Dr Andrew Greenland: 0:03

So welcome back to Voices in Health and Wellness. This is the show where we dig into what's really happening behind the scenes in today's care-driven businesses. I'm your host, Andrew Greenland, and today I'm joined by Brian Schultz, the founder and lead chiropractor at Amplify Health and Wellness. Based in Littleton, Colorado, Brian has built a thriving practice known for its patient first mindset and its integrative approach to long-term wellness. What makes this conversation especially timely is that Brian's not just focused on treating patients. He's also deeply involved in managing the operations and admin that keep the practice running. So, Brian, thank you very much for your time and welcome to the show.

Brian Schulz: 0:36

Thank you for having me.

Dr Andrew Greenland: 0:38

You're welcome, so maybe you could just start off by telling us a little bit about your role and how Amplify came to be you to start off by telling us a little bit about your role and how Amplify came to be.

Brian Schulz: 0:49

Okay, so a little backstory. I've been a chiropractor for 25 years and the vast majority of those years I worked for other chiropractors and groups. I did own my own practice for a short period during those periods as well, but recently I finally have gotten myself out of my student loan debt and got myself in a position where I could purchase an office. This office was established in 2017 by a couple, and they needed to move closer to family. They had some young kids and the grandparents were in another state, so they decided to relocate there and I purchased the office from them. So currently, I'm the owner manager and sole chiropractor for Amplify Health and Wellness, and our goal is to try and help people to achieve the health that they don't even know, that they have the opportunity to gain through lifestyle changes, coaching, chiropractic care, a diet and exercise.

Dr Andrew Greenland: 1:37

Amazing. So you are truly a one man band. So what does a typical day look like for you at the moment, both clinically and operationally?

Brian Schulz: 1:44

Well, clinically, we typically see anywhere from 35 to 55 patients in a day, depending on which day of the week it is. Some days are heavier than others. We have a rotating schedule early two days a week and later two days a week to try and maximize the amount of times available for my patients. But obviously, since I'm not just a chiropractor, I'm also the owner of the office, I have to manage all those other hats too. So some of the issues that I've had is trying to figure out which hat I need to wear and which hat I need to delegate out to other services, and that's some of the stuff that hopefully we can touch on today.

Dr Andrew Greenland: 2:21

Okay, great, thank you. And how has your role evolved as the clinic has grown?

Brian Schulz: 2:26

I'm presuming, obviously since buying the office and taking over the operation how have things kind of evolved for you Well initially there were some things that the previous owners were doing that I tried to do and just didn't seem to be a good match for me.

Brian Schulz: 2:40

So there was some transition periods there where I had to actually figure out what is it that I really want to provide for my patients so that I can feel passionate about it and make sure that when I'm trying to educate them about what I want them to do, that they can see the passion behind it. I've had much more success with people following through with my recommendations when I'm 100% on board with those recommendations myself. So if there are treatments or protocols that I'm not 100% sure of, I either try to do the research necessary to get myself on board 100% or move on and do something else that I do 100% believe in. So to me, that's the biggest thing that's been. A challenge is trying to figure out exactly what it is that I want this clinic to be, and I don't know if that's the best place to be when you've already purchased an office, but that was part of my journey.

Brian Schulz: 3:36

I'm one of those people that likes to learn by making a lot of mistakes, so hopefully I can prevent some of you out there listening to this to not make the same mistakes that I've had to make and that cost me a lot of financial money to learn those mistakes.

Dr Andrew Greenland: 3:51

That's one of the aims of this podcast. We really want to share learning, not just of clinical learning, but sort of business learning. So that would be really, really helpful. So are there any parts of the business side that you've come to enjoy, or the other extreme you've come to dread, Because you know you've got many hats that you've come?

Brian Schulz: 4:10

to enjoy or, at the other extreme, you've come to dread because you know you've got many hats that you wear. They're probably some that you prefer to wear rather than others. What would those be? Yeah, honestly, my favorite part is actually the clinical side. I um initially bought this office intending to just manage it. We had another associate that was working in the office and they were doing the vast majority of the adjusting and I was expecting to just come in and manage the office. Turns out that I actually don't enjoy that.

