377 - How AI Will Impact Your Practice, Business and Patient Experience Next

[00:00:00] I truly don't think there will be another generation in human history that undergoes the transformational structure of the world when it comes to technology. Like it is a once in a human history era we're living in. When you go from, to your point, completely analog, no computers to AI in a generation is just insane.

[00:00:31] 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. With your hosts, Dr. Pete Camiolo and Dr. Stephen Franson.

[00:00:55] What's up, Remarkables? Welcome to another episode of the Remarkable CEO podcast, Chiropractic's number one business podcast. I'm Dr. Stephen Franson and I am joined with one of our awesome success partners. You probably know his name. You definitely know the name of his business. It's Gabriel Doty from Chiro HD. Gabriel is the founder. We're going to learn all about his role and emerging role in this incredibly exciting technology platform. Gabriel, welcome to the show, brother.

[00:01:24] Thanks for having me. I'm excited to be here as always. Yeah, so we're going to have a CEO conversation here. This is awesome. We're going to get to talk CEOs. We're going to get to talk technology, which is obviously so hot right now in every industry, definitely in chiropractic as we're just shifting and changing and accelerating the growth of chiropractic.

[00:01:41] Our, you know, the tagline for our success partnership is for helping us help more people help more people, right? So you guys are an awesome partner because you just help our people help more people through technology, make it more efficient, make it more effective, make their lives easier, right? So make their businesses more scalable, make them more durable, creating a greater impact and a greater income, right? These are all the things. These are all our taglines. You guys make it all real. So thanks for all the great work you guys are doing.

[00:02:09] We try, you know, it's, it's always hard to keep up with not just technology, but what practices want and what they need. It's a, it's an ever changing, ever challenging world, but we're excited to be in the middle of it.

[00:02:20] And that's what I want to talk about. So, you know, for our listeners, they know this is not going to be a chiro HD commercial. We're going to, we're going to have a business conversation, right? So through the lens of your experience with chiro HD and being in the guts, literally in the guts of chiropractic, what you're seeing, what you're learning, what you're thinking about the future, where are we going? Where's technology going? Where's technology taking us? What are people leveraging right now? What do you see is working, not working? Where is the puck going as they say?

[00:02:47] So Gabriel, why don't you tell us a little bit about, you know, your, the path to this, this product and how did you end up a founder of a software? How'd you end up in chiropractic? Just give us a quick back of the napkin. I'll just start right at the beginning. So I'm a software engineer by trade. I worked in ad tech for, for many years. And my ex-wife's a chiropractor. She runs a practice actively in, in Roswell.

[00:03:11] I don't know if I knew that. Yeah. No, no, no. And we're, we're still great friends. Everyone's always like, it's gotta be the, it has to come up in every single one of these conversations. And, you know, we're, we're, we're still very good friends. We consider ourselves business partners. She, she's very involved in a lot of things and also is a very good sounding board for a lot of these things.

[00:03:32] But yeah, so she's going through Life University while I'm working in ad tech and, you know, got exposed to, I think it was smart cloud at the time that was in the plug into life, but, you know, got to see what that ecosystem looked like and saw a lot of really big holes compared to the cutting edge. I mean, ad tech is bleeding edge technology. You know, they're always trying to figure out different ways to, you know, serve ads, make them more relevant, more interesting. You know, it's a big cash cow in the, in that world.

[00:03:58] So going from that bleeding edge to seeing what, what was being used at life and what was available to chiropractors kind of started that idea. It was not, it was seven years later. So that was 2010 that she started there. And it was seven years later before it became a reality where it was just like, okay, we have an opportunity to actually build something here. She had joined a franchise at that point and they were looking for another, you know, looking for a tool to, to expand their system. And, you know, the stars aligned, we started the company.

[00:04:28] I actually ended up working chiro HD as a side hustle for almost five years before I stopped my full-time job and went to chiro HD full-time in 2021. Yeah. So it was, it was a major side hustle running, you know, basically working two full-time jobs for, for four better part of four years. But then, you know, the kind of the wheels came off and then back on. And then, you know, any CEO knows it's not a, they're on or off. It's what's the panic, but, you know, we, which one's loose.

[00:04:55] Yeah. And which one's loose. We went from, you know, zero, obviously in 2017 to when we took on our first private equity round in 2022, 300 clients, and now to over 1500 on just the chiro HD platform today. Awesome. So it's been a very fast ramp with a lot of bumps and a lot of good and a lot of bad along the way.

[00:05:15] Yeah. So let's talk a little bit about that concept. I call it riding two horses, right? So everybody's got their side hustle going on. So focus is my second favorite F word. And I always joke as faith is my first. So everybody knows that.

[00:05:31] My close friends are chuckling even louder when they hear me say that. So the concept of having two things you're focused on chasing two rabbits, right? There's so many people listening right now. What was your experience there looking back? Cause I did the same thing, right? So I had my coaching business. I started that up while I was running France and film my chiropractic, our chiropractic office. And, you know, at one point, you know, they were both just crowing and going. And I knew I was riding two horses and I knew it was my next chapter. I was delaying it. Right. So it was just like the idea of like selling

[00:05:59] my practice was just incredibly foreign to me up until like the year I decided I got to do this. So what was your experience? Like what was the journey like? Yeah. I mean, I think you, you nailed it. Right. Like at least from my experience, I think I also say like the CEO, my CEO, when I was working in ad tech was very encouraging. She knew I had a side project going on and she, she's an entrepreneur. What she always shared was like, there's no better place in time to like test your side hustles than when you have a secure stream of income. So first off, just huge props to her.

[00:06:29] For recognizing that, encouraging that her employees. I thought that was a really, and she recognized like if people are investing themselves and trying to learn themselves that even while I have them here, they're, they're doing better for me. It's what like, like, she's like, they're, they're, they're becoming smarter. They're understanding problems bigger. They're trying to look at it from different angles. I think that was a really awesome environment that I got to sit in.

