, really quick.
Dr. Justin Rabinowitz:
By the time this comes out, we'll almost be halfway through the year. And as we speak about the communication side, really the rest of 2026 for our business, Rehab Chiro is going to be speaking about a lot of this communication by the time the patient walks in the door. And the reason why I think it's so important is actually because of something that is going to change, which is all the stuff with AI. And the reason I say that is because so many things will be automated. There's going to be AI bots answering phones, there's going to be processes put in place, there's going to be admins. But the one thing, at least not today, is that when someone walks into your office, it's still a human interaction.
And what I believe is that the more we become AI agent forward, the more that the actual one-to-one is going to become even more important where people are going to crave that and it's going to become more awkward for people that don't do it. And so I don't think for the next four or five years, if I do nothing else in my business other than help people by the time people walk in the door, communicating with them to understand their problem and how to execute on it clearly, walking through, I don't really think there's much more ROI that I can provide for people. And so I think that with all this tech happening, it becomes even more important. Do you still treat patients?
Dr. Benjamin Stevens:
Rarely. I mean, I do probably more consults than I do actual patient treatment.
Dr. Justin Rabinowitz:
So most of your time is spent in the education space at this point?
Dr. Benjamin Stevens:
Yeah, it's either on the knowledge in the actual education space or the kind of delivery and structure behind it. Yeah.
Dr. Justin Rabinowitz:
One thing I'm passionate about right now in our field is how AI is going to help chiros all across the US and Canada. The actual hands-on clinician who might not change that much, but there's so much room for innovation away from the treatment room when it comes to AI. It's not surprising that Ben is taking full advantage of this new technology. How do you stay up on the technical developments and/or the education or research to make sure you can do your job, number one? And then how would you recommend a practicing clinician do that as well to stay up to date on the evidence informed side while still doing all the things that are required to treat patients and run a business?
Dr. Benjamin Stevens:
Yeah. I mean, to answer the first question, it's really easy now. It's significantly harder when you're in practice, to stay up to date on everything. And I think it's actually unreasonable to ask everyone to stay up to date on everything. I think it's more important to have the mindset of humility to know and to be able to kind of judge when things are coming in, whether or not you can use them. I think it's a stressful place to try to pretend that you can stay on top of all the research, all the techniques, all the latest thought. I think that's just a very frustrating game, but I think getting systems in place to do it are really important. But anyway, for me, I have a whole bunch of systems in place. It's really easy for me because I go to so many conferences and seminars and read so many papers and I have used a mass amount of AI to structure these things for me.
I don't get AI's interpretation of the evidence, but I will get AI to find the evidence and give me a roadmap a lot of the time of things that I'm looking for. As an example, last week, I was thinking so much about patient communication last week and about patient-doctor trust that I got AI, I got Manus to go create essentially a course for me, a podcast series for me on all of the nonverbal factors that doctors can use, or that we know there's evidence for or against when it comes to building patient trust. And this was literally everything from facial hair, tattoos, the color of your paint, the humidity in the room, the type of lighting, the car that you drive, whether you're ground floor or second floor. All of these things that are just, they're not about this one-to-one, but they impact the human experience.
And so me going to find that one paper at a time, nearly impossible. No one's actually created a resource like that. And so I went into Manus, I spent about 20 minutes kind of prompting to make sure I really had it, and I said, "Go create this for me." And it came back with kind of a series of podcasts and little things to teach me so that I can then go turn... And I wanted it to reference all of it. I said, "Give me every single data point where every single one of these came from, because I want to be able to fact check." Now I can go and I can teach that to people and I can say, "Here's all the things you may or may not have considered around what you're doing with patient communication. It's not going to be the basis of everything."
Dr. Justin Rabinowitz:
That's part one of my chat with Ben. Tune in in the coming weeks for the rest of our conversation. And if you're listening to this and you think you need some advice on your chiropractic journey, go to the link in the show notes and talk to our team. Don't forget to follow the podcast and leave a rate or review and comment wherever you get your podcasts. I'm Dr. Justin Rabinowitz and this has been Business School for the Rehab Chiropractor. Thanks for listening.