376 - This is the Only Sustainable Way to Scale a Business Profitably

[00:00:00] Patient Retention, Customer Retention is just sort of a discarded sort of afterthought for so many business owners and what a mistake that is. I think it's probably become more, let's call it fashionable or at least it's been pushed into the limelight because man, it feels like new customer attraction, new business development, marketing, lead generation has become at the very least much more expensive, if not more difficult, right?

[00:00:26] So, and at the end of the day, the best customer you can have is the one that you keep. Hello and welcome to The Remarkable CEO Podcast, a show dedicated to chiropractors who want to transform their job into a business so that they can have a remarkable practice as part of a remarkable life, not instead of one.

[00:00:54] With your hosts, Dr. Pete Camiolo and Dr. Stephen Franson. Welcome to another episode of The Remarkable CEO Podcast, chiropractic's number one business podcast. I'm Dr. Pete Camiolo. And I'm Dr. Stephen Franson. And, you know, we are practicing what we preach. Dr. Stephen, one of the things we believe strongly in is coaching.

[00:01:18] That's why we have this amazing coaching business, which I'm so thankful and honored to be a part of with you and so many of you who are listening. But it's also vital that you are getting coached. And that's something that we have, we've spoken about that a lot on episodes in the past, but it's important that you continually put yourselves in environments and in rooms that you're going to be challenged, that you're going to have an opportunity to grow, where you're going to be exposed, where you're going to be held accountable. And Dr. Stephen, we are doing that. And so today we get to jump into a topic that I think is really important.

[00:01:48] We're going to center our conversation around retention, both sides of the coin, the practice and the business side of the coin. But this is something that hits close to home for all of us. Anybody has a business, I don't care whether you have a pizzeria, a hotel, a chiropractic business, a coaching business, no matter what business you're in. If you're in the business of serving people and you want to help people, you might just be selling bars at Whole Foods. We were just talking about bars before. You want people to keep coming back and buying more of your bars, right?

[00:02:16] So this idea of retention, Dr. Stephen, hits every business. And, you know, we don't want to guess because we're stressing. We got to know our numbers. And we're going to go through some calculations today that maybe some of you have never calculated before. I know it was new to us a couple of years ago, and we've instituted it in our organization. We brought it to all the docs who we serve and we coach. And we're taking it to the next level when it comes to running more intelligent businesses. So, Dr. Stephen, it's great to have you back. I know you've been on the road. And, man, it's great to be together in the studio today.

[00:02:46] Yeah, it's great to be home. I was in Las Vegas, lovely Las Vegas. I do love Las Vegas. I love it for the restaurants. I love that you can't get a bad meal in that town. Or I should say you can really string together some pretty awesome meals. But it was 114 degrees when I got there. And I'm just like, oh, my goodness. It's like walking out into a convection oven. It was just unbelievable. But, man, the heat was actually in the seminar that I went to or the meeting that I had.

[00:03:12] It's like at a coaching meeting with, as you guys know, I've been working with Hormozy's team, having him audit our business and helping me just create a pathway for our company to go through the next breakpoint and build a $50 million company. So it was like I have never done that before, and they have. So, of course, coaching is the fast forward button, right? So how do you compress time is you go and you hire somebody who's already done it and say, hey, take a look at what I'm doing. This is what I'm trying to accomplish. What would you do differently so we could do this faster, right?

[00:03:41] So, like you said, we eat our own dog food here, Dr. Pete. I always have coaches, right? So TRP, we always have coaching, and we are coached. We're coached in every aspect of business, right? We have marketing coaches and sales coaches and delivery coaches, people, development coaches, money coaches. I got coaches all around me. I'm always on the hunt for the next great coach who can compress time and pull success forward from me. Sign me up. Take my money, right? So I'm in it to save some time because we're helping more people help more people, man. This is like I want to do it faster.

[00:04:10] So, yeah, we'll talk about some of the big takeaways I had from coming off of this particular weekend. We're going to drill down on a couple of them. We're going to talk about churn because it is. It's a big deal, man. I mean, patient retention, customer retention is just sort of a discarded sort of afterthought for so many business owners. And what a mistake that is.

