by Ivan Delman, DC

Many marketing plans focus on how to get new patients. The best application of a good marketing strategy will include new patient retention.

When you analyze the efficacy and value of your patient services, you must examine, in detail, all the segments of your practice that will best enhance the doctor-patient relationship.


The 5 Basic Elements

The successful doctor-patient relationship is a balancing act. In other words, it is an equation with you on one side and the patient on the other. To best make this equation work, you have to have, at least, the following five basic elements:

• Utilization of all your chiropractic technical expertise and life experiences in your treatment protocols

• Maintenance of a strong, consistent program aimed at projecting your image as a competent and professional doctor to the patient community

• Construction of a fee schedule that is affordable to the greatest population in your marketing area without demeaning the value of your services

• Reminders to your patients of the value they are receiving as a result of their visits to your clinic

• Development of a strong rapport between you, your office and your patient. Your prospective and current patients do not intellectually dissect your adjusting ability, your X-ray competence or your diagnostic acumen. Your patients base their relationship with you on trust. One of the key elements of your patient’s confidence and good feeling toward you is how they are treated in your practice. It is a given that your chiropractic work is just short of Merlin’s magic. Your technical abilities, however, are only a small part of the processes necessary to develop rapport, confidence and trust between you and your patient.


Nothing New Here!

We knew our “stuff” by the time we had earned our licenses. We were confident that our technical orientation was on a higher plane than that of a proofreader working in an M&M candy factory (apologies to any proofreaders).

Our patients expect us to be technically competent; therefore, when we advertise that fact to them, it’s not news. They expect us to be on top of our game and to know our trade. The marketing strategy whose success depends on showcasing your technical competence

is an ineffective approach. Unless you have very special training that can be addressed to a substantial market which requires your knowledge of that special training, you will severely limit your growth.


Trust and Respect

A remarkably valuable asset is having the ability to develop a solid rapport with patients. After you establish a trusting doctor-patient relationship, you then follow by helping patients better understand the benefits of your chiropractic services. Image has an important place in that type of planning. An image is much more than appearance.

Obviously, you shouldn’t totally ignore your appearance because that is also important. For example, your normal office attire shouldn’t include pants you picked up at the local Goodwill store. Patients expect the doctor to have a clean, professional look. Informal is OK, as long as “sloppy” or “homeless” doesn’t describe your informal attire.


Creating a Picture

Image is more than how you look. Your looks judged alone are a superficial evaluation. More importantly, you should be alert to the image you create in a patient’s mind as a result of your other actions.

To explain…You demonstrate your technical expertise when you accurately diagnose then resolve your patient’s presenting problems. This creates a positive image to your patient. Concurrently, you create a strong image to your patient by the way you and staff manage that patient.

To illustrate the image you can create over and above your expertise, here are some questions to ask yourself when you evaluate your patient management protocols:

• When your patient first entered your clinic, were they greeted by the front desk person in a friendly manner?

• If your front desk person was on the phone when your patient arrived, was the patient acknowledged with a wave and a smile?

• Did your patient wait more than five or 10 minutes in the reception area before the start of their treatment?

• If the patient had to wait more than 10 minutes, did you or staff come over to them and let them know they were not forgotten?

• When was the last time the doctor came into the reception area to apologize for making his patients wait too long?

• Was a patient taken on the day they called with an unscheduled problem even though they had no appointment?

The idea behind all of the above questions is to see if you and your staff are consistently working to make the patient feel valued. That’s one of the most important keys to the doctor-patient equation. The patient must feel you are worth the time, effort and expense they will be spending to see you for treatment.


Increasing Your Value to Your Patients

You spend a large amount of your time and perhaps a good chunk of your budget to get

new patients into your practice. You might want to ask yourself, “How much of my assets (time and money) should I spend to keep these valuable people?” As you know, it’s better to keep your patients than have to constantly look for new patients.

Let’s start from the basic idea that you are not alone in providing chiropractic services to your marketing area. You work in a competitive atmosphere. Assuming you’re not going to invent a new type of pie, there are others who want a piece of your existing flavor. In order to grow your practice, you have to figure out how you’re going to make your services special. You want to be noticed and needed by the chiropractic consumer.

If you want to get noticed by your community, you can leave your clinic for a day and rob your friendly local bank. However, I doubt if you’ll be wanted except by the authorities.

You can drastically reduce the cost of your services; however, it might demean the value of your services. You also could be declaring bankruptcy in a couple of years.

