031: How Two Practitioners Transformed Their Practices




Ronda Nelson: Welcome to The Clinical Entrepreneur Podcast. I’m your host, Dr. Ronda Nelson. I’m super glad that you have joined me today. I’m actually in the middle of a big move in my office. We moved everything out of my office, got new carpet, and got it all fixed up. It’s quite a job to move out. As the girl who loves books, I think there were about 18 boxes of books we had to pack up and move out. It was a little bit of an undertaking, so I’m in a little bit of a kind of a Jimmy-rigged studio right now. I’ve got chairs, trash cans, boxes, and all kinds of things set up to be able to do this podcast for you, but I’m really glad to be with you today. I have two practitioners that I want to introduce you to today that have completely transformed their practices by making a few simple changes. I recently hopped on and did a couple of interviews with them because I saw the dramatic changes they were making, they are making more money, seeing more people, and loving, loving, loving being a practitioner. You and I know that sometimes the business of running a business is hard. It’s just hard. That’s all. We want to be clinicians. That’s what we went to school for. 


Every once in a while, you’ll find that rogue person who’s really great at the clinical side and the business side, but most of us had to learn it. I did. I know I did. I had to learn it the hard way, and I have a business background, but you don’t know about the clinical business. I didn’t know about fees and patients and discounts. I get the systems and the hiring, all that stuff, I can do all that. I know how to do all that and that’s what I teach practitioners how to do. But to actually put all those pieces together and run the clinic, that was the part that I didn’t do well and it got me into a lot of financial trouble many years ago. Now, what I love to do is to help practitioners grow and scale their businesses and practices so that they can live the life they love, make enough money, serve more people, and be happier. That’s the whole game. 


Anyway, these two ladies, I can’t wait to share with you their interviews. They are remarkable and they both have some similarities. They each share the top three things that are most important to them. Are you ready? Let’s go. The first one is Dr. Tera Pfarr. 




Ronda Nelson: Well, this is my friend, Tera Pfarr. She is an amazing practitioner and was part of the Business Coaching Collaborative some time ago. I want you to hear from her about the three key things that she implemented to change her practice. Before I hit the record button, Tera and I were just talking off-camera about the transformation that she’s had, which really in spite and in light of what she went through in 2020 is pretty dang remarkable. So, Tera, thanks for joining me. I’m so glad you did.


Dr. Tera Pfarr: You’re so welcome. Thanks for having me.


Ronda Nelson: So, what are your three key things? If you were going to talk to a practitioner and say, “Okay. These are the things that moved the needle the most for me in my practice,” what would those three things be, number one?


Dr. Tera Pfarr: Number one would definitely be systems, organization, and flow of the office, an all-in-one. However, there is for sure the stress, there’s a lot of stress when there is the dysfunction of the flows and runs. You have to smooth out, streamline, and walk through the whole process of when a patient walks in, how that all happens, and the cascade of events that happen. Once you streamline it, that is really what made my business more efficient. It also took so much pressure off my shoulders because I knew everything was in place and everything was running smoothly.


Ronda Nelson: And did you do that with your front desk? Or did you just do it yourself and then roll that out with your staff person?


Dr. Tera Pfarr: It was kind of both ways. I implemented a lot of different changes as far as online paperwork goes. So, when they got to the office, they didn’t have to sit and do anything. It was all pre-done before they came in. Some basic stuff that I needed as a clinician I implemented but I sat down with my staff and I said, “Where are you seeing some hiccups? Where can we make things more efficient?” They gave me a lot of good feedback as well and helped make their lives easier, you know?


Ronda Nelson: Right. Did you get any pushback?


Dr. Tera Pfarr: No, not really. Change is always difficult for people but they were positive about everything I did. I told them I was in this program and that we were going to change some things. They were prepared and I wasn’t just throwing everything at them like, “Where is this coming from?” We knew that changes were going to be happening within the next few months but, they were very receptive. Now I think how many months out are we since then? Five, six months out. So they’re very thankful and appreciative of everything that we’ve implemented in the last year.


