Are Cash-Only Practices On The Rise?

In the last post (Chiropractic Marketing Is A Changing) I began revealing the answers to a recent blog survey I conducted. I left the answer to the final question to be discussed in full today.

The question I asked my readers was:

5. What is the biggest challenge you see facing you as a chiropractor over the next year?

The answers I received were very surprising. Let me explain…

First, a bit of history. I asked a very similar question in a survey about a year and half ago. The most common answer at the time had to deal with getting new patients. This was no surprise, as that has always been the biggest struggle in running a chiropractic practice.

Chiropractors struggle with the problem of getting new patients for a couple of reasons.

Reason #1: The common misconception of chiropractic by the public.

Reason #2: Most chiropractors complete disregard for using effective marketing and measuring ROI.

Number 1 above we can do little about individually, other than keep making our practices successful so we can reach more people. But the second reason above is totally within your control.

Why do most chiropractors have a complete disregard for using effective marketing? There are various reasons I’ve heard from doctors over the years, ranging from the “marketing is not professional” to the “it just doesn’t work in my area”.

So it wasn’t a big surprise to me that this was the most common answer with my survey last week. 36% of people mentioned new patients or marketing as their biggest problem. It’s definitely still a problem chiropractors face, and will be until we all become better educated on real chiropractic marketing.

What was a surprise was the second place answer, coming in at 35% of respondents mentioning it in their write-in answers. This new category of answers had to deal with health care reform (Obamacare) and the issue of cash practice or cash patients!

Now you may think this has been around for awhile, so it’s not big deal to see that answer. But think about it for a minute. Almost as many people are concerned about how the insurance industry changes will affect their practice as are concerned about actually getting new patients. This is a big change in our profession.

Especially when you consider only 4-5% of people mentioned anything about insurance or cash patients 1.5 yrs ago in my survey.

Also, what I’m noticing is that chiropractors are looking at the cash practice as a better, less stressful business model because of these new health care laws. This is much different from 5-10 years ago, when most chiropractors were switching to cash practices for more philosophical reasons.

I’m curious as to what you think about all this?

Leave a comment below telling us what type of practice you have now (cash or insurance), and if you plan to change it in the future (and if so, why.) If you didn’t participate in the survey last week and you leave a comment below discussing this, I’ll send you the link to the bonus marketing audios I gave away. (I can see your email address when you leave a comment, so you don’t need to put it in the comment itself.)

Chiropractic Marketing Is A Changing

As Bob Dylan once sang, ‘times they are are a changing’, and this is especially true in the profession of chiropractic.

Most of you can feel it, knowing that there is a wind of change blowing through our industry. Currently it may feel like a small breeze. But soon I fear it will be a strong, gale force wind.

But while some things are changing, still others remain the same. Which is good if it’s a rock solid marketing method, as I’ll soon show you below with the results of my recent survey.

Why are things changing? Two big reasons.

#1. A recent recession and still weak economy. This has caused some chiropractors to withdraw all marketing ( very dumb move if your marketing was previously working). Others had thought their low return-on-investment marketing would get them through the recession, but it didn’t. And still others sought after the magic pill that would save their practice, expecting a new marketing product would undo years of bad business management.

#2. Health care reform. (Also called Obamacare by some.) This is the biggest reason for change occurring in chiropractic. While there are still a lot of questions over this recent congressional bill, many chiropractors get the sense this bill is bad news for their practice. The ACA and ICA both seem to be convinced this is an “historic pro-chiropractic” bill, mostly because it will not allow insurers to discriminate against us. Of course some chiropractors have said to me they’d gladly take a little discrimination as opposed to an across-the-board-medicare-like system that has low payouts and excludes payment for exams, x-rays, therapies, etc.

Other chiropractors have taken a “wait-and-see” approach to this bill. After all, we have 4 years to figure things out, right? Well, if you are anything like me, being reactive is not something I like. Being proactive in growing my businesses has always been extremely successful, whereas being reactive to problems others throw at me ends in mediocrity at best.

Last week, I ran a quick survey to my list of blog readers. I limited the survey to 100 respondents and offered a package of marketing audios to those who answered every question of the survey. (Links to the audios will go out Wednesday to those who completed the survey. Thank you!)

Let’s look at some results of the survey. The first question I asked was:

Question 1. What area of marketing do you want the most help with right now

Now I expected a wide range of answers, which I certainly got. But I did not expect the answers to be strongly skewed toward what’s referred to today as “offline advertising”. Over 67% of the responders chose an answer in the offline group of marketing which contained newspaper advertising, internal referrals, MD referrals, attorney referrals and public lectures. Very few wanted help with their websites, pay per click, blogs, Facebook & Twitter. Is this because D.C.’s don’t fully understand these online methods yet? Or is it that the offline methods are continuing to outperform newer, online marketing strategies? (What do you think? Please leave a comment below.)

Question 2. What area do you currently spend most of your marketing budget on?