An excellent strategy is to improve your services so they are special and increase the value of your services to your prospective or current patients. Let’s look at that part of the equation.

Let’s assume you’re already in practice and your technique is fantastic! You feel you are a technique legend, but in reality, you’re legendary only in your own mind. Patients will place more importance on the doctor/patient relationship than even the ability of the doctor to resolve their problem.

If you have trouble swallowing that concept, how many patients have you seen that never return? You bent over backwards to help ease their problem. Why didn’t they come back?

Some of the non-return reasons might be related to money; however, many patients will answer, “It (the treatment) was OK, but I prefer Dr. So and So down the street.”

Why? Dr. So-and-So Down the Street has been able to develop stronger doctor/patient relationships than you.

When you talk to your patients to find out what can be done to increase your service value, they will not want to hurt your feelings. They’ll tell you, “Doc, you’re a fabulous chiropractor. I don’t know what I’ll do when you _____ (add in any word applicable such as retire, move away, get pregnant, etc.)”

Yet, when those same people disappear (though they are still in town), did you ask yourself why? This question becomes even more important when you start to receive requests from local DCs for that patient’s records.

Therefore, you should try to find out if your current patients are happy with the service in your clinic. It is the rare patient who will give you an honest answer. The patients will usually give you the answer they feel you’ll want to hear at that time. The true and honest answers will either be missing or changed to suit the listener.

Unless you’re really sharp on reading body language, listening to the tone of their voice or watching the respondent’s eyes, you’ll miss the well-meaning lies of your patients. Don’t kid yourself! Your antenna doesn’t always pick up all the channels.


How to Use a Third Person

The key to getting honest answers from your patients about the value of your services is to not ask the questions yourself.

This is where a third party enters the arena. The person you pick could be an outside party or a trusted member of your staff. Your third party will be entrusted to obtain practice information about you and the value of your services. Again, marketing research reveals that a person will give more honest answers to a third party asking the questions than when you are the questioner.

Also, if you are considering surveying your patients in discussion groups, that atmosphere is not conducive to giving you answers you can use to form a strategy. Patients will give answers they feel the group would want to hear. You’ll hear answers such as, “Oh, I’m very happy with the doctor’s services.”

Now that statement may hold a lot of truth; however, it rarely will hand you the data needed to accurately assess the level of your patient services. You must use a third person to obtain that information. Survey cards are also useful but are less successful.

The single most important question your questioner should ask the patient is: “What can the doctor and his staff do to better serve your needs?”

As we said in the beginning, you have to figure out how you’re going to make your services special, be noticed and also wanted by the chiropractic consumer. If you key in on the patient’s needs and perceived values, you will be able to elevate the value of your services as seen by your patients.


You Be the Patient!

To help you come up with the questions to determine what makes you special now and what will enhance that situation, place yourself in your patient’s shoes.

For example:

• Take the time to sit in the reception area and listen to the chatter of your staff. Check out the comfort level of your seats. Is the literature what you want patients reading? Do they bring their children? Is there a place for those children to be comfortable when the parents are otherwise occupied?

• Put on a robe and sit in an exam room. How long does 5 or 10 minutes feel? How comfortable is the seating area in the exam room? Are you able to hear a lot of noise and chatter from the exam room?

• Take the time to fill out all the new patient paperwork. Are there redundancies in the intake forms? How long does it take? Is there a comfortable place to fill out the paperwork?

When you put yourself in your patient’s shoes, your new perspective will be illuminating!

Think of your best and also your worst patients, keeping in mind all the aspects of managing and moving that patient, with the exception of techniques. Always keep your focus on the patient’s needs and perceptions.

By the way, when you are looking for responses from your patients, don’t ask your relatives or the few of your patients who might have too much chlorine in their gene pool.

The answers you get from the “fringies” will skew your analysis.

Your answers should come from your general patient population.

Your patient’s loyalty to you, and subsequently your practice, will be based on how they feel appreciated and the value of the services from you and your staff.

Incorporate those elements into your practice and watch it become stronger and grow!


by Ivan Delman, DC. Reprinted with permission from Do Write Publishing.

Dr. Delman is the author of the book The Business of Chiropractic: How to Prosper AFTER Startup. He has degrees in both business and chiropractic. After 38 years of enjoyable, productive work in both fields, he and his wife have retired to travel and write.

Dr. Chris Clark, a chiropractor and consultant, purchased Do Write Publishing and Business of Chiropractic Publications in 2007.