Chiropractic Marketing | Chiropractic Advertising | Chiropractic Ads

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 Elite

Internet Marketing for Chiropractors

Chiropractic Marketing Academy

PI Marketing

Internal Referral Marketing System

Neuropathy Doctor 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.

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.

In my last post, we looked at the “5 Biggest Questions About Chiropractic Ads“. But due to length, we only got through 4 questions and answers. So today’s post is the 5th and final question we get asked most from buyers of my ads kit. And it’s probably the most important question to get the answer for.

The question comes in various forms, but it goes something like this, “I ran your ad and want to know why we didn’t get more new patients?”

Now, as you might realize, this is a hard question for me to answer. Mainly because I don’t know how many new patients he did actually get. And how many did he expect to get from the ad?

What’s a good number, 10, 15, 20? I know expectations have been elevated to unrealistic numbers in chiropractic. What else can we expect after years of hyped up marketing strategies that said they would give us 100 new patients every time we ran them, or make us $1 million a month the first month!

Don’t get me wrong, my ads work well to bring in new patients and I don’t think they’re overhyped. We even give a guarantee for those who aren’t happy. But I can say right now it’s unlikely you’ll get 80 new patients every time you run them. Maybe if you’re in a small town with no other chiros, but as for the rest of us we’ll gladly take 10-30 new patients each run.

But what’s strange is when we get an email of a doctor who’s actually doing very well, ‘making a killin’ actually, but he didn’t get “as many as he expected”.

For example, once I was told by a doctor they had received 5 decompression patients from one of my ads. This doctor knows that other doctors are getting 15-25 decompression patients per ad, so his question would have been a good one if he was asking “how do I get as many as those other guys do”. But alas, we rarely get that question asked of us. Instead, this doc was saying that 5 new patients just wasn’t enough. After all, he had paid $1000 to run the ad.

But hold on a second. We’re looking at this scenario completely backwards! Let me explain…

I asked him if all of the 5 started care. He said yes. I asked how much his care plans were priced at. He said $3000. Quick math lead me to determine he got $15,000 back on his investment. What was his investment? Cost of $1000 to run the ad.

That’s a 15-to-1 return on investment! Who wouldn’t like a 15:1 ROI?

There are very few businesses anywhere that get that kind of return. But this doctor was bummed that he only got 5 new patients in for $1000 spent. Do you see where the premises are wrong with this kind of thinking?

You cannot measure an ads success solely by the number of new patients it brought in. And you certainly can’t measure it’s success by how much money you spent. It’s your return on investment that matters. The money spent (ad cost) is only used to figure out the ROI.

Think about it this way…

What if a new patient come into your office with an 11 out of 10 (!) on the pain scale. They got their first treatment, looked at you angrily and said “I’m not happy doctor. I paid you all that money and only got a 60% reduction in my pain today!” After picking your jaw up off the floor, you’d kindly remind the patient of how they are were doing when that crawled into your office on their hands and knees. Therefore, you’re telling them to compare the “before” to the “after”, which is essentially their return on investment. How much they spent doesn’t directly have anything to do with how much better they got.

Are you measuring your ROI?

It’s simple to do really. Take all the new patients who come in from the ad and record their name in a spreadsheet. Then keep track of how much money each one spends in your office. Your patient accounting software should make this number easily accessible.

So your spreadsheet might look something like the one to the left here.

If I hadn’t kept this spreadsheet and tracked every patient, I might try and rely on my memory of how the ad performed. And think, “man, that ad really sucked because Antonio never started care, and Maria she didn’t even come back after the exam. Bah, advertising doesn’t work!”

But the truth is I got a 2061% ROI, or a 20-to-1 return! You can bet I’m running this ad again after seeing how well it really did. (And this ad is actually in the Ultimate Chiropractic Ads.)

So start tracking your ads. Not using “memory” tracking, where you just try and remember how well it did. But actually record the numbers and see what the real story is.

In a recent decompression marketing webinar, I answered one of the most common questions I get about my ads: “Do newspaper ads still work?” This question doesn’t just apply to those with decompression tables, but to everyone in chiropractic.

