The Game with Alex Hormozi - Helping A Chiro Scale Past 6 Locations | Ep 818

Episode Date: February 14, 2025

Want to scale your business? Click here.Welcome to The Game w/ Alex Hormozi, hosted by entrepreneur, founder, investor, author, public speaker, and content creator Alex Hormozi. On this podcast you’ll hear how to get more customers, make more profit per customer, how to keep them longer, and the many failures and lessons Alex has learned and will learn on his path from $100M to $1B in net worth.Follow Alex Hormozi’s Socials:LinkedIn | Instagram | Facebook | YouTube | Twitter | Acquisition

This is Raymond. He owns six chiropractic clinics and he does about $5 million a year and we're going to help him scale. So hey Alex, my name is Raymond Cooner. I own Cairo First of Washington. So we're chain of chirophatic clinics in the Greater Seattle area. So just a little bit about my business. We currently have six brick and mortar locations in the greater Seattle area. Trilling 12 months revenue 5.2 million. You've got over around roughly 1.2 million. And our net profit is about 23%. Do you buy those or did you open up organic? So far I've bought all of them. Oh, really? Okay. Yeah.

But I think moving forward, we're going to change our strategy a little bit. Yeah, so who do you help specifically? So our key demographic that we help is 35 to 65 year old men and women that have some kind of condition that we can help with, whether it's pain, discomfort, or loss of movement. So you're kind of like income level or anything like that? Yeah, they need to be employed. Insurance or cash? We're about 75% insurance.

Oh, interesting. Okay. Got it. So how do you help them? So the way we help them is when someone comes into our office, we'll design a custom treatment plan for them. That might be over a period of 60 to 90 days. It might include chiropractic, rehab, and spinal decompression. So spinal decompression kind of differentiates us from a lot of our competitors because it's a niche service that we offer for people that have disc-related injuries. Is that like stretching people out kind of thing? Yeah, exactly. Cool. Well, how do you make money? First, so basically on the front end, we offer a free

consultation. So then when the patient comes in, our packages can range from 4,400 to 3,600, over a 60 to 90-day period. We're primarily a reoccurring revenue model. And roughly one out of every seven of our patients, they come in for a larger case value. So like a car accident or work injury might be worth up to $10,000. Okay. What's advertising? How do you find them? So for paid advertising, the two means of advertising are number one is Facebook ads. So we spend about $1,000 per location on that. The second one is Google Ads. So we're spending roughly $500 to $1,000 for month on each location.

Okay. So what's sales velocity? How many do you sell per month? On average, we're getting about 35 leads per month. And out of the 35, we have 28 that show. Okay. And so we have a show rate about 80%. That's great.

And our closing rate is about 71%. So total sales. probably roughly around 20. Cool. Solid numbers. Okay. So what's the goal? My three-year goal is to try to get to $5 million, even though. I want to try to build a business that can run individually, but then I also want to entertain selling to an institutional buyer. Okay, so this is very much up here, Ali, what we talk about? Okay, so that's the goal. So what's staying the way? What's the problem? So if I were to prioritize my constraints, what I think they are, number one, I would say is probably lead flow. I think that we could do better in that.

department it's not consistent okay when I had one location it was really easy to predict that and to to change the outcome pretty quickly but as we've scaled I'm having a tougher and tougher time you know scale the marketing right so I would say that's like a big one for us second one would be like our sales infrastructure because we are 75% insurance based there's so many different plans out there right so when the patient comes in we have to determine what kind of insurance they have by verifying it and then make a customized plan based off of that so So if there's a way to streamline that into one day,

I think it would be much more effective for us. When I personally practiced, I was able to do it in one day, but I'm having a tough time training my doctors to be able to do that. Number three, scaling issues. So just centralizing the marketing has been a challenge for us. Limited employee pool, right? So right now we're not expanding.

But when we do expand, it's harder to find a doctor, obviously, than a regular person. Because you're buying it from another person who's leaving, correct? Yeah, and then I got to put one of my guys. in there so the hiring pool is a lot smaller for me than it would be for other people but that's not an issue right now I don't think it's a it's a pressing issue for us until we scale start expanding yeah got it okay and then people operations that's people

operations so obviously when I had one location it was really easy to control the standard right but as we expand it's harder and harder to have that same standard so let's see the numbers so going over the numbers again so top line revenue 5.2 million last fall months profit 1.2 net margin is about 23%. Our CAC is about 700. Our lifetime value is 3,400. So that's 4.8 to 1 LTV to CAC ratio.

Marketing spend, we're spending about 1,500 to 2,000 per location right now. The short rate's 80%, close rate 71%, and our annual ad spend on marketing is about 110,000. Huh, okay. Do you have anything broken out between channels? Between Facebook and Google? I do.

