Educating your patients and promoting your practice can be accomplished with one stroke. Learn the most effective ways to increase your patient base from these eight experts

What methods are you using to inform your patients about chiropractic? Are these tools working to attract new patients and retain your current ones? Chiropractic Products asked eight experts to guide the way.

Daniel Dahan, DC, is president of Practice Perfect, a multidiscipline health care management and consulting firm. He has trained thousands of dedicated doctors.

Bruce Goldsmith is president of Visual Odyssey and has been manufacturing chiropractic patient education tools since inventing the Neuropatholator electronic nerve chart system in 1976.

Kent S. Greenawalt is president and CEO of Foot Levelers Inc. He is also chairman of Foot Levelers’ Educational Division, which presents license-renewal seminars and other programs throughout the nation. Greenawalt is the recipient of numerous awards and recognitions such as the Lifetime Philanthropy award from Parker College of Chiropractic and Parker Seminars.

Steven Madnick is the president of Health Visions Patient Education Co and has been producing products for the chiropractic profession since 1996. Health Visions offers quality patient education products that help build practices and encourage family care.

Sigmund Miller, DC, has been in chiropractic since 1977. As CEO of Healthy Practices Inc, he helps DCs grow using online technologies. He is also editor of Chiropractic Gateway.com, an information service that reaches more than 43,000 DCs, CAs, and students.

Mark Sanna, DC, is a second-generation chiropractor and CEO of Breakthrough Coaching LLC, a practice development system. Founded in 1988, Breakthrough is recognized for systems that are outcome-oriented and respected by a diverse cross section of modern health care providers.

David Singer, DC, is CEO of David Singer Enterprises Inc. The Singer system utilizes practice expansion seminars, one-on-one consulting, and a complete product line. The company was created in 1981 after Singer received numerous requests from colleagues to share his secrets to a successful career.

Michelle Turk, DC, has been a coach and senior consultant for The Masters Circle Inc, Jericho, NY, since 2000. Previously, she ran a high volume subluxation-based family practice in Bayside, NY.

---

How can chiropractors create a unique niche using patient education/practice promotional (PE/PP) tools in their practices?

Dahan: To maximize patient knowledge, doctors need to attach their business cards with a complimentary new patient evaluation to the back of their brochures for their clients to pass on to their friends. This way patients are educated, which increases retention; and information is shared with others, which generates new potentials.

Goldsmith: A chiropractor’s niche is generated by the local demographics, health-related specialties, and interests that define their ideal patient and find PE/PP tools that are dynamically targeted to that market. Most important is the consistency with which doctors follow through on their commitment to build their practices. Is the DC willing to utilize a strong ROF, a daily communication program, regular patient lectures, outside speaking engagements, and spinal screening opportunities?

Greenawalt: Have a unique topic, technique, or evaluation to present. Put the presentation in terms patients will appreciate, and be sure it communicates precisely how much money, pain, or worry your care will save them compared to the alternatives.

Madnick: A simple way to create something unique is to have a weekly theme in the office that focuses on a specific topic, such as a particular symptom or upcoming holiday. This will require patient education material that complements the theme and planning a few weeks at a time. Each time the patients come in, they will be introduced to something new and learn more.

Miller: The biggest challenge relates to building relationships with those we do not yet know and finding effective ways to connect with them. According to recent Internet surveys, local residents are going online by the millions in search of health-related information. Using simple online technologies (such as e-newsletters) provides chiropractors the opportunity reach out to their communities.

Sanna: The key is to market the unique area(s) of expertise for the individual office. For example, one practice that specializes in the treatment of TMJ would regularly make presentations to a group of 12 dental clinics on the importance of posture/workplace ergonomics and the effects on TMJ. This practice received a tremendous number of referrals from these sources.

Singer: Public speaking is one of the most important skills to utilize for business and life success. Lectures and seminars establish doctors as authorities on the topic they are presenting. Many may be afraid of public speaking, but if the presentations are on slides or in PowerPoint with research to back up every statement, all you have to do is read the screen.

Turk: It is imperative that DCs make an impact in presenting the chiropractic model. PE/PP tools serve as valuable support in helping get the message out in a manner that is professional, clear, and impressive. It is done with a consistent organized campaign including health care classes, advanced workshops, visit to visit education, patient literature, in-office videos, and effective use of the chiropractic clipping service, which provides press or media documentation.

What are the most effective PE/PP tools to attract new patients? To retain current ones?

Dahan: Reports of findings and x-ray results and pictures can be printed next to normal variances to show mensuration lines. Patients appreciate when they are shown their own films.

