A Student Interviews Me on Chiropractic Marketing

Recently a student from University of California Riverside contacted me for an interview regarding chiropractic marketing. I thought you might be interested in his questions and my answers. It’s a little longer than my usual blog posts, but I didn’t want to divide it up into parts.

Here is the interview:

Greg: I’m a student at UC Riverside. I am taking an internet marketing course and we were all assigned a niche (ex. chiropractors, plumbers, dentists) and was told to create an online marketing plan for these professions. I was assigned chiropractors and in my research, I found this site. You seem to be an authority in the industry so would it be ok if I ask you a few questions either through email or phone about Chiropractic Marketing and ROI.

Thank you for taking the time to answer my questions. I really appreciate it. My class revolves around internet marketing and its impact for businesses today. I have a couple of generic chiropractor questions and a few more specific internet marketing questions.

My first question: When you are training to become a chiropractor, do they teach you just what you need to be a skilled practitioner or do they also teach you how to run your own chiropractic business. Basically, do they teach you how to market yourself?

Dr. Beck: No. Most chiropractic colleges have one class on the business side of chiropractic and it is very bland. The teacher is often not in practice or if he/she is in practice, they are reluctant to give too much information on marketing, fearing that the college would not approve. The chiropractic schools do a great job of teaching us how to be skilled practitioners and caring doctors, but the business training is really lacking. And you see this affecting the profession with many chiropractors struggling to make ends meet.

Greg:  Do Chiropractors in large cities charge significantly more/make more than those in smaller cities? Or is it mostly standardized across the nation.

Dr. Beck:  There is certainly more potential in a large city for higher income, due to the higher density of potential patients. However there is more competition in large cities and overhead expenses are much higher. Smaller towns allow lower monthly overhead so that the business can have a higher profit margin. Plus smaller towns can allow for easier referral capacity. So it’s a toss up in my mind. I say live where you want to live and raise your family.

Greg: I saw on your website that you mentioned for one example that the lifetime value of a patient is $1800. Is this factual or was it just used for the example? If the latter, what would you estimate the lifetime value of a patient to be.

Dr. Beck: The term “lifetime value” is a typical marketing term used to estimate marketing costs and return on investment. If you take the lifetime value of a customer, then you can determine how much you can spend on marketing to acquire that customer. The lifetime value of a chiropractic patient is between $1000-3000 on average, depending on the type of practice, location and services offered. Some highly specialized niche practices will make higher than $3000. Anyone making less than $1000 per patient, averaged across 12 months, will find it very hard to be profitable in today’s world, unless of course they are getting hundreds of new patients per month.

Greg: I’ve noticed that in many large cities, the Google PPC ads are about $2-$3 a click. Even with a 10% conversion rate (just a guess by me), $30 for a patient worth $1000+ seems like a steal. What are you thoughts on this? Are chiropractors just unaware of these options in acquiring more patients?

Dr. Beck: A 10% conversions directly from Google Adwords would be quite high in my opinion, for any business. The actual number ranges between .5-2% depending mostly on the landing page copy on the doctor’s website. If we assume a conservative 1% conversion rate and high (in most areas) $3 per click, then it would take $300 to get a new patient. At a lifetime value of $1800, that is still a “steal” as you say. The return on investment (ROI) is quite high, with a $1500 profit per patient. Are chiropractors unaware of this? I don’t think most chiropractors understand Pay Per Click well like Google Adwords and they may have been screwed over by a company running it for them in the past. Also, many chiros have been told bad marketing proverbs like “you should never pay over $100 per new patient”, which causes them to quickly decline paying $300 per new patient.

Greg:  In our study one of the questions that we have to answer is if we had a website that ranked for “chiropractor in city” and was getting 100 targeted clicks a month. Not knowing how many people are going to call the chiropractic business, what should we charge the chiropractor for this website per month. What would be a fair price for the chiropractor as well as the webmaster on a monthly basis?