Ronda Nelson: You know, when you start to streamline the way that your practice runs, everybody’s just happier because items don’t get dropped, balls don’t get dropped, and then as the CEO and the leader, you’re not saying, “Hey, how come Mary didn’t get a follow-up call? Or what happened over here? Or how did we drop the ball on this order or whatever?” When you get those precise systems in place, it really just makes everybody’s life better. 


Dr. Tera Pfarr: Absolutely. 


Ronda Nelson: All the way across the board. Okay. What’s number two?


Dr. Tera Pfarr: Number two was something I didn’t think I needed, but it was financial help. As far as getting someone to organize the books and accountants. Just trying to clean that up because that was something that you recommended, and we ended up doing that. We now do a monthly program with them so I get to see profit loss every month. I look at weekly collections. Now with the finances of the office, I have someone else do it for me so I do not have to take the time to do all of that work. 


Ronda Nelson: Yeah. When you’ve got that, it’s kind of a system. I mean, you put in a financial system, and the numbers are what a lot of practitioners don’t want to talk about. We don’t want to look at that because it’s like, “Oh, I’m not making enough money,” but the focus isn’t as much on the making of the money. It’s looking at the relationships between your income and your expenses. How much you’re spending on your overhead, your staff (which is your biggest expense), but how much you’re spending there? And are they helping you leverage to make income to offset their wages? Technically, staff should pay for themselves. So, I love that you’re doing that. You’ve got somebody that gives you good numbers and lets you see because I know that was a little bit of a sticking point when we talked at one point. I’m so proud and excited about that. 


Dr. Tera Pfarr: Yeah. That’s going great and it’s kind of cool to see now. You know, before the numbers were just numbers. I didn’t even know what they meant. And now to see the percentages, I’m like, “Okay. How can we get the overhead down a little bit to offset some of these expenses?” and there are certain percentages you want in each department. So, this year, my goal is to streamline efficiency within the office financially, to see where we’re spending, and how we can cut back or what we can spend on.


Ronda Nelson: You know, a good thing to remember too is that I always say that sometimes you have to get coaches that specialize in the thing that you need. I can help you get the system set up for your finances but I’m not a CPA. I have a big strong accounting background and I can get you started but that’s not what I want to be really good at. And so, you find that right coach, that person to come in and kind of guide you and teach you, “Okay. This is what this number means. This is what this number means. And this is as the relationship between those two numbers.” And now all of a sudden looking at a financial statement becomes super easy. Okay, what’s number three?


Dr. Tera Pfarr: Number three was more of a personal transformation as far as seeing myself and having confidence in myself as the leader in the clinic, not just being an employee. You constantly said you’re the CEO of your business and now I feel like I’m running the business and the business isn’t running me. That was a huge transformation to make. I felt like an employee that just went in every day, did my thing, and then had piles of other stuff that were just building up because I just couldn’t keep track or couldn’t get ahead of the game. Now, ever since I’ve put these systems in place and outsource things I don’t want to do, everything is more efficiently running and I’m more confident as a boss, as a business owner, and as the CEO of my company.


Ronda Nelson: That is music to my ears. I so love hearing you say that because it is so important that we look at ourselves as a CEO. The buck stops with me. And if something gets dropped or something didn’t work or something happens, I have to take responsibility. Whether I directly did it or not, it falls back on me as the leader. So, I love that. Now as we wrap up, if you were the coach, what’s the one thing that you would tell a practitioner in their clinic that maybe was in the same spot as you, what they can do right now? 


Dr. Tera Pfarr: Oh, that’s a loaded question. There’s so much.


Ronda Nelson: I know. I know. 


Dr. Tera Pfarr: I would most likely say one of the big things is to walk into your clinic doors as the patient and see how everything flows from their eyes. Are you seeing the smile on my receptionist’s face, the decor of my office? And those little things and those little emotional triggers that a patient has when they first walk in the door, what they smell, what they see, how they feel, it sets off their whole visit with you. Just walk in that front door as a patient and from a patient’s point of view and see how they approach and how they interact with your office because that’s a huge game-changer.