[00:06:52] I think it was really good for a few years. Like if you look at the track of it, it was like, it was really managed. Like, so four and a half years, we'll call it, I'd say two years was really manageable where like, I felt like I did, was doing a really good job on both sides. And then there was two years where it was starting to get questionable. A year and a half where it was starting. It was questionable. Like, okay, like I'm one is definitely consuming more time. And I'm good enough at my other job where I'm, I'm skirting by.

[00:07:18] Right. And then there was one year where I was just like, I should have abandoned ship a year early because I remember that year. We were like, okay, like I'm, I'm not doing a good job on this side. Now I feel bad to my employer and I'm also not doing a good job on this side and it needs my full-time attention. And so I think the, the one takeaway I would have had is I wouldn't jump ship a year earlier, but it was terrifying. Right? Like I, even once I jumped ship, I didn't take a salary from Cairo HD for a full year.

[00:07:47] So I had a full year of unpaid, you know, for the vast majority that where I, I had to rely on other, you know, ways of supporting my life and my family. That was not a job, which was terrifying. And I don't know if I could, so it's, it's, it's a balancing act. It is scary. There's so many docs that are listening to here and they do have side hustles and, you know, I don't want to discourage people from exploring, like, are you getting called? Like, do you have a, has God seeded like some vision that you have to manifest? You know, you're called to it. Right.

[00:08:16] So man, whatever it takes, walk that out. Right. But for most people, they're just doing it like, Hey, I'm trying to pick up some cash over here. And it's all my practice is not as profitable as I wish it was. So I'm going to start and I'm going to buy car washes and vending machines and start my Airbnb business. Cause it's passive incomes. No, it's not going to be that. Or I'm going to start this other business. Cause I know, you know, that I've got a, you know, I've got a big idea that I think is going to change the world. Right.

[00:08:42] And it is just such a tenuous situation. Right. So looking at them and be like, you have got to be super clear that at some point you have got to move. Right. And you've got to make that move. And I would say, don't, don't do anything until you know that you've built the durability so you won't be missed. Right. So we were talking about our mutual friend, Alan minor earlier, Alan's got a great expression until you can take 90 days off from your business and it keeps going and growing.

[00:09:07] Like nothing breaks. Then you can start something else, whether it's a second practice or you build that software you've been inspired to build or some kind of product offering or open another business. But you've got to be able to walk away for 90 days and it keeps going and growing without you. Right. It doesn't break. So that two horses, man, is the best metaphor for us. Like at one point you just knew you had to move and make it happen. Cause you were just slowing down what you've created now. Chiro HD is probably two years behind where it would have been had you had got out, get out of there sooner.

[00:09:37] I think that just like, that's the lesson you look back and be like, as soon as you know, you're going to go on, go all in. I think, but in that moment, it's hard to see, but, but I think the, you know, when you see that you've got, you know, maybe not lightning in a bottle, but like you've got the pieces and you see the momentum. And it's especially that thing that you really want to chase to your point about, like it wasn't vending machines.

[00:10:02] It was like, I really want this idea. And I really think this is where, where, what deserves my attention. My next job, my next chapter, like, especially that type of movement. Like I would have given a lot to go back and jump ship six months earlier. A hundred percent. Now, do you surround yourself with like, do you have accountability partners and like, you have to have other crazy people around you? Like I have found like, I, I have my friends and family who are my conservative gang and they're awesome, you know, wonderful, really valuable. Right.

[00:10:31] But I know that I don't bring my ideas to them. Right. So it's like, do you have your crazies that you hang around with? Do you surround yourself with a, with a good, I think, I mean, I think it's shifted over the years, but short answer is I always have some, some group. Right. Right. In the, in the first part, I was surrounded by, you know, chiropractic entrepreneurs building, jumping on into that, that franchise that we were originally a part of. So that was a lot of people, you know, pushing themselves on, yeah, lots of crazies on that front.

[00:10:56] And I was also part of a, a business executive coaching company called Vistage, which is. Exactly right. Yeah. So Vistage was awesome. And especially at that point where I was going from a individual contributor to learning how to be a CEO and really leading from the top was Vistage was a priceless coaching experience. Resource. Right. And resource. Yeah, exactly.

[00:11:20] I don't think we talk about it enough to be honest with you. This is like, like I'm involved in like two or three groups. I like some are, you know, I, I, if I can find a program, that's a proven program and some coach that I can pay to keep me accountable to following something. Or if I can join some group where I know that I'm not the most experienced in the room and most successful in the room, I don't have the biggest business in the room or definitely not the smartest guy in the room. It's just like, I want to put myself somewhere in the back half of that room. Right. So it was like, I always have people like pulling me forward. And I don't think you hear that enough.

[00:11:47] It's just like, you've got to just be very selective, very discriminating or about who do I spend my time with? Because if you're not, if you're not bouncing your ideas off of people who, you know, they've got to share your core values. They've got to buy into your vision story, but they're going to ask you wicked hard questions. They're going to help you see around corners. They're going to tell you things. And I mean, that's, I don't think there's any shortcuts, but there's definitely fast forward buttons. And that's one of them is just your circle.

[00:12:11] Yeah. I also would add to that, that it's that phrase of like, you are the average of the five closest people that you, you know, you've heard those types of things. But I think, you know, especially in the crazy entrepreneur world, like there's two buckets of people. It's like, Hey, I'm going to jump ship and leave my job for this thing. And you've got those people that are like, that's the craziest thing I've ever heard of. I would never do that. And then you talk to another group of people who they're like, that's what you have to do. Like, that's how you do this.

