April 2002

Sequence Matters

by Mark Radermacher, D.C.

President of Total Practice Management

            Dr. Radermacher has been a chiropractor for 22 years and has been coaching some of the largest practices in the country for the last 14 years.

            The sequence in the steps of implementation in a multi-task endeavor is often the difference between success and failure. In many multi-task endeavors, the implementation of some of the steps can literally be random with success still being achieved. In some multi-task endeavors, certain steps can or must be accomplished simultaneously in order to achieve success. Yet, in most multi-task endeavors, certain steps must occur in a specific sequence, or success will be thwarted. It is in the sequencing of multi-task endeavors that most chiropractors must become immersed in order to advance and sustain success in their office.

            Understanding how to succeed using the different types of sequence implementation is imperative. Take, for example, having the option to randomly implement some of the tasks in a multi-task endeavor, while still obtaining success. A simple example in a chiropractic office would be the multi-task endeavor of a routine patient visit. This unpretentious five-step process simply requires all of the steps to be accomplished; the order of the steps doesn't matter. In fact, complete success will be achieved using any random sequence in this multi-task endeavor. The five-step process includes: 1) the patient signing in, 2) the patient getting adjusted, 3) the patient being taught, 4) the patient paying for the visit and 5) the patient rescheduling for the next visit. Every task is randomly interchangeable. For example, the patient could: 1) pay for the visit, 2) be taught, 3) reschedule for the next visit, 4) sign in and 5) get adjusted. The end result is still a complete routine visit.

            The sequence can be debated, but what is most important is for the doctor to consider style, effectiveness and efficiency. If, as a doctor, your style includes teaching and then adjusting the patient, this is the most reasonable order to use. However, many doctors have improved these two steps by learning how to teach a patient while the adjustment is taking place. In this instance, efficiency is improved without the loss of effectiveness. Moreover, a doctor may have chosen to have a patient visit the front desk twice during each routine visit, for example: 1) sign in, 2) get adjusted, 3) be taught 4) pay and 5) reschedule. A more efficient sequence would be to visit the front desk one time only, for example: 1) sign in, 2) pay, 3) reschedule, 4) teach and 5) adjust. In this sequence, no effectiveness is sacrificed, and all tasks are still accomplished.

            Consider, for a moment, the willingness to modify style in order to greatly enhance efficiency, even to the point of increasing effectiveness by impressing the patient with your organizational skills. If you were to combine the five tasks required in a routine patient visit as follows: 1) sign in, 2) pay, 3) reschedule, 4) then teach while 5) adjusting, you would be maximizing effectiveness and efficiency. In this instance, effectiveness and efficiency would also be noticed and appreciated by patients. In a consistently well-organized office, patients who pay prior to being taught and adjusted often have more appreciation for the chiropractic component in the visit. Furthermore, many patients will notice and appreciate the efficiency of stopping at the front desk one time only and being taught while being adjusted. Most patients either have, or at least perceive having, busy schedules; any opportunity for them to save time will be greatly appreciated.

            In some multi-task endeavors, certain steps can or must be accomplished simultaneously in order to achieve success. A new patient pre-consultation is an example of this point. There are at least six tasks to consider in a new patient pre-consultation. They are: 1) determining the patient's personality style, 2) matching the patient's personality style, 3) asking specific questions, 4) acquiring specific answers, 5) exhibiting doctor confidence and 6) using quality doctor listening skills. In this example, the opportunity to randomly implement the six steps doesn't exist. You simply can't 1) acquire specific answers from a patient, 2) match their personality style, 3) become confident, 4) determine the patient's personality style, 5) listen well and 6) ask specific questions. No doctor would consciously attempt to develop a style choosing this ludicrous sequence. Unfortunately, without thought, this ineffective and inefficient sort of random sequence occurs all too often. In reality, these six steps are a very good example of a multi-task endeavor requiring simultaneous action in order to achieve success. A doctor must walk into a new patient pre-consultation prepared to simultaneously be confident, listen well, determine and match the patient's personality style, ask specific questions and receive specific answers. It is in the seamless immuring and simultaneous implementation of all six of these multi-tasks that can produce a style that is both effective and efficient.