Here’s a clip from the webinar where I cover the actual numbers released in a study from the Newspaper Association of America.
(If you have a decompression table and would like to watch the full decompression marketing webinar, visit http://www.decompressionmarketingelite.com)

If you haven’t picked up the Ultimate Chiropractic Ads, click here and start using newspaper advertising to bring in more new patients.

This week, I read Jim Collins’ new book How The Mighty Fall: And How Some Companies Never Give In. I knew this book would have application to chiropractic offices as soon as I read the back cover in Barnes and Noble.

“Whether you prevail or fail, endure or die, depends more on what you do to yourself than on what the world does to you.” – Jim Collins

How true this statement is. Not in a mystical, ‘think and it will happen’ kind of way. Not in a flippant statement some consultants throw at their clients for a ‘pump-me-up’.

But simply a statement of truth.

The success of your practice depends on you! Not the economy. Not the size of your town. Not where you practice. Not the government’s attempts at screwing up healthcare. Not Obama’s spending that you’ll never see a dime of.

Sure, these things make practice a bit more difficult. No one would say they don’t have an affect. But they are not the determining factor in your success.

You would be amazed at the doctors who’ve simply given up marketing their practice the last couple of years. And paid dearly for it. Some haven’t done any outside marketing in 10 or 20 years, but now find themselves forced to due to a declining practice.

Granted, most marketing out there sucks at bringing in new patients. Yet there are proven methods and strategies that work.

And the simple fact is that if you’re not marketing your services to the public, it’s just a matter of time before you’re practice will decline.

Back to the book. Collins has taken various failed companies and studied them to determine what caused their decline. Based on this he has uncovered 5 stages of decline.

Below I list the 5 stages and show how they apply to a chiropractic office. I’ve chosen to give our imaginary chiropractor a name, Dr. Decline, so as not to insinuate that all chiropractors are declining. But it’s very likely many of my readers will be in one of these 5 stages, whether they know it or not.

Hey, I admit I went through stages 1-4 in my early days of practice. Most of us do at some point. But hopefully reading this will help you to recognize it better next time.

Are you in one of this 5 stages?

1. Hubris Born of Success

Hubris is a word from ancient Greece that means overbearing pride or presumption. It’s the thing in Greek mythology that always brought down the hero. It’s what Proverbs 16:18 says well “Pride goes before destruction, And a haughty spirit before a fall. ”

This is what Dr. Decline says at some point, “Things are going great right now. I’ve done well. Money is coming in. Why should I even pay for that ad in the newspaper anymore? I can cut back and just rely on referrals. After all, my patients refer because I’m the best doctor in town, not because of some words they read in my newspaper ad or website.”

2. Undisciplined Pursuit of More

Collins thought his data would show declining companies had become complacent and lazy, watching the world go by. But his data showed quite the opposite. He found “overreaching much better explains how the once-invincible self-destruct”

Here our doctor says to himself, “Maybe I’ll buy that new decompression table or new rehab equipment. What’s a big fat lease payment when I’m doing this well. We better hire some new staff too, to get ready for big growth. Things have been busy lately, after all. And I’ll have money because I’ve cut back on my marketing expenses too.”

3. Denial of Risk or Peril

This is when the effects of stage 1 and 2 are starting to set in. Money is still coming in, but signs of danger are starting to appear. There aren’t a lot of new patients on the books next month. The bills are starting to pile up. But the leaders deny the risk.

But our good doctor says, “Ah, it’s probably just the economy or the summer slump or insurance companies. Things will be fine. After all, I’ve been in practice over 10 years, and I’m still here, right?”

4. Grasping for Salvation

The risks of stage 3 have now become a reality, throwing the company into a sharp decline. Collins says this is a pivotal time and brings up the critical question of “how does its leadership respond?”

Does Dr. Decline grasp for a savior in the form of a charismatic chiropractic coach, a “bold but untested strategy” or any other number of magic pill solutions? What he does here is pivotal because once in stage 5 below, there is no coming back.

5. Capitulation to Irrelevance or Death

“The longer a company remains in stage 4, repeatedly grasping for silver bullets, the more likely it will spiral downward”, says Collins. The leaders abandon all hope and either sell out or liquidate assets.

This is a sad state for chiropractors when this happens. Let’s hope Dr. Decline never gets here. But the truth is some chiros do.