[00:12:40] Like, and no brainer, man. So like, like there is that difference of like, if you only surround yourself with a conservative, you're never going to get that push around the edge. That's right. And I also, to your point about seeing round corners, right? Like that's where Vistage was such an awesome piece is like they could, you have these people who are CEOs of companies that are a hundred times my size, literally sitting in the same room with me. That aren't in software, but they're still dealing with personnel problems and capacity problems and innovation problems. And like, it's still the same issues.

[00:13:10] And I think it was bi-directional. There was two things. It was awesome to have those people speak into my life and just into my business and what I was dealing with. But it also reaffirmed my own thinking when I could sit there and offer them advice that they took and changed. Like they're a hundred times my size. And they're like, oh, that's a perspective I hadn't heard before. And it was validated like, hey, like I belong in this room. Like there was, it was a bi-directional thing. That's right. So as you say that, you know, I'm thinking like, you know how you have focus points.

[00:13:38] Like when you're young and single, like you're looking for a mate, right? You're looking for a girlfriend. Like when, you know, then you're mature and you start like, hey, I want to find people that do the things that I do. Like, oh, I love to find other CrossFitters to hang around with or people who go to my church or, you know, somebody who's like now chiropractors. We all want chiropractic friends. And you seek those people out. I love surfing. So it's like, I'm always looking for surfing buddies, whatever. So now at this point, I'm like, hey, I'm looking for people who have built a 30 to $50 million company. It was like, like a hundred or $500 million company.

[00:14:07] They forgot everything that it took to go from 15 million to 30 million. It's just like, and those are the people that you want to like, like seek them out actively pursuing those people. It's like, if you have a $3 million chiropractic business and you want to build a $5 million chiropractic business, go find those people and be like, okay, so what am I missing? Right. What will pull me forward? How do I compress time? Yeah, for sure.

[00:14:28] I, and then, and then as we started going through the PE route that became, so we, we had great investment bankers that really helped us through the PE transition, but they are also amazing networkers. Right. So they, they host like three or four major networking events a year and I am at every single one of them all the time, but you get to meet all these businesses that are to your point. They're all in the same stage. They're all looking at the same things. They're all looking at investment to risk ratio. And am I, am I just trying to sell my company or am I trying to fuel growth in it?

[00:14:57] And, and so like, I would just say to your point in investing and being very proactive in seeking those relationships and circles is, is huge. Hey doc, Steven Franzen 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. Most chiropractors don't own a business at all. They own a job. It's a job they love, but it's a job.

[00:15:24] 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? Is it all up to you? How about patient care and delivery?

[00:15:50] 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. They worry about their business. Let's slay that dragon.

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[00:17:18] We look forward to working closely with you in creating the business that supports your Remarkable life, not competes with it. You've brought up private equity here. And you've been in this gamut, right? It's such an incredible crucible, right, to go through just this process. It just forges the best businesses in the world, best business minds in the world. And it's brutal, like a rough workout, right? So it's like awful while you're going through it, but you're psyched you did because you come out stronger. And what have you learned about what makes a really strong business?

[00:17:46] What makes an attractive business? Because private equity guys, they're the smartest minds in the world. They've got a whole bunch of money that they have to 5x in five years. They're looking for, you know, obviously opportunity. They're looking to mitigate risk. And there's attributes in these businesses that they're looking for. It's like, we're going to take our money, put it in this business, grow it, and sell it at a premium. What have you learned about, like, what really makes a really quality business that could translate to this conversation for kairos who are trying to build great chiropractic businesses?

[00:18:15] Yeah, I mean, we could probably spend the next three hours talking about this. If I look at the core things, I think vision still wins. It's one thing that I always want to get out in front of on all of that, because I think, you know, the metrics are one thing and they're looking for metrics. But I think if you look at the clash between the founder paradigm and the PE paradigm, like they are ascribing numbers to vision, not the other way around. And I think any founder that is stuck on trying to deliver numbers to a PE is missing the mark.

[00:18:45] And I will hold to that for forever. Like, your vision is what matters. Your vision is what drives numbers. Your vision is what gets you there. And if you start, like, just hyper-focusing on, well, like, I'm going to lose my vision to get to my numbers, then you're chasing the wrong thing and you probably should go a different direction. So more than anything, vision is the most important thing that you're going to do. And if you execute your vision well, you're going to be a really attractive company to any of these ones. But, you know, the things that every company is looking at are things that we all understand deeply.

[00:19:13] And you might not want to hear it, but it's the same metrics around all of them. It's growth, it's retention. And, like, those two things are the main, you know, and then revenue is a third behind it. But, like, revenue is not as important if you're growing really fast and you're retaining your people because they know they'll eventually get their revenue from that equation. But those three things, like, if you combine them and you're growing in all aspects of them, it's awesome. If you're lagging in one of them, it's a problem. If you're lagging in two of them, you're never going to get there. That's right. All right.

[00:19:43] So let's stay here because chiropractic is just spinning around this one and they just miss this. This is just such a critical thing. And, by the way, it's very much an on-purpose, on-mission conversation when we talk about retention. Right? And I'm going to project my philosophy there when I say that. I think people should be under regular chiropractic care for life. That's where we do our best work. I recognize the compound benefit of being under chiropractic care regularly. Right? So this is very much a purposeful as well as a principled chiropractic business conversation. Right?

[00:20:08] So when you look at the enterprise value of a business. Right? So the ability to retain your customers, having retained revenue, retaining your customer base is the singular most important, most attractive element in a business. And, you know, people talk about scaling all the time. People don't understand the term scale. Right? So it's like, you scale a business by retaining your customers. You scale a business by keeping your customer. Right?

