Matt: 0:01

Hi everyone and welcome to the Adjusting the Mic podcast. I'm Dr Matt Sherson, and today we're joined by Dr Anna Heath, NZCC graduate and Chiro for Kids extraordinaire. Anna, how's it all going?

Anna: 0:14

Great, thank you.

Matt: 0:15

For a lot of our listeners who maybe don't know who you are, I we should probably start by getting you to just introduce talk about your journey from College and what is it that makes practice location the best place to be.

Anna: 0:27

My name is Anna. I graduated from the New Zealand College of Chiropractic back 2013. Unlike my classmates, I didn't jump straight into full-time as a chiropractor, I actually chose to work at the New Zealand of Chiropractic as their Recruitment Manager. And I did that for a couple of years, just over 18 months. I was based at the College, but the majority of my job saw me around different universities and colleges, both within New but a lot of international travel as well. So supporting the international recruitment from area that we covered. And that was a really cool opportunity because it meant that I talking TIC to people from all walks of life, some that were really looking at where their career path would take them. And I really enjoyed talking to people and hopefully inspiring to join the profession and study chiropractic. And along the way, it gave me a really cool opportunity to pop different practices, to catch up with different chiropractors the globe, see how they do things in their practice, steal some shake my head at a few things. I'm like, it's not for me. And it helped me to kind of build where to next from that role that I had. And at the time, the president of the New Zealand College was Phil McMaster. So him and I shared lots of conversations about what my career look like and where I would go from the College. So it was great to sort of, I guess, have an opportunity out of college to set myself up for practice. And I knew from the outset that I would probably go and open my practice, especially with having had that experience behind felt confident to just go and open my doors and figure out the along the way. And that's exactly what I did when I finished working for the I moved myself back to Whakatāne, which is where I was born And Whakatāne is a rural town, but it's a service town for a lot of nearby towns as well. So we have people that travel from an hour and a half away to healthcare, vehicle servicing and maintenance, food, all of that kind of stuff. So it's a service town. It has about 40,000 people, but it probably services at least again. So really sound agriculture, horticulture, industry around us. And then we're right on the coastline as well. So great for work-life balance, and a nice place to raise a access, we're close enough to bigger centres like Tauranga and We're a plane trip away from Auckland, so quite good in that as well. So you've got access to bigger cities and bigger services if you need it. So it was kind of a no-brainer to come back and start a practice here. When I came back to the area, there were three other They were all sole practitioners within their practice. The three of them practiced different techniques. One of the practices had quite a big focus on activator care. One of the other practices, he had graduated from the States, and so he was manual practitioner. And then there was another practice that was more Gonstead So it was quite cool. They all had their place, I guess, their individual techniques. And I came in the only female chiropractor in town, which was a for some people, that's important. And my interest was completely the opposite to the rest of them in that I just wanted to hit the ground running with families. So I was no threat to them. We all got along well from the start. In fact, probably being young and wanting to create that kind of camaraderie and support, I was like, hey, let's catch up and meet up and let's kind of come together and work together, which bit of a foreign concept for them. And you know, that was cool. That started us off from the start on the right foot. And I believe it doesn't matter where you sort of set you want to build those relationships and you want to be that is taking the extra to go out and introduce yourself and make yourself known, but do it in a friendly and connected way. So that was in 2015 that I came back to Whakatāne. And it took me about six months from getting back to properly the doors to the practice. In that time, I kind of fell into working from home. I was actually staying with my parents initially, and my mum is a hairdresser by trade, and she had a salon at home. She saw clients from home, and quite quickly I was getting in for taking up the entire car park with people waiting to see me of our spare bedroom that had a table in it. So I literally went to town and went, that looks like a good Let's get going. It was a blank canvas, so I got to decide how it would look. I got to essentially design what this building was going to look like. And I'd pulled that from what I had seen and other practices and a little bit of how I wanted it to work. And to this day, we're still in that practice 10 years later. So it's changed a little bit, but the general structure of the is the same. The practice has obviously grown a lot over the years, but we have four adjusting rooms, an x-ray room, a very small staff room, a toilet, and a large enough area that families can wait to be and adjusted. And now we have four chiropractors working at once on And this is all in 120 square meters. So it's a bustling hive of activity, particularly in the peak which is 24-7. So there's not a lot of dull time within the practice. We start at 7 am and we finish at 6 pm. And we've got six chiropractors, so we're all on And you know, that allows people from all walks of life. Your tradies come in in the morning, usually mid-morning to sort of early afternoon. You've got young families, mums and babies coming in, and then have your school kids, and then you have your people coming after work as well. So there's a pattern, I guess, with the times of day that different people come through. It's a it's a busy little place, and we wouldn't have it any way.

