What Chiropractors Are Doing Wrong

[cs_content][cs_section parallax="false" style="margin: 0px;padding: 45px 0px;"][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-center"]I’m a Chiropractor, I've been a Chiropractor for nearly 15 years. There, I said it. It feels like the start to an AA meeting. The truth is that chiropractors get a bad press at times, and in my opinion, often for the right reasons. I am writing this article to you, as a Physiotherapist/Physical Therapist/Osteopath to bring up what I think is wrong with my profession, but also what you can learn from it.
[/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text][x_custom_headline type="left" level="h5" looks_like="h3"]What chiropractors are doing wrong[/x_custom_headline][/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-justify"]
Each and every hands on practitioner has the same dilemma. We are tied to our hands and tied to our time. Many practitioners I speak too are torn between professional ethics and patient care and the business aspect of overheads and profit. If we want the business to grow, we will at some point hit a ceiling once we are constantly fully booked. We can then either employ associates and let the practice grow with other people offering the care to patients, or we can work more ourselves. Working more can mean extending our hours or slimming down the time we spend with patients. I haven't got a problem with efficiency; all of us remember how long it took us to perform a new patient examination in college. I think it took me all morning with a lie down in a dark room needed at lunchtime.

Many chiropractic colleagues of mine have ‘trimmed the fat’ from their treatment sessions. Admittedly a chiropractic adjustment is a different process to your treatment sessions but there is a fine line between efficiency, and reducing the quality of care that you offer the patient. I think this is where many chiropractors fall down. I have worked with some amazing practitioners that only spend a few minutes with each patient. Yet they perform regular re-examinations which are pre-set in agreement with the patient. They have specific rehabilitation programmes for the patient, and may even have an assistant that goes through the rehab with them or performs other therapeutic modalities at each session. I haven't got a problem with this. The chiropractor is performing the chiropractic adjustment, just like the dentists pulls a tooth or the MD gives an injection. As a patient you are not paying the dentist for how long it takes them to pull your tooth, but their expertise and the benefit derived from the procedure.

In my chiropractic example above, the practitioner has a system and team around them to make sure that the patient receives the best all round care; and this doesn't all have to be given by the lead practitioner. However the problems occur when people reduce the patient visit times, in the name of efficiency & profit, yet do not create the systems around them to support the patient in other ways. I think many chiropractors have followed this path that if not astute could at best affect their reputation in their community by reducing their level of care. At worst, missing something serious or opening themselves up to malpractice claims.

At times, although rare I have heard (unconfirmed) stories of chiropractors using unscrupulous ways of getting new patients and also keeping their current ones. Fortunately, this is much less common in Europe where I practice, and in particular the UK because we have the National Health Service. Most stories are from the US, where practitioners have tried to play the health insurance system; health insurance is still fairly uncommon here in Europe, with only a small percentage of clients claiming from private insurance policies, I would guess less than 10%. I have heard stories of practitioners offering TV’s to people who come in and get their spine checked - not good! Alas, this is a very small minority, so let us move on.

Some busy chiropractors also have a very narrow scope of practice. Meaning that their sole purpose is to check someones spine and correct and adjust what they find. This can mean that they do not look for an alternative diagnosis outside of the chiropractic model. Again, I am not against specificity, Many healthcare models including acupuncture, reflexology, reiki all focus on ‘doing what they do’. My concern is that chiropractors are Primary Healthcare Practitioners, which in my eyes also brings with it a duty and obligation. Yes of course practitioners will see mostly what they always see in practice. Yet a primary healthcare practitioner has a duty to also spot red and yellow flags, ask the right questions or send for further tests. I feel that if we only ask questions related to a very narrow scope of practice, and only perform examination techniques to support this, then why do we need the status of a primary healthcare practitioner!

Having said that, from the publics perspective, I fee that having a narrow scope of practice can be an advantage. Having something clearly defined allows people to decide if it is right for them. Even though the title of this article was ‘What chiropractors are doing wrong’ I think it is worth also exploring what they are doing right…
[/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-center"][x_blockquote type="centre"]What would you do with this patient if they were your Partner/Husband/Wife/Child.