[00:20:35] So you can't just keep being, you know, you can't just be churning through your customers. You can't be all new patients become replacements when you have all your patients falling off on the back end because they're just not completing your care plan. They're not staying out of care. They're not recommitting to care. Right? So, and now with the cost of our customer tax getting so huge, it's becoming more and more and more expensive to convert new customers. Right? So to get new patients, the absolute best business model in the world is retention. Right?

[00:21:02] So speak to that because I know you're in the retention business and in any SaaS model whatsoever, it's like all of the valuation is in the ability to collect and keep your customers. Right? Yeah. I mean, for me, I think this is one of the areas that is like the equation doesn't meet the burden. If I, if that makes any sense, what like, and then I think, I think it's probably the area that we have the biggest, not conflict, but where the most abrasive conversations happen

[00:21:31] in PE versus this is like from my seat. It's always been to my original point, vision drives retention. Right? As soon as people start feeling like you are not delivering on what you set out to do or what they bought when they, when they signed up for Chiro HD, when they bought, when they bought your care plan. Like if, if they see a loss in vision, they're not going to be retained. That's right. And you know, on the PE side, like, I mean, they care about that to some degree, but all they care about is like getting the retention there.

[00:21:59] But what I find in those conversations, it becomes like a, they, they try to focus in my opinion, and I, and I would say this to all other faces. So this isn't, you know, is they focus on the mechanics of driving retention. Like let's put them in a contract. Let's let's do A, B, C, or D to drive retention. And, you know, I call BS on that. Like, I mean, like, sure, maybe you might, you might scrape by this year with a better retention record, but like, it's in my mind, it's, you've lost vision.

[00:22:29] You've lost something that, uh, that you sold when you, when they signed up for you. Yeah. Um, uh, uh, I will remember a sermon analogy that I think applies to this, that I think is fantastic here. And it's like, you know, um, whatever you did to sell someone is what you have to do to retain them. And so the, from the sermon things is if you do a hot fudge Sunday service thing to get people into the doors and you stop doing those hot fudge Sunday services, you're going to lose people. That's right. Right. Like, so it's, it's, you have to be true to your vision.

[00:22:59] You have to keep driving it. And if you're having a retention problem, I think you need to look inward and not outward. All right. Let's go deeper here. Um, you know, you and I are both in B2B2C, right? So this is, this is like, this is a multidimensional conversation we're having right now. It's like you and I are B2B, right? So, and all of our clients are B2C, right? So you and I are business to business, specifically the chiropractic space. We're in this conversation and then B2C, all of our clients are B2C business to consumer or customer, which is your patients. Right?

[00:23:27] So we have to, I mean, you have to, as much as I do, everything we design is not just about keeping you guys. We know that if we can design something that helps you keep your customer, we're going to keep you guys. Right? So it's like, this is a compound effect here. This is not a, this is not a superficial conversation we're having. Right? So when you talk about vision, you went right to vision, which I love by the way. So when people run out of vision, they run out of your business. Right? So biblically it's without vision, people perish. Right?

[00:23:55] So when you, when you, when people run out of vision, they run out of your business, which means your customers run out of your business. And so do your A players, your team members. Right? So it's like, as a visionary, I'm taught, we're talking to the visionaries here now, Gabriel, like these are, these are all the CEO visionaries. We're talking. It's like, you have to understand that you're, you are the vision caster. This is your job. And we both start here, right? So this is the first side of the Rubik's cube and TRP is vision, a clear and compelling vision. People have to see a better tomorrow with you than without you. That's our job. It's like, you have cast that vision.

[00:24:24] So people see that they're going to be better off with you than without you. And to make sure that everyone in that organization has total clarity around that. And everybody in that organization understands not only what the better tomorrow looks like, but also what their role is in creating that. Like they've got to have that clarity around that as well. So that's, you know, that B2C piece of this can be the trickiest part for the chiropractors because, you know, you can't convert somebody and then expect to retain them just based

[00:24:54] on why they started, right? So people will start to solve a problem, but they stay to achieve a goal, right? So people start to solve their problems and they stay to achieve goals. I'm sure it's the same thing with software, right? So to move softwares is like getting divorced and moving out of your house, right? So this is like, it is the biggest pain boy. You guys have a massive inertia to overcome with your customer, but you guys have to create such a compelling reason for somebody to shift away from one platform into yours.

[00:25:24] They have to be in so much pain and for you to keep them, they have to see a better tomorrow with you guys, right? So talk to us. I mean, that is the chiropractic story. I mean, people have got to walk away from their outside in philosophy and walk away from all their trusted providers, their parents, teachers, and preachers, everything they've ever been told, they've got to get divorced from that idea, move out of that house and move into chiropractic, right? That's a big deal, right? There's got to be sufficient pain for them to make that move.

[00:25:54] And then you've got to make sure that there's a brighter future with you. So talk to us about like, why do most people, why do they make that shift? Why do they overcome that inertia? What is the activation energy? What kind of pain are people showing up with where they've actually been like, I got to change my EHR. I mean, this is like, I've had enough, I'm moving. Yeah, it's, I mean, you outlined the problem really well for me. I don't have to even like, you know, it's the, every time, do you make migrations easy? And every, like, I just give them the hard truth.

[00:26:23] I'm like, there's no world in which this is going to be easy, right? Like, just prepare yourselves for pain and ask yourself if you're ready for that transition. And, you know, but I will flag something that I think is really interesting that I see, which is counterintuitive to the way most people would expect, right? Like, so if you, if you look at the offices that onboard successfully and quickly and with the fewest complaints and with the, the, the best outcomes and all those things, intuitively,

[00:26:50] most people would say like that comes from the, you know, the smaller clinics that have less overhead. They, they, they have less to move over. They, they have, you know, they've got two staff members who have lots of available time that can really help the transition. You would think that the smaller customer set and the smaller patient, you know, the more like all these things would indicate that these things are going to move faster. It's never the case. It's always the more sophisticated, the, the clinic seeing a thousand patients a week with two staff members.