Okay, sweet. So this is our Facebook. data I was able to put together like our 12-month numbers for all the clinics for ad-com. Okay and then for as far as the challenge that we have is because we're insurance-based we don't get paid for like 30 60 90 days after so I had to go back and I pick Q2 for three clinics yeah okay so these are the numbers for for for those three clinics in quarter two okay so why is Kent so much better yeah I don't know that's that's what I want to replicate that's where we don't have

consistency is that your first location that's our number one yeah it's not our first location it's our third location but it's our number it's probably our number one right now is the dock they're different than the other docks is you go to sales they're about the they're about the he's he's he's good but he's he's about the same I would say that culture of that team is really good I think that's one thing that stands out mm yeah because if you look at because because KAC is is I mean you know half of Capitol Hill right yeah but the amount of money that you're making is like you're getting it more you're getting more LTV and lower

or Kaka Kent. Right. So are they set like, is it that the people that are coming, because it's insurance, so is it that they're like, like they're billing better? Like what, like how could they get LTV to be so much higher? Yeah, great, great question. So Kent would have a higher proportion of those $10,000 cases I was talking about because that's a blue collar and then Capitol Hill's white collar.

So it's got less of those case averages that are really high. I would say that's one thing for sure. Interesting. Do you have any other markets that are in that kind of blue collar damage? Yeah. Everett's right. as well hmm well then based on that would we have more like ROAS because the CAX you know close and rose is a quarter so right why are the why are there so many more cases in Kent

than Everett yeah so I would say ever it has more of those 10,000 of our cases than Kent does that makes that interesting so I didn't calculate that into the Facebook marketing and the Google out oh so you didn't include that okay but ever it's a good market it's a good market for those but I don't like to be too dependent on one source of patient if that makes sense but I don't want to be too heavy on those auto accident cases in the location got it okay do you have any other data that's that you've collected together this is our Google okay data yeah so this is from Google AdWords well these obviously do significantly better than your Facebook ads yeah

for sure interesting all right are you are you maxed out on spend here I don't think I am the I work with a a third-party company on this and and I basically go off their recommendations. Okay. I personally would love to spend more obviously on this because they're returning so high. Yeah. And these people are in you know immediate need of help. Yeah. So they're much easier. The case acceptance goes up much higher with these patients. High intent. Yeah. Yeah. Really good. Well I mean shoot this is this is the most promising part. Okay. All right. Let me think about some other other kind of walk

me through the sales process. The sales problem. Yeah. So we have a two-day process, right so day one patient comes in we do a consultation we take x-rays we'll do an exam and actually start me from click to close so the person clicks on is Google is basically the sales process for Google ads different than the sales process for meta or how's it how's it flow for you yeah so Google they will call directly into our we have a centralized call center okay yeah so the call is click-to-call is the ad click to call or click to schedule on our web if they go to our line you know what the split is is is a lot of it call or is like I'm just curious

Yeah, I don't know the answer to that. Okay, no worries. That's a good question. Okay, so click to call or they self-book, got it. So then they talk to a rep that's centralized. That rep does some sort of discovery call. Correct. Like triages them and either says, I mean, do they look at their insurance at that point on the call? They don't, but that's the thing I'm thinking of adding in so we can get on top of that.

Keep going through it. So they do some sort of discovery. They're currently not doing insurance on the call. All right? So then they do what? So then they schedule them the next available time. We try to get them in the same day or next day right away. What's the sharp rate for the calls?

Because the sharp rate that you have here, what you showed me earlier was really good, but that's because they also just got it. They had a conversation prior to doing that too. Right. Okay. So what's the sharp rate for that other step? So for the call?

Because some has clicked to call, but the ones that book onto your calendar, you then call them at the designated time? Yeah, no, they just schedule. They can schedule online, and then they can confirm. To show up to the facility? Yeah, we just take them.

Oh, okay. Yeah. I try to reduce as much friction as possible. No, no, I dig it. Okay, that makes more sense to me. Okay, got it. So some people call, and then they book them, and the people who self-scheduled just booked directly.

Got it. And then what's the kind of like reminder sequence there to make sure of that? Because you have really good sharp rates. Yeah, so we do three text messages. Okay. And then we do a phone call. If they don't respond to text messages, we do a phone call the night before.

To confirm. And then we'll do another one like, you know, two hours before their appointment. Okay, so three reminders and call if they have not confirmed their appointment. and follow-up call as well if they didn't pick up the first call or the other ones. Correct. And then if someone doesn't hit any of those five, do you pull them off the calendar? We don't pull them off the calendar, but we kind of expect them not to.