Matt: 6:20

Perfect.

Anna: 6:21

Yeah.

Matt: 6:22

Wow. A lot to unpack from a very different start, obviously, working the College and doing that role. And I think definitely from your point, going around all the practices and seeing how they run, seeing things you liked and like, that is very key. And something we tell our students is until you've actually around and observed at different practices, you can a very skewed idea of what chiropractic is and what it isn't. And so that's it was a great opportunity for you. So definitely something that we recommend, and I'm sure you as well, is that if you're about to graduate, get out there the profession, see who's practicing and see what really gels you. I really liked the comment where you said you went out and yourself to the other three chiros. Something that I find with students is they're a bit nervous. New grads stepping out into the profession are worried that practitioners that have been entrenched are going to be or defensive to someone moving into the territory. Do you see it as a benefit moving into a smaller town, per se, to Auckland? And maybe there is already established chiropractor there. Do you feel that is a benefit or a challenge?

Anna: 7:27

Oh, it's definitely a benefit. We talk all the time in our practice, so we are actually the practice now in Whakatāne at the moment. And I think that in itself is a little bit of a setback. Like there's always room for more. There's nothing more challenging than when you are the And so everyone would agree that not every person is going to with you and how you do things. You have this responsibility as a chiropractor, obviously, to anyone and everyone that wants chiropractic care. And so if you're in a town that's got multiple practices, so many positives that are coming from that because you're all to educate the community. It's not just your responsibility. You're all providing an integral service for the community. You all do it slightly differently. So people have choices and you've got somewhere to weed your to as well when you need to. And we're used to, you know, between the different practices, have someone come in and this person would be, you know, sharing their history. And I would never hesitate to say, you know what? This is an amazing journey, what we're talking about here. But I really do think that there's another chiropractor in this that is best suited to you. So we'd get on the phone or we'd send an email and we'd say, look, we've sent these guys down to you. Here's their history notes, here's x-rays, any scans or anything like that that we've done. Please get in touch. They'd love to come and see you. And that works so well. And they'd do the same with us. If they had a family or children or young babies or, you inquiry in that department, then we would receive those people into our practice. And that works for you as a practitioner, but it also works for person or that family in front of you because they're getting to the best care for them. And it creates such a great feeling within the community as So yeah, I think don't hesitate to do your thing, you know, as you're not trying to do someone else's thing. If you're being authentically you, then there's no one out there that's going to do it better than you.

Matt: 9:17

That's a real abundance mentality. Like there's more than enough people to go around. And I think if you spend your time with your practice, and yes, we should open the practice to everybody, that is true, but there be people that gel with you better or are more aligned with your practice philosophy. And having an avenue for those people that don't, or maybe are for something different or a different service to be able to go see someone, that is something that's really, really important. So that's great. Do you feel the weight of pressure of being the one practice town? And do you feel like is that the thing that's moved you to put in and have a number of other components that have made it really a center, a hub for families to go to?

Anna: 9:54

Well, I actually put the X-ray machine in right at the very start. When I first opened my doors, I made space for the machine and the practice. And my intention was that I was going to see how it went for the first year and make sure I wasn't going to go tits up in that year. You know, the business they teach you in business class that practices go to this time and then some of them fall out here, and then if not there, then there. So I was cautiously entering into my own practice. But within eight months, the machine arrived and we installed it. And I haven't looked back. We have a local radiology hub that we can refer to. But because of that fact that we have people that travel a to see us, I mean, we do an initial consultation or a new and then we do a reporter findings on a separate day. But if we were referring out for X-rays, you could have been three days, a week, like it just was such a hindrance to that process. And I knew that having the X-rays on site was going to be a changer for us. And so we haven't looked back from that. Yeah, it's an outlay at the start, but it pays for itself. You get a business loan and all good. Within five years it's paid off.

