Are you sub-niching your marketing prospects?
Watch this segment of a decompression webinar I gave. Whether you do decompression or not, you need to understand what sub-niching is. (If you do have a decompression table, watch the complete webinar here.)
We all want to grow. We want our practice volume to grow, our income to grow, and our positive influence in the community to grow. Often times in our quest to grow we jump at every strategy that comes our way, thinking we’ve finally found “the secret” to growth.
But the truth is there is not a huge secret to growth. There are 5 simple strategies to grow. If you improve in these 5 areas, your practice could not keep itself from growing. If your struggling to grow take a look at this list and find the one (or more) strategy that you need to work on.
1. Acquire More New Patients
As I’ve said, there is not secret and this point proves it. Everyone realizes you’ve got to get more new patients to grow. While there are plenty of business coaches telling you to plug the “leaky bucket” and not worry about new ones, common sense tells you that new patients are the life blood of your practice.
So if everyone knows about this strategy, why aren’t more people successful at it?
Well, knowing about it and being good at it are two different things indeed. Most chiropractors (any health practitioner for that matter) have been told various lies about marketing, like: it’s degrading, it’s not for doctors, and my personal favorite “marketing is unethical”. Of course there are snakes out there doing these things. Yet one bad apple doesn’t mean all the rest are bad too. If you’ve got a website, that’s marketing. A business card, that’s marketing as well.
You get the point. Marketing is extremely ethical, especially if you’re in a profession that can help people. It would be unethical to be able to help people and then keep them from finding you for your services. So the question you really need to ask is “how do I find and use effective marketing?”
The general answer is to find and use marketing that proves itself. If you have proven yellow pages work in your area within the last year, by measuring the ROI, then keep using them. If your town has a newspaper, then you should know if a good ad will work there. The specific answer is to look at the links above in the menu bar and the Other Tools where I recommend other people’s products.
2. Get Stronger Conversions
What good goes it do to get 30 new patients a month if you only convert one of them to care? I struggled with low conversions when first starting in practice. Some of my problem was confidence issues, but the bigger part was poor presentation. No, you don’t have to be a sweet-talking care salesman, but you’ve got to present your case with truth and certainty. Imagine going for brain surgery and the surgeon is nervous, uncertain and not very trustworthy. Would you “start care” with him?
The easiest way to get better conversions is to bring in better qualified patients. Patients referred in by others are usually very qualified for care and have already gotten a recommendation from someone else. Also, by using effective marketing like I mentioned above, you can market to certain conditions which are more likely to follow through with your care recommendations.
For more tips on conversions, see my article entitled “14 Ways to Increase Your Conversions“.
3. Collect More Per Visit
How much do you collect per visit on average? Not a guess, but the actual number?
If you’re like I was the first 2 years in business, I had no clue. I thought that since my charge for adjustment was $45, that was my average. Imagine my surprise when I actually did the calculation and found it to be $17. No wonder some coaches tell people “not to worry about the numbers” — wow! How many visits do you have to see at $17 to make a living these days?
So the point is figure up your number and know it. Take all the gross collections you made last month, or last year, and divide by the number of visits in that time period. You may be surprised at what you find.
So how do you increase this amount?
You need to add more services that the patient wants or needs. Easy ideas are massage, nutritional supplements, rehab, weight loss programs, etc. I’m not saying you’ve got to be a Walmart and offer everything under one roof. But adding a couple of extra services you and your patients are interested in will only benefit everyone. Another thing you can do to collect more per visit is raise your fees a little. The costs of running a practice do go up over time, so don’t be shy about raising your fees to make up for it. If you’ve been holding off for years from doing this, now is the time.
4. Increase Your Patient Visit Average (PVA)
Of the 5 things listed here, this is one of the most difficult. I know, you’ve heard stories about people having a PVA of 100+. And they may be using the easier way to increase PVA, which is to discount everything down to nothing (like the $17 a visit mentioned above!)
But for the rest of us, we realize that human nature is what it is, and we live in a world that does not like to commit. It’s nothing for people to have an excuse for missing appointments. Other may not like the perfume your front desk wears and they’ll go down the street to see someone else.
The best way to increase PVA is simply to tell patients at the beginning how many visits you recommend. Not scaring them into it or anything like that. But simply saying here’s how many I think it will take. Other strategies that help are patient education, front desk follow-up, in-office marketing, and having a good rapport with patients.
5. Lower Your Overhead
The one everyone body loves to hate — overhead expenses! But the easiest way to increase your income is to keep more of what you make.