Ronda Nelson: It is a huge game-changer. We talked a lot about being that patient and going through the experience with your patient hat on, not your eye on the business hat on. And not only just walking through the front door, but that conversation and that experience that starts from the time someone answers the phone, a form is filled out, or there’s an email that goes out in response saying, “Hey, thanks for reaching out. We’re super excited to talk with you.” There are all those multiple ways that people come into your practice. Knowing how to really tune those up and make it a win for the patient is huge. 


Oh, man, I am so happy to be able to chat with you. You are just absolutely delightful. I’m going to put us back side-to-side. I loved working with you, I consider you a friend, and I’m so proud and excited about the growth that you’ve had. You told me before we went on camera that you were, in your words, so busy and that you’ve started to outsource and dive into marketing. All of that happens because you put your CEO hat on, you got those systems in place, you started to deal with the business of the business as a CEO rather than ignoring the business, just being a clinician and being frustrated all the time. So, I’m so proud and so excited for you. Thank you very much for joining me for the interview. I’ve loved chatting with you and I will make sure for those who are listening to this put-together podcast that Tera’s information is in the show notes. You’ll be able to connect with her, share the love, like follow, interact. Go find her because she really is a rock star clinician. Tera, thank you so much. 




Ronda Nelson: Was that amazing or what? I mean, she had some serious truth bombs in there. I hope at least one of those was impactful for you and made you believe that you don’t have to be that outlier practitioner that never gets it right but now you got some ideas on what you can do to be able to start making it right and making your practice run better. Okay. Enough about that. Let’s hear from Dr. Jeni St. Onge. She’s our next practitioner, and you’re going to love this. 




Ronda Nelson: All right. Jeni St. Onge and I have worked together in the past and she is one of my favorite people when it comes to drawing a line in the sand and deciding if you’re either in or you’re out. This last year, at least in 2020, was a remarkable year for her from the very beginning, not even including COVID, it was a really remarkable year for her. So, I’m going to minimize myself. I’m going to put Jeni on the front and let her chat with you. Thanks for joining me, Jeni. So glad to have you with me. 


Dr. Jeni St. Onge: Thank you, Ronda. It’s such a great honor to be with you. I’ve learned so much from you from a clinical perspective but perhaps even more important than that. It is the business stuff that I have learned from you when I really didn’t even want to have a business. I was terrified to have my own business. I just thought, “She’s going to work for somebody,” and then I realized that just wasn’t going to be a good fit for my family and the freedom and what I wanted out of it. So, I had to just roll up my sleeves and figure out a lot of things and she helped me do that. I’m super grateful for that. 


Ronda Nelson: And we really had a great time when we were working together inside the Business Coaching Collaborative, but we’ll talk more about that later. I want to hear from you. What were your three big takeaways, or things that you said, “This is what I figured out for me”?


Dr. Jeni St. Onge:  I would start with pricing. I feel like so many of us as healthcare providers…we love people, we love to serve people. Especially me coming from a chiropractic background, that’s a $49 visit or it’s a visit priced at one point. However, if you’re going to take the time and invest, I invested years becoming certified in functional medicine and learning and doing that. So, when I sit down with somebody, I’m visiting with them for an hour and I am reviewing all these tests that they brought me and this is time-intensive. And for me to offer that level of service that I think is transformational with health, you have to charge for it.


Ronda Nelson: Absolutely. Preach it, sister. Come on. 


Dr. Jeni St. Onge: I just didn’t do that and I have a mess now in my practice because I’ve got new clients that I have priced properly, and ones that I haven’t. It’s just this hybrid situation of transitioning, and I really wish I would have done it right from the beginning. It was fear and scarcity mentality. 