Matt: 11:04

Perfect. From our perspective, obviously that the College uses that's an important component. I also noticed that from your website you do utilise INSiGHT station and things like that. How have you found that in practice?

Anna: 11:15

Yeah, so I guess you could call it the NZCC package, but it's modified to each practitioner. But yeah, we take full spiny x-rays where indicated, and we have the INSiGHT scans. So the INSiGHT scans are great because obviously they provide us with an objective measure, particularly when you're working children as well. We use the HRV every day in practice with babies. That's our baseline, that's our objective measure. And that's something that I think really helps. Our mission, I guess, is to make sure that we're educating and people as well with what we're doing. So we really pride ourselves on making sure that our assessment really thorough, but we give that information back to people as So we sit down with them when we take x-rays and we talk through those x-rays. And people have had x-rays before, but they've never had it to them in a way that we can communicate that to them. And same with scans, you know, like it gives people a little bit more information about that whole holistic but also neurological focused chiropractic care. It enables us to support somebody that's come in with an to actually understand that it's not just about pain, it's about function. And it's such a simple way to provide that information. And then it's great because you can use it to measure, right? So it's an easy way to do progressive measurements and it just to empower people when they truly understand what's going on in body and why their body is the way it is and kind of what's brought them into our practice. So yeah, we find them really valuable both for onboarding people but also for progressing people through their care as well.

Matt: 12:46

Yeah. And if your sole focus isn't symptom relief, which a lot of are, and that's nothing to say anything wrong with those types of practices. This gives you a little bit extra, gives you that objective of function. And if we're saying that a function is improving, it helps to shift that person's mindset from one that's focused on their pain to something where it's like actually we have an improvement in these other dimensions. So very, very good. I like that. I'm impressed. Yes, it is NZCC package in a way, but I'm sure you've made it own.

Anna: 13:16

Um I said that jokingly.

Matt: 13:18

Yeah, yeah, you know, I know I get it. And I suppose I will say that, and that's probably off the record for everybody who's on the podcast. We do get a lot of interns who go, okay, when I get into practice, I won't do what I taught in College. I'll go and do another seminar or do something else. How have you found utilising what you were taught in College? Were there things that you felt like you needed more work on? I know you did work in the Peed space, but again, one thing for new grad is they always feel like they need to do so much. Did you feel that you got out of College and you had enough or were there things that you wanted to really build on?

Anna: 13:51

It's a really good question. I genuinely felt like, you know, I was confident in what we taught, and I felt like I had access to support. Like if I needed it, I knew who I could contact and call. But in terms of the Peed stuff, I definitely I mean, we're healthcare providers, right? But when you're in a smaller town, when you're in a rural area, when people don't have direct access to specialist type care, when GPs have to cover so many different areas, when you don't have large cohort of complementary providers, like your OTs, your PTs, your lactation consultants, all of that kind of stuff. I was having lots of conversations with practice members children about all of these weird and wonderful things that at that stage of life. And at that point, I didn't have my own children. And what I identified is there's not always a fast enough between somebody has a presenting complaint and then they elsewhere. And then I did find when they were going down the pediatrician or they were going down the OT route, I didn't truly understand, I guess, what was going on in terms of how they were being but I knew that we had a key role in what we did. And so I wanted to make sure that the care that we were providing was one, complementing what they were also going through But I also wanted more information in the realm of like who we be referring out to and when and what does that look like? And so I started looking into, I didn't have any concerns around adjusting children. I'd done a couple of seminars already that I felt, you know, gave me some skills that could also complement what I'd also been taught already at the College. But yeah, the main kind of, I guess, inkling for more information came about from what are all these weird and wonderful things happened in childhood and how as a chiropractor, like what's my as a chiropractor in that journey for these families? And that's when I found the pediatric diplomate with Braden so the Chiropaeds programme. And like everything, it wasn't in New Zealand and didn't have kids at the time. I was prepared to jump in and do the two-year programme and do the travel and take the time to work through that programme. So that was done over two years. And every sort of six to eight weeks, I was flying to Melbourne and doing a weekend module, and then I'd come back, and that went on for a couple of years until I completed that exam for that and got my diplomate that way. And it was amazing. I mean, like I could have learned that information without doing that course, and I didn't do it for the title by any but it's definitely something that works in terms of having those letters next to your name being more kind of respected within community of other providers, so the paediatricians, the OTs. It has helped a lot for our credibility within the practice and for the associates within the practice, knowing that we all work together. I think that's really helped us to have a little bit more respect from these guys. And that then flows on to the families that are getting care from us. Even the GPs recommending to these families that they see us as chiropractor for that reason. Oh, these guys, you know, they've got lots of experience with families. They've done study in that area. We're comfortable recommending that. So I think that was what I wanted to gain from it, and that's what we've achieved from it, which is really cool.