Many doctors think there is nothing that can be done about their monthly business expenses. But this is not true. Everything is negotiable, from lower rent and CAM charges on a lease to a lower monthly cell phone bill. Simply contact all your vendors/suppliers and ask them for lower rates.You’ll be surprised how many will budge.
Also, paying interest on debt every month can kill a practice. What if you kept all your debt payments every month and pocketed them. How much would that add up to? Develop a plan to repay your debt as soon as possible. I followed and recommend the Total Money Makeover.
Some doctors cut out their marketing budget to reduce expenses. But this is very, very dangerous and can send you into a deadly spiral (which I wrote more on here.)
Which of these 5 strategies do you struggle with? Leave a comment below.
Which marketing strategies are currently working the best? How much should you spend on each of them? Find out in these two snippets joined together for you from my recent Decompression Marketing Elite program.
In the video I mention the following categories. More resources can be found to help you when you click on these links:
Chiropractic Newspaper Ads
Google Adwords
Websites/Blogs
Internal Referrals
Social Media/Facebook
Workshops/Lectures
The end of the calendar year, what many Americans call the Holiday Season (Thanksgiving, Christmas, New Years), is quickly approaching. For many chiropractors, this is a bustling time of new patients and high profits to finish out the year strong. For others it represents some of the hardest and leanest months on record.
Why the difference?
It comes down to your view of marketing. There is a myth that’s been perpetuated in our profession for many years. The myth that says you shouldn’t market in certain months because of holidays and vacations. Have you ever heard such nonsense?
I actually had a consultant when I first started out in practice that went through all the ‘bad marketing’ months. January is insurance deductible rollover month. Feb. was probably okay. March was spring break, so not good there. April was tax month, so that was out. The summer was out because everyone went on vacation. December was bad because of all that Christmas spending, no one had money to come in. Plus insurance plans were maxed! And on and on. I think he ended up listing at most 2-3 months out of the whole year that I should use paid marketing!
You may remember the Dynamic Chiropractic poll which was taken awhile back on this issue, finding there was no difference between summer, fall and winter when it comes to marketing. The interesting thing was that 22%, a fourth of doctors polled, said it the season didn’t make any difference in their marketing.
Now that’s the attitude you should have. If anything the Holidays are an excuse to ramp up your marketing because your marketing will stand out even better as your competitors will have believed the myth and pulled back on their spending. Many doctors have realize this little secret and done very well.
Sidenote: In case your not familiar with this blog, when I say “marketing” I mean effective, proven marketing strategies, methods and techniques. I’m not speaking of getting more brochures printed up or drop a few business cards off at the local restaurant.
I’ll never forget the year I put an ad in the newspaper the week before Thanksgiving. It was later in the month I would have liked, considering I believed at the time I shouldn’t be marketing at all near the end of the month. And my ads usually have a 2 week deadline to take action on the offer. But things just didn’t work out for me to get it in earlier. “Oh well”, I figured, “at least they’ll have 1 week to come in.” The results surprised me. A few came in that first week, but we actually got swamped the three days before Thanksgiving Day. I think we had 7 or 8 new patients the day right before, meaning when came back the following week I was going to be doing multiple report of findings. What better thought to have on a 4 day holiday?
Let’s look at the reasons why you should market heavily during the next two months.
Now I’m not saying you should ignore certain aspects of the Holidays when you do your marketing plan. I would not put an ad in the paper on Christmas Day or New Years day for example, or even the day before. Also, you shouldn’t run ads when you’ll be closed unless you have a good answering service.
Here’s where my focus would be on marketing in the next two months.
Newspaper Advertising: Run a chiropractic ad or decompression ad at least once in November and once in December. Twice each month would be even better, but in December run your second ad before the 20th. I would also have an ad coming out the very first week of the new year. (Look for a special New Years ad I’ll be mentioning in a few weeks.)
Internet Marketing: I would keep it running right along smoothly with article marketing, email marketing, SEO backlinks and Google Adwords. Now there is a trend at the end of the year on Google (see chart below) where people do search less for the term “chiropractic”. But we need to consider a couple of things here. First, since you only get charged 
when your ad gets clicked, if no one is searching for this term your ad won’t show and you won’t get charged. Secondly, even if someone does click your Adwords ad, they are interested and have just as much chance of coming in as someone who clicked your ad in April, or June, or any other month. Thirdly, you definitely should be marketing to other keywords than just chiropractic. In fact all keywords take a dip in mid December on Google (except for toys, gifts, etc.), but they also spike quite a bit right after Christmas.
For example, take a look at the chart above which is a Google Trends graph for the search term “sciatica”. See that spike right at the end of the year. You want to be running your ads then for sure. And lastly, it’s been confirmed from Google Adwords experts that one of the worse things you can do is to turn off your ads. This messes up your past history of success with Google, jacking with your bid rates, quality scores and more.