[00:04:30] I think it's probably become more, let's call it fashionable, or at least it's been pushed into the limelight because, man, it feels like new customer attraction, new business development, marketing, lead generation has become, at the very least, much more expensive, if not more difficult. Right. So and at the end of the day, the best customer you can have is the one that you keep. Right. So it's the most cost effective way. It's how you decrease your your CAC. It's how you increase your LTV.

[00:05:00] And the LTV CAC ratio is just such an important metric to describe the wellness or to assess the wellness of your business, the health of your business. So, man, you want to increase your LTV. You want to decrease your CAC. Man, work on your retention. That's going to be today's conversation. Yeah. Being in business. I think the launch phase of your business, you know, it's all about getting new customers. You know, once you start getting into build and then scale, it really becomes about retention, especially in scale.

[00:05:27] And, you know, we talk about, you know, in this podcast, obviously, the remarkable CEO podcast to focus a lot is on scaling. We know the definition of scaling is we're able to give more, love more, serve more, make a bigger impact. And it's not all dependent upon you. Right. That's scaling. And so inside of scale, we know that turning your job into a business, we need to look at operationalizing everything. We need to professionalize our team and we need to optimize everything that we're doing. So we're always looking at it through that, that lens.

[00:05:56] We always have a microscope looking at everything that we're doing, saying, is this optimized every quarter? We have a best practice, a discipline. We analyze the five domains, the 15 primary functions of the business. We ask two critical questions. Is this function of the business optimized based on our goals and our outcomes? And who owns this? Is this the right person? Are they in that right role? Are they doing the right work? Are they doing it the right way? So we've got to make sure that we are analyzing our businesses.

[00:06:25] And so, Doc, when we released the Leadflow Worksheet, this was a couple of years ago, one of the greatest revelations that we had when we released that was we had this amazing data tracking program called the Vital Signs. And, you know, when you're a coach and you're analyzing people's data and you're going over that and trying to get to the main thing, right? Really cut to the here's the one to two or three things we need to focus on. It was it's a lot to do that.

[00:06:50] So the Leadflow Worksheet was one of those one of those developments that came from just being in the trenches and just wrestling stats down for decades. Right. And it came out of it. And one of the stats that we we discovered and we added to your Leadflow Worksheet is this stat called churn rate. And a lot of docs who encountered this for the first time were like, I have no flipping idea what you're even talking about. Like this is so, Dr. Stephen, I think we need to go back to like 101.

[00:07:18] One, we're going to go to a couple of layers deeper today, but let's back this train up and let's talk about how we even arrived at this. And I'm going to start here and then I'll throw it to you. But, you know, the classic chiropractor talking about their practice and how successful they are really came down to one or two stats. What's your volume was usually the number one. We all base our success based on volume. And the second one, maybe second was, what's your collections?

[00:07:48] If there was a third, it was how many new patients do you guys get per month? I mean, those are like the three numbers. A more mature doc fourth one, maybe PVA. But even that isn't even calculated correctly. Right. So you look at some of the top numbers and until the PVA number really came up, none of them had to do ultimately with retention. To be honest, if we really looked at it, there's a couple of vanity stats in there and they're important. Those aren't not valuable stats. I want to know our volume.

[00:08:17] I want to know our collections. I want to know our new patients. Absolutely. But man, there's some deeper stats that show us the real health of the business and churn rate is one of them. Yeah, 100%. I mean, if you forced me to pick five numbers for a scorecard and you only got five for the whole business, churn rate would have to be one of them. Right. Well, let's have the conversation from both sides of the chiropractic coin. Right. So let's talk about both on the practice side as well as the business side. Right. So practice side is the clinical operations, the business side being the economics of it.

[00:08:47] So there's two numbers we want to be thinking about when it comes to churn. Right. So churn, we hear people use terms like discontinuance or patient dropout or people quitting, people going inactive. That's what churn is, guys. Right. So we're talking about churning, people turning or churning out of the business. Right. So this is people quitting. So there's two flavors to this. Right. So the one side of the coin, the operations side, we're going to be talking about logos churn. Right.