Matt: 17:18

Fantastic. You mentioned before that when you first set up the practice, it took maybe six months to get started. During that time, a lot of practices look at just doing the I've noticed that with you, you've established some practice and some goals that you have, and you mentioned your mission How important is it for you to have a practice mission or or even a list of goals that you're working towards?

Anna: 17:41

Very important. Particularly if you're going to have a team. That doesn't matter if it's a team of chiropractors or a team as in, you know, CAs and that kind of thing. You're not doing anyone any favors if you don't know why you're what you're doing, and if they don't know why you're doing what doing. For us, our core values are what create our culture within our They're what we lean on in times of challenge or conflict. Culture is just so important. You can't invest enough in your team. And that's something that we really focus on is the team culture. So we make sure that we do things as a team. We do team days out, you know, like all of those kind of things are so important. And the mission and the values are what will keep you together and make you stronger. And yeah, that's something that we created from the start. And we have it, it's publicly available information so that people that are coming into the practice are like, yeah, well, these say this and they definitely do that.

Matt: 18:36

Awesome. So you mentioned before that you have a few associates and with people that you had working at one time. When a new associate comes on board, what sort of technical skills or personal skills do you look for when you're employing a new And obviously, with so many, you've had a lot of experience in area. So from maybe a principal chiropractor who's out there who's at starting to have an associate, what do you look for in

Anna: 19:02

So I think that all depends on what your mission and your vision is, really. I think as a principal chiropractor, you need to be aware raising a chiropractor. So again, you need to be really clear on your vision and your and your why, because you're bringing that person into that as And so you want that to not sound like a foreign language to as well. You want that to resonate to them. I don't obviously push it, but when we have the first conversation, I ask them what's attracted you to come and have a conversation. And nine times out of ten, it's your values really resonate me. And that's a tick because you can't fake that stuff, right? If values don't resonate, then that's going to be a relationship breakdown probably sooner rather than later. And it's going to be a painful journey. Nobody likes a painful journey. So I think both for the associate but also for the principal write down what's important to you. What is your ideal practice? What does that look like? Who's involved in that? You know, what are your deal breakers? It's just like going into a relationship.

Matt: 20:03

True, true.

Anna: 20:04

This is somebody that you're going to spend a lot of time with. And this is an environment that you're going to spend a lot of in. So if something about it gives you the ick, then it's probably not the place you want to be. And I think everyone needs to be really honest with themselves the start. Like if I take myself back to potentially being an associate or feeling of, oh shit, like we graduated, we're in the big wide now. There's this expectation that I'm going to go and find a position or I'm going to be an amazing chiropractor. And so sometimes we do things that maybe go against what our gut's telling us. And that would be something that I would really encourage people to think long and hard about. Like even if you think you're only going to be in a practice for one or two years, think further than that. Like, what if I end up here? Would I be happy here for five years? You know, is this somewhere that I genuinely think I would be And what about this makes me feel amazing? And what about this makes me feel a little bit concerned? Because those are the things that are going to, you know, hold back. And same from the principal side of it, asking questions of a associate about, you know, from the start, what is your ideal Do you see yourself somewhere long-term, short term? No answer is wrong, but you want it to be kind of in line with you're thinking as well, you know, for them. I think with anything, you know, nowadays we can be a little cautious about asking some of the hard questions.

