Why Every Chiropractor Needs Online Scheduling with Dr. Erik Kowalke

Founder of SKED

Necessity is the mother of invention. When Dr. Erik Kowalke was looking for practice-building tech to power his practice, he wasn’t able to find what he was looking for, so he created SKED. From those humble beginnings, he has built a tech stack that helps hundreds of chiropractors fill their schedules.

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Episode Transcript

Dr. Jeff Langmaid: Hey, smart Chiropractor. Welcome to the smart Chiropractor show in our featured guest segment, this has been one that we had circled on our calendars for a while. Dr. Erik Kowalke of Skid Practicing Chiropractor Family Man, Businessman, Entrepreneur I am excited to ask you a variety of questions about your endeavors. Thanks for taking some time in chatting with us today.

Dr. Erik Kowalke: Absolutely. I’m excited to be here.

Dr. Jeff Langmaid: One thing I want to kick right in on SKED because this is, you know, something maybe docs have seen it at some of the trade shows. Maybe they’ve seen it online and are unfamiliar with exactly what it is. I’d love to kick it off just with that. Then we can get into some of the back story. But what is SKED for any of those docs out there that are unfamiliar?

Dr. Erik Kowalke: Yeah, that’s a great question. We we run a big clinic in Grand Rapids, Michigan, and we developed scared to just start to help us because we couldn’t find enough good team members, which I’m sure we’re the only ones with that problem in the whole world. And we needed software that could just help us scale our business and automate a lot of things. I think if you if you’re an entrepreneur and you think about growing and becoming a CEO, you delegate, automate or eliminate and we delegate, we can only delegate to people that were on our team, which we didn’t have a lot of them. So there was nobody else I could take on any more and there was stuff we just couldn’t eliminate if we eliminated reminding people of their appointments and we eliminated the ability for them to reschedule, our volume would go down and our business would go down. So the only one left was automation, and there was no software that could automate all the things that we wanted it to do. And so that’s what we created. Typekit is really a software platform that integrates with EHRs and patient apps and creates an extraordinary experience for the patient, but at the same time allowing you to automate a lot of the things that you’re manually doing now. But what’s so unique is we did it so that it doesn’t feel like robotic automation like you would think of automate. You think of like a robotic assembly line or something. We did it so that from the patient perspective, they don’t even know that it’s automated. It comes through so authentic and original that the experience is if there’s a team member manually doing all of the communication, even though that it’s automated. And so that’s really what we created SKED for, and it’s just grown and grown and grown and grown over the last five years to do so many different things to help chiropractors to scale and grow and keep that authentic experience between them and their patients.

Dr. Jason Deitch: That is a super high value, Erik, and thank you for putting that together. I’m looking at your website while we’re talking as well and you do. The app does a lot of different things, and I guess if I were a potential client of yours, how would you prioritize? What are the most popular things or what’s the main intention? Oftentimes we sort of build it to do this and then we get a bunch of requests and you do that also. And the other thing and you sort of creep into other things. But what’s the main functionality and the main intention of SKED?

Dr. Erik Kowalke: Yeah, I think it’s scheduling. That’s our core. That’s what we started with. You know, that’s the problem that we identified was we didn’t we didn’t have control over our schedule and we were having team, you know, there’s always human error. So we would either be slightly overbooked or under booked. So we’d have a whole bunch of people to adjust and there’d be nobody for 15 minutes and then a whole bunch of people would come in and then there’d be nobody or a bunch of people would come in at the same time as a new patient and a reevaluation and a financial consultation and an extra review. And you’re like, Ah! And then nobody for a half hour, you know, the team’s like, well, they just no showed or they called last minute and said they couldn’t come in. It was just an inefficiency in our scheduling. And as Chiropractor as we focus and we put so much time and energy and money into getting more new patients, you know, if you ask the average Chiropractor, what are you going to do this year different than last year? We’re going to go get more new patients. But then we process them, we onboard them and our scheduling just falls flat and we leave it up to the one person at our front desk or two people to manage all of that. And so we really built it on like, OK, what are the rules that you would train SCA? You hire a new person tomorrow. What would you tell them for scheduling scheduled these codes? At these times, it takes this long.