Ronda Nelson: What’s the thing that you use? What was the mental shift that you made to make that transition to believe that you were 100% worth the service that you were providing, and that it was 1,000% worth the fee that you were charging? What was that shift for you? 


Dr. Jeni St. Onge: The results. People would come back and you’d have to be really careful. We’re not diagnosing and curing people. But, people that have already been diagnosed with really scary stuff, come in and we help them in a different way. We are changing their life and when they go from some big scary diagnosis to not having it anymore, you think if they would have had to go through the medical system and treated their leukemia as one. That’s been an “aha” moment for me. If they would have had to treat that medically, they would have been six figures out-of-pocket even with insurance, more without it. Now, in that process, not only did we help that reverse, this person is healthier and happier and feels better than they’ve ever felt. So, is it worth it? Yeah, you bet it is. 


Ronda Nelson: So, set your price based on the results that you know that you can deliver and invest big, then you price big. Meaning that you’re not low balling it. And I know that that’s not what you did. You did not lowball your prices.


Dr. Jeni St. Onge: No. To me, it was like when I felt like I was worth it, I started doing it.


Ronda Nelson: Oh, I love that. That makes me so happy. 


Dr. Jeni St. Onge: Thanks. I just ask myself, “What do I need to do to be worth it?” I like asking good questions like that. 


Ronda Nelson: That’s such a good question. Such a good question. Okay. We can talk about that forever. 


Dr. Jeni St. Onge: I know there’s so much in there. 


Ronda Nelson: I know. That’s like a little goldmine. In fact, Jeni, how about this? How about if you and I jump on a podcast, another full podcast episode where you’re not sharing it with anybody else, how about that? 


Dr. Jeni St. Onge: Yeah. 


Ronda Nelson: We’ll do that later. Okay. So, Jeni will be back with us. But now, okay, so number two, pricing is number one. That was the top number one thing you learned in 2020 or in your practice growth, which happened last year. What’s number two? 


Dr. Jeni St. Onge: Number two is to have your systems dialed in. 


Ronda Nelson: So important. 


Dr. Jeni St. Onge: Oh boy. And I’m still working on this. I just really appreciate the visual you gave me when we work together of creating this highway that is moving efficiently before you go adding all the traffic, right? I always think about this and I’m having some traffic jams now because I’m growing and expanding, but you can only solve the problems at the level you’re at. So, new level, new devil. I am further along than I was last year so I have some new challenges. And so, I have to figure out how to deal with that because I so want to take really good care of people but now I’ve got more people. I have to make sure that my systems are dialed in. Are there automations and tools that I can use? You always had some really good recommendations about that. Then I’ve just tried to protocolize more stuff so I don’t have to reinvent the wheel.


Ronda Nelson: That’s exactly right. And you said something so impactful, that whenever you grow, your systems have to change. Because what worked for you, when you were only seeing three people a day, four days a week, because your kids are at school or at home or whatever, whatever your life is, you create the systems that work for where you’re at, for your volume, your life, your practice, the amount of money that you want to make. But as you grow, then you go, “Oh, crap, this isn’t working. I can’t do this anymore. I got to fix this. This is not working for me.” So, that’s awesome. Okay. Number three, what is it? 


Dr. Jeni St. Onge: Number three is to figure out what your non-negotiables are. 


Ronda Nelson: Oh, that’s so good. What were yours?


Dr. Jeni St. Onge: So, I have an intake process and I asked some questions on that. And it’s like if someone comes to you and says, “Well, I’m not willing to change my diet.” Non-negotiable for me. I just say, “You know, what, I’m sorry, you’re not in the right place. I’m not going to be able to help you.” I don’t waste their time and we just know we’re not going to be a good fit, then. 


Ronda Nelson: I’m going to jump in here. Do you feel like the patient feels respected or disrespected when you have that conversation with them? 


