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This 1 Aspect of Practice Growth (is completely different from bodybuilding)

I hope your holiday season has been excellent. I’m not 100% sure why, but I’m incredibly excited and bullish on 2022.

Maybe because ‘rona seems like it’s finally getting under control (whatever that means to you). Maybe because the last almost 2 years have been crazy, and we’re due for good times without (as much of) the insanity.

I think it’s mostly due to the fact that so many of our clients are making epic moves and getting dialed in for a banner year.

Regardless, I hope you’re as pumped as I am. We’re gonna crush in 2022.

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Over the last couple of months, I’ve shared a number of business lessons I’ve learned (or been reminded of) as I go through my bodybuilding show prep (A couple of the highlights are here and here if you missed them…)

I’ve found several parallels between growing Grade-A muscles and growing a Grade-A practice.

My physique show was a few weeks ago, and I haven’t shared an update since then. (No, I did not win. But the lessons I learned – and the physical results I was able to achieve – were worth the process).

To wrap up these lessons, I wanted to share one big way your practice growth efforts should in no way resemble bodybuilding, lest ye set yourself up for failure.

This will be particularly useful as you set your plans for the new year… 👇

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As you might imagine, the closer one gets to a bodybuilding competition, the more “dialed in” one needs to be. Adjusting calories and macros, meal times, meal size, changing workout styles, increasing water intake, and more.

Then of course there’s the ridiculous preening activities like dark-orange spray tan.

And all of this is scheduled down to the hour to optimize for literally a few minutes on stage.

All these efforts are designed to help showcase just a little extra muscle… shave off a bit extra fat and subcutaneous water… to get any edge possible in the competition.

Here’s the harsh reality that I learned leading up to the show (and particularly in the 3 weeks since it concluded):

Those ripped-up bodybuilders you see in magazines or on TV? Come to find out, they don’t look like that all the time. They do all these little adjustments and manipulations so they can look optimal for maybe a few hours, at their “peak.”

The premise of the entire “sport” of bodybuilding is that it’s not sustainable. It’s literally designed to NOT be.

And unsustainability is a huge red flag when it comes to your practice growth.

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The way we coach our clients (and how I live my life, if we’re gonna get personal) is the exact opposite of bodybuilding. It’s as sustainable as possible. It has to be.

We (you, your practice, me) can’t optimize our efforts around a 2-hour window every 12 weeks. We have to be ON every day. For our patients, our clients, our spouses, our children, our teams, our community.

For example, this is why we DO NOT build our trainings for the top 1% of sales people. We architect them in such a way that they are easy to implement for any competent team member who has a positive attitude and willingness to learn.

Most practices don’t have a team full of sales beasts (if you do, more power to you!). So they need strategies and coaching that works for what they do have.

Your practice growth systems must be sustainable.

Eat one wrong food at the wrong time in bodybuilding? You won’t “peak” when you need to. Mess up your water intake? You’ll miss your mark.

As much muscle and brute force is involved in getting optimal results, the sport of bodybuilding is actually quite fragile.

Your practice cannot be fragile. Because you’re thrown curve balls every day.

You’re customizing treatments to each individual patient. You’re hiring new folks. Others are out sick. A new treatment gets FDA approved and you need to check it out. You’re nurturing relationships with referring doctors (and courting new ones).

There’s always something. Especially with our clients because they move quickly, act aggressively and strive to dominate their markets.

You are blazing your trail on a daily basis, and to do that properly, you need durable, sustainable processes to make it happen.

(Don’t even get me started on how impossible it is to sustain a new physique AFTER the show. When your body is in starvation mode for the last 6 weeks of prep… and post-show you start to eat more regular food again… your body HAPPILY begins storing any extra calories it can. “You’ll never starve me again, Troy! I’ll make sure of that…” ugh)

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When it comes to sustainability, bodybuilding is NOTHING like an optimal practice growth plan. (And frankly, all the little adjustments and tweaks up until show time – only for a short window of benefit – frustrated me to no end.)

You need a sustainable process that provides predictable results with reasonable effort. That’s how we live, and it’s how we coach – from physician CEOs to surgery teams, even to my sons’ sports teams.