Dr. Erik Kowalke: Don’t schedule them here. Don’t do this. These regular adjustment codes for people that are on wellness, they can reschedule themselves. Let’s let’s, you know, there’s an app that they can use. We put all the criteria in there and they can reschedule themselves only let them do it this many times, only let them do it within this time frame of the actual appointment. And so we just created SKED as an automated virtual assistant, saying, Hey, here’s all the criteria that you have to. All the rules you have to abide by and then the patient can literally pull up their app. Click the service provider if you want to. And we’re running two locations six providers, 17 different types of appointment codes, and SKED manages all of that perfectly. For us, it never makes mistakes. It’s twenty four hours a day, seven days a week. Somebody sun. Night at 9:00 p.m., Those are scheduled for the week with their kids, sports and everything, and they can jump on the app and find the times at work for their family to come in. And so she’s automated that scheduling process, that’s the core, that’s the foundation. And then from there, it allows us to do so many other things because now we know when their appointment was, when they’re arriving to their appointment, if they arrive for their appointment, how much time after their appointment. And that just automates our communication through scheduling or through text message and emails and push notifications and that sort of thing.

Dr. Jeff Langmaid: Yeah, you’re speaking our language. We always talk about how many chiropractors have holes in their bucket. They have people coming in the top and people falling out all over the place and any tool, all tools. I think that can start a patch and fill those holes are critically important. I’m going to go a little bit of a different direction. As you’re saying this, it’s clear that you are a passionate Chiropractor. It’s clear that you’re also knowledgeable as an entrepreneur in the software, as a service space. I’d love to trace that back a little bit and understand, like, how did you get into it where you always, you know, really entrepreneurial. Getting into software is a big endeavor. Was there was that a mindset? Was it some somebody that inspired you? How did your career take that path to begin something like beginning a software as a service type business within the Chiropractic space? And I imagine expanding beyond?

Dr. Erik Kowalke: Great question. I’m a mechanical engineer, so I went to mechanical engineering school up at Michigan Tech. That was my initial profession. So I graduated. I was a diesel piston engineer for Cummins Diesel Engine Corporation for two years. And I think as an engineer, you just solve problems. You know, you make things better. Everything can always be better and there’s a better system and a solution for it. And engineers just think and try to figure out ways to solve it. And so that’s what we did. You know, we opened our office. My wife and myself and two kids built up the whole office in 2011. March 2011, we opened August 1st, 2011, and we grew really fast. We were at a thousand patient, visits a week in three years with myself and three team members, and we were only in 500 square feet. So it was a limitation of resources. We just even if we could hire more people, which we couldn’t at the time, there was no room for them to go because it was such a small office at three adjusting rooms. And this is where the idea came from because our phone was ringing off the hook and I’d have all these voicemails at the end of the day. And they weren’t all new patients. It was people calling to say, Hey, you know, I can’t remember if I was at 3:00 or 3:30 or I couldn’t come at three thirty, can I come at three fifteen or I can’t come today, but my husband’s going to bring Johnny. But Billy, that was also the schedule can’t come, and it was all these like just scheduling things.

Dr. Erik Kowalke: And my team was on the phone and I really needed them to be engaging with practice members in front of them because the wait was for 45 minutes all day, every day. I’m like, I need you to be entertaining everybody that’s in the waiting room right now and educating them on Chiropractic, not on the phone, you know, confirming that their appointment is 15 minutes from now or 15 minutes earlier. And yeah, we just thought, Man, I didn’t want to create this. I mean, I was like, There’s got to be a solution out there for us already. Problem was, none of the solutions seem to real time with our HR system, and so that we were the first company that created a software system that could sync with Platinum Gen. Chiropractic real time pushing and pulling data. So we knew if the office changed an appointment or a practice, no change and change an appointment in the app. Within seconds, that information was sinking back and forth, so we just would never screw up the schedule and the solution just didn’t exist. So I just found some developers and we started creating it. And if it was only for my office at the time, that was all. My intention was like, if this only works for me, it’s going to be worth it. And then people just started to find out about it, and they’re like, I didn’t even know that exist. Can we use it? And then we’re like, OK, well, maybe we should turn this into something that more people can use.