So how do you prevent the 5 stages of decline listed above?

It’s hard to say for your particular case. But a couple of general guidelines are “don’t ever stop using marketing that works” and cut, cut, cut your expenses.

Oh, and kill that awful sin we all struggle with: pride!

Why isn’t your decompression table packed with patients all day long?

This really is the ‘Million Dollar’ question for your practice. So the answer must be more marketing, right?

Well, yes and No. Join me for a Free webinar, where I’ll explain “How to Fill Your Practice With High Quality Decompression Patients”

To watch the replay, go here:
http://www.decompressionmarketingelite.com

You see, almost all chiropractors with decompression tables are using outdated, rehashed advertising and marketing techniques — those that worked in the golden days when decompression first came out.

But we both know these techniques don’t work anymore.

The world has changed. Potential patients you’re trying to persuade to come in have grown increasingly resistant to these obsolete marketing strategies

This year, I’m going to help one doctor per area have their best year ever by using my new Decompression Marketing Elite program.
Life’s too short to sit around waiting for the next patient to come in, while the table you paid thousands of dollars for collects dust.
No secrets held back.

Find out everything you need to know about this decompression marketing program now…without closing your office and spending thousands of dollars to travel to a high-pressure “Discovery Day”.

On this free webinar, here’s what you’ll discover…

• How to receive a new decompression marketing tool each month, bringing in quality new patients who stay, pay and refer.
• The only one-on-one personal decompression coaching, tailored to your practice to personalize the proven system to your own unique practice and city.
• How to get monthly decompression marketing webinars, where you’ll see exactly what other successful doctors are doing in their practice and discover how to increase your conversion rate to high-fee care plans.
• How to guarantee you’re the only doctor using this decompression marketing system in your area.
• How to finally stop living on the threshold of financial freedom and take your practice to a new level.

If you have a decompression table in your practice, you do not want to miss this call. Come and watch me reveal exactly how I’ll be doing it.

Because this program will be area exclusive, if you’re in a competitive area you should at least attend to make sure you’re not giving up a golden opportunity.

There was even a Q & A session after the webinar. Join me from the comfort of your office or home computer.

http://www.decompressionmarketingelite.com

P.S. Do you think there will be more or less patients with herniated discs this year? How about in 5 years from now?
Decompression is not a fad, because disc problems are not a fad. It’s time you really tapped into this booming market.

As we finish out 2009, I want to look forward at some possible trends in 2010. Today’s post looks at the last 2 predictions (out of 5 total) I see for next year. To view part 1, click here.

#4. Better Internet Marketing For New Patients

While chiropractors have been using websites for over a decade now, I predict an increase use of the internet to get new patients. This reasons for this are many — increasing use of the internet in general, rising popularity of Facebook and Twitter, Google’s affinity for blogs, and more.

In 2010, it’s likely that the majority of chiropractors will realize that internet marketing is about effectiveness, not the flashy graphics and “pretty websites”. Even in 2009 I noticed many of the website developers were removing their ‘rotating spine’ charts and adding more content instead.

Content really is king with search engines like Google. I have found that we are able to get professional websites with direct response copy up quickly using blog software. Then we ad a few blog posts written from the doctor-to-patient view point, and within days Google is ranking our brand new website in the top 5 spots. We can then keep this doctor there by adding new blog posts over time.

While many chiropractors realize the usefulness of organic or free search engine optimization, most do not yet grasp the potential of pay-per-click marketing (PPC).

Based on this, I also predict that more chiropractors will discover how well Google Adwords can work for new patient marketing. It surprises me that more chiropractors are not taking advantage of this great marketing tool. Many tell me it’s because they’ve tried it and it doesn’t work. However, the problem occurs when doctors send Adword’s “visitors” directly to their homepage on their website. By using condition-specific landing pages, with direct response copy, plus email marketing follow-up, my internet marketing clients are finding this method very successful and will continue to do so into next year.

Admittedly there is a learning curve to Adwords, along with the reward and punishment system Google has built into it.

But in my opinion its well worth the time spent for the return on investment, especially in the long run. Of course for those who don’t want to learn it or don’t have the time, we created ChiroPatients Online specifically for this reason.