Just like double book, kind of. Yeah, exactly. Yeah, exactly. Okay, so then they come in, so they show up to the appointment. Now what? They come in for their appointment. We'll do a consultation. So we have a patient coordinator that gets the preliminary data.

Okay, so it's like an assessment? Yep. They're like movement, like move here, does that hurt, that kind of thing? Like circle where you have pain. Kind of like half your close your framework. Okay. So they'll do the first half of that on there. And then we'll take x-rays.

We'll do an exam. And then we'll tell the patient that, hey, we need to process these films or these x-rays. And then we need to get you back in tomorrow so we can go over the results of the x-ray. Yeah, that's real. Yeah. Yeah. Okay. And then, so then we'll release them for, we'll still do a treatment that day.

We'll do a light treatment. And then we'll have them come back the next day. And by then we'll have everything verified. And then we'll have a customized plan for them. And then we'll present the financial. Interesting. I got some stuff there okay so I'm gonna say back to you yeah so a disco call that gets them booked reminder sequence three texts two calls only if they don't confirm via text they show

assessment clarify whether they're label the problem overview past experience then you take them through some x-rays and whatever test that you're gonna run then you do some light delivery and say hey you know come back tomorrow and then we will sell you the package Correct. And then whatever. And the people who you do that service for up front, do they pay anything? Like the 10 to 15% that don't actually come to the sales appointment. Yeah, yeah. So they'll still pay, like usually they'll have a copay. So that's what we have to verify all that information, right? So it's kind of, it gets complicated with the insurance. It's just cash, it would be so easy. But because the insurance is there,

we have to verify if they have coverage and then we'll charge them a copay. And it's different for every single person. But our cash fee for that would be like $99, for example. Okay, okay. Got it. What's the, You see you're running 23% margins. What's the best facility run? What's the worst facility run? Margins-wise? Best facility run right now, I would say, is Kent.

Out of these ones. Or you have the six. Go back one or two. There should be six on there. Okay, so we had all in there. So our two lowest performing are Auburn and Federal Way. All right. Our two top performers right now are Kent and Everett.

And in the middle are Capitol Hill and Bellevue. Okay. So what are the margins for the top two, like net margins for the facility? Net margins for top two are probably over, about 40%. Okay, so that's what it should be. Okay, got it. And what's revenue at those two?

Those are annual. Yeah. About 1.5 million, one point five million. Got it. That's what you want. Yeah. So those two you're happy with

because if you run in 400K-ish in profit on those times two. So one point, or shit, well, that's most your profit. Yeah, yeah, yeah. And then the other four kind of are just like... Yeah, and just the disclaimer like these other, like Auburn and Federal Ware

are like my newer locations. So like the advocate, so my unit was probably even higher than this but it's just the first six months we had to eat a lot of profit how old uh auburn is about a year old and federal way is about 14 months okay can you walk me through the ad funnel with the facebook ads so go back one or just or do no this just right here yeah so just like we walk through the sales process yeah can you walk me through the funnel of from the facebook ads yeah so like from when they click on an ad so we have we have a video ad out there do you have ads live right

now? Yeah. Can you pull up Facebook ads library? We're going to pull them up and we're going to, we're going to see it. We're going to see it for ourselves. All right. So we have different creative. It looks like it's the same copy. All right. So I think there's probably just some work that could just happen on the actual ads themselves. Like I think you can have a clear callout. And the first line, I would probably separate the callouts. So it's like, it's just your evidence surrounding areas. So instead of saying areas, I would go to like residents or something like are people, like basically combine the two where it says chronic back pain doesn't have to be a life sentence, attention efforts surrounding areas.

So it'd be like, attention to Everett, like, residents with back pain. That combines both lines, punch here, put two asterix on either side. It's like, okay, that's what it is. And you're putting proof first, and I probably wouldn't hear. I'd probably lead with a question, which would be like, are you, so either I would lead with a question that'd be some sort of like more specific pain, or I would lead with the offer and then have the proof of why they should believe that I can help them after they've seen the offer.

Because like, it took us all the way down to actually see what the offer was. and the headline, avoid surgery, tri-spinal decompression, I would probably just put like the offer there. So it's just like a restatement, like free spinal treatment decompression, you know, free spinal decompression, boom, $99, whatever, something like. Like that's probably what I would put there because I think it's just like there's a lot of words. And I think you could probably get, just like I combined the first, the headline and the next sentence into just like attention, Everett residence with back pain.