Dr. Jason Deitch: That is a great story, and we agree. We also are addicted to always making things better. And it’s a good thing. So thanks for doing that. What what are some of the most common, I guess, feedback or thank yous that you get from chiropractors who may go, Listen, I don’t need to sign up for another something. It’s it’s not a problem that I think I need to fix. Why would I need to spend more money? But oftentimes there’s a difference between spending and investing, and investing means you’re saving something later. What are some of the most? I guess the most common feedback you get from is who implement it? One. Is it easy to implement and to what do they tell you once they do? You know what’s the sort of aha? Wait a minute. I wasn’t expecting this, but thank you.

Dr. Erik Kowalke: Yeah, that’s a great question. I mean, I think, you know, in our office, one thing that we just constantly strive as a Chiropractor is to provide an extraordinary experience. You know, we want every person that walks through our door to. Just be wowed by every moment of it. So we just naturally carry that over into this corporation as get is, I know Chiropractor are busy, I’m busy. If you if you onboard me with a new software or do you tell me I got to do six one hour phone calls? I don’t care what it’s going to do for me. I don’t have time to do that. So we created our company to like, love onboard this whole experience. Customize it for your office, learn about how you run your clinic, how many providers, how many services, what it’s like, what are all the nuances? And then we have an entire customized onboarding team that does all of the stuff on the back end. And then once you set it up, it just runs on its own. And so that’s, you know, that’s what saved us time and we just created that same thing. But I think the biggest feedback we get is just frees up people’s time. You know, there’s something you just can’t get any more time for yourself or for your team, and it’s always more things that we want our team to do. There’s more things we wish we could do, and there’s just only so much time in the day, and most of those are eaten up by all these little tasks. And if you can start to automate some of that stuff and offload that stuff where it doesn’t create more work, but it actually frees up your team’s time and it frees up your time, and it does a better job than what you could do on your own.

Dr. Erik Kowalke: That’s just a no brainer to any entrepreneur that wants to grow and scale their business, especially in today’s day and age where team members call in sick. They, you know, they just quit. They don’t show up. They, you know, are just overwhelmed. So they’re inevitably going to miss something. If you can get a software that just never calls in sick, it always works. Every message always goes out. You can see that it’s confirmed delivery. Every patient is reading the message within 30 to 60 seconds of receiving a text message. I mean, how else can you communicate to people? And now in today’s day and age where you know they’re going to get the message within 60 seconds of reading? Ninety eight percent of everybody reads the text message, so I can literally right now, if there was like, Hey, there’s a snowstorm in my office is changing hours tomorrow. Within two minutes, I could have a message out to thousands of people, and I know 98 percent of them are going to get it. I mean, there’s just no other way in today’s day and age to effectively communicate information like that. And so that’s what scared allows me to do. It’s just another team member that communicates to your practice base that allows you to inform them with education and marketing and appointment reminders and all of that information that’s so important for us to grow a practice.

Dr. Jeff Langmaid: Consistent communication is critical to practice success. There is no question about that. If you look at sort of you mentioned, you know, really growing and scaling a practice quickly when you when you began and then moving into, you know, the software space as you’re sort of scratching your own itch, what do you believe are perhaps two characteristics within yourself that help guide that direction? What are two characteristics that have enabled you to be perhaps more successful than many docs listening and watching today? How would you identify that? And if you looked inside, what would we find?

Dr. Erik Kowalke: Well, I have six children, so my time is very limited and valuable, and I think I’ve worked with so many chiropractors, and I think the biggest thing that I see is thinking, well, when I get to this point, I’ll hire that next person. When I get to this point, I’ll onboard that next software that’s going to help me be more efficient. And it’s they never get to the point where they can afford or have the time to continue to create durability and scalability in their clinic. And I’ve always thought it the other way. If there’s a software or a person that I could hire to help us grow, I’ll do it before I get there, because that’s what’s going to allow us to get there. And I’ve never, always been hiring and always changing things every week to make things better. That just has allowed us to continue to grow and scale. And I think what’s so funny is when you get outside of the Chiropractic business space and you look at other companies, how many companies are one person away from everything, not working and shutting down Chiropractor? The average Chiropractor is one team member calling in sick and everything’s chaos like, what can you imagine any other company run anywhere? No one one person doesn’t show up to Starbucks, and they, like, can’t serve coffee that day. But it’s funny to think of that for most Chiropractic why they’re also stressed out. They’re like, Oh man, show up now I’m running everything on my own. I mean, just the margins in Chiropractic businesses are are are good enough. We can afford to hire good people if you’re running good systems and get the right software to run your business and just create durability. So you’re not one thing away from everything falling apart. And that just allows you to scale and have time with your family and be able to go on vacation and everything still runs and still works. And you just keep growing. You don’t go backwards, you keep your momentum going to your. Practice is always growing, and you’re just continuing to impact more people.