#5. Deeper Patient Relationships

Because of what many are calling the New Economy, patients are more careful with their money. Even though we are moving out of the recession and the overall economy will improve in 2010, people are not ready to be back in the 2008-2009 feeling where money was tight.

If you’ve been in practice for long, this really is no surprise. Patients, being human beings like the rest of us, tend to drop out of things over time. Yet I expect this to rise in 2010 as more healthcare opportunites will come into the market combined with more careful spending mentioned above.

Both of these, the careful spending and more competition, means that chiropractors will have to work harder to keep their current patients.

It still surprises me that doctors are willing to spend so much to get a new patient, but scrimp on spending anything to keep them over the long term. Something as simple as mailing a chiropractic newsletter once a month is a bare essential. Holding true patient appreciation events and creating V.I.P. lists will take your practice to an even higher level.

Other great strategies for keeping your patients longer include dinner workshops, patient of the month programs, referral contests, and stick letters.

You can also expect more online patient communication to grow in 2010. The most powerful of these is email marketing, but many chiropractors will also get their facebook and twitter pages up and running.

This concludes my 5 big predictions for 2010. I recommend planning for them sooner rather than later.

Did I miss one you thought was important? Do you have a prediction I didn’t mention? Leave your comments below.

As we finish out 2009, I want to look forward at some possible trends in 2010. Today’s post looks at the first 3 predictions I see for next year. While these are things you should think about, I’m not a prophet and could be proven wrong on some of these. So make sure and get a “multitude of counselors” before completely changing your business. They are simply my best guess at what’s going to happen and I’ll be advising my coaching clients in this direction.

1. More Cash Practices.

The number of cash practices will continue to increase. Having run both a cash-only practice and a more mixed practice, I generally stay away from this argument. It seems in the past, most people making the cash-only choice were doing it for purely philosophical reasons, and not for business reasons. My opinion has been that if insurance is good in your area, why not use it. And based on clients and customers I’ve spoken with, that has worked well.

But things are about to change. As I write this, it appears the U.S. government insists on getting its hands into the insurance game. No matter what some of the articles in chiropractic journals might say, this will not end well for chiropractors (or Americans in general). No matter your political standing, you know this will be true.

Here’s why..

Do you currently like the Medicare payments? Well, under this new legislation a proposed $480 billion dollars in cuts to Medicare will be done over 10 years. Do you think chiropractors will be at the top or bottom of those cuts? How well do you enjoy Medicaid in your state? Now even more of your patients will qualify for Medicaid under the new government “health exchanges”.

Because most Americans will have to buy into these exchanges, or pay a $750 fine, more people will have these plans. This likely will not bode well for your practice. I could go one, but have 4 other predictions to cover. You can read a summary of the proposed bill here.

#2. More Focus on Specific Niches

Because of the drastic effects mentioned above, I predict more chiropractors will have to focus on specific niches. This is good because it will allow you to help more motivated patients and you can charge higher case fees.

Niches are subgroups of the overall patient population. Not only will you need to market specifically to them using language they understand and related to (as in the Ultimate Chiropractic Ads), but you’ll need to set up specific treatment plans for them. Examples include spinal decompression, neuropathy, fibromyalgia, migraine headaches, etc. As you can see, some of these niches will require you to purchase additional equipment. But this need not be overly expensive, especially if you look at what other people are doing.

For example, Dr. Hayes showed us how he put together his neuropathy treatment program in the recent webinar we did (replay at http://www.neuropathychiros.com).

It’s better to make these changes now before you have to because of lower income. A practice focusing on and marketing to a few specific niches is the key to having a high-income, low-stress office.

#3. Additional Products and Services.

Predict chiropractic offices will focus on selling additional products and services to their patients. This includes additional products and services the patients is already getting somewhere else. Different types of nutritional supplements that help in healing and weight loss. Physical therapy or rehab services that increase that speed healing.

For the patient, this will will be a benefit since they can get more in one place, and have the doctors recommendation too. The benefit to you of course is increased income and patient satisfaction. The more satisfied they are, the longer they are likely to stay a patient in your office.

Look for Part 2 next Monday, where I’ll discuss the 4th and 5th predictions for 2010.