Would the session look different?[/x_blockquote][/cs_text][/cs_column][/cs_row][/cs_section][cs_section parallax="false" style="margin: 0px;padding: 45px 0px;"][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text][x_custom_headline type="left" level="h1" looks_like="h3"]What are chiropractors doing right? and what can you take from that.
[/x_custom_headline][/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-justify"]Back to efficiency. I am not suggesting that you spend 90 seconds with each patient, but take a moment to think about your last week in practice. Think of the general trends, what happens in a typical visit. Do you collect everyone from reception? Do you wait for Mrs Jones to hang her coat and seven jumpers on the hook? Does each patient change into a gown or does Mr Brown take his socks and shoes off and roll his trousers up whilst you stand twiddling your thumbs? Maybe you have it more efficiently set-up with a changing room attached to your treatment room, and can collect each patient ready to go? Then what happens in each session?

A good question to ask yourself is what would you do with this patient if they were your Partner/Husband/Wife/Child. Would the session look different? I doubt that you would skimp on the quality of care when treating your family. So what differs when you treat Mrs Jones? Usually it is perceived value, if someone is paying for a session, then we feel an expectation to do certain things, sometimes unnecessary things to ‘pad out the session’. If you only do what is best for the patient, then hats off to you, but you are in a minority. Most of us have an issue around charging for a treatment session, whether we are conscious of it or in denial. It is a classic dichotomy for healthcare practitioners, and is the reason we are often bad at marketing ourselves and our businesses.

The first tip a chiropractor can give you is remove all focus on ‘time’ on your treatment sessions. If the focus on your website, literature and in reception is on your 30 minute appointments, then you are tied to that forever. Focus on giving the patient what they need, today it may be 20 minutes, next week 32 minutes, time isn't discussed - benefit is. If a patient expects 30 minutes and gets 20 they will feel cheated, but thats only when YOU are focused on time too. A caveat here is not to change things all at once; maybe ‘graduate’ certain patients to the next level, do a formal re-examination and review their progress, use percentages and scores to show how far they have come and how much further they need to go, and of course discuss the steps needed to get there. At the same time, start all new patients from a different model, they wont know any different. You may be surprised, will they miss the 10 minutes electrotherapy or heat gel rub that you give them, or would they rather have that time out living their life?

The second tip was touched on above; re-examinations. Most chiropractors I know have a very good formal re-examination procedure in place. Yes of course they re-examine each visit, but people are paying for your services, and some conditions take a long time to recover. People do not always see the gradual changes they are making until it is pointed out. Do you discuss with the patient the prognosis and likely path the treatment and their recovery is going to take? Do you arrange a formal review at a set number of treatments/days/weeks in the future. In my practice we tally up the number of examination procedures performed at the initial consultation and tell the patient how many they passed/failed or give them a score. We then repeat those tests at the re-exam and discuss their score. We will point out that their lumbar flexion was 20 degrees and now they can touch their toes, neurological findings etc. Just as important as the positive changes, we need to discuss those areas that have not improved as much. For example the loss of sensation in the lower calf is still there, and reassure the patient that this is normal for this condition, and will recover slowly over time. Of course we also outline the next phase of treatment, and rehabilitation exercises or lifestyle modifications they need to perform and agree on the treatment frequency until the next re-examination. The patient signs the ongoing care form, consenting to further treatment and everyone is happy. I feel that this is vital not only for professional conduct, but for a patient who is paying for your services. I think they need milestones to see their progress so that they can justify the ongoing expense to themselves. I may be teaching you to suck eggs, but if you are not doing any of this, I feel that your patient retention figures would increase just with this formal procedure… On that note, do you monitor statistics?
[/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][x_image type="thumbnail" src="http://mediamarketing.clinic/wp-content/uploads/2016/08/statistic-1564428_640.png" alt="" link="false" href="#" title="" target="" info="none" info_place="top" info_trigger="hover" info_content=""][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-justify"]Statistics

Chiropractors love stats, most of us have practice management software that does this for us. A mentor that helped me in my early days in practice once said:

[x_blockquote type="center"]‘If you are not monitoring what is happening in your practice, then its just a hobby’[/x_blockquote]

Harsh words I know, but it has stayed with me for my entire career as a chiropractor and now when I coach practitioners and run their online marketing. How can you justify paying me to grow your practice if we are not measuring the ROI (Return On Investment).

I have written a separate article on this topic and will include a link at the bottom of this one. It is called ‘The Three Doors To Your Practice’. I feel it is must read for anyone serious about growing their practice. Most of us only focus on ONE door, the front door.. where New Patients/clients enter, but leave the other two doors wide open.