It's like, boom, we got that. And then it's like, you'd be amazed at how much like just changed. tweaking the headline probably compressing the copy into a handful of bullets that's like do you struggle with boom boom boom boom boom And you've probably tried boom boom boom boom boom but there's a better way This is how we do it we've helped this many people for limited time. We're doing X Y and Z and I think I think that would probably work well I cannot guarantee availability as we can accommodate 10 vouchers up to our patient schedule I do like that probably be compressed we can only see 10 new patients per week right and scheduling availability first come first serve for this treatment

Done. Do you think it's good to go like because with Facebook, right? Like people aren't necessarily going on Facebook and on my back server and like, you know, Google AdWords? It's like on my back stopped up. I need to call somebody. I think so. There's tons of carpox to advertise on Facebook.

Yeah. Tons. Yeah. So I don't think there's any issue with advertising on Facebook. Okay. For sure. Got it. What's the landing page look like?

So the landing page. So it's just that Insta form on Facebook, right? Uh-huh. And that goes to a calendar on Go High Level. Okay. Okay. And then they just schedule all. So there's really not even a landing page.

It's just like they're going to lead form straight to basically redirect to scheduler. Scheduler and then we double book for Facebook because the show rates lower for Facebook. So basically we give them like certain times in the day where they can schedule so they'll schedule their own appointment and then we put it into our, then we have to manually put that into our schedule, right?

Oh, you manually, you have to like basically transfer them over? Into this, into our EHR. Yeah, yeah, okay, got it. Because it's not connected to our EHR. Okay, understood. That's for Facebook. Google is Google's a little different. Google will be kind of like this,

like where they can schedule online. On a page, you mean? Yeah. But okay. So when it gets $5 million, EBITDA you're doing 1.2, we basically have to get the other four to be profitable.

There's a couple of things that I think we can go over in terms of sales process, lead magnets, things like that. Honestly, I think a big part of it that's not up here is the ops. Because in this type of business it's so operational heavy

in terms of like operational excellence. It's probably, because like, you absolutely can run a 10 to 1 15 to 1 row well you're already doing on Google but you can do that on Facebook as well if the offer's right and so right now the offers like there really isn't one it's just like try this thing it doesn't even say free and so I think yeah so let's do that once you come over here and then we'll walk through game plan all right so got a lot of like

there's inconsistent lead flow there's the sales process that I would look at I think the the discovery process, need something, need a better front-end offer, increase the eye spend. So those are the really tactical things that I'll walk through, but I still want to talk about ops. So if we have these six locations, what would you say, like, are the team structures the same between all six? Is the business model the same between all six? Yeah, identical. Okay, identical model, got it. So the people coming in are different. That's part of why the LTV is different. And so in terms of the

individual location operators if you had to power rank them like one to six who's the best okay is the is the doc kind of like the manager of the location is that kind of how it works that's kind of that's what we're relying on right now okay once you walk me through with the actual like what the model looks like and we'll do the boxes and they'll talk about the acquisition stuff like the org chart yeah yeah so the doctor should be the so docs here okay got it and then underneath them is like a team lead okay like an office manager or anything yep yeah I guess you can call it We don't call them that, but yeah, sure.

Yep, and then there's just usually a scheduler and a rehab tech, that's it. So I try to keep it to four employees per location. I like that. So you've got a schedule, so basically we nurture. Are they remote or they in person? So this is a scheduler for when they come into the office. I also have a remote team that does all the inbound calls.

And it's centrally. Yeah, central, yeah. Yeah. Got it. So that's the model. Okay, I mean, shoot clearly. What do you have to pay the docs? They make between base of 80,000 a year,

but they probably, like our, pop-ons making like over 150 okay and did they get some sort of like profit share or something like yeah I offered they range between 10 and 20% net profit okay that's good that's good that's I mean that's usually what I what I like to have especially for like a high skill thing profit that makes sense question on that though like you recommend getting like I try to get them equity so because I want them to be come along with the ride or does that cause I mean that would increase our EBTA obviously because it wouldn't be payroll that 20% will go under it would improve our EBTA but then it also gives them ownership or would you not recommend

doing that um well if you think about equity right you've got you've got um cash flow so like distributions you've got sale like if you sell there's value from that there's risk and then there's control so like that's what equity gets you right now they're not going to get control because you're the one who owns it you're going to be making decisions doesn't really matter right they probably don't want their risk no okay so then it just comes down to them getting paid on a sale and them getting distributions in the meantime you already have this one If you want, you could include something called a profits interest. Because you probably have LLCs for each of them.