Dr. Beck: Words like “fair price” will mean different things to different chiropractors. So if asking them directly what they would pay for a website, it would depend on the money they are making at the time. Many chiropractors are paying upwards of $3000-5000 for really bad websites; websites that looks great but fail at getting new patients. Other companies charge a monthly fee like $500 for a website design and maintenance (which does not include an PPC.) I personally think no more than $1000-1500 for a website and additional monthly fees for Adwords management.

Greg: What would be the maximum you pay for the lead. We are going to assume he is a random patient meaning he may only go to the initial appointment or he may stay for a few years.

Dr. Beck: How much would I pay for a lead in practice? Almost nothing since leads do not equal new patients. I once bought a chiropractor’s files who was going out of business and mailed out letters to all 1000 of them. Not one came in. But I assume by the word “lead” you mean new patient. How much would I pay for a new patient? I would pay at least 70% of the lifetime value. But few chiropractors will do this high of a number, because of multiple factors mostly related to now knowing their numbers. (Most physicians and healthcare practitioners are not known for their ability to keep good business statistics.) Many chiropractors have been told they should pay little to nothing to get new patients in. Some have even been taught it’s unethical for a doctor to do any type of marketing. Also as I mentioned above, there is this proverb going around that we shouldn’t pay more than $100 per new patient, so that’s a baseline for you to consider.

Regarding a “random patient” who might stay one or might stay 100 visits, all this is factored into the lifetime value number as it is an average across your practice.

Greg:  I appreciate your time. I’m grateful for any help and I am looking forward to hearing from you. Thank you very much, Greg Larkin, Student at UC Riverside.

How To Determine The Success of Your Marketing

How do you know if you’re marketing is working?

Many would say the answer is “by the number of new patients” or “by the number of phone calls.”

While these are both good signs that help you to determine if an ad is successful or not, they are not the right way to measure success in marketing.

Let me show you how measuring your return on the number of new patients only can mislead you. Here’s an example of a conversation I once had:

Doc: Dr. Beck, I only got 5 new patients from the ad I ran. I consider this a failure!

Me: How much did the ad cost you to run?

Doc: $500

Me: Did all 5 patients start care? And how much is your average case fee (or lifetime value)?

Doc: $1,800

Me: So you made $9,000 from an ad that cost you only $500 and you consider that a failure?

I know as chiropractors we get all wrapped up in talking about the number of new patients we get from certain marketing campaigns. It is an important stat to keep. But successful business know that it’s your return on investment (ROI) that really matters.

That’s ROI for the whole practice and specifically for each ad we run.

So how do you figure the ROI? Let me show you by using some real numbers. Here’s an email I just received from one of my Decompression Marketing Elite clients:

Hello doc,

Stats update from first EM ad ran as insert; collections in my hand. Ready for this? lol!

I ran in as 21,500 inserts in a free paper; printing cost $515.41 Distribution for inserts cost me $376.25 = total of $891.25 combined
15 day only offer of $35 expired 9-6-11;

Grand total= $17,490.00 collected with residual collections for multipal payment program option uncollected yet. Table is now filled for next 6.5 weeks!

27 new SD patients were scheduled
7 still remaining to be seen.
8 signed and paid in full

Now let’s do some math. I calculate marketing return on investment the quick and easy way. Take the total amount collection and divide it by the cost to run the ad. 20:1 ROI (19.6 rounded up) as of right now, just 2 days after the expiration date of the ad!

$17,940/$891 = 1962% ROI
or 20:1 Return

It goes without saying that not everyone will get these kinds of results. Some will do even better. Many will get a great return although it may not be this high.

But the point is this doctor has kept excellent records of his ad and is quickly able to figure ROI. He’ll need to re-figure the results later after ALL the money has come in. So in the end, it should be even higher than a a 20:1 ROI since 7 new patients have not yet come in and the residual payments have not all been collected.

What kind of returns are you getting from your chiropractic marketing? And if you aren’t measuring ROI, how do you know if your campaigns are successful or not?