[00:27:19] And, and, and I've looked at this over and over and tried to make sense of it. And it really comes down to, I think two or three things. Number one is mindset, right? Is like these, these office, they're operators. They understand the role of software in their company. They understand the, their own level of responsibility in transitioning and becoming accountable to a new system. They understand, they understand systems in general. You know, they have a mentality. If every single one of those clinics, they are work using 10 different softwares, right? They're using Google spreadsheets for this.

[00:27:48] They're using this for this because they understand like no one has the responsibility to fill in their gaps and that they, they're going to make a decision here and they're going to, you build a system around the gap of that particular thing and that they are, they are just seasoned operators. That's right. And so it's, it's counterintuitive kind of interesting thing that I always like to point out. But another thing that I find. I love that you went there with that, you know? So the, the expression we use in the remarkable practice is you can't fire a cannon from a rowboat and you know, you guys, Kyra HD is a cannon, right?

[00:28:17] So you, you have the most spectacular technology that you want to bolt onto an existing infrastructure, right? So it's like you bolt cannons to battleships, right? So what we do in the remarkable practice is we create battleships, right? So we create that infrastructure. And like you said, infrastructure implies not just technology tech stacks, but having processes and procedures and systems in place. You have teams in place. You have culture in place and culture, like integration, implementation, execution, that's all culture.

[00:28:46] And you're just showing up with this bad-ass cannon and they're like, oh my gosh. So we're not going to need to cobble together these four or five different platforms where we're like duct taping and super gluing, you know, everything together and trying to move things from here to here. And you're like, no, no, no. So they're like, okay, that's my pain. You're making this move. So you're like, let's get this done next week. Right? So I love, I love recognizing, Hey, this is going to hurt. The remarkable CEO always chooses acute pain over chronic disease. Oh, that's great.

[00:29:15] And if you're, if your software is holding you up, that is a headwind that's kicking your ass every single day, your ass, your team's ass, you're cutting down on efficiency and effectiveness. You're taking months, if not years off of your team members tolerance for how long they're going to stay with you. It's like, it is wicked expensive, wicked fast when you have the headwinds of a bad EHR. Yeah. It's huge. And so on the, on the flip side of that, so that's one, like, so that's one persona is

[00:29:42] like the office that is trying to push ahead in their, their progression. Right. And that's usually the one I just talked about. We also get the, um, the greenfield, which is like our favorite, of course, like coming out of school, we don't have to deal with any of the legacy. It's the least painful of all of them. Um, and then there's probably two other tiers, but I think the one that's worth really talking through is, um, it's the last ditch one, which is the hardest. And the ones that we sink our most time into, and we want to, but it's also, you know, it's

[00:30:09] like, Hey, my business is struggling and I, I need to make some sort of change, right? Like I don't, I need a catalyst. I need something to move. I need, I need a switch in there. They're looking for the software to become part of it. And, you know, I think in those situations, we like, we kind of morph into a, as much of a implementation and software company as we are a business coach. Yeah. It's like, as we are onboarding and implementing, it's like identifying gaps and being like, Hey,

[00:30:37] you know, you've got 900 appointment types, you know, our average most successful clinic has eight, um, you know, things like that. Like, like, like what, what's going on here? Like, so we ended up in that coaching role, which is rewarding, but also really challenging because you're in this spot where you are taking on some responsibility on like, Hey, we hear where you're at. We know why you're coming on board and we're going to do our best to try to really help you figure this out. Yep. Yep. Yep. So talk to me about enterprise level.

[00:31:04] Like you guys do a lot of work with enterprise groups, right? We're multiple, multiple brick and mortars. What does that, what does that look like? What are the challenges associated with that? It's a whole different thing. Again, like to, to that, your, your, uh, battlefield or your, uh, your battleship analogy, right? I think, you know, a lot of those groups, if they're not PE back, they're PE minded. Um, so they think of things completely different, right. In terms of, uh, business complexity is, is one in terms of like how, how many NPIs and

[00:31:33] EINs are in a single building and like who's involved in commission structures and some things that you don't typically see in some of the smaller businesses. Like, so the, the pressure on reporting becomes a very different animal. Yeah. More centralized functions. More centralized functions. We want to control things across the ecosystem. We want regional prices. We want to understand when people are changing prices. We want to understand when an office is diverging from our systems and our plans and our structures. We want to understand, um, all these things. We also want to roll up reporting.

[00:32:02] We want to understand that continuity across all the reporting. Yeah. That when I say, how many visits does this have office have versus this office, we're talking about the same thing, which is a way bigger thing than most people think that we have lied awake many times trying to, you know, with the, what is a visit question is like the only thing worse than no data is the wrong data. It was the wrong data. Yeah. So I think if you want to sum it up into words, it's like pressure around consistency and reporting is like what we see from those groups more than anything. Yeah. Especially when, you know, there's a third party scrutinizing the whole thing or will

[00:32:32] be right. So yes, absolutely. So let's talk about the future. Like what an incredible time. Right. So I feel like, I think you and I are old enough where we experienced the analog to digital shift. Right. So my generation is definitely going to be the one that's like, Hey, we grew up analog shift to digital. Like we're the only, I mean, I built a thousand week practice before iPhones came out. Right. So, and then ran it for another 15 years with social media. Right. So this is like, I've been on both sides of this thing. Right.

[00:32:58] So now I feel like we're doing that same thing as AI obviously takes away. I feel like it's almost the next internet, if you will, or have that much of an inflection, if not more, because it's just going to be ubiquitous because the internet's everywhere now. What do you see? What's coming? What's exciting? Like, what do you look at? I mean, like, give us the behind the curtains. Like, what are you guys talking about? I mean, you, you sound a lot more optimistic than I do. And I'm going to, I'm going to play to that. Right. Like, I mean, I will, I've also seen Terminator.