[00:09:14] Logo or head head count, which we also call total active patients. Right. So that's your logo churn. And then on the other side of the coin, it would be your revenue churn. Right. So when we think about the money associated with somebody. Right. So remember, we're talking about clinical, which is the impact and then the business, which is the income. And you have to be thinking about both of these. You know, they both sting guys. Right. For the on purpose entrepreneur, they both sting. Right.

[00:09:41] So losing patients is off purpose and bad for business, off purpose, practice side, bad for business, business side. Right. The economics of that. Right. So churn rate, we very often talk about the net momentum. Right. So churn rate is a metric that you can extrapolate from your net momentum conversation or calculation.

[00:10:00] And then the revenue side of it is, in essence, it's going to be measuring what is your retained revenue, which retained revenue is one of the most important qualities of a business when you're trying to explore like or establish what is the enterprise value of a business, especially if you have a recurring revenue model. Right. Hey, doc. Hey doc, Stephen Franson here. If you're like me, you know that we're in the business of saving lives. And when business is good, everybody wins. That's the good news. But here's the bad news.

[00:10:28] Most chiropractors don't own a business at all. They own a job. It's a job they love, but it's a job. And far too often, it feels like that job owns them. Is this true for you? Do you own a business or a job? Have you built and do you run your practice on brute force? Does it rely fully on your time, your effort, a pound of your flesh? Are you responsible for all growth, for all new patient generation? How about new patient conversions?

[00:10:58] Is it all up to you? How about patient care and delivery? Are you a sole practitioner, an owner operator who owns the practice, but is also the only one that is head down and bum up, taking care of all the patients? Is revenue generation or collections all up to you? Let me ask you the most telling question. Doc, what would happen if you took 90 days off? What breaks? In my experience, most on-purpose chiropractors do not lay awake at night worrying about their practice.

[00:11:28] They worry about their business. Let's slay that dragon. The Remarkable CEO program has helped hundreds of chiropractors just like you turn the job that they love into the business that they've always wanted. Are you ready to run and build your practice on leverage instead of brute force? Do you want to create the scalability and durability that will allow you to make a bigger impact and a bigger income? What would it mean to grow your practice, increase your productivity, and your profitability? Do you want to get your time freedom back?

[00:11:57] Doc, are you ready to turn your pirate ship into a battleship? If this sounds like you, then the Remarkable CEO program is for you. Just last year, 53 of our Remarkable clients received the 7-Figure Club Award, meaning they hit the million-dollar mark for the first time or their next million-dollar level. Be it 2 million, 3 million, 10 million, up to 36 million and growing. Now, Doc, is it crazy to imagine that your practice could be next?

[00:12:24] Click the link below and learn how to apply for the next cohort of the Remarkable CEO program. We look forward to working closely with you in creating the business that supports your remarkable life, not competes with it. Let's dig into these, right? So from a high level, starting with Logos churn, L-O-G-O is headcount, right? So people churn. This is our net mo conversation. So when we talk about churn rate when it comes to people, the way to calculate this is you look at on the top or the numerator,

[00:12:52] the top number is the number of people that go inactive during any time period. So just for the sake of sanity and ease in this conversation, let's just talk monthly, right? So what's your monthly churn rate? Look at how many people dropped out of care this month. That's the top number. And you divide that by your total active patients. Total active patients have five criteria. Number one, assuming you give care plans, recommendations for care, you're giving recommendations for care. Don't judge me, guys. Whatever your care plan is, you say you need three visits and then we're going to reevaluate.

[00:13:22] Guess what that's called? That's called a care plan. If you say we're going to do visit by visit and we're going to schedule you as you go and we're going to pay as you go, guess what? That's a care plan. It's a shitty one, but it's a care plan, right? So if you're, hey, we're three times a week for four weeks, two times a week until the balance of four months, that's a care plan. So number one, we're assuming you're giving recommendations for care. Number two, they said yes. Number three, they scheduled them. Number four, they paid for it. Number five, most importantly, they followed your recommendations for care. That's an active patient, right?