Going into 2022, make sure you have processes your team can execute repeatedly. Processes that are simplified. That account for curve balls.

This goes double for your team members who are responsible for booking your consults and surgeries.

And while you’re at it, take stock of your personal life. Your family. Your health. Your fitness. Where do you need to simplify processes to make them more sustainable?

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That’s it for my bodybuilding lessons. I hope this little series has been useful and maybe even entertaining for you.

If you have any questions about the physique training, hit me up. Happy to share more about my experience as a beginner, if it’s something you’re curious about.

Have a blessed rest of the year, and I’ll see you in your inbox in 2022.

– Troy “Crush The New Year” Cole

PS – A couple of folks have asked about photos from the show. If you’re curious, you can check them out here. (Or totally don’t, won’t hurt my feelings either way)

No, the Patient Does Not Come First

Time to address a trope in medical care (and business in general):

This idea that “The customer is always right” or “The customer always comes first.” (Or in your case, the patient)

Of course we focus on our patients. Of course they are a priority. No one is claiming otherwise, so don’t get triggered.

But here’s where challenges arise:

When you put patients first at the expense of your team. Over time, this destroys your culture, ruins morale and kills your excellent patient care.

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Think back to a time you were a patient, or even a customer in a business. You’ve probably been in this type of situation, which happened to me a couple weeks ago:

I’m in the waiting area. I see the team at the front desk bickering, one of them scolding another. It wasn’t loud or intense, but it was apparent. And I could feel the negative energy.

Then one of them walks out, puts on a fake-ish smile, and says “Yes, Mr. Cole, please follow me right this way…”

It was clear to me that this team probably doesn’t get along. There’s tension. Likely drama. And the fact that she’s “smiling and being kind” to me doesn’t override what I just observed.

Humans generally don’t like seeing people dump on other people. It puts off a negative vibe that repels us. Certainly was the case for me at this office.

AND SO, what am I saying?

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The patient doesn’t come first. Your team comes first.

It has to. And here’s why:

When your team comes first…

When you focus on building a thriving and positive team culture…

When everyone on your team is supporting and encouraging and assisting each other…

The natural result of this behavior is excellent patient care.

In my example above (and based on other observations I made at that practice), they clearly don’t have this positive team culture. And for that reason, their claims of “patient-focused care” and fake smiles simply ring hollow.

Strong practice culture is like ripples in the water:

1. Starts with each individual caring for themselves, then

2. It moves out to the team taking care of each other, and

3. That ripples out to the patients.

For those practices that overlook Step 1 and try to shortcut Step 2 because they’re overly concerned about what happens Step 3, that’s simply backwards thinking. Reverse it, and you’re good to go.

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Moving into a new year, it’s a great time to assess and re-focus on your team.

Are you doing team meetings? One-on-ones? Celebrating wins? Do you know what drives and motivates your people? These are all essential to building a thriving team.

You or your admin or someone take charge and build the culture you want.

Because if you want to maximize your patient experience…

Your team comes first.

– Troy “Team Work Makes the Dream Work” Cole

PS – Generally the better your practice culture, the longer good people will stick around. Good people are *really* hard to find right now, and you want to keep them!

BONUS of a strong culture – If you do accidentally hire a bad egg, they will often fire themselves because they know they don’t belong and their cancerous attitude is not welcome.

The boring thing works (so do more boring)

An update on my physique competition prep…

I’ve mentioned how my trainer talked me into doing a physique competition. In case you haven’t been opening my emails (your loss) I’ve got t-minus 3.5 weeks to go.

And I continue to learn (or at least be reminded) of principles that apply to my business and yours.

Today – we talk about doing the boring work… then doing more of it.

Since we’re closing in on the homestretch of competition prep, we’re in cutting mode. Basically a time to focus less on muscle bulking and more on trimming fat so we look nice and lean on stage.

(PAUSE: If any of this sounds ridiculously narcissistic, I totally understand. But another weird aspect of prepping for these competitions is that you start talking about your body objectively, like it’s one of the miniature donkeys I would show at the State Fair of Texas in high school. It’s less vanity and more pure assessment. Like they literally call the body a “package” as in “We gotta do XYZ to take the best package on stage.” It’s so weird…)

Alright so what do you do to trim fat? Well, you adjust your ratios to eat more protein, fewer carbs, and do more cardio. That’s about it.