Referral Marketing: Continue with an effective internal marketing plan, but adding to it at least one special event near Thanksgiving food drive, Christmas toy drive, or New Years “get back to health.” As Dan Kennedy says, these are great times to create a special marketing event. Don’t waste it. Also, these events allow your patients to give to those in need helping others to enjoy the holidays.
We’ll look at more ideas in the coming weeks. Have you laid all this out on the calendar yet and put things into action? If not, what are you waiting for, Christmas or something?
Axiom Worldwide, LLC, the maker of the DRX and DRX9000 decompression tables appears to be in liquidation.
What does this say about the current decompression market in the United States?
Not much in my opinion. There are too many questions left unanswered to determine what the cause of their bankruptcy was.
Was it caused by the recession, meaning less sales on their part? Was it due to bad management, hubris born of success, or their recent troubles in Canada? Did it have something to do with the FBI raids on their office back in 2007?
We simply do not know.
What I can tell you is that if you own a decompression table, many people will be trying to use this as a marketing ploy to scare you. One company sent out an email to some chiropractors, trying to scare them into “buying” publicity websites so as to drown out the negative publicity for DRX tables on Google. I’m sure others will soon follow, using fear to motivate you to waste money on useless marketing.
So if you own a DRX table (or any kind of decompression table), what are you supposed to do in light of all this negative news?
As far as marketing your practices goes (which is my specialty, not law), I’m recommending my clients focus on growing their practices and getting more new patients. Decompression offices are still overflowing with new patients, as the need for such treatment has not dropped off and likely will not as the population ages.
Here’s one thing I would NOT do if I was your shoes…
I wouldn’t be using old outdated advertising that talks about “NASA claims”, “FDA Approved” or even mentions the name DRX or DRX9000. You see, that’s the problem with promoting the name of a piece of equipment instead of your practice. If the name of the equipment gets a bad rap, you’re up a creek without a paddle. But if you market your practice as designed to help people who are suffering with herniated discs, sciatica, etc., and a company goes bankrupt or gets bad publicity, it doesn’t affect you.
When I first started looking at decompression tables, I was told the DRX table was the only “true spinal decompression table”. That they would be patenting the term “spinal decompression” soon and no one else could use it. One prominent marketer (at the time) even had ads written for his clients. I personally would not be making this claim any more either, as it is likely not going to go over well with the current news about DRX tables.
Keep marketing the results of your table in an ethical and professional way. This is why testimonials are so important. You’ve seen patients get better. You’ve seen them get well, preventing back surgery or a lifetime of dangerous medications. So you know decompression works. The problem is not if it works or not, but how we market it. Do we make hyped up claims or simply use educational advertising with condition-centered copy?
Decompression is about results for the patients…not about any specific table.
Over the past few years I’ve proven educational ads focused on patient results provides the best results. This is why I write non-hyped up ads. NASA and walking on the moon has nothing to do with decompression tables, and it never has, therefore I don’t put those claims in my ads.
In the end, I’m sure all of this will blow over and be a thing of the past. But what about your practice? Will your practice be thriving or barely surviving at that time?
If you are thinking about getting a decompression table, but have not yet, I urge you to read my previous article on this entitled “Decompression Marketing Solutions“.
One of the most frequent questions we get about the Ultimate Chiropractic Ads (and even Decompression Marketing Elite) is…
“Can you send me a sample of one of your ads?”
In most cases, I understand that this is an honest, sincere question to see what type of ads I write. Usually, it’s to compare to past advertisements the doctor has used in his office. So I realize people aren’t out to steal my ads. But there’s a big problem with this request. To me, this question might as well be…
“Can you send me $50,000 in cash as a sample, to just look at?”
Why would I equate the two requests? Because unlike custom made advertisements, where a copywriter sends over samples he’s written in other industries, my ads are ready to go for one specific industry. That means any chiropractor can quickly change their name and number, insert them into the paper and start getting new patients. (Like the customer who called us yesterday from North Carolina and said his phone has not stopped ringing after running the neuropathy ad one time, scheduling over 40 new patients so far!)
You see, the ads I write aren’t “samples”. They are real ads I’ve spent quite a bit of time and money researching and writing. We don’t have any samples. The ads are all ads, ready to go and bring in quality new patients. Even if we did have samples, reading it would tell you very little. Unless you’ve spent thousands of hours studying copy-writing and testing ads, you’re not going to be able to see the nuances of how my ads work.
That’s not being harsh, just being honest. I’ve had two chiropractors, who’ve spent years writing their own ads, now use mine and love them. They’ll be the first to tell you that their own ads worked okay, but after using mine they won’t likely ever go back.