Goldsmith: There are many PE/PP categories: 1) advertising—yellow pages, newspapers, radio, television, and Web sites—which help generate community awareness and new patients; 2) in-office tools such as posters, charts, models, DVDs, and interactive software to keep the message in front of your patients; 3) take-home materials like brochures, videos, interactive software CDs, computer games, and Web sites to develop family support and referrals.

For retaining patients, focus on powerful doctor/patient communications with thorough ROF and group orientation. Reinforce with interactive take-home materials, such as questionnaires, personalized ROF booklets, and computer programs.

Greenawalt: The most effective tools involve the maximum number of senses—if they see, hear, and touch, you are more likely to hit their listening style.

Madnick: Any patient education tool that can be used consistently and effectively will be successful in attracting new patients. Internal marketing is the key to getting more new patients and retaining your current patients, such as in-office educational materials—videos, posters, patient workshops, and dinner talks.

Miller: Effectively build meaningful relationships in communities by using simple online technologies. For example, doctors can launch a community e-newsletter that provides health information. It should not be not self-serving, but rather focused on areas of wellness and health care, such as how to make better health care decisions or how to improve the quality of life. Doctors can be one of the leading and trusted health information resources in their community.

Sanna: The most effective tools are the ones that communicate the doctor's passion and integrity. Sales promotions and slick media undermine the key to attraction. The most effective tools build on relationships of trust usually in a vehicle of public service and education. Your image leads to credibility, which leads to respect. Then, people are more open to listening to your recommendations and opinions.

Singer: I teach our clients completely new and innovative ways to do what are called screenings. We deliver this program in the form of wellness days, which are more acceptable and easier to schedule than spinal screenings. One of my clients screened 148 people in 5 days and turned 91 of them into new patients.

As for retention, doctors must educate patients on how chiropractic can get and keep them well throughout their lives. I recommend 10–15 minutes over 4 days of educating patients one on one. Through this method, I have converted 80% of our patients with or without insurance into those who understand what chiropractic can do.

Turk: We offer CD-ROMs called “There Has Never Been a Better Time to Be a Chiropractic Patient” and “10 Keys to Longevity” which can both be used for presentations in the community. Other recommendations are reception room videos, in-office patient education systems, and newsletter templates.

What tools or methods work best in different regions of the country?

Dahan: Most widely used modalities are ultrasound and electrical muscle stimulation. These inexpensive tools have great results and almost all carriers pay very well for such services. They are also easily transported from room to room, and the staff can be taught how to use them without much difficulty.

Goldsmith: What works best in all regions of the country is developing a program of daily visit in-office communication that introduces patients to the benefits of chiropractic and the diverse conditions that can be helped. For instance, featuring a poster of the day is reinforcing and keeps office conversation focused on chiropractic.

Greenawalt: We have not measured a significant difference by region. The success does seem to be more related to the doctors’ level of enthusiasm and ability to ask patients for a commitment. It may be as simple as “Will you read this brochure? Watch this video? Share this report with your spouse before your next appointment?”

Madnick: Many chiropractors can focus on creating a theme that fits with the demographics of their office. For example, outdoor activities in warmer climates or focus on the types of patients that you attract.

Miller: The effectiveness of online strategies is not based upon where they are being used, but rather to whom they are being directed. If you are looking to provide educational information in order to build relationships, make sure it connects and serves the most important person in your community—mothers. They are the ones who will take this information and disseminate it to other family members and which doctor to see and when.

Sanna: Stereotypes are caricatures of stylistic differences.  Some are even true. In the Northeast, concise and directness are appreciated. In the South, it is important to observe respect and politeness. The Westerners, for the most part, are eclectic nonconformists who value openness and acceptance of things that challenge the status quo. The middle of the country are dedicated hard workers who carry their own weight and take pride in doing the job. The key is marketing around a seasonal or regional theme. In Colorado, for example, outdoor events are attractive promotional ideas.

Singer: There are some variations in what works in the East or the West, but I’ve found that the most compelling variations relate to the size of the community in which a chiropractor is located.

Rural areas or farming communities do not have a lot of lectures or screenings. These areas require more direct community involvement through charitable programs or specifically designed workshops to fit the needs of the community.

When you move into the bigger cities and urban environments, you have more industries and corporate offices. These are prime locations for health fairs or outside lectures such as those that teach employees proper ergonomics, how to reduce on-the-job injuries, and prevent and treat carpal tunnel syndrome.

Turk: Everyone just needs information presented in a manner that is clear and logical and compels them to take action. Remember to cater your communication to the population you are addressing. For instance, in a presentation to young mothers, I would choose different examples and analogies than in a presentation to senior citizens or corporate executives.

What is the most common mistake DCs make in choosing their PE/PP tools?

Dahan: Spending too much money too fast. Doctors need to first experiment with low quantity and do a market analysis.