Dr. Jeni St. Onge: I try to come at it from a place of making them feel respected. Again, I don’t want to waste time and money. Because when I first started, I would go through this initial workup process and we’d get to the part where I’m telling them what I think they should do and they would say something like, “Oh, I didn’t know I was going to have to change my diet.” And now they’ve spent $300 for me to tell them, “I can’t help you.” And labs are another thing. If people are really balking at having to order lab testing and get some data, I had this conversation today with somebody. I said, “I will help you as much as I can. I feel like in order for me to bring my best to the table, I need some more information,” and they look like these two lab tests that I’m recommending. “If you don’t want that, just know that I will love and support you but I don’t know what to do without the information I feel like I need. So, it’s up to you.” 


Ronda Nelson: Yeah. And that’s where the patient gets to decide how invested in their care and in their journey that they want to be. What I love about what you’re saying is that you’ve provided them a roadmap. You’ve given them a roadmap and said, “Okay. We’re at this exit off the freeway, right? We just took this exit and now we’re over here in the rest stop because I can’t go any further. After all, I need a little bit more information on the map and I can’t get back on the freeway until I know where we’re going. What’s our next steps?” And sometimes those tests, those lab tests, they exactly do that. So, all right, Jeni, I love this. I love this conversation. You make me smile from where you came from when I first met you in the Business Coaching Collaborative. When I first met you, you were like, seriously, in a meltdown all over the board, don’t know what I want to do. You were a little all over the place and it makes me so happy to know that you really just buckled up and dove in. You’re ready to hire staff, grow your practice, you’re more profitable, happier, and I could not be more excited for you. 


Dr. Jeni St. Onge: Thank you. I really love what we did and that with the coaching and the group and I still keep in touch with some of the people that were in the group and made a lot of good connections. I very much appreciate your leadership. There’s so much going on now that it’s nice to have someone that’s showing some leadership and helping us all. So, thank you for that. 


Ronda Nelson: Well, you’re welcome, and thanks for joining me. I have loved chatting with you.




Ronda Nelson: Amazing! I told you, you were going to love these ladies. They are both exceptional practitioners in their own spaces. And interestingly, neither one of them really talked about their niche, but they both had them and they both worked hard. I’m going to just rat out Jeni just a little bit. When I first started working with her inside Business Coaching Collaborative, which is open for enrollment this week. (So if you want to jump in and you want these kinds of results, that’s where you need to be.) But when I first started working with Jeni, she was all over the board. “Do I want to be an associate in a practice? I don’t want a niche, that feels really scary. My husband’s a chiropractor. Do I want to practice with him? Do I want my own thing? I don’t know what to do.” She was literally all over the board, like squirrely. And I kept saying, “Just decide who you want to serve first. That’s the first decision you have to make. Who do you want to serve? Who do you want to serve?” And once she made that decision, she just changed her head game. She just changed the way she was talking about herself and her practice. All of a sudden, boom, everything opened up, and now she’s just killing it over there. I’m so proud of both of these ladies that not only are they past students, but they’re also friends and I could not be more proud of them. 


So, if you are listening to this and it’s too late, and the enrollment for Business Coaching Collaborative or BCC as we call it, if it’s already closed, that’s okay, you can still click on the link and you can get on the waitlist. But if you’re listening to this podcast and it’s before February 11, you are good to go because enrollment closes on February 11th. There is a bit of an application that you do have to go through but if you feel like your clinic, your business skills need a little sharpening and you need a coach or a mentor, I can help you. I’ll be that coach for you. I’ll walk you through that. Your business, your future. your finances depend on you being the practitioner that I know you can be and Business Coaching Collaborative is where we do just that. I’m going to transform you. You can have results just like Jeni and just like Tera. So, join me. Click on the link below. I can’t wait to see how you are going to transform your practice. Until next time on The Clinical Entrepreneur Podcast. My name is Ronda Nelson. I am your practice growth strategy coach, my friend, and I’m going to come committed to helping you get the practice that you want and that you deserve. Alright, my friend, follow me on Facebook. Follow me on Instagram. You can DM me anytime. Contact info is in the show notes Take care. Talk to you soon. Bye for now.




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