[00:33:27] I'm not quite to that level. I'm just, you know, AI. I think you're exactly right. It's not just the new internet. It's probably, I like to tell people and project on what I think, like, I don't know. We're very privileged or cursed, whatever you're, whichever side of the equation, like, generation in humanity. I don't, I truly don't think there will be another generation in human history that undergoes the transformational structure of the world when it comes to technology.

[00:33:56] Like, it is a once in a human history era we're living in. When you go from, to your point, completely analog, no computers to AI in a generation is just, is insane. And I think the, so impact on things, like going back to vision, I think that's like, I'm going to keep coming back to that as the central piece, because, you know, when we launched Pyro HD, we were the second real cloud provider, right? There was a few that kind of got into it and never really fully actualized and got bought out.

[00:34:26] But like ones that were actually able to run a practice at scale in the cloud, we were the first. And so we got to ride on that for two or three years as like our defining flagship. Like what, why are you guys different? Well, we're fully cloud-based and always have been, and we can run a 300 visit a week practice and a 600 a week practice. But as things shift and change, that's no longer a fact, like everyone's finally pushing their way into that space and they're solving all the problems. And now we have to redefine ourselves again and what makes us different now.

[00:34:54] But to the core essence of it is I think that we are always and continue to be aligned with the idea that we are only as successful as our clinic success is like one of our core internal mantras. Like if our clinics are not winning, then we have no right to win either, right? Like we are partners with them. We are deep in the trenches with them. And if we're, if they're not winning, we're not. And so when we look at things like AI and how they're transforming the space, we are very aggressively looking at how those things impact clinics.

[00:35:25] How does that drive new patients? How does that drive retention? How can that drive those things? Who's like, how do these things work effectively? We've seen a lot of our competitors slap AI things into their products and say, we're now an AI enabled software company, but it's not actually driving change to a clinic. It's not driving better revenue. It's not driving better retention. And so we've honestly, we've been a little slower on the release of these things because we're diving really, really deep on these and trying to understand how does a chiropractic office use AI effectively?

[00:35:55] Not just how, how does a general practice, how does a general business use these things? But like, how do we make this as easy and accessible as possible when the first time someone uses one of ours, they're like, oh, wow, that, that solved a problem immediately. And it was fascinating and interesting and, and helped me deliver a better experience to our, our patients. Like we're really, really, really focused on that side of it. And so, I mean, I could, could you cheat a little bit and give us a little, for instance, some of the sort of practical applications.

[00:36:22] Like, what are you guys like building that, that I know that my clients are going to like put to use and be like, oh yeah, you guys struggle with this. So we created that. Yeah. I mean, like some of these are so simple. You would think. Simple and sexy. I love that. Right. Like I, I'm going to contrast back, like the thing that everyone's been pushing on with scrap, right? I want an AI scribe to do it. And I, I've pushed back on that forever and we are going to release a scribe fairly soon, but it's always been one of my biggest complaints because you're taking the most legally important

[00:36:48] document in your clinic and your hand, like if you ask a doctor why they want scribe, it's because they, to be frank, they want to be late. They don't want to do their notes. They don't like. We're saying for every doctor. It's like writing notes, right? I mean, yes, no one wants to do it, but it's like, it's a very important part of your practice and it's the part that makes you a doctor that gives you that, that level of understanding of what's happening. And so I've always wanted to, and it's also not how doctors talk, which is my other complaint

[00:37:12] is no one is sitting here with a patient saying, well, I noticed a fixation at C1 to C2. So I'm going to adjust you supine on the, like, you're just not doing that. And so I've always been frustrated with that as the main push, because I'm like, I can deliver so much better value in other areas. So we're, we're weeks away, hopefully not going to, hopefully I don't get in too much trouble for saying that. Like two really, that's our job. We break things. There's AI intake summary.

[00:37:38] A patient submits their intake paperwork and you, they come in for their new patient appointment and you get a detailed summary of their intake with flags for, oh, this patient has had five seizures in the last year. They are a type one diabetic. They're a type two diabetic. They're like things that are just like, you know, big red warnings. Like, Hey, these are really important things you need to take care of or take, take attention to. Here's a clinical summary. And also here's your initial subjective part of your note so that you can start that note from a really well orchestrated layer. Right.

[00:38:08] A lot of other companies have had like this structured thing for a while. So one of our biggest competitors have this for a while, but it's not, it's, it loses context because you have to have their paperwork, right? Like we customize our paperwork. We have a thousand clinics that have a thousand different forms of paperwork. And now I can work across all of those. And then the other, the flip side of that is care summary, right? You have a patient that's been coming in for two years. You're come there. You want to bring them in for a re-exam. And instead of you pouring over, you know, two years of history, trying to understand is

[00:38:37] just to get like a cliff notes. Hey, they came in for this. They've had three exacerbations. There was this fall and here's what happened here. And here's all of it. And just one quick little succinct way before you do a re-exam. Small, tiny things, but let you spend that same time that you were doing prepping for those meetings with the patients instead. Awesome. Awesome. All right. So last thing, let's fast forward three years. We do, what do you, what do you see is like the biggest difference in the chiropractic

[00:39:05] space business from a tech side? Like what do you, what do you see is coming down the pike. That's going to be like really disruptive. Like things that like everybody has this fear around like, oh my gosh, AI is going to take care of this and take this job. And we're at the, at the end of the day, it's going to enable people who are doing great work to outperform people that are not leveraging AI. So it's like, what do you, what do you see? I won't ask you five years from now because I just, things start getting a little wonky five and 10 years out, but three years from now, you know, what do you think's the biggest difference? Yeah.