[00:13:51] So when people go inactive, those are people that either say, no, I quit. I'm out or they die or move away or they ghost you for X number of visits. I say three visits or they ghost you for X number of days. That's I say 30 days or they you fire them as a patient because they're out of integrity with another office policy. So that's a just kind of a thumbnail sketch for active versus inactive patients.

[00:14:15] So let's say you said I've got 300 total active patients and on July 1st. And at the end of the month, I look and I say, OK, at the end of July, we had nine people quit care during the month. You take the nine and divide it by 300. So nine inactive patients or nine patients that churned or quit or discontinued divided by 300 total active patients. That's going to give you a percentile, right?

[00:14:42] You multiply that by 100 is going to be three percent. Right. So nine is three percent of 300. And Dr. Pete, that would be your churn rate when it comes to logos. Right. So the headcount, you'd have a three percent churn. You know, we use a term called brutal facts and, you know, one of the most painful things that, you know, any of us can do as chiropractors, especially, you know, on purpose, principal chiropractors who believe that the families that are in our practice are healthier, safer than those that are not in our practice.

[00:15:11] That chiropractic is a lifestyle success strategy, healthful human beings, that people, you know, the healthier, the longer you're healthy, the healthier you'll be. All of these things like better, stronger, healthier. Chiropractic is done with you. Anyway, we believe this principle. When you go into your inactive folder, you go into your inactive files, you start looking at all those. It's very painful. It's brutal. I'm just telling you right now, I hate it. Even you talking about it, I was just getting angry. My blood pressure was going up because I hate it. I hate churn. I hate inactives. I don't hate them.

[00:15:41] I just hate the fact that it's something we have to do. You know, we have to go through because you just want to keep everybody. You just want everybody to stay. They were in our house. They were in our house. Get adjusted every week or every other week. I've been doing that since I was, I don't know, 20, maybe 21, I think. So it's like I'm trying to think of a reason why someone would not continue with regular chiropractic care.

[00:16:10] And I can't think of one. I've still not been able to come up with one reason why every person that's been in my office shouldn't be under regular chiropractic care. Like it's just, so churn is just a painful thing philosophically for me. It hurts my heart and it messes with my brain a little bit too. So what I love about what you did, Dr. Stephen, was you gave us some definition. Because you know what definition gives us? It gives us sobriety.

[00:16:36] It enables us to say, I'm walking around like a, I don't know what's going on. And it gives us a clearly defined, this is active and this is inactive. And you have to have those two things clearly defined. And I know that some of you are listening, don't have a clear definition of an active patient. Meaning if I called your office right now and I asked you, could you get your check-in to the end of the phone or check out? Yeah, yeah. Just quick question. How do you guys define active or inactive? And if I, they can't tell me that we don't have a clear definition.

[00:17:04] Therefore, the person that's governing the retention of your practice doesn't know the answer to that question. Then I'm sorry, but we don't, we have no clue what's going on in your stats. So if I asked you how many active patients you have, how's your retention? That's good. We have good retention. We have to give a lot of active stages forever. Okay. Okay. Yeah. Good. Perfect. Perfect. No, but this is a brutal fact, actually, even what you went through. So I just wanted to emphasize that like, this is not an easy conversation for us to have.

[00:17:29] It's painful no matter who you are, no matter where you're at, especially if this is the type of business that you have, which is a retention business. And actually even you had a world-class retention business. You talk about your numbers. We had a world-class retention business, but we didn't really still, we had way more inactive than we had active. So therefore, yeah, like we did not have 10% compared to 90%. It's brutal. It's brutal. So these are brutal facts.

[00:17:51] But what you have to have is you have to have definition because facing the brittle facts, at least you know, the only thing worse than not having stats is inaccurate stats. Right? So we want to know what is actually going on. So giving those, you named five criteria. So it's like having those criteria enables me to say, check, yes, presented with recommendations for care. Yes, they agreed to them. They signed. Yes, they were mapped, scheduled and mapped out. Yes, they paid and are on a payment plan. Yes, they are coming in and they're compliant with their business. Cool. I did those.