Goldsmith: Too often, DCs invest in tools that do not target their ideal patient. To avoid making a mistake in choosing PE/PP tools, DCs should match likely effectiveness with their willingness to implement it, and they should test it on their best, most helpful patients. Often this process of getting the patients involved in evaluation will increase their awareness of your mutual goals and chiropractic. This results in more immediate referrals and compliance.

Greenawalt: Doctors who pay for educational and demonstration materials when so many are available for free or next to nothing.

Madnick: Chiropractors need to utilize the patient education tools that work best for them. If they are too busy to educate, then they need to find the tools that require less effort. Also, most chiropractors focus on the cost of the products rather that the value they will bring. This is a big mistake because the value will always outweigh the cost if used effectively.

Miller: Doctors are looking for one magic bullet that will turn their practice around. It doesn’t work that way. Any effective strategy takes time, effort, focus, and commitment. Most important, strategies should focus less on selling chiropractic. This type of approach does not appear genuine.

Sanna: The most common mistake is trying to advertise their way to a successful practice. Media messages help but they must support the public perception of validity that doctors have earned through patterns of service and trust-building. Secondly the quality of the image portrayed often shoots them in the foot and undermines the process.

Singer: Doctors fail to implement successful systems into their practices. Doctors needs systems to get people through the doors of the practice, properly educate new patients so they stay for care and refer others, schedule lectures/workshops and reach more people in the community, and recall previous patients so they return to care.

Another common mistake is to think that all new-patient marketing methods are the same or require some form of unprofessional conduct. The key is to be more effective in areas of communication.

Turk: The most common mistake is thinking that the tools are responsible for new patient attraction or patient retention, and therefore look for tools with that something extra. The truth is that new patients come from doctors’ energy, focus, concept, and vision. Patients are retained in practices where value for the services is created by the doctors and their teams. PE/PP tools are valuable supports to get the message out, but patients are attracted and retained by the doctors, not tools.

What are the most underutilized PE/PP methods in chiropractic practices?

Dahan: Gifts—we need to learn from dentists, who are notorious for giving their patients hundreds of gifts and gadgets throughout their treatment plan. Patients love to receive gifts and remember these items more than anything else and for longer periods of time.

Goldsmith: The computer is still underutilized. Every DC should be using one to interactively demonstrate whatever they are discussing. A truly versatile software program will offer a library of graphics and animations. Also underutilized is humor and emotional rapport. Humor comforts, educates, and opens people’s minds to new ideas. As a demographic, children are an underutilized target market. They are the future patients and help introduce new ideas to their families. This is why I like the concept of chiropractic computer games so much.

Greenawalt: Demonstrating the improvement patients can experience. We are a hands-on profession. Too often we rely on printed materials to speak and demonstrate for us.

Madnick: In-office workshops are probably the most underutilized practice promotion tool. These workshops are effective when done on a weekly basis. Consistency is the key to making your patient education tool work.

Miller: I would like to see more focus on relationship marketing. A doctor’s focus on community service. People will be drawn to you. They will like you, begin to trust you, and want to hear more of what you have to say.

Sanna: The use of the business card—chiropractors are afraid to hand them out; and CAs should also have cards. Another underutilized method is the power of a harmonious and energetic team. When doctors have properly educated, trained, motivated. and inspired team, patients refer, pay for care, complete their programs, and give glowing testimonials. 

Singer: Doctors underutilize the power of public speaking. There are training products and services available to help chiropractors learn the skills they need to become confident in front of a group.

Turk: The PE/PP methods that involve great table talk. We have limited time with our patients, so it is essential that we make an impact on them in this time, not only with great clinical care, but with great education about chiropractic and its benefits. Talking about sports, weather, or current events may make doctors believe that we are developing rapport with our patients, but it does not serve our purpose. Doctors that utilize systems for visit-to-visit PE tend to have the most patients that stay, pay, and refer.

What new technological PE/PP tools would you like to see developed in the near future?

Dahan: Digital videos of patient testimonials that can be accessed via a touch-screen monitor in the reception room for patients to view.

Goldsmith: I’m looking forward to a 40-plus-inch plasma-style, flat display with a touch screen and built-in computer selling for $1,000 or less. 

Greenawalt: We are working on a scanning system that will evaluate total body balance from the feet to the head.

Madnick: More products need to be developed that will require less effort from doctors and staff. Chiropractors will get busier and busier in the future and need tools that will do the majority of the education for them. Computer and video-based products will interact with the patients while the chiropractor is adjusting patients.

Miller: Media in the form of personalized audios and videos so the wellness message can be delivered by the chiropractors to their local communities.

Sanna: A technological advance that would allow the common man and the scientific community to get the big idea by capturing the scope and impact of a chiropractic adjustment. There are several excellent tools out there already. The key is utilizing them to their fullest potential by implementing them in a company-wide marketing strategy.