For this article, Iet us focus on that front door. The Front Door is all about New Patients/Clients coming to your practice. Again, this is another area where I feel that chiropractors are doing it right.
[/cs_text][/cs_column][/cs_row][cs_row inner_container="true" marginless_columns="false" style="margin: 0px auto;padding: 0px;"][cs_column fade="false" fade_animation="in" fade_animation_offset="45px" fade_duration="750" type="1/1" style="padding: 0px;"][cs_text class="cs-ta-justify"]New Patients

Of course referral is the holy grail source of new patients. I have worked with many practices over the years that have managed to create a 100% referral based practice, with New Patients having on average a three week wait for an initial consultation appointment. They do wait, they trust the person that referred them, they do not want to go anywhere else! This takes time to create, its a long-term nurturing process, and your whole team need to be on board, referral is not all on the practitioners shoulders.

Until you reach that place, then you will need to look for ways to attract new patients into your practice. Here are a few ways that chiropractors keep a consistent number of new patients in their practice book. The top practices will incorporate all of these procedures, and many more.

INTERNAL MARKETING

[x_blockquote type="center"]‘Your Team is your biggest asset; invest in it’[/x_blockquote]

Referral: What can you do inside your practice to promote referral. Referral is not a passive process, it needs to be nurtured and welcomed. The most vital part of this process is You and Your Staff. Without a cohesive approach, all the brochures in the world are pointless. Train your staff, role-play how they can bring up referrals to patients in reception. Mrs Jones is talking about her pregnant niece and you specialise in obstetric care. Did Mrs Jones know that? Get the front desk talking to her, bring her the pregnancy brochure and talk to Mrs Jones, Maybe also include a half price consultation voucher for her niece. If the front desk is clever they will ask her nieces name and write that on the voucher so it is personalised. The front desk will also include the pregnant lady’s name on the prospect sheet with a link to Mrs Jones. This sheet will be looked at regularly and brought up the next time Mrs Jones comes in, to ask how her niece is. No need to mention the consultation this time, just ask how she is doing and let Mrs Jones talk; she will fill in the blanks and feel like your practice really cares!

I cannot stress the important of your team, they are your biggest internal referral asset. Spend time, energy and money on your team. Then the tips below will bare far more fruit, and are just resources for you and your team to use as you see fit.

Brochure rack: I’m sure you have a rack full of brochures, is each one stamped with your contact details? Make sure your team keep their ears open for opportunities to talk with a patient, educate them about what you do or offer a referral voucher. Your team will feel more fulfilled, especially if you incentivise them on referrals.

Gift of Health: To be given out as a voucher as explained above with the pregnant niece, or for example at Christmas or on a patients birthday, and any other time you feel is appropriate. Yes this loses you money, but if you know your stats from above, you know the average total ‘value’ of a patient. You will also know how much it costs to acquire that patient, say through google adwords, and consider that offering Mr X a free consultation is worth your time. NB. This is a suggestion, please make your own mind up for each of these tips.

Focus events: World spine day, Children’s backpack week, Asthma awareness week, sporting events.. There are so many events for you to run awareness within your practice and to get active in your local community. Have a regular focus in your practice, educate your clients; and change the theme regularly. Sometimes make it serious and informative, other times light hearted.. Many Chiropractors have a Valen-spines day promotion; its great fun. You can steal that one, I don't think its trademarked.

Charity events: Organise or participate in local charity events, raise your practice profile. I would also combine this with something internal to engage your current patients. For example, at Christmas time I would run a canned goods appeal. I would offer patients to come in for an additional visit to their regular schedule on a special shift, say Christmas eve or a sunday. The cost of this additional session is one bag of canned or dried goods. We then box all the foods up like hampers and take them to a homeless shelter or food bank for Christmas. We do the same at Easter: Easter Eggs for the children's ward @ the local hospital. Chat to you local charities and get creative.

Testimonials: Reviews are vital in our current world, nothing more-so than in our industry. Each time you have a positive experience with a patient, or perhaps they score very highly on their re-examination form. Ask them for a referral, take a photo or even a video (ask for permission & make sure you get them to sign something, it can be added to the bottom of your review forms so its all done together). Even better, ask them to write you a glowing online review, such as a google or Facebook review. Seize the time that they are really happy with their progress; or even better, have your team do it all.