[00:18:21] I can track and measure those things. So anyone on my team at any given time can tell me active or inactive, on track or off track. And then we have a criteria, like Dr. Steven said, where there's some sort of a line that says this is when they go inactive. Either they said they're done, they're moving, they died, something happened, or they just have no showed and no responded over a period of time. You set that, let's say 30 days, and then we move them into another category from active to inactive, right? Or maybe missing an action, then inactive. However you guys do it.

[00:18:50] But the end of the day, you have to have clear definitions to be able to do this, Dr. Steven. So you gave us the calculation, but it starts with us defining what it actually means. So I have an active person and I have an inactive person. So Logos, which is a practice stat, this falls under the operational side of the coin, the practice side. We're looking at people, headcount, net momentum. So you calculate net momentum by, you take your total number of new conversions.

[00:19:18] So new people that said yes to those five things, plus people that who were inactive, who actually return and get back on a plan. And they agree to that plan and they map out their visits and they're on a payment plan. They're following the recommendations again. They meet those five criteria, newly converted people and reactivated people. You add those two together and then you subtract that number of people. Let's call it the nine.

[00:19:44] And so if you added 10 and you reactivated three and then you lost nine, right? You have a net mo of plus four for that month, right? Because you added nine new people. We reactivated three people. We lost nine. 13 minus nine is four. That's net momentum. So this month, after all the blood, sweat and tears, after all that work, the question is, did we grow?

[00:20:11] And growth really of a business ultimately is measured in your net momentum. And the net, net, the net momentum of our business was a positive four. That is net momentum. And that's, that's one way to measure it and look at the health of your business. And it's a way to actually even that I never knew, never would have known that. I didn't know that. I still don't know anybody else that teaches this besides us. Yeah.

[00:20:36] This is like, this is, but this is the, it's the number, it's in the top five, like you said, metrics that you must know in your business. It's net momentum. So churn is a part of the calculation of net mo and net mo tells us a lot about the health. If not everything, it's almost everything about the health of your organization. Yeah. Net mo is how, you know, did we grow? So for some of you are sitting here like, I really do even, I don't even know. Am I growing? Are we contracting?

[00:21:05] Are we stagnant? This is net mo. Net mo is how, you know, if you grow, right? So you gotta, you gotta look at it from the position of the logo, right? So it's like in our head count, are we serving more patients? Do we have more total active patients? Because you can have a negative net momentum as well, which means that you're contracting. Now, some of you are like, okay, I get it. Well, how, how do we influence that? This is a two and a half day seminar, right? So thank heavens, lucky for you. We're doing that, right? So that's the remarkable practice immersion, right?

[00:21:33] So it's Thursday night, all day, Friday, all day, Saturday. This is a two and a half day study of the process of how do you create and collect ideal patients, right? So that, that is what the remarkable practice immersion is guys. So if you're thinking to yourself, oh man, I want to increase my new patient conversions. I want to increase my reactivations. I want to decrease my inactives so that I can increase my net momentum. I can increase my total active patients. I can reduce my logo churn, right?

[00:22:00] So that's what the remarkable practice immersion is all about, right? So there'll be a link in the show notes here for you. Hopefully this is airing before the immersion. If it's coming in after the fact, we apologize unless you're in Australia or Australasia in the Southern Hemisphere, because lucky you were doing it in November. And then we're going to go on and do it again in New Zealand, right? So Dr. Pete, that's the practice side of the coin, right? When we're talking about total active patients, we're talking about throughput, right? So we know that throughput drives output, right? Throughput is patient services.

[00:22:30] Output is the revenue and profit that is produced from those patient services. So let's have a business conversation, right? Because we know that churn or people dropping out, right? So churn is off purpose practice and bad for business. Let's talk about business, right? So when we look at people dropping out, guess what else drops out with the people? The revenue, right? So the revenue is, that is the exchange of value, right? You deliver value and capture value, right?

[00:22:59] So it's like you're getting paid for those services. So if your throughput is reducing, your output is going to be reduced, right? So in the way you measure that is through retained revenue, right? So when we look at retained revenue, now we're talking about the economics of churn, right? So it's like, I want to know about your revenue churn. Like how much revenue churned out? Is this much of your patient base churned out? If this is your churn rate for logos for your people, there's going to be amount of, there's going to be revenue that churned out as well.

