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4 Major Concepts to Uplevel Your Practice

Do you know where you are at right now and want to go to the next level, today we are talking about planning, hiring, and onboarding, training, and budgeting. Do you feel like you have struggles or challenges in any of these areas, this episode will help you understand and fill in the gaps and create the life and practice of your dreams. 

Key Points:

·      Planning Time and knowing how much time you and your team need to create the life and practice of your dreams.

·      Hiring and Onboarding – Who is the right person, for the right role, doing the right work, doing it the right way? Pour into your new team members for the first 90 days.

·      Train the team and create a culture of training weekly.

·      Budgeting and the importance of knowing how much and where to spend your financial resources to grow your life and practice in the most efficient and effective way.

About the Host:

Dr Clifford J Fisher

Dr Cliff Fisher – Owns several offices all over the US and has a coaching business Dream Leadership Institute to help people find the greatest version of themselves. He will help you get to a foundational understanding to create the business and life that align with your being.  


Dr. Joseph Esposito, CEO

Dr. Joseph Esposito, D.C., C.C.N. C.N.S., C.C.S.P., D.A.B.C.N., F.A.A.I.M. C.T.N., is the Founder and Chief Executive Officer of AlignLife. As such, he is responsible for the direction of AlignLife as it expands further across a dynamic and rapidly changing health care landscape. Dr. Esposito has more than 20 years of experience in a broad range of businesses, including chiropractic, nutrition, technology and internet marketing.

Dr. Esposito has extensive post-graduate academic accomplishments, as well as 15 years of experience managing successful chiropractic clinics in multiple states. He also is founder and CEO of Aceva LLC, a service-based nutritional company providing products and services to the AlignLife clinics. As the former CFO of an internet publishing company, Dr. Esposito understands the power of leveraging the internet to impact the lives of millions of Americans.


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AYP Intro/Outro:

Align Your Practice podcast with Dr. Cliff Fisher where your best practice and life awaits you. Are you tired of running a practice on your own? We want to come alongside you with experts to help you create your dream practice in your dream life. Here is your host.

Dr. Cliff Fisher:

All right tribe. Welcome back. I'm super excited last time, we made it all the way through all the different ceilings in chiropractic. And so today, what we'd like to do is really sum up and talk about like, after we went through that, like I had a couple of takeaways, Dr. Joe, I know you had a couple takeaways. So I guess like for we talked about it, but what were your two favorite takeaways of everything on how to go from each level, because we talked about level two level two level, but there's also this thin red line that kind of keeps everything tracked. And it was like the same thing. It's just different up leveling, do whatever your two favorites.

Dr. Joseph Esposito:

So I think yeah, a lot of it was granular data. But overall, as a premise, going from launch, to build or build to scale, those three stages, my number one thing I think that has to happen is it has to be an up leveling of the planet, the maturity of a planning, time you spend on planning. And I know you're gonna go down the road of people, and teams, so important, but I feel if you don't plan adequately, as you go through the stages, you're going to get in, you're going to get in trouble. My second one would be budgeting, maturity and the way you budget money. Because as you grow, and there's more money coming in as more people to be paid, and it's more goals and deliverables, you got to get more mature in your budgeting, what would be your chip.

Dr. Cliff Fisher:

So my two, just like you alluded to, number one would be hiring and onboarding, like getting the right people and making sure the right persons in the right seat on the bus. And then the other one was training and equipping. And so and super,

Dr. Joseph Esposito:

don't realize that onboarding, training. That's important. Yeah.

Dr. Cliff Fisher:

Yeah, so tell me about planning. So what's your thought? Like? What do you feel like people should be planning because I think that's a huge blind spot for people. Yeah, it's

Dr. Joseph Esposito:ger and seasoned Manager with:Dr. Cliff Fisher:

Yeah, cuz I mean, when I had to shift to planning, I felt like I was being lazy, because I'm like, Oh, I'm just sitting in front of this, I'm not bringing any money into the clinic, I'm not doing any work, real work, it was tough. It's,

Dr. Joseph Esposito:

there's a guilt associated. So take this point by Cliff, really, strongly take a note of that, because you're gonna feel that once you step out, but if you don't step out in scale, scale is leveraged scale is what everyone wants, when they own a business, there's two parts of scale, you either stepping a little bit out of your clinic here, you're not the main practitioner, or you're opening another facility. Either way, planning is gotta go up significantly. So just set that in state, about 30% of your time planning, put it in your calendar. And I know, Cliff you and I, we have an area of strategic planning, we have an area for planning, you have a thinking chair in your office of when you think planning is, is so essential. So that would be my take left for for my number one.