Yep. Yeah. And so this would be something that basically functions equity like. So that if they sold, they would get whatever percentage of the profits interest. So it would be like, okay, we're going to say that the business today is worth 500K. And you're going to get, you know, call it 15% above that goes to you. Okay. And then it's also key for them too because you're like, hey, for us to get,

above a $500,000, you know, EV for this thing, then we need to have profit for the location at, at 200 or whatever. Right? And it's like, hey, but if you get profit per year to 500K, then we're probably looking at something like 4 million. So you're going to get 15% of 4 million, so you have another 600K check

on the database. That way. And I would just draw the same quadrant, which is like, there's four elements, and so I want to make you an owner, and this is how we're going to do it. The benefit to them is that when you do this, there's no tax implication. Got it. Because it's like, If you were to issue them shares, they got to pay taxes on it.

The other benefit is, and this is just being real, is that let's say in five years you don't want to sell, you change your mind, or they decide they want to move with their family, your equity doesn't walk with them, it comes back to the pool and you can give it to the next person. So basically this is fundamentally like phantom equity. And I think that's totally fine if you want to do that. The question is whether or not that actually changed their behavior.

Yeah, yeah. And so that's kind of like- I tend to agree for this particular role. But I do think the profit share is a much faster feedback loop and that and I think that works. Because there's months where they hit like the 20% and they, they could be taken on like 12,000, 15,000. They see it.

They see it. But then that kills our even up for the next month if that makes sense. Because it comes out of the payroll versus distribution. Yeah. I don't know if that makes sense. No, I understand. It's basically, maybe it's too small thinking. No, it's, I mean, there's, the thing is that when you sell, there's adbacks.

Right. Okay. And so like, the person who's buying it is going to do their own math on what they think. Got it. So like you're even, they're going to, they're literally going to throw out your financials. they're going to do their own financials and then decide. Then that means that the other four locations probably really low revenue. So Auburn and Federal Way for sure.

Okay, what's revenue of those two? Revenue is roughly 40,000 a month. Okay, so like $5.00kish. Yeah, 500K. Okay, that's the issue. Yeah, which is like our breaking number, right? Then Capitol Hill and Bellevue are higher than that, so they're middle. Are they, how geographically concentrate are these?

They are all within 30 miles. Oh, so all of them are one city? Yeah, so in the same area, but Auburn, Federal Way, and Kent are awesome because they're like within five miles. And it's so easy to rotate staff after, et cetera. So do you say Kent, Federal Way and what's the other one? Auburn, or like five, ten miles. Auburn, interesting. Yeah.

But those are two new ones, right? So like Auburn and Federal Way, kind of hard to judge. And if you looked at our EBITDA now, like if you did six months trailing versus 12, it would probably be a lot higher ratio than that because they were kind of eating themselves in the beginning. Yeah. Yeah. You had to put some cash in too. Yeah. Exactly, yeah.

Got it, got it, got it. Okay, so starting with the lead magnet, I think that offering $19, $29, somewhere in their first consult or free X-ray or something to that extent would probably go way better. And I do like, especially for your type of business, to do a low ticket and say it's something like this. So it'd be like $29, X-ray plus, you know,

assessments, blah, blah, blah. And the reason I like this is because you get the credit card on the phone. And even though it's an insurance thing, it's like, yeah, no worries. We just put a card down just for shop rate. Obviously, we have a doctor who's going to be there, which is to make sure that you're going to shop. Right. And the thing is, if we bill them the 29, then the likelihood they shop is super high. And this is literally just to take shop rates to like basically 100%.

Hey, guys, real quick. This podcast only grows from word of mouth, quite literally. There's no other way to grow a podcast than word of mouth. If there's some element of this that you think somebody else should hear or would be relevant to them, it would mean the world to me if you shared this via text, via Instagram, via DM, via whatever way you like to share stuff with the people you love. Thank you. So then, and this is over the phone.

So we do this. Now, when they walk in the door, okay, so this is going to be a little bit of a departure. Okay, yeah. So they walk in the door and when you, and I think the reason that you probably sold better, obviously you're better at sales than probably your docs are. But if you think about how sales works. So sales, you want to sell at the point of greatest pain, not the point of greatest satisfaction.

And so the easiest analogy I have is like, okay, someone's starving. They come to my restaurant. I give them a steak. And they're like, oh my God, that steak was amazing. And I'm like, hey, do you want another steak? And they're like, no, no, I'm good. But that steak was amazing, though.

I'm like, yeah, but do you want another steak? And they're like, no. And so it's kind of the same thing here where people are literally coming in pain. Right. And ideally, what I would want to do is we take the assessment instead of doing the treatment then, I want to sell the package. Got it. Then if you want, if they have time, they can do it, or they can come back tomorrow,

get their first treatment. Got it. So it's the same time scale. We just move the order around. That makes sense. Because, like, I mean, I've been this patient. So, like, I go to the chiropractor. They do some thing.