[00:23:26] If you've got, especially if you've got a recurring revenue model where you've got, let's say patients that are on corrective care or wellness care or maintenance care, and they're in a recurring revenue monthly payment, and you've got 10 people that drop out, guess what? That's 10 payments a month that drop out, right? So that's revenue churning, right? So you want to have an awareness of revenue churn as well. So when we're looking at revenue churn, there's an equation for this as well. For my note takers, it's the starting revenue in the beginning of the month minus the revenue

[00:23:54] that's lost from churn or people quitting divided by the starting revenue, again, as the denominator times 100, right? That's going to give you your retained revenue rate, right? So if you look at, hey, we were doing $100,000 going into the month in July, and we had $10,000 worth of recurring revenue quit the practice, that means 100,000 minus 10,000, right? That's going to be 90,000 divided by 100,000.

[00:24:24] That times 100 is 90%. You're going to have 90% retained revenue, okay? So you retained 90% of the revenue because 10,000 of the 100,000 dropped out, right? So you've got $90,000 that you retained. Dr. Pete, this is the measuring of the economic impact of churn, right? So like I said, when people drop out of care, it's off purpose. It's going to affect your impact and your throughput, but it's also going to impact the economics or the output in the practice.

[00:24:55] Please stick around for more business insights from this week's bonus interview with our remarkable success partner dedicated to helping you more successfully help more people. Enjoy. As chiropractors, we focus on the nervous system and nervous system health, and there's bad habits everywhere in life. So today we've got Dr. Andrew Powell from Better Balance Orthotics, and it's not what you think.

[00:25:22] It's not all about your standard orthotics that you have. It's about nervous system function. So welcome, Dr. Andrew. Hey, Mel. Thanks for having me. Okay. So first of all, Andrew, we've had lots of discussions around how Better Balance Orthotics impacts the nervous system. Can you go a bit more into that? Sure. So look, I've searched and searched, and as far as I can see, they're the only orthotic in the world that really fits the chiropractic paradigm, and that's because they're not arch supports.

[00:25:52] They don't create any sort of support. When you support something too much, you actually weaken its function. So our orthotics are purely designed for stimulation. They stimulate the nerves in the feet, which gets the muscles firing, gets the fascia working. But more importantly than anything else, it sends the right sensory information to our brain so that our brain can determine our balance, our posture, and our movement patterns correctly. So we were talking just before about how through evolution, the bad habits through the industrial revolution really on. Can you talk a bit more about that?

[00:26:21] Sure. You know, we understand as chiros, we adjust the nervous system, but we also want to help our patients. We want to educate them because we know that there are habits that really work against health and there are adjustments and there are habits that really support it. And we understand that there are certain things we were never really designed to do, right? We all agree we were never designed to stick all day. We were never designed to stare at a computer all day. We were never designed to stare down at a smartphone all day. But one thing that most of us don't think about, and I certainly never did for most of my career

[00:26:50] before I got into this, was that we were actually never designed to wear modern shoes and walk on flat surfaces all day. You know, this morning I let my dog out for a pee and I stood there in the grass, right? We'd sneak the most. It was a little long. It was wet. And I can feel the wetness. I can feel the coldness. I can feel the squishiness of the earth under the feet. I can feel like every tiny little pebble that I step on. Our feet are an incredibly rich sensory organ. The smallest nerves in the peripheral nervous system are actually in the feet.

[00:27:19] And so for millions of years, almost every minute of the day, our brains were receiving this just flood of sensory information through our feet. And then all of a sudden that was gone, right? We've got these modern squishy shoes, soft, comfy, supportive, even traditional orthotics that push our feet into a certain shape so that our feet don't actually have to do the work. We spend all day walking on floorboards, concrete, flat surfaces, and we just don't get that sensory stimulation that we used to get. Yeah.