Big surprise here! A whopping 38% of respondents chose newspaper advertising compared to the second most popular answer (websites) being only 17%. This result was very telling of our profession for 2 reasons. First, there are many ‘salesmen’ shouting that newspaper ads are dead. If this was the case, why are so many chiropractors in June, 2010 still spending a large amount on them? And secondly, most businesses don’t continue to spend money where there is no return. Therefore, newspaper ads must be bringing in a decent ROI at least, compared to other advertising.

You may think this answer is not surprising, because after all I developed the Ultimate Chiropractic Ads, so of course the answers would be biased. But the interesting thing is, most of the people filling out the survey have never bought my newspaper ads.

So here is an example of one thing that hasn’t changed much, which is good because its working and continues to work well. Marketing that works well doesn’t need to change.

Question 3. Which form of marketing/advertising is currently most effective for you?

Here I gave the same choices as I had given in the previous 2 questions. No surprise here that the answer “internal referrals” won by a large margin. Everyone knows referrals are the easiest to convert to care and cost almost nothing to bring in. Taking 2nd place was public lectures and 3rd was newspaper advertising (which confirms the assumption I made about ROI above.)

Question 4. Which of these products, if any, would most interest you?

The answers to choose from were  weight loss, associate hiring /training, massage therapy and write in your own. This question brought a pretty broad range of answers. Write-in answers varied with 16 different answers typed in. Weight loss won, (but just barely) and all the other answers pretty much tied for 2nd place.

5. What is the biggest challenge you see facing you as a chiropractor over the next year?

This was a completely open ended question, with the ability to type in what you wanted here. This is where I saw the biggest change in our profession. Huge actually! But you’ll have to wait until Friday because I’m going to do a whole blog post just on this topic. I know, it’s annoying to wait, but sometimes it’s well worth the wait, right?

See ya Friday.

Neuropathy and Chiropractic Marketing

The neuropathy niche is becoming bigger and bigger. Millions of people suffer from this debilitating condition. But questions remain about who will provide the most effective treatment for these suffering patients.

Even the U.S.government realizes neuropathy is becoming a difficult problem to solve. The Neuropathy Association, Inc. states “The National Institutes of Health spent $35 million in 2004 and $29 million in 2005 on peripheral neuropathy research.”

People are looking for answers. And drug companies are not providing a solution.

This is why it’s an opportune time for chiropractors to teach neuropathy patients how they can help.

When I first starting writing neuropathy ads, I wanted to get across to the reader that chiropractors had a solution. One that has been proven to work in many cases. This educational aspect is still a part of the neuro ads I write each month for the NeuropathyDr program.

As the doctors who’ve ran my ads can attest to, the neuropathy market is a wide open niche. There is just so little competition out there right now. Which means you’re message can get through faster, easier and with very little expense compared to other niches (like decompression, fibromyalgia, etc.)

Here are just a couple of success stories doctors are getting with my neuropathy ads:

“Wow!  My first Neuropathy Ad brought in 12 new patients… about $5,000 and only cost $700 to run.  My practice is recovering and so is our cash-flow.” –  Julian Chipley, DC

“We have 37 new pt. scheduled from the ad.” –Dr. Chad Keeney, D.C.

“With Dr Beck`s ad I had 21 NPs and many of them have since referred other patients to us. The ROI thus far exceeds 20-1, and the tab is still running. The difference in my opinion is his copywriting skill…If I had his program 10 years ago, you wouldn’t be reading this, I`d be fishing off my tropical island someplace! – Dr Ren Halverson

Just like spinal decompression was all the rage 5 years ago, the neuropathy niche is only going to get bigger and bigger. Don’t be the last chiropractor in your town who taps into this market of patients.

No doubt there are neuropathy patients in your town right now looking for help. They’re tired of being pumped full of drugs to stop the pain. They want a natural solution.

The only question is how are you going to reach them and what treatment protocol will you be using?   While you don’t need to spend $100k (like you did on chiropractic school) or get some fancy equipment to help neuropathy patients, you should know something about what’s been shown to be effective.

Many chiropractors are including other modalities like the Rebuilder, nutritional supplements and rehab into their neuropathy treatment plans.

But which of these really work and which don’t? And how do you build a care plan around it?

Join Dr. John Hayes, Jr. and myself on a free webinar Thursday, June 17th, at 1:30 PM EST as we discuss a “Mid-Year Update” on the neuropathy niche and what you need to be doing right now to get more neuropathy patients.

Register for the free webinar here:

Chiropractors and their incomes

Are you happy with your income so far this year?

The June 3, 2010 issue of Chiropractic Economics magazine is entitled “DCs: Are You Back in Black?” The feature article in this issue is a their “13th Annual Salary & Expense Survey”.

This survey was taken from a good number of practicing chiropractors spread evenly throughout the U.S. Here are some major points that I got out of the 3-year comparison chart on pg. 33.

1. Franchises are declining. According to the percent of franchises in our profession from 2008 to 2010, the number is dropping significantly. The chart shows 3.9% of chiropractors surveyed in 2008 had a franchise, 1.4% in 2009, and only 1% in 2010.

