Adding low-tech rehab and therapeutic exercise programs is just one marketing strategy to grow your practice

Most chiropractors in practice today would agree that competition is increasing among health care professionals. The health care pie is being divided into smaller and smaller pieces by more diverse professions than ever before.

Add the increasing difficulty of collecting for services rendered, and success becomes more elusive and difficult to attain. Successful DCs must depend not only on clinical expertise, but also on marketing their professional services economically, with a clear message, and in an ethical, professional manner.

Success requires work. I have noticed similarities among successful practices, and one shared feature is the concept of constant practice building. The question is, of course, what needs to be done? How do you spend those hard-earned marketing dollars in a way that will yield an acceptable return of your investment?

Common methods used to promote a practice can be broadly divided into external-promotion and internal-promotion methods. The former generally requires a marketing budget that can require expenditures of as much as 30% of one’s gross income. External-marketing strategies usually include yellow pages advertising, telemarketing, newspaper ads, and shopper ads, to name a few. These promotions could take a year or more of continuous placement to get an acceptable return. They have a variable return on investment from about 4:1 to about 10:1. External marketing requires repetition and a budgetary commitment.

Several methods are used to calculate how to allocate enough money for office promotions. These calculations are beyond the scope of this article, and I would recommend getting professional help to determine these calculations for your specific office situation.

Internal-marketing strategies are intended to provide increased services and develop additional revenue streams for the practitioner. Internal marketing requires using the existing contacts and patient base to generate repeat business and generate new patient referrals. This is a very direct, time-efficient, and inexpensive way to build a practice. At the most fundamental level, this requires asking satisfied patients to refer anyone who might benefit from your care. The range of referrals would depend on how well you educated the patient on your scope of practice and the type of conditions you are interested in treating.

Developing a patient re-call system is a personal mechanism allowing your office to keep in touch with inactive patients who have not been treated or who have not come in for a checkup in some time. Surprisingly, many patients respond by saying they were “thinking about calling the office.” But it is your re-call that initiated the scheduled office visit.

Producing an office newsletter is another way to educate inactive and active patients about current and upcoming events in your office.

Low-Tech Rehab and Exercise
One service that has caught fire recently with the public is the addition of low-technology rehabilitation and therapeutic exercise programs to your practice. This is a cost-effective, easy-to-implement method of marketing your practice by increasing the services your practice offers to patients. This can be accomplished without a large commitment of time, space, or equipment.

Once patients are instructed in the basic therapy program, they can continue with minimal supervision from the doctor. While this is not necessarily labor intensive, the doctor is responsible for progressing the therapy quickly as the patient improves, and monitoring the exercise for correct form and signs of strain. Necessary equipment includes physio-balls in 55-mm and 65-mm sizes, a rocker board and wobble board, and some type of resistance. Elastic resistance is typically an inexpensive and versatile apparatus that can be easily used to perform various therapeutic exercises. The amount of resistance offered can be easily increased and decreased, and the angle of resistance can just as easily be modified. The advantage of this versatility is that doctors can easily employ diagonal protocols to their patient’s routine. This equipment makes it as easy to rehabilitate an ankle as it is to rehabilitate the cervical-thoracic region.

Adding rehabilitation protocols to your office, in addition to increasing patient retention, can reinforce the chiropractic adjustment and increase patient satisfaction by offering more complete services at one location. One of my favorite outcomes is having patients really enjoy the rehabilitation process. Patients see and feel a difference before and after the exercises are performed.  Patients become active in their care, and share more responsibility for getting and staying healthy.

A back-pain patient who has sustained a severe low-back injury while performing some minor activity will be reluctant to become active, for fear of repeating the injury and experiencing the same outcomes of pain and disability. If this patient was injured to the point where he or she could not work or care for his or her family, this person fears the possibility of acute exacerbation of the injury. When therapeutic exercises are introduced at the proper time, and in the correct intensity, volume, and duration, patients find the challenge an acceptable one. The confidence patients experience in their abilities to increase activity by applying therapeutic techniques to work and activities of daily living helps patients avoid disability and undue mental and physical distress.

Marketing Through Products
Another approach to increasing in-house referrals is to offer a few important accessory products that can help patients recover from their injuries and possibly reduce the recurrence of future injury. The use of custom-made orthotics in practice is one marketing tool. Put a display in your waiting room featuring these orthotics and educational brochures describing their indications and benefits to patients. Patients will naturally develop an interest and inquire about these products. In 2004, to find out whether chiropractic patients were satisfied with their physicians who prescribed orthotics, I randomly sampled a list of patients who had previously ordered custom-made orthotics. Out of 100 questionnaires that were completed, 79 were satisfied with their orthotics and 73 would recommend orthotics to a friend. This is an example of spontaneous internal marketing based on patient referral.

Manuel A. Duarte, DC, MS, DACBSP, DABCO, CSCS, is a graduate of National College of Chiropractic. He has extensive teaching experience and lectures on a variety of topics, including manual treatment procedures, rehabilitation, orthopedics, and sports medicine.