—How did you lead this client to realize his self-defined goals?

He had a lot of dreams when he graduated from school, but he had internalized a belief system with a ceiling about how successful he could be based on how he was raised and what he had been taught. He didn’t know how to succeed. Every time he did well he would stop in disbelief, not thinking it was possible. After working with him for a number of sessions we determined what it was he really wanted and if it would be possible for him to achieve it. Some of his dreams were realistic; some were not. We then zeroed in on what he really wanted and how he was going to get it. Once his path to success was broken down into steps that he could take one at a time, he was able to see that his goal was within his reach. I asked him the question which enabled him to see the advantage of a step-by-step approach: “How do you eat an elephant? One bite at a time.”

He knew he needed to see fifty patients a week to break even and meet all his expenses. The solution was as simple as understanding how many patients he needed to see a day and how to market his services to produce that result. He was an excellent chiropractor and knew how to treat patients, but he lacked the knowledge of how to run a business or an office. He had to learn how to direct patients to understand and follow his systems and procedures—for example, to become expert at his consultation, examination, and report of findings. His lack of standardized procedures had prevented him from being the master of his own practice.

—So there are issues that doctors don’t consider when committing to an office of their own.

Yes. When a doctor starts a new practice, he must be able to look ahead and understand what he’s getting into. He must be able to address his specific wants and needs as far into the future as he can before signing the lease, because that’s the time to take care of it, not later. For instance, a doctor may not realize that after ten years he may want to sell his practice and move somewhere else. He may get married and want to relocate. It’s important that a tenant stipulate that he’s allowed to have another doctor assume the lease or that he’s allowed to sell his practice. The owner and the doctor may write into the lease that a certain percentage of the sale will go to the owner to make such a transition go smoothly. Other expenses can also be negotiated up front. For example, if the doctor does a build out, must he leave the space as he found it when he vacates? That’s hard to do after a build out. If a doctor’s not using x-rays initially, he may want to add an x-ray facility. Will he have room for it? If he wants three or four adjusting rooms, will he have the space? What will the flow be like in the office? Will patients be able to get around easily? Will the office need additional electrical and plumbing facilities? Landlords will make concessions if you ask up front. The process of beginning a practice can be very expensive if you don’t understand what you’re getting into.

—How can coaching help doctors who are already successful?

We’re talking about doctors who are at the top of their game, who are great chiropractors, great clinicians, and they know how to run a business. They’ve been doing it for decades. They love what they do, and they want to know more about what’s possible, how to streamline what they’re doing, get more up-to-date on systems procedures and computer systems. They want to make sure that their staff is up to date. I can either do this over the phone, or I can coach intensively, in person, coming into the office to observe and meet with the doctor and staff.

— How do you interact with a doctor’s staff?

I talk to the staff the same way I talk to the doctor. The chiropractor’s assistant will be shown how to prepare herself/himself in advance of the phone call, so when we talk we can zero in on specific areas that need work.

In a busy practice, seconds count, and a chiropractor’s assistant may be doing ten things at once. It’s essential that a chiropractor’s assistant learn to prioritize and master communication —how to direct conversations with a patient to get answers as quickly as possible while making the patient feel that he/she is the most important person in the office (which he/she is). A patient should leave the office with that feeling. A chiropractor’s assistant can make or break the practice. She’s the first person the patient sees and the last. If she’s not doing her job appropriately, it will affect the practice. The doctor may not always know how that’s going. It’s amazing how many smart, well-educated and talented doctors don’t know how to run a business or how to cultivate a staff that represents the office.

—What is the “gift of chiropractic”?

Moving bones all day can be boring. What’s really special and unique about chiropractic is the practitioner who’s in touch with the healing force that goes from the doctor to the patient. It’s interesting to note that when a doctor is distracted by personal problems and turmoil in his life, people start canceling. What makes chiropractic unique is that it taps into essential healing energy. Of course it’s also important for a doctor to master diagnostic and therapeutic techniques.

—It sounds like you combine acute business experience with an ability to move clients past their psychological blocks so they can imagine an expanded future.

—What other kinds of clients do you coach?

Besides chiropractors, I coach acupuncturists and other health professionals as well as non-health-care clients who need the kind of support I give. I enjoy working with a diverse group of people.

I’m passionate about working with people in transition. I have been all my life. I always try to move and grow in the direction that brings out the best in me. Lately people in their 40s and 50s have been contacting me to coach them in their next life transition, to assist them in doing things they’d love to do but are afraid. The questions I ask them are very similar to those anybody who wants to move ahead to the next level must answer: "what it is you want to do? By when? How can it be done? Is it realistic? How can we make it happen? What are the steps you need to take?"

My coaching is very action oriented. I always find that the most important step in coaching is to make a client aware that he has to do the work. It’s not just calling me up and talking about their issues and then getting on the phone the following week after nothing has happened. It takes a person who is ready to step into action.

My coaching services involve working with a client for three sessions a month by either phone or email. I’m always open to email or a quick phone call. We set an agenda for that week, and 24 hours before the call a client emails me about what he has completed, what he hasn’t completed, what was successful, what was helpful, what was hard and what he doesn’t want to do anymore. If they don’t do the work it’s a waste of their money and my time. If I’ve accepted someone as a client I expect him/her to do the work.

—Descibe a client whom you coached through a major life transition.

One of my clients had been a headhunter for a Fortune 500 company for 25 years. She’d recently divorced her husband; her children were in college, and she wanted to change her life. She wanted to be an artist, but she knew that would be impossibly difficult. She didn’t know how good she was, and it turned out she was very good.

She felt, emotionally, that she could no longer do what she had been doing, and a change was essential. She knew that she needed to produce income because of her financial situation after the divorce. We met for a year and a half, approximately three times a month. Through our work together, she found that she was able to consult part-time as a corporate headhunter and never go into the office. She was able to earn approximately 60% of her former salary, although without the expense of an office she was able to work less while her net income actually increased. This freed her to devote three days a week to her art. That was three years ago. Now she works solely as an artist.

Her life-changing transition was actually easier than she thought it would be. She believed it impossible until we calculated very clearly what it would take for her to feel financially secure every step of the way, so she wouldn’t have to walk away from the life she had built up. Her brilliant idea, which she came up with on her own, was to sell her business. She now lives on Cape Cod, paints all the time and is very happy. She is selling her art work and in the winter goes to St. Barts!