Dr. Cliff Fisher:

That was funny, because I'm bringing up mine, I'm like, man, so hiring is also planning because you can't like when we were talking about your two and my two as like, my two are interrelated. Like they come together like this. It's not like anything separated. So it has to be like a system that functions and so hiring and onboarding. So one thing with hiring, hiring, for me is like the foundation. And I think my tendency when I first started was to hire people I liked. So I had a whole bunch of people that were like me. And so I had no diversity on my team. And so there was a lot of exposed areas and a lot of weaknesses that I couldn't compensate for, because I didn't have the right team member on our team. And so we don't have to be good at everything. But we have to have a team that's good at everything. And so we were really like our whole team was relational. And, you know, it really created a bunch of gaps for us that we had to rectify later that we didn't even really see. And then now starting to build new offices. I'll go ahead, Joe.

Dr. Joseph Esposito:

Well, I think when you stepped out, and you have a good story, which we'll talk about another podcast, but you stepped out fully where you weren't in the clinic, you weren't around the clinic eventually. I mean, you went back and forth. Yeah. But eventually weren't there. Those holes probably became more glaring, easy to see. And scary, right? First, when you were in your energy, you didn't even smell it. See, it tasted as much, right?

Dr. Cliff Fisher:

Yep. And you could rectify it faster when you're present. When you're a present owner, it's definitely a different game. Yeah. But when you're a non present owner, like, you know, you have to use the data, you have to use the stats, you have to make sure you have the right people who are going to drive it because like I had one office where we put in a caregiver doctor, and we're trying to build the practice, and he was the only doctor there. And it really struggled. And then now we put in practice builder and the office is just taken off. So making sure you have those right hires. And then onboarding is a 90 day process, the worst thing you can do is when you hire somebody, just like you talked about with your office manager, I would hire somebody, I'm like, oh, man, they get it. I would just, I got other things to do versus nope, pour into them for 90 days, Dr. France, and he taught me that it's like, just keep pouring into him for 90 days. And you know, that'll pay off for three years or 10 years.

Dr. Joseph Esposito:e management level, let's say:Dr. Cliff Fisher:

Yeah, it's all planning, right? Yeah, I totally agree. And I think like a couple things are back on the hiring, right. So if you hire the wrong person, it's going to cost your company three to five times their annual income. If you lose the right person, it costs you 10 times their salary, in lost production,

Dr. Joseph Esposito:n's income. If they're paying:Dr. Cliff Fisher:

Yeah, it's definitely a place to slow down to speed up, hire slow, just like you said. And then, you know, fire fast like, and you alluded to it earlier on the core values. And like, why that onboarding so important, because they need to know what the core values aren't. I know how I am. When we bring people into our offices, I'm like, Okay, here's our core values. This is what you can expect from me in our entire team. And this is what we expect from you. This is also what we hire and fire based on. And so I do that on there. Day one.

Dr. Joseph Esposito:

Yeah, well, I learned this in great detail from pain of hiring. Remember, I hired two people for a line like corporate office, or for the franchise, I had at the same time we started with I did an hour and a half or two hour lecture to these two, and my team. And one of them lean forward in the chair, jaw, open eyebrows raised, taking notes, and, you know, asking questions that relate to our children and our mom, her neighbor, like, Oh, my goodness, and the other one was looking at her nails. I saw an eye roll once a big Huff puff, looked away. And it was so easy, is so easy when you speak your mission, your purpose, to read energy. And I don't know why this isn't taught at the entry level hiring, right? I mean, if we all just did that, then you know if they're on purpose or not, if I that person decided not to take the position, right before I told them, they're not right for the position, I went up to the table to tell her and she goes, You know what, and we both had the same message. That's before we even started. Most people be six months in trying to force that person. And in view, and this is key guys, what we do is we start lightening up our our purpose or our mission, because we don't want to make them uncomfortable. So we soften our mission to appease people as we love people, just because of the wrong seat and bus. You know what I mean? I mean that that does happen.

Dr. Cliff Fisher:

Yeah. 100% And I think if anything we've learned from COVID It's like lean into your principles, not away from them because as soon as you take a stand, you're just going to attract your tribe and the people that are like you and want to be around you.

Dr. Joseph Esposito:

And that's is not in our top four here. But that's something to take note on, is, make sure you stand stronger for your principles. When you go from launch to Bill, like put a line in the sand and strengthen your belief systems on what you convicted on what you believe, when you go from Bill to scale, and now you're, you're not the operator, you're the visionary and the strategic planning partner, or leader, you've got to level up that conviction, because you're going to be a step further away from the energy of the operation. So I think that's a good point.