[00:39:34] I'm going to focus on the optimistic side of this point. I mean, I think, I think clinics operate more efficiently, more cash efficiently. They see, I think we have more successful clinics overall. Right. I think that comes through two different things. I think the not so great clinics are going to fall by the wayside during those periods. And, and the ones that are, are to your point, the ones that do good work and serve their patients are going to thrive. And then we're going to see, I think we'll see less, you know, the, the gap between thriving and, and, and suffering.

[00:40:03] I think is going to, I think you'll see a overall stronger industry. I also have some incredible technologies, diagnostic technologies, information technologies, exchanging of information. I think that there's probably going to be some really interesting methodologies that come down the pike, just applying all this data and information and databases, data banks, like everybody's going to have much better patient records. All of it will be recorded and transcribed and captured. And, you know, I, I, I'm bullish on it. I'm excited about it. It's like, you're, you're talking about profitability.

[00:40:33] I mean, I think that labor costs are obviously, you know, we're going to become much more efficient. Uh, and, and, you know, that just was going to free up our people to do maybe more creative things. Uh, and I think that there's going to be better communications. People have a better understanding of chiropractic. We can start measuring things like how does the chiropractic adjustment affect the brain, right? And being able to demonstrate the power of the chiropractic gear. I'm super excited, man, but I'm pathologically optimistic. I'm an idealist. It's served me well so far. Uh, Gabriel Doty, man.

[00:41:03] Thanks for all the work that you're doing, man. Behind the scenes, just helping us help more people, help more people, bro. You guys are awesome. Uh, how can people learn more about chiro HD? Like what you guys got going on? Where are we going to find you? Yeah. I mean, chirohd.com, um, is the catch all for everything. There's a contact form on there. If you want to reach out to our sales team or anyone there, that's easily the best place to go. Awesome. And we appreciate you guys being one of our success partners. So we'll see you guys in Maryland in October, October one, two, and three, first, second,

[00:41:29] and third of October, the remarkable practice immersion, which is our operations version talking about, you know, if you want to see more people, make sure you bring your entire team to the remarkable practice immersion in Maryland, October first, second, and third. Thanks brother. Appreciate you. Yeah. Awesome. Thanks for having me. Awesome, man. 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.

[00:41:59] Enjoy. Welcome back to the remarkable practice success partner podcast. And today I have someone very special with us. We have John from Next Healthcare and they are the leading radiology group in Australia and with chiropractors. So John, it is so great to meet you. Would you like to give a bit of an introduction about yourself? Thank you, Dr. Oz. Pleasure. Thank you for the introduction. My name is John Kennedy.

[00:42:28] I'm an accountant by trade, but I've been in radiology for 25 years. Started a very successful business in Melbourne called Capital Radiology that went Australia wide and was publicly listed and now I've been taken over by another group called IDX. Since then, since my departure of many years ago, I decided to be a bit more specific in radiology and we developed the next healthcare was the next iteration. And next healthcare predominantly does radiology reporting services with chiropractors.

[00:42:57] And we partner with chiropractors to ensure that we have very good outcomes for them, but also their patients. Love it. So you mentioned late helping chiropractors, partnering up with chiropractors. So let's say that I put an X-ray machine into my business. What exactly, what specific problems can you help solve for us? As we know, most chiropractors will take an X-ray first time out for a new patient. If you get the, if you write a referral and the patient has to leave your practice, the chances are they're not going to come back. Okay.

[00:43:27] And if they do come back, it may be a week or two weeks before you get the films and the report back. That's a delay in management and a delay in that customer touch point, which is really important to ensure that they actually keep coming back. Right? So a one-off visit, you know, it's not really enough. You really want to get a patient in there for at least, I just saw a chiropractor myself, someone who does the CBP. Okay. That was a 12 week consultation. I know how important it is to go there consistently over a period of time.

[00:43:57] One or two visits isn't enough. Radiology is one of those mechanisms, one of those tools which enables you to articulate the patient's problems immediately and get, and be on the process or a pathway of a management plan. Right? Where we come into it is unfortunately radiology has an unintended consequence. Right? So you can't just say as a chiropractor, I'm going to take a full spine x-ray.

[00:44:24] But all I want to see is the, is basically the vertebrae. Exclude the lungs. Exclude all the soft tissues. It doesn't work that way, mate. And that's the problem that exists is that when you take that image, you own it medico-legally and we get so many situations where there's pathology, okay, that a chiropractor wouldn't necessarily see. And that's the unintended consequence of, of getting a chiropractic x-ray.

[00:44:51] When we come in is that we actually alleviate that problem. Once you send this to Phil, the risk goes from you to our radiologist in effect. So that's the benefit. So that's how we get on board. What return on investment can chiropractors expect working with you? Yeah. So the way we work is that we're a partnership model. So we partner with, with our chiropractors and we share the, the returns or the profit.

[00:45:18] So basically all our reports are Medicare compliant. The re, the fees that we generate, we enter in what we call a service level agreement with our partners. When we distribute, we enter into a profit sharing effect. The way we do it has been medically, as if Medicare has approved our model, okay. So I have no issue or people can say, well, you can't give money back. Well, you can, if you structure it correctly. If you lead to a Medicare act, it actually says a profit distribution is what they call a permitted benefit. Okay.

[00:45:47] Now it depends how you structure it. Medicare has checked over our, our agreement and given us the old tick. So we've got a letter from Medicare saying, you know what, you guys are good to go. There's nothing that they, obviously the government can change regulations and legislation anytime they want, but as of today, it's fine. We normally remit back to our partners within five business days at the end of the month. So anything, so let's take May, for example, May will end on Friday by next Friday, next week, our partners will get their profit shed.