[00:27:49] It is something that a lot of chiropractors don't think about. I know you've been a chiropractor for 24, 25 years, around that. Yeah, almost 25, yeah. You're a chiropractor at heart. And just the problems that you solve, how did you get into using the Better Balance Orthotics? For me personally, I started wearing them myself because I always had flat feet. I found traditional orthotics didn't work for me. Originally, I used them in my practice for treating scoliosis because that's what they were actually developed for. Yeah.

[00:28:18] But pretty quickly, we came to find that all these other things got better too, right? Knees, hips, feet, necks, lower backs, all these things. So that kind of led me on a journey to start to understand why they were working the way they did. What I really came to realize is that they're actually helping patients hold their adjustments better and get the most out of every adjustment. And it's because our brain uses all that sensory info that we talked about to set up our balance,

[00:28:44] to set up our posture, to set up our gait, to set up our muscle firing patterns, to set up tension, right? How much tension should I have in my hamstrings or my neck flexes? All of that's influenced by the information that's coming from our feet. So the way I describe it to my patients is say, if you're getting bad info from your feet, you're going to have bad balance, bad posture and bad neurology. And unfortunately, if we're not addressing that, that's working against us from the minute that patient steps off our adjusting table. Yeah. And that's a big one, isn't it?

[00:29:12] Is that you can do your great adjustments, which obviously the chiropractors do. And the minute they stand up, there's that bad habit that they don't even think about, which is they can be unwinding the subluxation pattern right there and then as soon as they step off the table. Yeah. Or else they're just shifting it around, right? That segment that you just put back in place. Now it's kind of transferring that stress to the next weak link in the chain. Yeah. And we see that, right?

[00:29:40] We see that, you know, you fix one thing, there's something else there. It's these compensation patterns. And like I said, for years, I just, I never really thought about how important the feet were in that whole kinematic chain. But of course, everything starts with the feet, right? That's our anchor to the ground. So it influences everything above it. Yeah, it is the base of support of the final frame. So you touched on that, though, originally developed to help scoliosis.

[00:30:06] And a lot of chiropractors may not even think that that through the feet, you can impact the spine. But you have seen that over and over again. You've mentioned some of the other ways that it helps other problems it solves, like knee problems, hip problems. Can you go a bit more into that? One of the huge things that it really, I started to see was lower back problems resolving when people wear these. And when you look at the postural changes, we track them, we take postural photos, we measure all these different variables.

[00:30:36] When a person's feet dysfunction, it throws their weight too far back on the heels. And so in order to compensate, to keep their center of gravity aligned, they have to sway their pelvis forward. So you get this loading up around the lumbar sacral area, you get that kind of sway back posture. And so you get this inappropriate load on the SI joints, on the L5, on the discs. Huge impact on lumbar discs, L4, L5. A lot of back problems really start to calm down and resolve and hold better when you actually

[00:31:05] get this sensory info from the feet right. And then, of course, when the pelvis translates forward, the neck has to go with it to maintain our center of gravity. So you look at how many of your patients have forward head posture. I would say that's the number one thing that we see change more than anything else in the posture photos that we take and retake. And of course, as the head comes back over the shoulders, we take pressure off all sorts of things in spite. Absolutely. And I mean, that's epidemic around the world, isn't it?

[00:31:32] So forward head posture, almost everybody has forward head posture. And you mentioned about the forward. So this is for any age too, isn't it? So what's the sort of the youngest age you work through to the oldest you can work through? You know what? It is, it's pretty universal. And again, because we all have the same problem, right? We're all walking on the same surfaces. So I used to shy away a little bit from fitting kids because I knew they were going to grow out of them, that kind of thing. But I've realized there's a developmental window there. And the sooner you actually get things working here, the better.

[00:32:02] Because parents notice problems with their kids' feet and their kids' posture. And they go to the doctor and the doctor says, oh, it's just normal. Don't worry. They'll grow out of it. And of course, they don't grow out of it. They just deepen those compensation patterns and lock them in over time. You know, the youngest child I've fit was actually four years old. He clearly had the gait problems and postural problems showing up. Usually they're not that old. I would say maybe six, eights more common. And there really is no oldest age.

