Treating your patients as customers will enhance patient care, thereby increasing perceived value of chiropractic care

What can you do to influence patients to make the chiropractic care purchase from you? Treat them like valued customers. No matter what your practice philosophy is, I know you will agree that the American Heritage Dictionary definition of customer—“one who buys goods or services, especially on a regular basis” and “one with whom we must deal”—can be applied to our patients. To many chiropractors, terms such as marketing or even business are dirty words that seem to go against the grain of being perceived as a doctor of chiropractic.

As healers, many DCs find it difficult to put a price on their services. Many doctors advertise free examinations, free massage with adjustments, or first ten visits for free after an initial consultation or presentation. This is a very destructive mind-set. In fact, it is not only bad for you, but also for your patients and chiropractic.

Free Lunches Don’t Exist
“Free” does not seem like a bargain because it inherently has no value. For example, a woman was offering kittens for free, but could not find anyone to take one. She then changed the sign to: “Kittens—$5,” and found homes for the whole litter in 2 days. People expect to pay for value.

The universal law of exchange is immutable and demands a fair exchange—something for nothing goes against the laws of nature. Therefore, you are entitled to and must receive a fair fee for services rendered, and vice versa for your patients. In the end, it is a more satisfying relationship for all parties involved.

The economic reality is that you vie for customers in the marketplace, thereby competing against anyone for the customers’ dollar, such as family practitioners with a broad scope of practice offering treatment chiropractic in nature or pharmaceutical companies with staggering advertising budgets to influence the uneducated to use of drugs instead of natural healing. Even the local restaurant becomes your competitor when a patient chooses a steak dinner over an adjustment.

You are also competing against other chiropractors, and although I like to think of us as colleagues and not competitors, the reality is that when a customer chooses a chiropractor, the rest of us lose a potential customer and patient.

People have finite amounts of expendable income and choose to spend it with the most appealing persuader. You must become aware of your competition to have a fighting chance. First and foremost, you want to influence a decision to buy chiropractic care.

Since many of our patients often come to us as a last resort, they may have either unreasonable expectations or be completely without hope. You must address the cynical or noncompliance issues in the beginning. During the consultation, remember you have two ears and one mouth. This is the time to listen twice as much as you talk. In my practice, I schedule patients another day for the report of findings, because I have found that this is the perfect time to talk and solidify our relationship. Reiterate what they said in their initial meeting to let them know you have heard and understood. Ask for clarifications if necessary. And if they cannot understand what you have to offer, or you cannot convince them that chiropractic care is in their best interest, tell them they may be in the wrong place for what they expect. This may sound like a radical concept—actually letting the patient go—but you must recognize when it is not a good fit from the beginning, because you are looking at potential heartache down the road. This is good customer service—realizing that you may not offer what the customer expects, and then directing him or her to others who do. And by telling the truth, patients may change their minds and decide that you are the one who can help them—thereby gaining a loyal customer.

People will pay for perceived value. Many chiropractors think that a practice is insurance-driven—that a person will only buy if covered. I used to think that way too, and it seems that as soon as I changed my perspective, new patients walking in the door had changed theirs, too.

While taking a taxi-cab in Montreal last summer, I noticed a large, beautiful house and asked the cab driver about it.

“A chiropractor lives there,” he replied. He said that in Canada, medical doctors (MD) are basically government employees and are not as financially successful. MDs are paid by insurance companies to perform a cursory job, which is why many Canadians come to the United States for serious care.

Chiropractic, on the other hand, is not covered by a failing socialized medical system, therefore patients pay cash for care. These customers realize the value of chiropractic because they know what it is and what it can do for them. People are willing to spend money when they perceive the value they will receive.   

Location, Location, Location
All of us have heard of the legendary DCs who have tiny offices off the beaten path, yet attract patients from all over the area and even from miles away. But remember, they are the exceptions. For the rest of us, location is a key attraction factor. Consider your office: Are you in the area you want to serve? Is your office visible from the road? Do you have ample parking? Is your office easily accessible?