I'm in pain. They adjust my back. And then they're like, hey, come back for this. And I was like, I don't know. I'm good. Like, you fixed it. I'm great. Yeah, totally.

Right. And then they're like, but it's not a long term solution. And I'm like, good enough for me. like and I'm out for sure and so that might be an immediate like 15 you know 10 to 15% boost in sales so like that's number one but the thing is is that I think that your close rates are going to go up so one is like you're losing some on the drop off right but I think close rates are go up and like when you're in pain your desire for a more per like all the desire is there in that moment and we're motions are we're missing it right and so um I always had this rule at least like with fitness is like when someone walks in the door first thing I want them to do is expand the gap of where they are or where they want to be So I have everybody hop on the scale. And the amount of people's like, oh, I don't wanna hop on this. Like I know, I'm like, get on the scale.

We gotta know where it's just a number. We gotta know where we're at. That makes sense. And so it's the same idea with this. Got it. Lead magnet in terms of offer, I do think this would be good. This will increase show up rates overall.

Getting somebody to get a $29 credit card purchase on the phone is like not hard. Right. They do that. That secures their spot. Then when they come in, we do same day. Sale. What has been the issue with the docs making this sale?

Like you said they struggled with this. So there's two elements. You say there's some insurance stuff there. So what's the issue here? Yeah. So the issue is a patient comes in and then we have to verify their benefits. So there's like 20 different insurances and every patient has a different coverage or whatever. Right.

So then we have to make our treatment plan and then take out whatever the insurance covers and then they pay their co-paid or co-intrates. So just doing that process. I think when they're on the floor, seeing patients and then having to switch gears and do the math of like what this, you know, here's my recommendations. or you know, all that. I think that part kind of stresses them out. How much of it is templated? Most of it's, like as far as the, so we have an Excel. We know that someone has Blue Cross per Shield, so whatever.

Yeah, yeah, it's all Excel spreadsheet. We can punch in a number. We have a financial calculator for that. So question. So, someone calls. So basically there's two spots that we can put this process. So either we can do it on the phone with the disco. Yeah.

Or we can do it the moment they walk in the door. So it would work like this. So someone walks in and say, hey, do you have your ID on you? I just want to confirm your appointment. Yes, I'm Sarah. Cool, great. Do you have your insurance card on you? Yeah. And so you ask that.

That way we can get the templates already like ready to go. Right. So that then the dot goes. Yeah. And then he leaves them in there and he says, cool, let me get the x-rays. Yeah. And then he comes in with the x-rays and with a template for their specific insurance. Totally.

And then you can just mash them and just do the sale. Yeah. So the issue is like some of those, some of those. So I centralize where they verify those benefits, right? Some of them can take like 30 minutes to an hour to get the time. So if they're, that's the best. Okay. So then we have to do.

the phone yeah I agree okay yeah so um so if the $29 thing gets in the way yeah then we can still just do the just like you can either do a free offer like free x-ray for assessment whatever just if that's an issue um I mean personal preference get the credit card and the insurance card yeah yeah over the phone if it seems like a training issue then I would prioritize the insurance card yep um but then that way it's like you already have everything they're preloaded and so then they can come out after after the x-rays get it printed out from the scheduler at the front desk right and I mean, shoot, the morning of, I probably would just add the SOP, print all the, print all the packets out for everyone.

And then the doc gets them in the clipboard when they walk in the door. Perfect, yeah. I mean, do you think that would work? I think so. Okay. And then if they ask, like, hey, why do you need my insurance? I thought it was $29. Then we'll say, like, hey, just in case the doctor thinks he can help you, we just want to know all your insurance.

Yeah. I'll give you a different one. This is just how we always do it. Okay. It works only every time. It's just like, oh, this is how we compute our patient profiles. Okay. Perfect.

Like, it's better to appeal to policy. Totally. Yeah. Yeah. Exactly. So they'll get this. If this, for whatever reason, issue, you'll prioritize the insurance. They'll come in.

They're going to have the printed out stack of all the insurance. The doc gets this on a clipboard, right, in order of the patients that he sees that day. Perfect. He's like, okay, Mrs. Johnson, I've got your x-rays here. I've got your insurance here. Okay, this is what we're going to do for you, and then this prescriptive clothes. Makes sense. Okay.