Matt: 21:24

Yeah, true.

Anna: 21:24

But ask the hard questions because it's going to be harder if locked into a relationship together and it's not pretty.

Matt: 21:30

Yeah. Hard questions at the start solve big problems at the end. So I think if you're willing to step and say this is where our here, and if the values aren't aligned, it's always going to be to make that separation before a contract is signed or before started. Whereas a lot of people they fall for the practice and the ideal, which might not be real. And then after three months, which is what we're seeing at the with associateships, and it's not necessarily stuff out of New College, but that three months to six months window, people are second thoughts. And again, I don't think that's a reflection on this chiropractors or anything. I think it's a need to really establish a good connection at the start and see whether we're on the same page.

Anna: 22:12

And I would say that there's probably a few assumptions that are made in there as well. Like what I was saying about, you know, ask the hard questions, can do that in a really kind way too. You're not going to be an arrogant or an ignorant person by those questions. I think you'd be more likely to be arrogant or ignorant if you ask the questions.

Matt: 22:29

And most people are happy to have those frank discussions at the outset too. Yeah, if you're asking questions down the track of why do this or why are you not seeing any of these types of it's probably already too late at that stage because there has been a separation. So we're going to move into some little tips and gold nuggets you can give to the profession. So if you were talking to a colleague, maybe someone who's in on their own, perhaps, what is something that you would recommend that they brought into their practice that they could start from, say, Monday morning? Something they haven't even thought about doing, something that do regularly.

Anna: 23:02

I'm really big on making sure you stay connected with the So this is not necessarily an in-practice thing, but it will have an effect on in practice. I think staying involved, giving back, doesn't matter how or how much, it all has an effect and it comes back around I think if we think about that in terms of wanting to bring on make yourself approachable, you know, like if you're turning up seminars and conferences and you're a familiar face, then you're gonna be a lot easier to approach as a potential associate into your practice is gonna find it easier to, you know, oh, gonna be able to say, Oh yeah, I know who Anna is. I've seen her at blah blah conference. So those kind of things I think are really key if you're at building a bigger practice in that respect. And in terms of what somebody could do, I guess, on a Monday, I come back to investing in yourself in terms of your personal forever learning, finding weaknesses in your day-to-day. If you're a sole chiropractor in a practice, you're a business as well. And we all fall short in that department because our love is and delivering chiropractic. And we're generally not amazing at the other stuff without more about it. So that would be my kind of encouragement is make sure that you time in your day to work on your business. And that involves your team, that involves you, that involves structure, your systems, your processes. You can't do this long term without burning yourself out if you have all of those little things in place. So take the time to really make sure you can work on that

Matt: 24:41

Awesome. Now, probably gonna put you on the spot a little bit with this What was the last book or podcast or even an audio book that listened to that maybe wasn't chiropractic, but something that you took a lot of benefit that you've put into practice?

Anna: 24:56

That are put into practice? Yeah. Maybe into the business. It's a good one. My partner and I dabble a little bit in property investing. My partner's a builder, and so that's kind of a love of ours And so business development and you know, that's been something I enjoy doing. And so I guess if it was non-chiropractic related, it would in that realm. I've started not consistently, but go to and from diary of a CEO. Um, that's follow along. There's always different podcast information there. Last year I spent a little bit of time doing a business course, uh, like a business owner's programme. It's interesting when you're in a programme like that and you're surrounded by other business owners that are not at all in our of work, and so bouncing ideas off them. I get a lot out of sitting in a room and learning that way rather than picking up a book and reading. So for me, I'm constantly looking at what's some area that I go into a seminar. And one of the ones that I'm looking into at the moment is trying to figure out where I can learn more about the HR side of We have an amazing practice manager, but when you've got a team, you're always dealing with different personality types and how keep everyone happy. So that's my current adventure, I guess. And I can't give you an answer. I haven't got the solution yet. But yeah, I guess that's a roundabout way of answering your