New protein? No, the same boring chicken and fish I was eating before.

New cardio? No, the same boring walk on the treadmill at 15 degrees and 3.5 miles per hour that I was doing before. (Just for 60 minutes a day instead of 40.)

“But but but shouldn’t there be something new or fancy?” That’s what I thought.

And apparently the answer is no. Ever. You do the same boring thing that has been working. You just do more of it.

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This has many parallels in the business world. Entrepreneur Alex Hormozi ($100+ million in revenues each year) talks a lot about the benefits of doing the boring work.

Want to grow your practice? Keep doing the same boring thing that has been working. And just do more of it.

Do the followup calls to non-converts.

Write the Thank-You notes to patients.

Recite the same script to every happy patient, asking for a 5-star review.

Do the same intro greeting for every patient who walks in the door.

These things can be… boring. But we do them because they get the result we want.

Few people love a shiny object more than me. New ad platform? New scripting? New treatment options that we can market? LET’S GO! I love the new, the fun, the flashy.

But I have to pump the breaks on myself constantly. “Is this new thing going to keep me from doing the boring things that get me results?”

Most of the time, I take that shiny thing… add it to a list of ideas… and leave it for later. That’s a discipline I’ve had to develop over the years in my profession.

With the competition prep, it’s been much easier because I told my trainer from the start, “Just tell me what to do and I’ll do it.” And what he continues to communicate to me is, “We’re just gonna keep doing the boring stuff, bro.”

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When you are able to focus on doing MORE of the boring thing that’s working, life gets simpler.

For example, I’m on a call with a client the other day to talk about increasing their leads. We have a self-test set up for them that converts at 20%, meaning that 1 out of 5 people who click on it turn into a lead. Pretty solid.

How do we get the result we want (more leads)? Well, I could list off 100 different things we could try. But one very easy and obvious way is to get more eyeballs on the self-test.

Driving people to a self-test = kinda boring marketing. It’s not nearly as fun as doing a silly video for Instagram, shooting a trendy TikTok, or designing a fun new t-shirt. But it’s the process that gets you closer to your surgery goals.

And following up with those folks.. .and leaving messages… and sending texts… and getting them on the phone… and getting them booked… kinda boring process. But it’s the process that gets you closer to your surgery goals.

Sure, there’s room for fun and creativity in the way you get more people to the self-test – various campaigns, different demographics, etc.

As long as all that is geared toward the successful, boring thing that you should do more of.

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The wildest part of doing the boring thing? It tends to generate the most anti-boring results.

My clients that do the boring review-ask with every happy patient? They’re the ones whose 5-star review volume is growing faster than a “Let’s Go, Brandon!” chant at a Crimson Tide football game.

And me doing the boring competition prep…

without any weird fad diets, funky workouts or off-the-wall pills and supplements…

well, I’m in the best shape of my life. And getting a little bit better each day.

In conclusion, do the boring work. And then do more of it.

And if you need me, reply to this email. I’ll be on the treadmill.

– Troy “Treading” Cole

PS – You may think, “Troy, I get what you’re saying. But we don’t know how to even do the boring work. We need a roadmap.”

If that’s you, cool. Email and tell me.

I’ve got the maps. You can have one. Just ask.

This question surprised me (but I’m so glad she asked…)

I’m not a therapist, but I play one on Zoom…

One of my favorite parts of our Team Development coaching programs – the Office Hours calls. These are Zoom meetings we host multiple times a week, and anyone enrolled in our training programs can jump on.

It’s typical that a call might look like a few folks from practice A, 1-2 from practice B, maybe 10 from practice C because the call is during their lunch break for example.

And we take this time to address questions, overcome challenges, and do “in the moment” training on hot topics and issues that we’re seeing practices face right now.

A funny trajectory I’ve noticed – A practice will start our bootcamp, and on week 1, their people won’t say anything on the call.