[00:32:29] One massive thing that I've seen with these is that because they improve the sensory impact from sensory input from the feet, they improve balance, they improve stability. So for our older patients who maybe don't move as well, who feel unsteady, falls risk, it's huge. I had a patient come back and say, I've thrown away my walking stick because I don't feel like I need it anymore. Amazing. Yeah. Absolutely. You know, there's no upper limit on age. I think the older you are, the more important it probably is that you have these on your feet. Yeah.

[00:32:57] Because a lot of people, a lot of chiropractors only think of orthotics for feet problems, but because it impacts the whole lot, any age. So I know that this is something that's used all over the world. You've started in Australia, but now it's in US, in Australia, New Zealand, all over the world you're using this. As an extra service that you can have in the practice to help the patients more, it's also a very good business model.

[00:33:22] So can you go over about how impactful this is and how practices implement this into their practice? Yeah. I mean, it's very, very easy to implement. We encourage practitioners to get the first pair on your own feet. We'll run through the training with you and your team. It's really simple, takes minutes to implement. You don't need any expensive or complicated equipment. You don't need new staff, new systems, any of that. So it's just super easy to plug and play into your practice. The results for your patients are profound, but of course, there's a financial benefit to your practice as well.

[00:33:51] I actually had a patient in yesterday. He's a Parkinson's patient of mine, and he's been having some falls. And he'd gone to the podiatrist, and they had prescribed him with a pair of orthotics, just a normal, standard, custom-made, but $1,900 he paid for his orthotics, which I nearly fell off my chair when he told me that. I knew it was like $800 to $1,000, right? So patients aren't going to pay anything like that for our orthotics.

[00:34:19] And in Australia, they're covered by health funds. So what it means is that there's a profit to the practice. There's a low cost to the patient. You get better results. And really, everybody wins. And so it's something that it supports your patients. It supports you as a practitioner in the results you generate, but it also supports your business. Yeah. And I know we've talked before about how initially you used it for people that you thought might have an issue. And now you've recognized that everybody needs these because everybody's walking on artificial services in the wrong shoes.

[00:34:50] Just talk just very briefly about that. Yeah. So really what we see, what I've seen in my own practice and what we see in the practices we work with is that, you know, we're all busy in practice. And if you leave it up to thinking about it, you're going to miss every now and then a patient comes in and they've got a problem. I go, are you wearing orthotics? They go, what orthotics? It's like, I keep myself like, man, I could have had this problem solved already. So in my practice, we assess every new patient. And then it just becomes part of our initial consult. It becomes part of our report of findings.

[00:35:19] It becomes part of our care plan. The reality is we want every patient to get the benefit and we want them to get the benefits as quickly as possible. And we know that this is the way they're going to get the most value out of their adjustments. So when you put it in a system like that, one, it takes it out of you having to think about it or remember it. It's just part of the system. My doctors know it. My team knows it. Patients love it. By the way, patients really like them. But it also means that you've got a financial system behind it as well.

[00:35:48] You've got really a whole nother stream of revenue. And then probably chiropractic or one of the problems with our business model is it's labor intensive, right? It's hands on. And so there can be a limit to the leverage and the scale that we create there. But when you add something like this in, it really creates some more leverage for you. It creates a way that you can generate a result and an income without having more hands on time. Yeah, such an amazing one. Use it on my family. It's used all over the world.

[00:36:19] So how can people get in contact with you, Andrew? So our website's .com. If you want to reach out to us, it's info at betterbalanceorthotics.com. My wife, Jodie, is the email person. She's very responsive. She's much better at email than I am. Yeah, just reach out. We've got all sorts of resources, videos. I write a newsletter every week, which I try and make super clinically useful. So you can jump on board with that. So reach out to us. We'd love to talk. Absolutely. So thanks so much for informing everyone.

[00:36:48] So looking forward to seeing you in person again soon. Yeah. Love it. Thanks for having me. Thanks for listening to this episode of the Remarkable CEO Podcast. Remember, what the world needs now is chiropractic. And what chiropractic needs now is more successful chiropractors. If you like this podcast, please subscribe, share with a friend, and leave us a review. And if you'd like to connect with us personally, direct message us on Facebook, LinkedIn, or Instagram.

[00:37:18] Now go and be remarkable.