Brian Schulz: 4:29

I really enjoy the clinical aspect and treating patients much, much more so that's the part that I'm really passionate about is being in the trenches with my patients, working with them one-on-one.

Brian Schulz: 4:40

the things that I don't like is marketing, because I'm not necessarily very good at that, and that's been a frustrating part of office ownership, simply because that's one of the things that drives profit, of course is bringing in those new clients, and so it's been a little bit of a struggle trying to figure out the right mix to make sure that we're getting those people in the door, and I think we've finally figured it out to a good degree brilliant.

Dr Andrew Greenland: 5:09

Um. What are you noticing in your sector, your niche, in terms of where things are going? What are the major shifts that you're seeing in chiropractic care in the industry right now?

Brian Schulz: 5:19

I'm not sure I've got my finger on the pulse of the entire industry, but maybe locally and specifically in my practice, a lot of my patients are kind of looking more at the nutritional side of things.

Brian Schulz: 5:34

A lot of the research out there is showing very good promise with metabolic disorders and ketogenic diets and carnivore diets and all these different things that people can do to kind of reset their system.

Brian Schulz: 5:49

One of the big things that's been huge in the last five to 10 years, of course, is the gut biome and gut health and how that plays with the gut brain access and how important it is that we have the bacteria living inside of us, the right mix of them, because they actually do control our hunger signals to a large degree, more so than just whether or not our stomach is full of food or not. So I think that's kind of where I'm seeing things going is more towards looking a little bit closer at the quality of our food, the specific diets that we have and ways to get ourselves out of the metabolic diseases that we've developed because of the poor food quality we have in the united states over there in europe a lot of those things are not allowed in your food supply and unfortunately in the united states there's 500 plus chemicals that we allow that you all over air do not, so I'm hoping I can educate some people about that too and presumably these are things that you can integrate.

Dr Andrew Greenland: 6:47

You you have been integrating into your practice this more holistic approach and exploring these sort of metabolic biome aspects yeah, honestly, one of my goals is to be my patient's primary care physician.

Brian Schulz: 7:00

Now I don't know if I can be categorized that way specifically, but in often cases my patients will come to me with any problems they have health-wise and they'll get advice as to can we manage this ourselves and watch this ourselves, or do I need to refer them to a practitioner to get further testing or evaluation? And so many of them develop that relationship with me because I see them regularly so I get to know them as human beings. I'm not just running in to write a prescription or write a referral and in and out of the room in 30 seconds. I get some time with my patients and get to know them, and so they feel much more comfortable sharing things with me than they would, you know, their primary care in the medical field, because they just don't have the time got it.

Dr Andrew Greenland: 7:45

What about? Um? Obviously covid's been a big deal for us. I don't know how you fared during covid. Um, I guess I don't know do you have to sort of shut down or truncate what you did?

Brian Schulz: 7:56

yeah, at the time of covid I was actually in the state of kentucky and they were pretty harsh on us.

Brian Schulz: 8:00

They shut us down for five weeks, um, and so the unfortunate thing about that is I had two patients who were pretty significantly impaired and because of the inability for me to see those patients for those five weeks, they ended up needing surgery, and so I was devastated to not be able to take care of my patients the way that they needed to be taken care of, because the government said you can't do it. So that was tough. Now in the United States they did have a lot of programs out there to help employers, not just in the medical field but in all the small business fields, like PPE loans and things like that. So on the business side of things, the United States fared pretty well as far as the businesses. Unfortunately, I think there was a lot of fraud with it too, so a lot of waste. Unfortunately, people taking that money that really didn't need it, going on vacations and things like that, instead of actually keeping the employees happy that they were supposed to use that money for were there any changes in patient expectations after covid?

Dr Andrew Greenland: 9:03

I mean, that was a major shift in the way we had to live for a couple of years, but has it changed anything in terms of the way that clients present and have expectations now?