Why are franchises declining? I’m uncertain. I have heard a few past franchisees say they didn’t get what they expected out of the deal. Perhaps the marketing didn’t live up to the franchisees expectations.

2. Associates are up, almost double from what they were in 2008 and 2009. 9.4% of those surveyed had an associate. This could be due to the recent recession, as more graduates are looking for a job, since they are unable to get a loan to start their own practice. Yet, this number is also telling of the owners who hire the associates. Are practices growing in 2010 to the point where they can hire more associates so quickly?

3. Salaries and DC compensations are still low. While definitely up from last year’s depressing numbers, the 2010 average salary of $87,538 has not returned to the level observed in 2008. The lower salary could be explained by the increase in associate doctors, but the overall DC total compensation is still low as well at $112,368.

4. The average chiropractor’s advertising expense is embarrassing. A general rule in business, one I heard even in chiropractic school, was that you should spend at least 10% of your monthly gross collections on marketing. I realize this will not always be the case. Some times you spend more, like when you open a new practice for example. Other times you spend a bit less.

According to the study, the average gross collections for chiropractors in 2010 will be $323,421. Yet the average spent on marketing is projected to be only $10,660. This isn’t anywhere close to 10%! The amount spent on marketing by the average chiropractor is only 3% of their collections. This is actually down from last year’s average of 4.6% spent on marketing and 2008’s 3.7% spent on marketing. This means chiropractors on average are cutting back this year on their marketing spend. It doesn’t make any sense to cut back now, as the economy is showing signs of recovery and many business are hitting a growth spurt right now.

What lessons can you learn from this?

If you don’t want to have just an average practice, increase your marketing spend immediately. What better time for your marketing to stand out than now, when everyone else is still cutting back.

Of course, you shouldn’t waste your money on useless marketing that doesn’t work. It’s best to use direct response marketing to bring in new patients every week of the year.

If you’re spend increases on productive marketing, your practice can only grow. And then you’ll be far ahead the “averages” mentioned above.

Here’s a list of tools & products I recommend for helping you get more new patients in over the summer. Some are mine and others are excellent products from friends of mine who’ve proven themselves in the field of chiropractic marketing.

Use these tools now to bring in more new patients. Don’t waste the whole summer, thinking “everyone is on vacation, no one will come in.” Cut the excuses and grow your practice to the level you always wanted it to be!

The Ultimate Chiropractic Ads

Decompression Marketing

Internet Marketing for Chiropractors

Neuropathy Marketing

The Best Time of Year for Chiropractic Marketing

When is the best time to spend money marketing your practice? What season brings in the best return on your investment?

Ask most chiropractors this question, and you will get a variety of answers.

Some will say you should never advertise in the summer, as everyone is gone on vacation. Other chiropractors, especially the more northern ones, will say do not advertise in the winter due to holidays and bad weather.

I actually had a consultant years ago who went through all the months that were bad for marketing. January is insurance deductible rollover month. Feb. was ok to market in. March was spring break, so not good there. April was tax month, so that was out. And on and on. I think he said 2-3 months out of the year which were good to advertise in!

So what are the best and worst months?

In the June 3rd issue of Dynamic Chiropractic, a poll was taken of 144 chiropractors, asking them “Do more patients seem to come in during a particular time of year?” Here were the results:

Spring – 29%
Summer – 15%
Winter – 17%
Fall – 17%
No real change – 22%

From these results you might be lead to think that Spring is best for new patients. But this poll shows that almost a quarter (22%)of those polled said it didn’t matter which month, there wasn’t a big difference!

Not to mention there were still quite a few doctors who said Fall, Summer and even Winter was their best season for new patients.

Here’s the truth…

There is not magic month for marketing your practice! You should be marketing you’re practice every single month of the year. The month you take a break from marketing your office, it will suffer. Maybe not right away, but it surely will suffer during the following months.

Some doctors take a month or two off from marketing, and this puts them into a tailspin that becomes difficult to recover from. A month off causes less revenue. Less revenue usually less to spent on marketing. Less spent on marketing means less new patients. And on and on down the spiral it goes.

But with that said, there are going to be months that are better for you than others. I tracked my office’s pattern for years, and found a general pattern of months that could really produce.

For me, they were March or April (usually 1 of the 2), July, and the block of Sept. through November as a whole. But you shouldn’t assume mine best months will be the same as yours. Look at your own stats to determine which months work best. (You are keeping good monthly stats, right?)

Some months I even had some huge swings, like the year December was my best new patient month.

So during these “super months”, I will double or triple up on my marketing. If I was running one of my Ultimate Chiropractic Ads a month, I might run 2 or 3 in those months. Or add telemarketing to those months only.

Don’t make the mistake of thinking these “super months” are the only time you should market your practice. If you find a great month, that’s proven itself (at least two years in a row) to be good for new patients, then it would be prudent to spend even more on marketing during that month in the future.

Now it’s your turn. Comment below and tell us what months you’ve found to be the best.