The Austin Cohen Podcast

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When I look at the chiros I’ve been working with this year, the biggest transformation I’ve seen has nothing to do with a new script or a new marketing play... it’s who they’ve become along the way.

In this episode, I share why the old model of memorizing the same scripts as everyone else never worked for me, what I’ve been watching happen as chiros run real leadership meetings, write their own values and get clear on their vision, and why a framework you build will always outlast a script you borrow. Because you can have every script in the world, but if you don’t change who you are, whatever you’re trying to change isn’t going to work.

In this episode:

• Why I stopped trying to copy someone else’s practice
• The difference between a script and a framework, and why your team can feel it
• Why your team will rise to the level of the leader in front of them
• The one question to add to your Define month goals

Growth Summit is this February, and seats are limited. If you’re ready to do this work in a room full of chiros doing it too, grab yours now.

https://draustincohen.com/growth-summit/

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Every January it's the same story... the goals go up on the whiteboard, everybody's fired up, and by the middle of March most chiros are still trying to figure out what those goals actually meant, who owns them, and what's supposed to look different on a Tuesday afternoon. By then a quarter of the year is already gone.

In this episode I walk you through the Practice Year Flywheel, the way I've learned to run a year after opening twenty practices and growing from one location to thirteen. It runs on five phases: Define in October, Install in November and December, Launch in January, Reset in July, and Finish from August through December. I break down the 5 Ps I use to define the year (Personal, People, Play, Prosperity and Professional), how to turn every goal into a system before January ever shows up, why July is a pit stop and not a breakdown, and how finishing this year while you build the next one keeps the wheel from ever stopping.

October is Define month, so if you're listening when this drops, you're right on time.

We've only got about a dozen tickets left for Growth Summit in February, the perfect place to pressure-test what you defined and installed right after you launch. Grab yours at the link below before they're gone.

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📩 Join the newsletter for weekly business & leadership insights:
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 @draustincohen

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 www.draustincohen.com

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A buddy at Runningman added up the followers between me and the two guys I was sitting with and announced 2.405 million to the whole group, and then pointed out that about 5,000 of those were mine. Everybody died laughing, and I laughed right along with them, but that joke followed me all the way home and turned into something I haven't been able to shake since.

In this episode I get honest about the comparison trap, and about how easy it still is to look at another practice's numbers or another doc's highlight reel and decide you come up a little short. I also tell a story I've never shared on this show, about a list of 52 people I wrote down back in 2016 when I had one office and a lot more hunger than answers... none of those meetings happened that year, and it took the next ten years of showing up before I got to know the people on that list.

We get into why most of what shaped my business came from outside chiropractic, why I choose rooms by what people are building rather than who's watching them, and how all that reaching eventually turns into belonging. If you've been keeping score with the wrong number, this one's for you.

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I ran a growing practice for about ten years without knowing the single most important number in it. It was 18, that's where our patients were quietly walking away, and the information wasn't hidden from me... I just never went looking for it. In this episode I'm walking through the five retention numbers I'd pull if I were starting over, including net growth, care plan completion, your black hole number, PVA, and one nobody in our profession tracks that I'd argue predicts everything else. Every one of them I learned outside chiropractic, from Netflix, Duolingo, Joey Coleman, Amazon and the Ritz-Carlton, and you can pull all five in an afternoon. Our industry is obsessed with the front door while the back door stands wide open, and this one's about finally counting what's walking out of it.

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A couple days ago I put up a post about quitting chiropractic in 2015, and it traveled further than anything I've shared in a while. So in this episode I'm unpacking what I actually meant by that, because I didn't stop adjusting and I didn't leave my patients... I quit playing it the way I'd been told to play it.

Every room I was sitting in measured the same two things, weekly visits and then top line revenue, and celebrated how little sleep you were running on while you chased them. And at some point I looked at the person headlining those rooms, the one with the number everybody wanted, and realized I didn't want their life. So I went and learned from people outside the profession instead, and honestly, maybe five percent of what built my business came from inside chiropractic.

In this one I walk through the three biggest lessons from that decision. Why Joey Coleman convinced me I didn't have a new patient problem, and how finding our own visit eighteen black hole changed the entire business. Why Jesse Cole is right that the adjustment isn't actually the product. And why Dan Cathy's closed-on-Sunday decision is the reason I stopped treating our values like a poster in the break room.

If you're chasing a number somebody handed you, this one's worth the fifteen minutes. Because you're probably going to hit it, and then you have to go live inside whatever it built.

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Somewhere between 2022 and 2024 there was a long stretch where I'd wake up before my alarm and lie there in the dark thinking I'd built something bigger than I could carry, and I never said that out loud to anybody. From the outside everything looked like it was working, and that's exactly what made it so hard to talk about. In this one I get into what those two years actually felt like, why working harder never bought me anything, and the thing I got wrong about what was heavy in the first place. If you've ever looked at what you've built and quietly wondered whether you can keep holding it up, this episode is for you. 

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On August 5th I was squatting 305. First rep of three, coming up — pop, pop, pop. Then I finished the workout. Box jumps, wall balls, dumbbell snatches. Because I wasn't in that much pain yet.

Five days later the MRI showed disc extrusions at two levels with a motor deficit in my left quad.

This episode is not a recovery story. I'm not recovered. It's what a few weeks of being the patient instead of the doctor has shown me about our profession.

I talk about the morning I decided I couldn't attend Adventure Summit — the event I built — with one minute to spare before my ride pulled up. About picking my son up from camp two days after the injury and still not being able to shoot a basket with him. And about the attribution error I caught myself making, the one I'd have called out in a patient in four seconds.

In it: why pain is the loudest signal and the least reliable one. Why decompression reactions show up 12 to 48 hours later, not on the table. Why you test sensation before you apply heat, every time. And why the team you build years before you need it is the only reason a practice survives when one of you goes down.

This is Part One. I'll report back in a few months.

One ask: this week, ask a patient what they've stopped doing and who they've stopped doing it with.

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This one is a little different than what we normally do around here. I'm sitting down with Twisty from Chiropractic Results and Dr. Andrew from Phynyx Marketing, and we're wrapping up day two at C4C with Jen and Dan, so instead of a traditional episode we just hit record and shared the conversations that were happening in the hallways all weekend.

And honestly, the hallway conversations are where the real stuff comes out. We had three doctors standing in the same circle, one with $7,500 in overhead, one at $20,000, one at $150,000 a month, and all three of them were taking home about the same money and asking the same question of how do I scale this without breaking. That's the thing nobody posts about on Instagram.

We get into why burnout is worse than I've ever seen it right now, and why it usually isn't a money problem or a marketing problem but a leadership problem that shows up as one. We talk about the doctor who wanted to blame his sales process until Twisty mystery shopped his office on a Tuesday and nobody picked up the phone at 9, 1, or 4. We talk about why "sink or swim" hiring is a losing mentality and what it actually costs you when you stop developing people on day 14. We get into the word that starts with B that will cap your growth faster than anything, and why your team feeling busy at 50% utilization is a scheduling problem, not a capacity one. And Andrew and I go back and forth on why your case value can't live down at $1,400 and what has to be true if you're going to hold that line.

We also cover something I think a lot of docs miss, which is that the higher your ticket goes, the more your referrals can quietly drop off if you don't have real referral systems behind it, not just a gift card play you run once and forget about.

Fair warning, this one is unfiltered. We had fun with it.

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A room full of experienced practice owners all said their training was handled. Forty minutes later, they scored themselves a four out of ten. Nothing changed except one thing... they finally saw the standard. This episode is about why a standards gap is the most expensive problem in your practice, and the hardest one to see.

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