[00:46:46] Okay. From charging the patient for your time and effort in communicating with them, the results of that X-ray. Okay. So the Iran interpretation, but also including the interpretation of the radiologist. So there's a financial benefit there. If you look at a machine cost, it's not that it's look, it's not crazy expensive. You're probably looking at all in once you do works and all the rest of it.

[00:47:15] It's probably about anywhere from 80 to a hundred thousand dollars. That's the cost of the machine. And it all comes down to volume. How many do you do? We've had some of our clients that have paid back the machine within four months, some six months, some eight months. Right. Um, it's really a functional volume. If you're doing 10 a week, which is two a day, you should consider consider getting your own X-ray machine. Cause not only does that, what that does is it actually heightens your probability of getting

[00:47:45] more new work because of it. Okay. Do not discount the marketing angle of having an in-house X-ray machine. Very, very. It's not five years payback. Okay. It's not that at all. It's actually relatively quick. Well, one of the things as well as chiropractors probably don't know or do know is that you can also refer other parts of the body apart from your spine and your shoulder. You can do shoulders. You can do knees.

[00:48:14] You can do feet as well. Okay. So there's no reason why you can't attach a right knee or a left knee or bilateral knees with that full spine X-ray. If the air day, it's, everything has to be based on a very simple concept is that it has to be justifiable. Okay. It has to be medically just, you just don't do it willy nilly because you're exposing radiation to someone, right? And governments have high penalties in relation to doing that without the clinical justification for it.

[00:48:40] One of the other benefits that we provide as well that I probably don't talk about enough is that we also help you get your patient immediate access to MRI at bulk billing. Okay. Okay. So unfortunately the Medicare system is based on hierarchy. The government rates you based on your, your qualification. Okay. At the top of the tree is the specialists, the dental practitioners, and then you'll see your, you know, dentist allied healthcare.

[00:49:10] And depending where you, where you sit on that, on that ladder, it's a government gives you referral rights. So because radiologists are specialists, they have the, they have the ability to write MRI referrals. So through our best scan product or best scan service, if you, cause in some of the reports, so what will happen is when you get a report back from our radiologist, there'll be some recommendations sometimes. And sometimes the recommendation is a CT scan. Sometimes it's a, maybe a joint injection or an MRI.

[00:49:39] At the moment for you to give the patient the pathway to that test, you would have to go through a general practitioner. Okay. So me, me being the example, I am 53 years old. Unfortunately, once I turn 50, a GP can't refer me for an MRI anymore and get bulk billed. I have to be referred to a specialist. So think about it. If I come to you, Dr. Oz, and you say, John, there's something not right with your knee. You need an MRI.

[00:50:07] You can only go to the clinic and pay three or 400 bucks out of pocket, or I can see, then you send me to a GP. The GP says, well, John, sorry, you're 53, mate. You don't meet the criteria. He's going to send me then to a specialist, which is another what? 400 bucks maybe, and wait four weeks for an appointment, who then sends me to the radiology. And then I have to go back to the specialist for the report, another 400 bucks. So in our case, you have the capability of writing an MRI referral. You know whether that patient is MRI or not.

[00:50:35] If your notes are clinically justifiable, they have the right reason. You can't just say MRI of the knee. There's got to be a reason, right? It could be ACL or whatever, torn ligament. The radiologist or one of our specialists will look at it, orthopedic surgeon, and they will say, yeah, I agree with you. They put their name on the referral. So that person now can take that referral to a radiology clinic and get that bulk bill. So again, we're shortening this patient care. You know, instead of taking two months, three months, four months, you can get an outcome within a week.

[00:51:05] Thank you. So what would be the best way to get in touch with you now? Well, simply just visit the website. It's called nexthc.com.au. On there, there's a contact details for Donna Hobbs. Donna's details are there. So her email address is Donna at nexthc.com.au. Her phone number's on there as well. Speak to Donna. Donna has, I've got to be polite, but I'll use the word veteran. She's been in radiology and the chiropractic space for a long time.

[00:51:35] So nexthc.com.au and just contact Donna. One of the things is I want to give you an insight into the future on one of the things that we're doing that will hopefully come to market sooner or later. And it really relates to AI. Okay. So one of the things that exists now is we will get a substantial inflow of work coming in on a daily basis. And you're relying on a radio. And it's basically reported on first in, first served, unless it's marked urgent.

[00:52:04] Where AI comes in, AI has the capability of triaging, right? So we're building an AI model that is not providing a diagnostic rapport, but he's flagging adverse findings, okay? So he thinks that there could be a problem here. So what that does is that will usurp that patient on top of the list instead of it being on a date or time-based stamp, right? That's very important.

[00:52:30] So we're trying to get, again, we're trying to get optimal patient outcomes immediately. And you don't know what's urgent or what else not, just looking at a patient's name, right? But AI does have the capability now of being able to determine. It can see something that we train it. So it's trained, right? This is a complex model that's, and we're able to do this purely because we have hundreds of thousands of chiropractic spines in our database. So we're getting to the point now where we're still testing it.

[00:53:01] Hopefully, well, towards the end of the year, we'll use this internally to triage. It's not fair to do radiology reporting. It's still done by a human. But what it's there to do is to highlight a patient that requires immediate attention, potentially requires immediate attention, okay? That means your patient, you'll know today, instead of probably three or four days on the track, that patient needs something. So I'm going to jump. Thank you. Thank you so much. Pleasure. I'm jumping on today and sharing it. So guys, if you want to get in closer to John, he's already linked to our website.

[00:53:29] I'm going to also make sure it's on the podcast so you can click on the link as well. It'll be in the description. So make sure you check him out and work with Next Healthcare because they're game changing. John, thank you. Thank you, Dr. Graz. I'll see you soon. Thank you. 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.

[00:53:58] 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. Now go and be remarkable.