Dr. Cliff Fisher:

Yeah. So my next one is, you know, so after you onboard them, then how do you keep a player so it's just it's training, and there's just certain things you have to have, you have to have certain rhythms, you have to have certain. Like, we have scorecards inside of a line life that you know, are awesome, and they help us keep our team member on track, because one of the worst things is you get an A player, and they don't know what winning looks like. And so with a scorecard, they know, am I doing well? Or am I not doing well, having clear job descriptions, so many people don't even know what they're supposed to be doing in some of these offices. Like, I know, I was working with the other business. And I'm like, Cool. Let me see your org chart. They're like, well, we don't have one. I'm like, Oh, okay. Any job descriptions? Not like, and he's like, Well, why people are underperforming. I'm like, they have no idea what to do. And he was blaming, like, they were blaming them versus like, okay, cool, like, help me get that. And so I think that's a huge foundational piece, like having those basic things. They seem fundamental, or they seem basic, but they're actually fundamental.

Dr. Joseph Esposito:

Yes. So onboarding is about understanding the purpose, mission vision of the company, the core values, and understanding their job detail, the behaviors that they're expected to do the resources, they're supposed to use, the software, the tools, the processes, the online infrastructure, the forms that the system, right, that's training is where you're refining their communication, you are refining the way they behave, how they relate with other, they got to come out of a position you call non existence, which means they just plopped into a facility or a clinic. They don't know who they don't know the person they report to. They don't know who reports to them. They don't have relationships, these people, they don't know what their strengths are, they're non existent. So what they their first move is to come out of non existence by building relationships with people finding out the accountability that each person has on a team, including themselves before they start the job, like what is your role? What is it? What are you accountable to, and then like Cliff said, you go to the org board. But if you're in build going to scale, it's important that you go back to the job descriptions, and make sure what they're doing is watching the job description. Because once you step out, open the second clip, it's like hitting that golf ball. If you put it and it's off by a little bit, you may still hit the hole. If you are drive it, and you're off a little bit, you could be 100 feet off the great. And I'm not a golfer, but

Dr. Cliff Fisher:

now you would mind.

Dr. Joseph Esposito:

Because it's swinging the club, I learned that quickly. So that's, that's finally important. I want to I want to say something about the scorecard verse job description. When we hire an online life. We're constantly refining job description, while we're learning through adversity and success. And the job description is really a set of behaviors that you're direct. That sir, I changed language, from your direct report to your direct support, your direct support person is giving you a framework of behaviors, that's going to give you the best chance of success. But it's just a framework of behaviors, your scorecard is the outcomes that your job is supposed to produce. So you use the job descriptions to understand behaviors, to create the outcomes that you have to accomplish on the scorecard. But it's really only about the scorecard. The job is about the outcome. If you find a behavior that may work better than what's in the job description, then you talk to your direct support. And you say, I want to try these things, you have a meaningful conversation. And you may shift a little bit of behavior to create the outcome on your scorecard. I know that may or may be confused, you may have enlightened somebody. To me, there's confusion between those two, and you got to know what they are. When you change your behavior, then you go back to your direct support person, and they may change the job description say this behavior. So it's a dynamic moving, beautiful process with the scorecard and job description, all attached to the org board that you mentioned. Saving Yep.

Dr. Cliff Fisher:

100%. So then for me hiring is about competency. A hiring onboarding is about competency training and equipping is about mastery. And so that's why those two for me are such a big deal. And I think that leads right into budgeting because if you don't have any money, you can't hire anybody. You can't do any of the things we want to do. And so tell me more about the budgeting Joe.

Dr. Joseph Esposito:months is:Dr. Cliff Fisher:

yeah. Great wrap up, Joe. So this is definitely one of my favorite thoughts just as far as wrapping everything up. And so the four things we talked about was planning, hiring, training, and equipping and budgeting. And, you know, one of the things that came up for me in budgeting was the profit versus top line revenue. Everybody talks about top line revenue. But what's really sexy, is that bottom line, what you take home, what you take home to your family, where you are able to invest, and just being able to have that planning and because what I see with doctors is they start to earn more, and then they increase their lifestyle versus like, go two or three years like don't let your lifestyle increase as much as you do let your business like invest in your business for the first three years

Dr. Joseph Esposito:

are counting from that works with franchises around the country gave us a compliment and said it's weird. You guys had a line line focus on net profit with the clinics, when most companies are, you know, that's doing service like we do or focus on top line revenue, like how much money comes in. And I said, you know, our line life has grown to this day, just by referrals and word of mouth, not so much by marketing, which we're going to start more aggressively because we look at making sure the doctor has money at the end of that sheet of paper which is net profit. We have to teach people how to do that because I know many doctors that run a multimillion dollar clinic that do not make money that guys are making a half a million dollar clinic because they're not budgeting right to make sure they get that so line life culturally focus on making sure doctors take home the money

Dr. Cliff Fisher:

Awesome. All right, you guys. I am excited about our next episode. Dr. Joe is gonna actually be talking about how to exit a business because now we've talked about okay, you spend your whole life building a practice and we don't want your practice to die with you. And so where as you exit not that you're passing away but so next episode will be on exit. Thank you guys so much for being here. I'm super excited for the next episode. Have an awesome day. Awesome.

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