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small stuff


Jeff Olson, in his superb book, The Slight Edge, illustrates how slightly different actions lead to radically different outcomes. His story explains “why some people make dream after dream come true, while others just continue dreaming”. For example, most everyone desires to be fit and healthy throughout life. Long-term, someone who chooses the grilled chicken with steamed vegetables each day has a significantly different outcome than an identical twin that orders the fried chicken sandwich and fries. Although change is not evident from day to day, a lifetime of slightly different choices leads to a dramatically different ending. At age 70, one might call the other “lucky” because they did not suffer from obesity, knee OA, back pain and heart disease…but luck was not the major influence.

We’ve all heard the saying: “Don’t sweat the small stuff”. While this may be helpful advice for overcoming life’s small challenges, it’s not so advantageous for running a successful life… or practice. “Best practices” maintain their slight edge by sweating the small stuff, particularly when it comes to:

Clinical Outcomes- Finding and changing mechanical irritants is critical. For example, we know that 95% of partial rotator cuff tears are due to repetitive impingement. 100% of impingement cases demonstrate scapular dyskinesis (the acromion does not move out of the way during shoulder abduction). Scapular dyskinesis is in part due to hypertonic upper traps. So…. (huge run-on sentence coming) if you only forget one “small” thing and do not advise your rotator cuff patients to optimize their workstation keyboard & mouse height, their upper traps progressively tighten all day as they hold their arm too high, diminishing the ability of the acromion to retreat during arm elevation so their supraspinatus tendon continues to be pinched while your outcomes suffer miserably.

Patient Satisfaction- Patients who receive a clear and personalized report of findings, well-planned exercises with helpful video demonstrations, and “best practice” care are much more likely to refer and rate you online- especially if that process is automated. The little stuff REALLY counts here. Small things like an evening phone call from the doctor after the first visit can make all the difference. (Check out the ChiroUp New Patient Experience marketing campaign for more “small” tips.)

Clinical outcomes and patient satisfaction are the 2 most significant metrics that will determine your success in the future. Practitioners who emphasize these 2 patient goals above their own will be rewarded handsomely. ChiroUp is a platform that helps you deliver “best practices”. ChiroUp puts the small stuff on “Autopilot”- giving you and your patients a slight edge throughout care.

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