Once inside, is your office comfortable and attractive? Is it clean and well kept? How does it feel in your office? These are key factors to customers wanting to return on a regular basis. Take a pad of paper and pen. Sit in your reception room and look around. What do your patients see? What needs to be fixed, painted, changed, or moved? Write it down, and execute your plan.

Keep your office clean and neat. Your decor should reflect your personality, yet appeal to most people. My office is unique in that it is done in bright pastels with a retro theme, which is fun and cheery.

Next, go into your adjusting rooms. Lie face down on your table. What do your patients see? What do they smell? Is it clean? I like to put a drop of scented oil, such as vanilla, for a homey scent when the patient is face down. Last month someone remarked, “Whenever I smell vanilla, I think of getting adjusted.” Don’t forget to lie on your back to check the ceiling and lighting.

The Soft Sell
The average person does not have enough information to make a properly beneficial health care decision. Purchasing decisions are usually made by emotion, even those that relate to health and healing. This is why many advertisements target feelings such as excitement, fear, relief, and happiness.

How do you present chiropractic: as an alternative to another healing art, or as a nonnegotiable necessity? You must prepare a report of findings so patients understand four critical points:

1. What is wrong? This is your opportunity to define the differences between chiropractic and other health care professions.

2. Can they be helped? Do you feel you can care for them so they perceive value? If you are totally subluxation-based, do you feel chiropractic care can satisfy the reason they came to you? If you are a symptom-oriented doctor, do their complaints fall outside the scope of chiropractic? If you think there are blocks to their progress, tell them.

3. How long will it take for them to get well or out of pain? You will have a general idea based on your philosophy, clinical experience, education, their age and overall health, the cause of the condition, and the length of time it has gone untreated.

4. How much will it cost? Tell them your fees and what you estimate it will cost to get them well. Deduct the amount insurance will cover, if applicable. The remainder is what they must pay. Don’t make this difficult. They do not expect your care to be free, and if they do, change their minds by discussing the value of care, the downside of not receiving care, the fact that things of value have costs attached.

Little things can make a big difference. Greet your patients with a smile and a handshake. Be sure your staff acknowledges each person who walks into your office. If you say waiting room rather than reception room, think about what the words imply. Do your patients come to wait, or to be received?

What other little things can you do to let your patients know you really care? In my office, we go to great lengths to control media input for the brief time people spend in my office. I do not leave out the latest copy of People magazine, replete with pharmaceutical ads. Instead, I have two photograph albums with pictures of our town in the early 1900s, and other magazines from the 1920s, 1930s, 1940s, and 1960s to complete the retro ambiance. I also offer chiropractic articles and pamphlets, which I change every couple of weeks, and play only chiropractic videos on the reception area television.

Another important rule of customer service is: do what you say you are going to do. If I promise a copy of a particular study or stretching exercises for the next visit, I make a note to ensure these promises are fulfilled.

Also of importance, own up to errors or off-days. I was applying ultrasound therapy to a patient, who politely informed me after 1½ weeks that I was treating the wrong side of her spine. I apologized and explained I got a little confused when she turned over and that the next five visits were on me. She is a cash patient, and this was my way of letting her know that I heard her and really do care. She has been with me for more than a year, and I am certain it is because of the consideration I showed her.

Be honest with your patients. They will appreciate and respect that you are not trying to sell them a lemon or shoddy service. They will realize that you are an honorable doctor who cares about the services you provide. Open your mind and hear, tell the truth about your services, charge and collect a fair fee, then give all you have to give. You will eventually have an office with a healing, compliant paying patient-base, who will become happy, loyal customers.

Robert Z. Rush, DC, has practiced for 9 years in Philadelphia at the subluxation-based Rush Chiropractic Healthcare Center. He was the cover story subject of the January 2002 issue of Chiropractic Products, which details his success in working with the medical profession and attorneys. Rush can be reached at 215-677-2225 or via email: doc@drrobertrush.com.