Week 2 rolls around, and maybe I can get someone to unmute and answer a question. But most folks are still keeping it closer to the vest.

By the time a practice is in the program 3 weeks, and their people are showing up to the calls, the dam breaks.

They’ve been through enough of our daily lessons loaded with gold nuggets, memes and gifs. They’ve started applying what they’ve learned about patient communication (and it’s working). And they realize this whole “learning how to convey value and book surgeries” thing is actually fun and useful.

By week 3 on the Office Hours calls… people are comfortable, they start talking, and we have some major breakthroughs.

I had a bunch of week 3-ers on the call earlier this week, and that’s exactly what happened…

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As we often do, we were digging out so much gold on this particular call:

How to describe the benefits of different treatments
The adequate amount of explanation you should give a patient (vital to know this so you don’t overcomplicate the process)
The difference between being “Kind” (authoritative) and being “Nice” (avoid like the plague)
A bunch of 2-minute tactics to boost our energy and attitudes during the day (uber-practical and beneficial)

We get toward the end of the call – and I ask for any other questions. And one of the bootcampers typed in the chat…

“How do we work on being friendly to each other, and not just the patients?”

And I’m like, y’all wanna go deep? We can go deep…

(and this is why I love these calls. Because this kind of challenge comes up, and it’s massively important for everyone on the team to understand how to handle…)

We dug into it. We discussed why we sometimes tend to get frustrated with one another. I explained the different ways to identify the root feelings that cause this animosity, and practical methods to fight against it.

Different team members chimed in to confess that they sometimes have bad attitudes toward others.

Apologies were made. “I love you guys” and heart emojis were shared in the comments. “We need a group hug!” someone exclaimed.

It was actually a touching moment (our trainings are many great things but “touching” is a word I rarely use to describe them…).

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“Cool, Troy. So you did a kumbaya on a Zoom call. So what?”

My point in bringing this up is that this question was off the beaten path from what most would consider “sales training” (which is our main focus – so you can book more of the treatments you wanna do at the premium rates you deserve to be paid).

But it’s a crucial question. And that’s why any good coaching program is set up the way we’ve done it. You can take this concept and apply it to the staff development you’re doing in your practice.

Our bootcamps are structured in a way to make sure everyone enrolled gets a solid foundation of persuasion, value-building, and clear communication. But that’s only half of it.

The other half is open-ended. It’s not just “Well, we’re going to cover A, B and C and that’s it.” Because every practice is different, every situation has its own nuance.

Sure, everyone needs the foundations. So make sure they have that. But the rest? We go where our clients need to go. Even if that’s to the friendship circle to talk about our feelings and how we can be kind to one another.

And while my “friendship circle” comment is a bit tongue in cheek, you know the monetary implications of getting this right, don’t you?

A positive, supportive team culture is critical to your success. Which means you have people bought into your mission who believe in it and can convey that belief with conviction. A team working together so you don’t lose productivity to drama or high turnover (esp at a time when hiring is a total pain).

So patients can see and experience your team working together, which profoundly impacts the patient experience.

Your practice culture is huge. And it can make or break your surgical volume growth, your revenues, your word of mouth and your momentum in the marketplace.

Solving the “culture challenge” has multiple-6 or 7-figure implications. And even if you don’t think you have a problem with culture / team satisfaction / whatever you wanna call it – make sure you’re keeping a pulse on the team so you know. That’s a message for another day…

Why did I send you this today? A few takeaways.

I like sharing my experiences with amazing practices, and I thought one would be useful to you. Hopefully it brought a bit of inspiration to your day.
When I say our programs are more comprehensive than awesome sales training, this is one of many examples of what I mean.
I want to convey the benefits of an open forum / feedback loop to discuss challenges with your team (whether that’s through one of our training programs, through weekly/monthly meetings you host in your office, or some other way)

That’s all I have for you today. Go forth and build a culture that serves your team and your patients. Make it a great weekend!

Best,

– Troy “Culture” Cole

Sometimes you have to borrow belief

In case you aren’t in the loop, I’m doing a physique competition in December.

“You mean where you get on stage and prance around in a little speedo and a spray tan?”