Singer: I’d like to see a nationwide marketing program called Miracles Can Happen, highlighting some of the miracles that can occur with chiropractic care.

Turk: The Internet is not new, but I would like to see more DCs using it for PE/PP. Every DC should have a Web site that patients can turn to for information about chiropractic. Then, new patients come in knowing something about chiropractic, what they can expect from the doctor, and complete their intake forms online.  Doctors can use email to communicate with patients and educate via e-newsletters or weekly health tips or articles.

Tell us a success story of one of your clients.

Dahan: One of our doctors has been treating back injuries in a large multidiscipline center. For several months, we had worked on establishing that center as a primary care clinic. Just a short while ago, Home Depot contracted with our client to become the primary health care provider for all their work injuries. We also established for our client an initial physical protocol as a screening forum.

Goldsmith: I received a letter from a DC who had just purchased our Report and Orientation software. This DC reported vastly increased patient understanding and improved ROF communications. He is now comfortable allowing staff discuss patient-specific portions of the ROF because of the consistency of the message delivered. Being able to delegate some of his responsibilities saves him time and gets the staff involved in practice promotion.

Greenawalt: A doctor wanted to communicate to his community about his substantial efforts to treat patients from head to toe. He had invested in several courses to perfect his spinal and extremity adjusting techniques, and his office protocols and procedures were systematized. Using a posture analysis and foot scanning technology, the doctor was able to involve his patients in a demonstration of complete body care. Patients were able to see problem areas and receive a report tailored to their conditions. As a result, the doctor improved patient compliance and gave the people in his community something unique to talk about.

Miller: We set up an interactive community—Health & Home eMagazines—so the doctor could establish mutually beneficial relationships with thousands of local residents, businesses, organizations, and schools. Within weeks of the launch, the local media contacted the doctor. He got a full-page feature article in the newspaper and a local radio show interview. He also began working with the local chamber of commerce.

Sanna: Amelia Case, DC, Chicago, shares that the “marketing strategies in this practice have been 99% internal (referral based). We spend extra time on new-patient visits and report-of-findings visit for two reasons. One, we want patients to follow-through with care, so we emphasize what is normal and abnormal in the body, and then we carefully review the goals of the treatment plan. Second, with new patients, there is an opportunity to train a sales force. We reinforce what they first learned in subsequent re-exams and consultations.”

Singer: When one of our clients first joined our program, she was seeing 30 patient per week. Over the course of the next 2 to 3 years, as she continued learning and implementing more of our procedures, her practice has grown to approximately 350 patient visits per week. She said the procedures for the lectures have had the most impact on her practice. Using the structure provided by our program, now she closes close to 80% of the attendees as new patients. She is now working toward a goal of 500 patient visits per week.

Turk: I was working with a doctor who had negative perceptions about health care classes. He didn’t think patients wouldn’t attend and believed he  couldn’t deliver a good class. Through coaching, he realized that the benefits to patients of attending a class were invaluable, because it helped them to gain a greater understanding of chiropractic, which led them to be more compliant and ultimately get better results. The benefits for the doctor were numerous as well, such as more compliant patients, more new patient referrals, and improved communication skills. Perhaps most important, this resulted in an increase in his self-confidence and self-esteem as well as his sense of control of his practice.

Any last words of advice?

Goldsmith: There are many ways to educate and motivate a community. Outside the office, interactive materials that get “play” time at home and promote a specific practice are very powerful. The in-office experience must make the best of all opportunities to tastefully reinforce a chiropractic wellness decision.

Greenawalt: There are companies that will send patient education materials and give implementation strategies to improve patient communication and compliance.

Madnick: All patient education tools are effective. However, choose the tools which you can commit to. If you cannot commit, find the tools that require less effort for you and your staff.

Miller: The opportunity to serve has never been more timely; the need for what we do has never been greater. I am very grateful to be a witness to so many incredible things happening around us.

Sanna: Quit trying to talk people into becoming your patients. Instead, find every way possible to meet, serve, teach, and share your vision of improving their lives with passion. Deliver quality service at a fair fee and let them tell your story. PE/PP tools work when they are integrated into an overall office marketing and advertising strategy to achieve the best results through service.

Singer: Success is the accomplishment of your personal goals. Identify exactly what you want to achieve and work out a plan to achieve it. Through implementing systems into your practice you are taking the first step toward expanding your practice.

Turk: Many tools exist and can be extremely beneficial PE/PP. They do not however, take the place of the doctor’s personal power, which is ultimately a more important factor in practice success. Coaching is an essential tool for any professional so that they can consistently show up in the best manner possible and achieve the practice they desire. CP

Julie Z. Lee is a contributing writer for Chiropractic Products.