All team members in the office should contribute to your practice’s marketing efforts

The employment rate of chiropractors is expected to grow faster than the average for all occupations through the year 2014 as consumer demand for alternative health care grows.¹

Chiropractors should invest in marketing to capture as much of that growing patient base as possible.

Chiropractic Products spoke to several experts about how chiropractors should market their practices. Mark Sanna, DC, CCRD, FICC, is president of Breakthrough Coaching, Vernon, NJ. Jennifer Wise, DC, is president of The Wise Method in Naperville, Ill. Daniel H. Dahan is president of Practice Perfect, Long Beach, Calif. Peter G. Fernandez, DC, is founder and president of Fernandez Consulting in Seminole, Fla.

What percentage of a practice’s budget should be spent on marketing? How should that break down between Internet, print, and other advertising methods?

Sanna: Ten percent of a practice’s budget should be spent on marketing for new practices and practices in growth mode, and 5% for stable practices. The breakdown will vary from practice to practice.

Wise: Simply saying 3%, or 10%, of billings or collections should be invested in patient education and marketing is not the answer. The real issue is to develop a practice based on income goals for the practice owner and then to work backward to determine the number of new, ongoing, and reactivated patients needed. First, calculate how many new patients the practice needs to acquire. Then, calculate the average lifetime value of a patient. Finally, once you know these numbers, you can arrive at the real number you must know, which is your allowable cost of patient acquisition. How should that break down between Internet, print, and other advertising methods? The golden answer here would be to test. All marketing efforts need to be tested and measured.

Dahan: As a general rule, 16% to 18% of the total budget should be spent on marketing the center. The largest percentage should be mainly on external direct marketing: newsletters, television, radio, and newspaper ads (about 10%), given the broadness and effectiveness of such programs. Budget the remaining 3% for lesser direct marketing (Yellow Pages, signage, and events) and the last 3% to 4% on internal marketing (patient education, coupons, and giveaways).

Fernandez: We recommend that a doctor’s marketing budget be 10% of deposits for practice growth, and 15% of deposits for more rapid growth. To determine how an advertising budget should be spent, we recommend the doctor “test market” potential advertisements and advertising methods to find those that produce the largest number of new patients and the greatest return on investment (ROI).

Which methods have proven to be the most successful, and why?

Sanna: Marketing depends upon relationship building. Marketing to your existing patient base for referrals is your most solid investment and generates the highest-quality new patients. This can most effectively be done through e-mail, direct mail, and patient workshops and lectures.

Wise: I utilize a very different approach with regard to marketing. I have formulated a marketing approach that focuses on patient education. I have a two-stage process for disseminating patient materials. Stage one is creating educational materials that stimulate the exact patients I wish to treat to respond and immediately call the office for an appointment. Stage two materials address the prospective patients’ specific conditions—explained in simple, layperson’s language—the cause, and recommended treatments. I not only give them recommendations of what I feel they need, I include what they want.

Dahan: A very effective and inexpensive method used lately is “the dialing message center.” Doctors purchase a system that dials to a designated list of residents (by ZIP code) and delivers a message with multiple options. The cost is under $200 per month. It requires 1 hour per month of set up and brings in six to eight patients per week. Given the cost, time, and minimal involvement, the return is incredible.

Fernandez: Newspaper advertising continues to be the DC’s advertising method of choice. Why? Because it produces the largest number of new patients for the least amount of expense. Yellow Pages advertising is the second-most-effective advertising. However, the success of newspaper and Yellow Pages marketing relies heavily on the actual ads being used. Ads should be designed by someone experienced in producing ones that attract the greatest numbers, and the type of new patients the doctor wants. It is still too soon to determine just how effective Internet marketing is or can be for DCs. I know of effective, low-cost Internet marketing programs, but while others are spending their marketing dollars test-driving this newest method of advertising, I recommend that doctors on a limited marketing budget spend their money on what has already proven effective—newspapers and Yellow Pages.

How can chiropractors measure ROI for marketing expenditures?

Sanna: You have to track it. Track the hours spent on getting ready for each event, track where all your new patients come from and how they heard about your practice, and track all of the expenditures for each event you hold. Many times, doctors do not realize all the costs that go into a project unless they see the figures written down. Calculate the costs and your return based on the number of patients that are attracted to the practice from each event. Set a goal for a minimum of a three-to-one return on your investment. An Excel spreadsheet is a great tool. Keep a marketing manual with the step-by-step procedures, cost, and response generated for each marketing event. When each marketing event is written in a step-by-step format, it is easier to repeat success without having to re-create it from scratch.

Wise: Acquiring a marketing database or management system that keeps meticulous track of campaigns and follow-ups is necessary to track the effectiveness of marketing. ROI may not always mean you made more than you spent, at least initially. Sometimes you could break even on a campaign or even lose money, and be very successful. This occurs when you understand and utilize the lifetime-value-of-a-patient concept. There is really no correct way to measure ROI from marketing until you include all the lifetime-value-of-a-patient connections that occurred from that original campaign.

Dahan: Using a simple equation, the doctor can measure the success of a marketing program. Take the total cost of marketing, divided by the amount of new patients received. Example: Cost of marketing = $2,000 per month. New patients acquired: 10. Divide 2,000 by 10 to get $200, which is the cost to acquire each patient using this marketing. Nowadays, the cost per patient should not exceed $100.

Fernandez: ROI is determined by comparing the cost of the advertisement (creating and placing it with the media) to the income generated from the additional new patients it attracts to your office. For example, if an advertisement costs $1,000 and it attracts 5 new patients that generate $200 each in additional income for your office ($1,000 total), the income to expense ratio is one to one, and that is your ROI—for every dollar you spend, you get one dollar back. This ROI is not adding anything to your practice; therefore, it is not a favorable ROI. A minimally acceptable ROI for chiropractic advertising is three to one.

How can the practice’s team members—the chiropractor, the staff, and the practice-management company—each contribute to the practice’s marketing efforts?

Sanna: A new paradigm is developing in successful practices—everyone is in the marketing department, and it is always a team effort. Friendly faces, great service, and results from care are the key to exceeding patients’ expectations so they will follow through with your recommendations for care and refer their friends and family to your practice. Plan your marketing events together, a minimum of 3 months in advance. Foster accountability by delegating specific marketing tasks to your team members, setting specific target dates for completion, and follow up, follow up, follow up.

Dahan: First and foremost, understand the clinic’s vision. Establish a set of reasonable goals with bonuses for staff. Have weekly meetings covering the information and reinforce directives. Outline all resources, and tap into every avenue available. Learn from past mistakes, and accept criticisms. Have a positive attitude regardless of the results, and believe in yourself.

Fernandez: The CA training provided by the doctor’s management company should result in the CA converting at least 90% of all call-ins to actual appointments. If the CA cannot be trained to do so, he or she should be replaced.

The doctor’s practice-management company has the following four responsibilities with regard to the doctor’s marketing campaign:

1) To provide the doctor with ads that work—ads that attract new patients.
2) To provide telephone procedure training for the doctor’s CAs—procedures that make it possible for CAs to convert at least 90% of all call-ins to new patient appointments.
3) To teach the doctor how to convert potential new patients into actual patients.
4) To teach the doctor and his staff those procedures that make patients happy and keep them coming back. CP

Reference
1. US Department of Labor Bureau of Labor Statistics. Occupational Outlook Handbook, 2006-07 Edition, Chiropractors, Available at: http://www.bls.gov/oco/ocos071.htm Accessed April 13, 2006.