Matt: 26:21

It is. No, no, that's a good that's a good answer. And I suppose once you scale to a certain level, things like HR become a way more important consideration because not only are a practicing chiropractor, but you're also a business owner, you're also a manager, you are managing staff and a team. So those other considerations of scale are important. And I know for a lot of chiros who maybe they focus on the tools too much and don't worry about let the CA do their thing. Sometimes as you get bigger, you have to actually make those

Anna: 26:52

And I believe too, like I'm not going to be the person that is managing that. We're always going to have somebody else that we outsource that But I think it's really important that you have an of it. I mean, I'm there to support our practice manager as well. So I think, you know, for her to have my support in that area is really important. And it's one of those things that I think if you don't love it, probably need to learn a little bit more about it as well. Um, so that's where I'm going with that.

Matt: 27:17

Perfect, perfect. Okay, so what would be the best piece of advice that you were by another chiropractor? And you can feel free to give a shout out. Is there something that you think about or you use regularly or a thought that comes across? That's a tough one. I mean, spending a long time with Phil, I'm sure there was a lot of things.

Anna: 27:34

How honest do you want me to be?

Matt: 27:36

Yeah, yeah, you can be honest. Give them a shout-out.

Anna: 27:38

If he listens to this, he'll be like, oh God. I think just having that reminder, you know, this won't be in Phil's words, but prior preparation prevents piss for would be one.

Matt: 27:49

I remember that one. Yeah.

Anna: 27:50

Yeah, yeah. And just do it, you know, stop thinking about it, just do it. And I've always lived by that. If you want to do something, you'll find a way to do it and just make it happen and stop making excuses about it, just do it.

Matt: 28:02

Yeah. That's the old phrase, action beats planning every time. Because with action, at least you've done something. With planning, you might never get to actually action at all.

Anna: 28:12

What's the other one? Paralysis by analysis, you know. You spend too much time planning. I think, you know, and that's how the practice started. I didn't spend time planning, it happened, and then I had to bring it to life. So yeah.

Matt: 28:25

You oftentimes don't know the questions you need to ask until actually you're in it as well.

Anna: 28:29

And you learn and you go, ah, that I should remember because that was a learning curve.

Matt: 28:34

Awesome. So the last thing we always end with is do you have a story, an inspirational thing that in practice really sets in your mind, maybe a patient interaction or even an associate interaction, where you were like, This is why I'm doing this job.

Anna: 28:50

Yeah, I did think about that because that was something that had been written down. And I reflect on it and I think about when I was at college, and you know, you'd listen to these chiropractors all about these miracles that happen in practice. And we've had loads of those, you know, in the almost 12 years I've been in practice now. I couldn't tell you how many of those amazing experiences we've And when I was making a few notes for today, I could have down a few stories and then I thought, you know what? I think the purpose of what we're talking about today is what like to have a family practice. And one thing I've learned along the way is that if you're ever or if you're ever unsure about what you're doing as a chiropractor or are you in the right path, start seeing families because is going to confirm how amazing chiropractic is than the that you'll have when you're working with families and the way you can change a family's life, helping them navigate the of raising a family in childhood. I think chiropractic plays an integral role in the family dynamics and wellbeing and the journey that a family has when their kids well adjusted, when they're well adjusted, the trajectory is phenomenal. These people can have challenges along the way, but the they adapt and it becomes this that's not a coincidence because I see this happening every day kind of experience when you see families. And it's just, you know, every day. And we talk about this amongst our associates, how crazy some of the cool stuff is that we get to see every single freaking day, know, like it's yeah, it's pretty powerful when you're working small people. And I say to families all the time, you know, like it's so cool we're working with kids because they don't have a lifetime You know, we're starting from the start. We get to paint their picture from the beginning. And for that, I'm so grateful. And obviously, having chiropractic in my life to raise my that way is also something that I'm really grateful for. And having a team around me that can support my family as well even better.

Matt: 30:51

Awesome. Thank you so much for joining us today, Anna, on Adjusting the And I really appreciate you giving your time.

Anna: 30:58

No, thank you. Thanks for having me.