Dr. Jason Deitch: That is awesome. I love where you’re going with that. I wasn’t planning on going here, but that’s what this is all about. So Jeff and I have got a book that we’ve released called the Payday Practice, and it’s all about teaching chiropractors how to think about generating monthly recurring revenue as a business owner, you know, at least with software as a service, I know that’s a monthly recurring expense or, in your case, monthly recurring revenue. I don’t know if in your practice you have sort of memberships or subscriptions that people subscribe to so that you can generate monthly recurring revenue. But what’s your take on that? As far as a business owner, the knowledge, the confidence you’re talking about stress and time and vulnerability. You know, we all, I think, agree working with chiropractors after so many years ourselves included that unfortunately, the overwhelming major stress most chiropractors are experiencing is financial stress, and that financial stress is due to their constant stress of needing more new patients. So, you know, what’s your thought on sort of generating membership subscriptions, recurring revenue so that you can at least sort of have that level of confidence that the staff is going to get paid? My rent is going to be paid, my mortgage is going to be paid, et cetera. Your thoughts as a business owner?

Dr. Erik Kowalke: Oh yeah, I wouldn’t do it any other way. It’s so stressful doing it. I mean, we’re we’re we run care plans in our clinic. So I bet you 99 or more percent of all of our revenues is monthly recurring revenue. And it’s it’s just so much better for everybody. But you look at everybody wants convenience. I mean, you look at the last two years, what’s happened in people’s lives. I mean, people are ordering everything on an app now. They get their groceries delivered. They order mobile either coffee, so they don’t have to wait in line. They just walk in and pick it up. Everything’s about convenience and Chiropractic. Now what we see is they can’t afford it. It’s not a financial thing like they have the money to pay for it and they want it. They get what we’re talking about. They want it now more than ever. And now it’s just, well, can I fit this in my life? You know, is this convenient for me? But can I can I see my appointments and my kids appointments through an app? Can I schedule? Can I reschedule really easily? Can I get in and out of the office efficiently? Do you just automate my payments so I don’t have to worry about like paying every time I come in? All of that is convenience. And so I think Chiropractor is look at it like people don’t want to do that for some reason and just in their head, it’s great. It’s better for them. Most people would rather just can you just automate my payment processes as I get it to make it easy for me to to make Chiropractic care part of my everyday life? And the more I just think like that, the more that it just people just keep coming because you don’t have to re convince them and you have to go get new people and just constantly convince them that they need Chiropractic care. So yeah, everything’s monthly recurring. Revenue is so much better

Dr. Jeff Langmaid: We could not agree more. We are. We are huge fans of monthly recurring revenue, something that we’ve been talking a lot about on this show and we’ll continue throughout the year. Erik, I really appreciate you taking the time sharing some of your experience. It has been impactful. It’s been great to learn a little bit more about you personally, as well as said we’d encourage docs out there to check out SKED if they do not have an easy way for people to schedule and reschedule in their practices on behalf of Jason, our entire team. Erik, thanks for coming on chatting with us.

Dr. Erik Kowalke: Absolutely. It was great to meet you guys. I look forward. I’m sure we’ll connect many more times in the near future. If you’re listening to this, our website is Sked dot live. Check us out. But if you ever have a specific practice question about how we integrate SKED into a certain thing in our clinic, reach out to me, Dr. Erik Kowalke on Facebook or shoot me an email, Dr. Erik at Drake. That’s good that like, I look forward to you guys.

Dr. Jeff Langmaid: All right, we’ll talk to you soon. Thank you.

Dr. Erik Kowalke: Thanks.

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