So right now, are there some locations that are having way higher close rates than others? than others or like what's the highest close rate probably I would say Capital Hill and what's the difference though the doctor has a lot of certainty no no no percentage difference oh so let's say Auburn is let's say they're averaging about 55 60 percent okay and then Capital Hill might be like 80 percent okay no I mean they're both okay yeah they're terrible yeah they're not terrible but if you look at because because a lot of these people have insurance so their entry level like financials not like super high on some of them so the ones that are this

10,000 or case they have zero out of pocket Yeah, I mean, you're going to have 100% Yeah, totally. So this is how I would, so I would imagine that the packages themselves are going to be similar. It's just how much is being covered is going to be the difference. Yeah. Yeah, and then also the fact that I think if a clinic sees a lot of those 100% coverage ones, then they kind of skit, then they start, they don't work on your sales skills for the ones that are,

right? And they can say, oh, these are crappy leads or shitty leads or whatever. Yeah. But you just because you have to work a little bit for them. Right. So I think just creating that training, that's what I'm going to train them and locally more. I'll give you something that will help you a lot with brick and mortar. So I've done a lot of brick and mortar sales processes in my life. And as much as possible, I'd like them to be like clicks and check boxes. So it's like when we sell supplements, for example, it's like

you literally just turn a laptop around and then you just like punch through it and you literally just say the words and then at the point that you ask for the thing, you ask for the thing. Like you really can machine it that way. And that will eliminate so much of the variability between people. And so I would look at what the top 80% guys doing consistent. Make that into the basically the deck so that they have a visual aid to go through it and then it just feels like oh this is This is the next step. I do this. This is what you need. This is what we cover He circles the thing on their on their thing turns it to them and then they They rock and roll and then they just hook out their next appointments I'm assuming so they're kind of looking at a teleprompter almost like okay, okay, but they can show it to them

Okay, so there's two ways to do it. Yeah One is you have the laptop and you turn it towards the customer and then you basically read the words on the slides Okay, that is like the perfect sales pitch but with visual aids and whatnot got it. The second way of doing it is you have that clipboard, but they don't know what's on the clipboard. Right. And so the clipboard just has the script. Got it. And so it's like cool, just you ask a couple questions. And so you basically go through the sales process and you just look like you're checking off the boxes as you're going through a script. But then they always say the script. And then the doc can visibly show this which they then staple to the patient

contract. That way, you know, they follow the process. And then it just keeps it consistent every time. So either of those work I've done them both. Okay. Okay. So, for you know, From, so that was, so number one, we had. Would you have the doctor do the sales process, or do you think it's okay to train them how to be good at sales? Do you think of having like a patient coordinator do the sales? You know what I mean? Because like, yeah.

Because there's, they always have some, you know. Reservations. Yeah, you know how doctors aren't compared to like a regular. I do know how doctors are. Yeah. Okay, so you're saying this person or this person? This person. Oh, this person doing it.

Like if you have a doc that doesn't have a lot of confront, or a conviction. A lot of times the manager will. So I don't know if it's better or if it matters. I mean, I like it better here. Okay. For some of the reasons that you already outlined. Right.

Because you already have this person. And if the thing is, you'll start hiring differently if that's their role because they'll really just become sales managers. Exactly. Yep. Which I'm not against, to be clear. It may impact the compensation of the docs, though.

Yeah. Because like this guy, this guy or gal probably needs to make somewhere in the neighborhood of like they should be able if they're doing a good job to hit a hundred or if you want like you know 100 grand yeah yeah for sure like if they're if they're hitting you know if they're getting out of the park they're doing 600,000 profit for the location they can make an extra 50 grand or 40 grand with commissions yeah that would be the most important position in the office yeah yeah 100 because I mean which I kind of like because then you could swap docs out

if you need to totally for being weird or whatever this right okay so I do like this so I would probably not roll that out immediately to all of them I would just like go to Auburn yeah and be like okay this is the person that I will try it out and if the close rate is higher and then also so you can get your efficiency up because totally yeah you the dock only does half work the other person does the other half right okay so the next one is I think ad spend needs to go up so what yeah because you're not spending

very much yeah I know I know it wasn't until I had to do this process I was like shit we could I mean because the return is so high on some of those things and if I mean I would spend out like a million dollars a month on Google AdWords if I could yeah so how do we like I guess that would be one thing to increase well the first thing I would just just literally tell them like I need you to double the ad spend and I need you to find more key words. Okay. So just find more for me. Got it. Um, the other thing that might be worth looking into, um, would be, uh, local SEO. Okay. Because SEO is especially for intent base. So it's like,

obviously there's search, but it's not hard to win at SEO locally. Okay. Like nationally, you want to win back pain and good luck. But like, yeah, you want to win Everett, you know, chiropractor, Everett, spine, Everett, pelvic health, Everett, Everett, Lombar, Everett. Like, you mean, there's so many sciatic, like all those, I think you could probably win on long tail keywords. And then one thing that helps us on that, I think, is we're pretty good about getting reviews. We have more reviews than everybody in our cities. Oh, that's great.