[x_custom_headline type="left" level="h1" looks_like="h4"]Other examples of internal referral magnets are:[/x_custom_headline]

Regular Workshops & Talks: Free to patients and guests. Put the workshops on EventBrite and promote them on Facebook, charge members of the public $10. Make your practice members and their guests feel special.

Educational TV in reception: You can create your own presentation, or buy a ready-made one. There are many in Chiropractic, I'm sure your profession has the same.

[x_custom_headline type="center" level="h1" looks_like="h4"]EXTERNAL & ONLINE MARKETING[/x_custom_headline]

Newspaper ads: A favourite for many years with chiropractors, particularly the advertorials. I feel that the Return On Investment is diminishing for newspaper adverts but it's still worth considering, especially in Geographically isolated areas with a good catchment. Online marketing gives instant feedback and is ultra targetable. Unless you live in a close-knit community and can engage people consistently then newspaper ads may just be too costly to pay and wait! We need to be clever with our advertising dollars…Marketing for the year we live in!

Screenings: Still beneficial, but make sure what your offer is interesting and engaging. Also make sure you have a way to book people in for a consultation THERE & THEN. You do not have the ‘branding’ budget of Nike… so handing out brochures is pointless. Have a free spine check, or chat with the doctor sessions; with a call to action to book an initial consultation TODAY. Chiropractors are good at this, but screenings have been overused, so if you choose to send a team out screening, pick your location wisely. Outside a supermarket as people walk to their car with a trolley full of frozen food that they need to get home is not the best use of your time and funds.

Corporate events: Great if you can get them, and the best source of leverage is your current clients. Cold calling businesses can be a very demoralising thing: best to start with a warm lead and get a patient to introduce you or mention you to HR otherwise it is a very fruitless tree. Get your team focused on gathering corporate contacts, chat with patients when you are running behind, do they know the HR director in their company? Because we offer free spinal health classes to local businesses!

Social Media: If done right, it works. You cannot just constantly ask for New Patients. It is the opposite of an advert. There is a famous book in social media called ‘Jab, Jab, Jab… Right hook’. With the right hook being a call to action - call us now for a 50% discount on your first visit. Up to that point the jabs need to be 'Giving' to the reader - pictures, free downloads, links, information, articles & generally showing them how nice & trustworthy you are. Unfortunately, this is mostly done by the practice owner or a receptionist between patients. The odd Facebook post or tweet, a funny photo of cats and a request for new patients: to a list of people who are already your patients. If done badly, without a strategic plan, it’s a waste of time!

Blog/Content Marketing: Vital if you want to become the leader in your community. Unfortunately it requires a LOT of time, and you cannot delegate this to your receptionist, it needs to be written by a practitioner. Even then, once you have written an article, it doesn't mean it is any good to increase your web presence. It needs to be Search Engine Optimised (SEO), put on social media et;, and not some auto-post software, but a crafted post. It needs to be sent out to a targeted audience of your ‘ideal patients’ and this takes time. Far more than most practitioners have! This article is nearly 4000 words, almost half a degree dissertation; it was written by a practitioner, edited by our SEO team and again by the Chief editor before it was posted and then handed over to our social team.

SEO Search Engine Optimisation: A buzz phrase at the moment, but incorporates many secret tactics that only the magic circle know. The aim is to increase your web presence and get the coveted number one spot in google, which in turn ‘hopefully’ increases your web traffic, and makes your phone ring! Most companies know that SEO is a mystery to most people so can do whatever they want for their money. The number one goal is for your phone to ring, if it doesn’t; its not a good investment.

Google Adwords PPC: Paying for adverts in Google which show above the natural listings that you are trying to get to the number one spot in your SEO campaign above. Targeted adverts for certain keywords. Keywords need to be reverse engineered to focus on what people are looking for, not what you are! For example ‘physical therapist New York’ is a keyword. However its probably very competitive and you would pay a lot for every person that clicks on your advert. How about making up 30-40 different adverts for the conditions that you work on, and Geo-tagging the location to within a certain radius of your office. That way, when someone who lives near your office types in ‘shoulder and neck pain treatment’ your advert SPEAKS to them directly. Google Adwords is another online service reserved for the magic circle, and clinics spend thousands of dollars a year NOT getting results. Make sure you pay an expert to setup your campaigns, let them monitor and tweak them until you start seeing results. You may then be able to manage it yourself, although if its affordable and your phone is ringing; keep doing what works!

This was a whistle stop tour, with SO much more to share with you.

If you have any specific questions, email us directly.
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