Sorta. Apparently the “physique” category requires board shorts. So I have that going for me. But yeah, definitely the spray tan.

I have no idea how any of this works. It’s all new to me, and I’m learning a ton as I go.

“Why are we talking about your modeling career, Troy?” First off, it’s not modeling, OK?

Here’s why: Because I share anything I learn that can help you level-up your practice, your conversions to surgery, your team and/or your life.

And what I’m learning as I prep for a physique competition is highly useful to your practice growth strategy.

So you’ll be hearing more about this in coming weeks as I distill and apply these lessons. I already see ways they are super-charging my business, and I know they can do the same for you.

Let’s talk about borrowing belief.

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I met my trainer “Chop” in August of 2018. It was 2 weeks after my mom died from cancer, and I was in a bad spot.

I was exhausted – mentally, emotionally, physically. And I had already been overweight and unhealthy for a few years anyway. I just felt… bad. In a number of ways.

I needed to do something. Some thing. A new hobby, an activity to get my blood flowing, get me back in shape, get some frustration out.

So I went to visit a local gym I’d heard about – Body by Chop – to try a HIIT (High Intensity Interval Training) workout.

And I liked it. And I signed a membership. And I started attending several times a week. And my body (and mind) began to transform.

I even did a couple of Chop’s ‘6-week challenges’ which were fairly strict in terms of workout and meal plans. And that accelerated my transformation even more.

Then about 6 months ago, it started…

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“C’mon, Young Troy. Just do it with me!” Chop is nothing if not persistent.

Running fitness classes isn’t Chop’s only gig. He’s also a personal trainer, and he has a bodybuilding team that competes in shows around Texas.

Chop saw my transformation and thought I had what it took to compete. So he asked me to join the squad.

He asked every week. Every week I said no.

I don’t have time. I can’t commit to that. I’m not interested. I’m happy where I am.

👆 These were my excuses disguised as reasons. The real reason – the main reason – I just didn’t think I could do it.

But his persistence worked.

And when he asked me one Thursday at the end of the summer… for some reason my answer was different. I said, “You know what? Let’s do it. If YOU think I can do it, then I can get on board. Tell me what to do.”

See, I didn’t have my own belief in myself. So I borrowed his.

And here’s the thing: As soon as I started his plan, and I followed the path, and I did what he said to do… even when some of it made no sense to me…

I started to see the results. Actions breed results which breed belief. My own belief. I’m seeing and experiencing it for myself. And I don’t need to borrow his anymore.

So how does this apply to growing your practice…?

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“Borrowing belief” is something I’m reminded of each week as we launch new practices in our bootcamps.

We have every bootcamper – phone team, techs, counselors, even front desk – complete intake surveys, so we can hit the ground running and help each of them overcome their particular challenges.

And many times, the actual cause of a challenge – inability to speak confidently about a procedure, difficulty handling pricing objections, etc – is rooted in a lack of belief.

A lack of belief that the results are worth the investment.

A lack of belief that your practice is the best in town.

A lack of belief that a $15,000 procedure could actually be the best money someone ever spent.

Whatever the issue is, we help our bootcamp members borrow belief as we teach them to create it on their own.

We coach them on techniques of borrowing belief from us, from their surgeons, from their patients, from their patients’ families, from scientific studies, from their own personal life experiences.

And it works. Just like it worked for me on my fitness journey to the physique show.

This concept of “borrowing belief” is not often talked about, but it has so much utility. I encourage you to leverage it with your team and even within yourself.

What is it that you’re trying to do? Where are you trying to go? Where do you or your team lack belief to make it happen?

Life is short. Windows of opportunity are small. Now is the time to make moves, take advantage and kick ass. Borrow some belief and let’s go.

– Troy “Don’t Stop Believin” Cole

PS – I am loosely documenting this physique show journey in my Facebook and Instagram stories. And I’m always dropping marketing and sales nuggets there too. So give me a follow if you’re interested in learning more about how this physique show thing turns out…

PPS – If you want a surgery schedule full of premium patients, it’s your team that’s gotta make it happen. Period. So if you want to talk about getting your team firing on ALL cylinders, hit me up and let’s have a conversation.