An advertisement works because it produces new patients. Not because it looks beautiful or professional (although I think my ads are both!) Even if the words of an ad are the most beautiful prose ever written, if they don’t bring in new patients they are rubbish.
To ask the question a slightly different way is to say…
“How are your ads different than what I’ve used before?”
Now this is the question most people want to know, and 90% of the time the ‘question behind the question’ of “can you send me a sample”. There are really only 2 reasons to want a sample. Either to run it and see how it does or to see how it looks and reads to differentiate it from other advertising the doctor has seen in the past.
As an aside, sometimes we get the “if you’re ads are so good, why don’t you let us try one for free, then we’ll buy the rest” type of request. I guess we could do that, if we were willing to get our attorney to write up a very long, lengthy contract, making this requester promise to pay a percentage of what he makes, with various clauses for defaulting on the agreement, etc, then pay said attorney thousands of dollars to prosecute violations of this contract, which we all know would be numerous. OR I could just give you a 90 day trial period with a money-back guarantee, and save both of us some legal bills!
But seriously, if you’re struggling in practice ( I feel for you, as I was once there myself), as hard as it is to sometimes admit it to ourselves, if the 3 payments are too steep for your budget right now it’s time to hold off from buying. If $465 is too much, then you aren’t going to have the money to run an ad in the paper once you get them. And I know for a fact my ads will not work if you shrink them down to a tiny little business card-sized ad to save money.
As to the question of “how are your ads different”, let me attempt to give a quick summary. (More detailed information about these differences are given on the websites linked above.)
I could go on and on, but these are just a few that I’ve listed here. We really have tried to come up with the best chiropractic marketing product available for you to bring in quality new patients. If you haven’t tried them out, what are you waiting for?
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!
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.
The more fishing poles you have in the water, the more fish you’ll catch, right?
I’m not a big fan of this analogy, and here’s why.
First, let’s look at what’s true about it.
It is certainly true that you want to have more than one marketing method being used in your office. And seeing as most chiropractors don’t have any solid marketing strategies in use, I can see why so many marketers are teaching this analogy.
In fact, many chiropractors expect there to be one magic pill that fixes their marketing woes. Relying on only one marketing strategy in your practice, even if it works great, is a recipe for failure. Hey, my Ultimate Chiropractic Ads work great in getting hundreds of new patients and thousands of dollars into your practice over time, but I have never claimed they’re the only marketing method you’ll ever need in practice.
With that said, let’s look at the fishing poles analogy a little closer.
More fishing poles is always better, right?
Are more new patients always a good thing, or does quality factor into the equation?
I don’t know about you, but I’d take 10 referral new patients over 50 telemarketing new patients any day of the week. You see, quality of patients is a big factor as well. Therefore, all marketing methods are not created equal.
I realize when we start talking about patients (people) having a measurement of quality associated with them, it’s going to make some doctors uncomfortable. I hope you realize I’m not talking about the way they dress, talk, or even act. Truth is, there is only so much time in the day. I would rather spend that time working with people who really want help and are willing to pay full price for it.
Back to our fishing poles analogy. After hearing it, you might think, “if having more marketing strategies is always better, why not 50 of them? Why not 100? Why not 500?” and so on.
I grew up fishing. My grandparents fished the rivers of Central Texas. My parents still fish the lakes every summer. By the time I was 18, I had eaten more catfish then most people do in a lifetime (and catfish is not the healthiest fish either!) I still like to go with my kids, when I can actually get away.
And there’s one thing I know about fishing…there’s a limit to how many poles you can handle at one time. At most you can hold one in each hand, then maybe have 4-6 in holders on the boat if you are really good. What do you think is going to happen if you try and add a couple more?
It’s very likely you’ll spend all your time just trying to keep your lines baited. If you get more than one fish on a line at a time, you’ll be in a bind, and maybe even loose one fish or both.
Now you could hire a “fishing pole” manager, akin to a marketing manager. And now that person can handle 8-10 poles while you can still handle your 8-10 poles. But the manager has to check with you every few minutes to see if she’s doing it right. Plus, you still got to tell them what kind of bait to put on the line, how long to leave the line out there, how far to cast, etc.
And what happens if you get a line tangled up? Now you’ve got to go mess with that and clean it up. Are you seeing the similarities to your practice yet?
Here’s the point…
You can only handle so many fishing poles at one time. That’s not being pessimistic, it’s just being real. It’s much better to have 8-10 really strong ones, shaving off the bad ones and adding news ones as you go along.