Brian Schulz: 9:12

I'm not sure I'm seeing a huge difference in that, maybe an overall shift in awareness of how important overall health is, because I think that's one of the things that COVID really did show us is that if you're overall not a healthy person, those are the people that suffered the most with COVID. You know, if you were morbidly obese, if you had other serious health conditions, you were much more affected by COVID than those who were healthy. And so hopefully that particular part of the pandemic has hit home with enough people, hard enough, that they're actually going to put the work in to change their lifestyle habits, because oftentimes human beings, we don't want to change unless it's more painful not to change than it is to change, and maybe for some people COVID was that impetus.

Dr Andrew Greenland: 10:03

Got it and I don't know how it is for the US in chiropractic. Obviously I'm UK based, but have there been any sort of local or national policy changes that impact on your practice at all, or have you pretty much practiced as you always have done?

Brian Schulz: 10:18

uh, I'm not pretty much practiced the same way I have at this point, you know, and obviously there was a period of time where we had to do all of the um, the ppe or the, the masks and the gloves and things like that, and we I think we had to do that for gosh, like nine months before Kentucky let us not wear masks and not wear gloves, which was weird to me, because in the state of Kentucky, if you were a massage therapist, you could work on your patients without wearing gloves and you're touching them skin on skin, but a chiropractor who's working through the clothing, we had to wear gloves. Skin, but a chiropractor who's working through the clothing, we had to wear gloves. And just that was one of the frustrating things about how it was handled. Here was so much conflicting information and rules and regulations that didn't seem to make much sense, and so hopefully god forbid anything like this happens again, but if it does, hopefully we're better prepared for it yeah, and so is what's working well for you in your team?

Dr Andrew Greenland: 11:18

I don't actually you have a team. Are you truly one man band? Do you have any team members at all?

Brian Schulz: 11:22

right now I have two staff and we're getting ready to hire a third. Um, so the therapies that we're doing are doing pretty well. Uh, we do the red light therapy and then we do a therapy called INDIBA I-N-D-I-B-A. It's a radio frequency electronic stimulation device and that particular device is relatively new over in the United States. I think they got FDA clearance for PT on that in about 2016.

Brian Schulz: 11:46

But in Europe they've been using it for 40 years and so that particular machine I've had great results with plantar fasciitis, carpal tunnel, neuropathies, acute injuries really helps them heal faster and even chronic injuries it can really make a big difference in reducing their overall pain levels and spurring on the healing process. So that particular frequency they've done studies on and it's supposed to in vivo studies have shown it increases stem cell production, the metabolic activity of the rates of the cells we're working on, and increases blood flow. So that therapy has been a pretty big game changer for me as far as patient compliance and patient satisfaction with the speed with which it can provide people the results they're looking for interesting and, on the other end of the spectrum, what's been frustrating or holding you back?

Dr Andrew Greenland: 12:42

I know you kind of alluded to marketing being a thing. Is there anything else with all the multiple hats that you wear? Is one of your bottlenecks or challenges in the way that you do things?

Brian Schulz: 12:51

yeah, well, uh, in colorado specifically, um, trying to bill for insurance and using insurance is not a very easy or good thing for chiropractic I only accept a couple of different insurances, and when I first bought the office, we didn't accept any insurances, and so I was like, well, I'm having trouble figuring out the marketing game, let me try and get in on some insurance action and see if that'll help. So we did get some extra volume from that, but it's just they want in the united states lot of them are they want pre-authorization. The insurance company wants to be in charge of what you get to do and what you don't get to do with your patients, and then they don't want to pay me very well either. So probably one of the challenges although I don't seem to have that much trouble with it now because I've been doing it more is selling the cost of the packages that I recommend.

Brian Schulz: 13:44

So in our office we're not a walk-in clinic, we don't do one-off adjustments, we do care plans, and the minimum care plan is three months long, and so I'm asking people to pay before they start their care, so they have to prepay for their care here. So oftentimes I'm sitting down in the report. I'm asking them to give me 1500 to 2500 and, um, obviously that's sometimes it's some sticker shock to people and so that can be a challenge. But at the same time, because I've been doing it now for about three years in the cash based type of a practice, I feel comfortable doing it now.