And then I think that helps with the local SEO. But yeah, and I guess the big question is like with ad spend, a lot of these, so the agencies that we hire, like they work with many chiropractors, right? So most carpenters don't do what we do, which is sell packages of 2400. They do visit to visit, which is a nightmare. So I think that they base our ad spend. They're recommending our ad spend based on that, but my return on it is so much higher than the average guy. Oh yeah. So then I'll spend everybody. Yeah. Totally. So if you might have to

talk in, um, in marketers speak for them. Okay. And just give them this our target CPA, like cost to acquire or CPL and just so like listen, I can I can pay up to this. Got it. So like make it rain, dude. As long as it's under this, I'm good. Okay. And would you, when would you consider bringing that all in the house? Is that, um, because I kind of, I hate dealing with these. No, I get it. I get it. It probably wouldn't be my priority right now. Okay. Because like if I look at this, I'm like, okay, we got 12 to 1, 24 to 1901. So I'm like, we're doing pretty well on this. Right.

And do you not have, do you have Google on the other three as well? Yeah. Okay, it's just not there. I picked a one, like a high, middle, low. Oh, so that's low, 9 to 1 is a low one? Yeah, for sure. Oh, that's great. Yeah.

Yeah. Okay, cool. So I would say basically I'd stop it at 5 to 1. Okay. And say like, so basically double or triple whatever the CPA there currently is. Right. And sometimes what you'll find, though, is that if you can double or even triple how much you can spend to get a you might be able to like 10x lead flow I see it's not like it's not it's not

it's not proportional right right because you just all of a sudden you out spend this many more people yeah okay so this is specific to Facebook okay which I think could be the like honestly this could be the differentiating factor in terms of how much like this could be something that's just like in terms of leverage yeah could be a double okay or triple on your Facebook which then would get you closer to that 9-1 or 10-1 which I think it should be right the ad copy thing we already talked about Discovery process is this new guy where we're going to get insurance in the card on the phone.

Then they're going to print it out the next morning or whatever print same day stack. The dock is going to just do the x-ray and the assessment. And then he gives the handoff with the clipboard that has for the patient sales manager then does the sale right then. And I think that we just book the treatment that next day. Okay. Just book them the next day. Okay. So I think if we do these things, and that's what we do?

and that's probably about six months of work yeah yeah and then would you recommend doing this like should i should i do this order this is in this order for locations also should i start with one or like because like would you do google ads been and the facebook at the same time um i so i would do these one at the time so google ads when you probably increase across all of them because you're yeah yeah because when i had one location i mean we did none of this stuff i mean all i did was growl out and then but you can't scale that it's so hard to scale that so you can it's just tougher it's just basically becomes more operational so like if you look at um you look at some of the like the big like gym chains and whatnot like they run their trainers the same way they go they do lead

boxes they go to whole food they stand outside they get names like they just that's just the culture um and in in a different way the cool thing about the grill and marketing is that it always works yeah right it's just it it it always works no matter how technology changes no matter where and i think that's why those guys do that i remember you still i used to laugh at them because i like could run facebook ads and i was I was like, man, these guys are idiots. And then I realized that they had a $2 billion company. And I was like, you know, maybe, maybe I'm the idiot. But it also helps with communication sales.

Because, I mean, I always read all my sales skills through that because I got shut down so many, got a kick in the nuts so many times that you just have to keep getting back up and do it over again, right? So, you have six. What did you do before this? Before the clinics? So I opened my first one in 2007. So you're a Cairo?

Yeah. Oh, I didn't know. Yeah. So I practiced until 2012, one clinic. Yeah. And then. What did you do in that clinic, top, top, bottom way? 3 million and top line and bottom line is probably about 1.7.

Yeah, great. Yeah. So, but yeah, so then it was burning me out though. I was like, I'm gonna burn other people out. Yeah, so then I started building houses. So then I started building houses and I was making good money off that for like eight years, like electric homes. But I still owned my main clinic and had I associated in there. It was doing okay. And then 2021, I thought that, or 2020, I thought the Mark was going to tank. Sure. So then I thought, hey, what can I do with my clinic? There must be something I can do bigger than just one clinic, right? and then started talking to some of my friends that were. Learned about M&A. Yeah, like one of my really good friends founded Valley Village.

Another one is dad found Sinaiban. So then I started thinking like a little different. In locations in terms of rolling things together. Yeah, they started. They started those, they're the original founders of those companies. Super cool. And then so just giving their perspective on things and what I should do to grow. And they told me, hey, you should open up.

If you can replicate it, open up multiple practices, you can sell to private equity. I like the lean. I like the lean model. Yeah. Okay. Well, dude. Awesome. Thank you so much.

Thank you. You're going to crush it.