Perhaps over 5,10, or 20 years you can build up marketing strategies that can be left alone to work. By using the internet you can plug in many marketing methods which will run on autopilot, taking up a very small amount of time. But getting 100 strategies set up? Not likely.
That’s why you’ve got to make sure your 8-10 are working well. I recommend doing niche specific marketing like PI marketing, decompression marketing, neuropathy marketing, and fibromyalgia marketing. You should do market in the newspaper, on the internet, through referrals, in office marketing, snail mail, email…even the radio and TV is your budget allows.
My last post on the new health care reform (entitled “Congress Has Done It, Now What?“), caused quite a few comments. Mostly the feedback was good. One lady called me a right wing nut and we gladly accommodated her request to be removed from the email list. I guess in today’s politically correct world, stating the obvious (that our taxes will go up and it will be more work on our practices) makes you a right wing nut.
A few concerned doctors emailed me trying to persuade me to see the “bright side of things”. They argued things were not so bad, after all the ACA or ICA (depending on which one you ask) was responsible for getting anti-discriminatory language in the bill. While I commend both organizations for fighting hard for chiropractic, I’m not so sure the gain of anti-discrimination language will justify the huge stack of problems the bill will cause.
Of course if your patients are mostly Muslim, Amish, American Indian or a Christian Scientist you will likely continue on as if nothing has changed.
As for everyone else, this type of government action brings up the age old chiropractic question, “cash or insurance?”
First off, I must state I do not agree with the mentality that has been perpetuated for years by many chiropractic coaches: “we must do cash because all insurance is evil” . There are good reasons not to take insurance, some of which are philosophical, but this type of rhetoric mentioned above is usually just a cop-out for those are are scared and don’t know how to bill insurance. Trust me, I know because this was me for the first 2 years in practice!
So with that said, let’s look at a the biggest reasons some doctors abandon insurance for an all-cash practice.
What the Proponents of an All-Cash Practice Say:
1. Insurance is too restrictive of the services you provide.
Many chiros do away with insurance hassles because of the burden it puts on their practice. They do not like to be told what they can and can not do with their patients. If most of their insurance patients are carrying these types of restrictive plans, they will choose to convert to an all-cash practice. Do you think Obamacare will make insurance more restrictive or less for chiropractic? (Leave your comments below.)
One medical doctor sent a letter to her patients stating she will not comply to the new laws Obama has enacted.
Of course the doctor who takes insurance will rebut this argument when applied broadly to the whole United States. His reply would be that “just because there are some bad insurance pockets, or even whole states, does not justify saying all insurance is bad and only pays for 12 visits anyway, so we might as well go all-cash.”
2. Insurance is too much work.
Other doctors choose not to bill insurance because they say it is too much work. They have to submit reams and reams of paperwork just to make $30 on a visit. Exams and x-rays require even more notes and paperwork. They’ll have to hire another staff person just to figure out all the billing codes and how to do chiropractic insurance appeals.
What does the non-cash chiropractor say to this? He would likely reply that “while some insurance plans and contracts require an insane amount of work, this does not mean that all insurance plans do. I simply do not participate in the ones that are bad.” He would also argue that whether cash or insurance, we all must have documentation. He would likely also add that many cash practices give the patient a superbill, which is essentially doing everything an insurance practice would do, except fight denials.
3. They do not pay special services.
A few doctors choose not to bill insurance because their practice is very specialized and insurance in their area does not pay chiropractors for these services. These include spinal decompression, weight loss, nutrition, cold laser, deep tissue laser, etc.
On the other side, many chiropractors will still implement these uncovered services, but also continue to offer chiropractic adjustments and therapy. So they will bill insurance for those services that are covered and do cash for those services not covered like decompression treatments, etc.
So which side of the fence do I stand on?
Neither. At the current time (and this may change in the future), I do not paint with a broad brush when it comes to this subject. Some states and areas are great with insurance, with plans giving 80-100 visits per year. I’ve even seen a few that allow unlimited visits to chiropractors per year. Other areas are so bad you’d have to be crazy to bill insurance there.
In my Decompression Marketing Elite program, there is one client grossing a million per year as an all cash practice. Another client has a mostly insurance practice and is doing nearly the same amount. Other clients have more of a 50/50 mixture, doing cash for decompression plans and insurance for other services.
You see, whether you choose cash or insurance, you should choose wisely. And once you make that choice, it all comes down to one thing — marketing. Insurance companies won’t bring you many new patients, if they bring any at all. Simply switching your practice to all cash won’t make people flock to you either.
I think too many people sit around thinking the grass is greener on the other side, when in reality they are not reaching their potential because of poor marketing choices.
What do you think about all this? Leave your comments below.