Brian Schulz: 14:21

So again for anybody that's out there that's struggling with anything. As far as patient communication is concerned, the first thing I would look at is how comfortable are you doctor? If you're not 100% comfortable with whatever it is you're trying to educate the patient with, you need to get there, because if you're not a 100%, the patients are going to be able to notice that, even on a subconscious level In some way, it's just not going to feel right to them and they're going to be more guarded.

Brian Schulz: 14:49

So number one have 100% faith in whatever it is you're trying to sell to the patient, because you know it works and with experience, hopefully you guys have all seen what we do works, so know what you do works 100. Believe that, then you're going to be able to convey that to the patients much easier got it?

Dr Andrew Greenland: 15:10

um, I mean, I've spoken to a number of people in north america and there's the. The commonality is about the whole insurance rebuilding thing, so I'm getting that as a theme across all the different niches. Have you what's your kind of secret sauce with cracking this? Have you cracked it to the best that you can, with all the limitations that you've said around? I'm not wanting to pay you properly and everything else. What's your kind of advice on this one? Well, the way that I do.

Brian Schulz: 15:34

It is I don't try to maximize the amount of uh insurance that I get. I try to use insurance more as a way to kind of like a bridge for patients who want to use their insurance. I'm going to let them use their insurance, but I'm not going to try and fight for every single cent that that insurance is going to give me. So, for instance, UnitedHealthcare is a big one in this particular state.

Brian Schulz: 15:55

They require pre- authorization, and so when I get the pre-authorization, they give me X number of visits. Usually it's six or eight visits is what they're going to approve initially, and then after that they generally give me three to six more, and then after that I don't apply for more. At that point I'm like your insurance is done paying. We're going to switch you over to a cash basis now. So here's what your insurance is going to cover. That's going to reduce your cost by X amount. After that, they're done with their portion. Now it's up to you, and you need to take responsibility for your health here, and so that's kind of how I handle that is, I don't try to. I try to move people from the thought of I need to use my insurance for this to this is something that's so important that I'm going to pay for it, whether insurance is going to or not.

Dr Andrew Greenland: 16:41

Good advice. So if you were to name one system or process that eats up most of your time, what would it be? Would it be the whole insurance thing or the other things that are a drain for you?

Brian Schulz: 16:52

Well, I would say it would be a combination of insurance and documentation. Ok, if I didn't do any insurance, the documentation that I would have to do would be at a different level, because the documentation I need is for number one. So I know what I did so that if anything ever happens I can say this is exactly what we did this day. So for two reasons number one I've had patients come in on a visit and they're like whatever you did last visit, doc, do it again. I feel so much better. And then if you look at your notes and you're like I don't know what I did different that day, that's a problem.

Brian Schulz: 17:31

So your notes need to be detailed enough so that you know if you did a little subtle, different adjustment that day. You can look at that note and go that's what I did different today. Let's make sure we do that again. So that's the first thing. But the other thing, of course, is to protect ourselves. We all have malpractice insurance because we all need it, because there's always a chance in any medical profession of a patient suing you, whether it's your fault or not, and so the notes need to be adequate to protect you there. But above that, the insurances require a bunch of stuff that you wouldn't need to satisfy those two other requirements.

Brian Schulz: 18:06

So, because I do insurance, my documentation takes longer. Does that make sense, matt?

Dr Andrew Greenland: 18:11

BONGIOVILE Got it. Yeah, I completely understand. So how do you, with all the hats, how do you balance being present with patients while managing all these behind-the-scenes tasks? What is the secret here?

Brian Schulz: 18:23

the number one thing I would say is every morning in our morning huddle. I'm a christian, I pray with my staff every morning and I ask for the ability for all of us to stay present for our patients in the moment, and so every morning I'm reminding myself and my staff to be 100 present in the moment with the patient.