            In most multi-task endeavors, certain steps must occur in a specific sequence or success will be stymied; this has, perhaps, been the most laborious endeavor for chiropractors to comprehend and attain. A somewhat challenging but incredibly pertinent example of this multi-task endeavor is that of success. Success is not stumbled on fortuitously; success is most often a multi-task endeavor that requires a plan consisting of certain steps occurring in specific sequence. These steps in sequence are: 1) defining personal and professional standards of success, 2) listing priorities and 3) maintaining balance.

            Defining personal and professional standards of success includes many points; some of them are: how much money you want to earn, whether or not you want debt, how much savings you want, the level of respect you demand, the level of integrity you operate from, the specific material goods you desire, the level and type of education you will achieve, the profession or position you will attain, your physique and your circle of friends. This rather extensive list needs to be defined, and the points in the list need to be addressed before advancing to the next point. The mistake many doctors make is borrowing the standard of success from someone else. Entire careers, indeed entire lives, are unhappily lived out by attempting to live up to someone else’s standards. This is not only indecent, it is also unhealthy. The definition of personal and professional success is as individual as a thumbprint. Furthermore, this definition must occur before any attempt to succeed be made.

            The second point, in sequence, is listing priorities. You can have just about anything you'd like, you just can't have it all. While attempting to have it all, you could draft a list so extensive in length, it would be overwhelming; therefore, listing your priorities is mandatory. Many people will omit this critically important step. Their approach is typically to borrow someone else's standard of success and then expeditiously rush ahead, attempting to succeed. Priorities and their importance are, of course, extremely personal. In order to make a point, the following priority examples are listed: spiritual well-being, health, relationships and responsibilities, fun, job or profession, money, travel, material objects, activities and, finally, self-discipline. The greatest challenge most people face is the order in this list. In other words, it is critically important to determine which priority is absolutely number one on your list. All priorities deserve focus and attention, but the number one priority deserves the greatest focus and attention. An important reminder that could be helpful in living out your list of priorities is the fact that focus and time need not be related. You can have success by exhibiting intense focus for seconds or minutes, whereas you could unsuccessfully waste hours or days with casual focus achieving little or nothing. Speed is another challenge for many doctors. How fast you get to your goals is less important than the ultimate success of achieving your goals. Besides misunderstood time and focus problems, it is also important to realize that a list of priorities can become too long or too didactic to practically live day-to-day. A shorter, but well-rounded, list is by far most propitious.

            Once personal and professional standards of success are defined and a workable list of priorities is intact, only then can balance be considered and achieved. Balance is that resplendent but dynamic state many people have heard about but few achieve with any consistency. Giving up balance always has a price to pay. For example, if physique is one component of success a person has defined, physique is on that person's list of priorities, and that person must address physique in a successful manner. That may include a regiment of daily exercise. If an exception is made and exercise isn't done for one week, there's a price to pay and a loss of balance occurs. The price to pay is a loss of energy, weakening musculature, painful lactic acid build-up when exercise finally resumes and the realization that you broke consistency in properly addressing a priority of yours.

            Maintaining balance includes reviewing your definition of your standards of success. It is common to inadvertently succumb to outside influence as to the industry standard of success. For example, a friend may build a larger house than you have and make the comment that "you make enough money and deserve to live in such a house, as well." If you are out of balance (tired, weak, and/or frustrated), you could be tempted to borrow your friend's standard of success and make the dramatic mistake of building an expensive house that was never part of your personal standard of success. Balance is a dynamic art which requires frequent and honest monitoring in order to benefit. The sequence of defining success, then identifying priorities before attempting balance, is obvious. You couldn't even consider balance if no definition of success and no priorities were ever identified. Living with balance is not ethereal utopia, balance is a very tangible framework to build and use in order to achieve your standard and priorities of success.

            A person succeeds with multi-task endeavors most often because of a sequence in the steps of implementation. When the sequence can be approached in random fashion, success can still be achieved. In a more complicated case, when certain tasks need to occur simultaneously, success can also transpire. In the most challenging, yet very necessary, scenario, tasks must be accomplished in a very specific sequence. Understanding and implementing multi-tasks in sequence may not be the elixir for each and every doctor who is struggling to succeed; however, it is often the capricious doctor who envies the disciplined doctor; and the doctor who is most often experiencing success is typically very disciplined in using multi-tasks in appropriate sequence.