Brian Schulz: 18:44

let's not worry about what we're doing after work. Let's not worry about what we're doing this weekend. Let's not worry about whatever stuff's going on in our life right now. Let's focus on who's in front of us. Let's 100% listen to them. Let's not be thinking about what we're going to say next, because that's what oftentimes people are doing when they're listening, they're not actually listening. They're waiting for an opening to say what they want to say next. So you know, we do a lot of training on that. As far as staying present, and, honestly, that's one of the biggest things in my reviews that stands out is most of my patients that are giving us reviews. It's not just necessarily about I feel better, it's the staff is amazing. I feel like I'm a part of a family, I feel like I'm being listened to, and it's just not me.

Dr Andrew Greenland: 19:30

It's the whole team. That's really really good advice, Thank you. So where would you like to be in six to 12 months with Amplify? What's the kind of direction of travel for you and the clinic?

Brian Schulz: 19:38

Well, right now we're staffing up because we're getting busier, we're starting to figure out that marketing mix, so we're getting those new patients in the door, so we have to get more staff to handle that volume, specifically with making sure that we can handle the therapy volume, because I need enough staff to be able to do one can be in therapy. I still need somebody up front doing the front desk. And then another thing I'm looking at potentially is having a virtual front desk so that way I don't need somebody listening from the phone. If the phone rings more than twice, it goes to a call center that I have trained. They get a bunch of different scripts and a bunch of different stuff that is specific to my clinic so they know how to answer questions.

Brian Schulz: 20:19

They can handle any phone calls that come through that we can't get on ring two, so that I don't need to hire another staff just to man phones. So that's a way that if you're kind of worried about well, I'm in between, like I kind of need more staff, but I'm really not in a place where I need it yet that can be a stepping stone between hiring another staff is to look for companies that will answer those phones, a virtual front desk type of a company. So that's something that we're gonna be implementing as well.

Brian Schulz: 20:47

But over the next 12 months I want to hire another uh associate and then probably another year. After that we're going to be looking at hiring a physical therapist in the office as well okay, I hope that all goes well.

Dr Andrew Greenland: 21:01

Finally, if you could wave a magic wand and fix one part of the business tomorrow, what would that be?

Brian Schulz: 21:06

uh again. Um, having all my new patients appointments full, that's really the only thing that, honestly, I struggle with at all in practice. If that's just not my my forte, even, you know, doing screenings and those sorts of things, I'm just not good at it, you know, and it's really important guys and gals out there to know what you're not good at.

Brian Schulz: 21:28

Okay and it's okay, we're all going to have things we're not good at. Be okay with that. Figure it out what you're not good at, because if you can figure that out, you can delegate that to other people who are good at it, and so that took me a little bit of time. Um, early in my career I kind of had a big ego, thought I could do everything myself, thought I knew, knew everything, and honestly, that got me in more trouble than anything else in life. So have some humility. People Know that you're not God and that you need some help too, and ask for help when you need it. You know and have your staff and other people mentors. Have a mentor. That's super important Somebody you can bounce ideas off of and they can go.

Brian Schulz: 22:06

You're a knucklehead. That's just dumb. You know somebody who can be that blunt with you and you're not going to get upset because they they popped your bubble. You know somebody you can really trust because they've got the experience that will save you more money than anything else and it's worth the money. If you have to pay a coach, it really is worth the money to do that. You end up spending way more money. Take it from a guy who decided I don't want to pay for the coach. I paid for a coach 10 times over through experience. So give yourself shortcut get the coach there's a saying isn't there.

Dr Andrew Greenland: 22:37

You either pay with time or money, and absolutely money is kind of the shortcut because you've basically taken experience unfortunately some of us.

Brian Schulz: 22:44

They got the money, so you just have to have to struggle through until you do figure it out. But you'll get there.

Dr Andrew Greenland: 22:51

On that note, Brian, thank you so much for your time this afternoon. Really interesting conversation, Really interesting to hear about you, your business and your presence in the business, which I really really value. So thank you very much for your time, Really appreciate it.

Brian Schulz: 23:02

Again, thanks for having me on, Andrew. It's been a pleasure, thank you.