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This is a guest post by Dr. Jonathan Walker

For most chiropractors, receiving referrals from medical physicians is looked upon with a healthy dose of skepticism. If you’ve been in practice for a long time you likely remember a day when MDs would just as soon refer their patient to a witch doctor as a chiropractor. If you’re newer to the profession you might feel intimidated by the prospect of trying to explain the neurophysiology of spinal manipulation to a seasoned medical veteran.

There is no single “magic phrase” to open the referral floodgate, but there are 3 crippling fears keep MDs from referring patients for chiropractic care. These are not pie in the sky theories, but rather secrets I’ve learned from marketing to over 300 medical providers in my area as well as working with doctors all over the country.

1. Fear #1: You’ll steal their patient
Regardless of what variety of conditions you treat in your practice, when working with MDs your emphasis must be that you’re a specialist in conservative musculoskeletal care and will not try and usurp their role as the patient’s primary care provider (PCP).

I always make sure to tell other doctors that we do not function as PCPs, but that we find patients are best served when their chiropractor and medical physicians are all communicating together. This gives them the comfort that you won’t try and undermine their treatment of the patient. We expect professional respect and courtesy from MD and this goes both ways, even when you may disagree with a particular element of their management plan.

As a matter of fact it’s a good business (and social) practice to go out of your way to tell the patient what a great doctor they have and what good hands they’re in. Odds are this compliment will make it back to the referring physician, and that’s always a good thing!

2. Fear #2: They don’t really understand what chiropractors do
Most MDs seem to view chiropractic in the same light as many chiropractors do acupuncture. They believe that there is validity to the treatment, but they don’t know a lot about how it actually works.

This fear is easily conquered by ongoing education to provide familiarity with chiropractic, our level of expertise in treating musculoskeletal conditions, and the latest peer-reviewed research. For all of my PI Marketing Elite doctors we recommend one print, one electronic (e-mail) and one live contact a month. We provide cutting-edge MD newsletters and e-newsletters 100% “done for you” to make this process automatic.

3. Fear #3: Their patient will get a 6 month long treatment plan on their first visit to your office
I’m not going to debate the pros and cons of recommending long courses of care with cash pre-payment, but I do want to point out that if you want to receive medical referrals MDs cringe at the idea of a 6 month long treatment plan given on the first visit.

I explain that in my office we do a trial course of care, typically lasting anywhere from 2-4 weeks, depending on the patient’s condition. At the end of the trial we reassess the patient and if they’re making progress we start spacing out the time between visits and giving them home exercises to do.

This type of approach fits the paradigm they’re used to working within when they refer to a physical therapist, so in their minds you then become a viable option for referrals.

By preemptively dealing with these three common fears you’ll unlock an untapped goldmine of referrals, and help countless patients find relief with chiropractic care. I’ve seen it work first-hand in my own practice, and you can replicate this success in your office!

Dr. Jonathan Walker is president of PI Marketing Elite, and a full-time practicing chiropractor. MD marketing is a key area addressed in the marketing modules of PI Marketing Elite, and we provide you with turnkey tools, scripts, and strategies to use in your practice. Log onto www.newpimarketing.com or call Dr. Walker directly at 904-616-1284.

Here is your chance to see an updated version of my friend Paul Wright’s free webinar entitled “The Practice Acceleration Program – 12 Steps to a Great Health Business in ONLY 42 Days”.

There are 3 different days you can register, go here to find out more:

http://www.netofficetoolbox.com/app/?Clk=4287445

This presentation outlines the 12 Essential Steps that you DID NOT learn in your university or technical education, but MUST know to be a successful health professional in these trying financial times.

Here’s just a sample of what Paul will cover…

• The 12 essential steps to a great health business – are you using them?

• Why failing to use these steps will leave you chained to your business forever.

• How these steps allowed Paul to run his clinics remotely – in fact he has only visited his six clinics four times in one 10 week period.

• How your admin team can kill your profits and what to do about it.

• Actions steps you can implement NOW to make you thousands in lost profits.

• The importance of cancellation reduction and how to make every treatment session “too important to miss”.

• How to get your hands on Paul’s exact procedures, scripts, steps and protocols that have taken him 20 years to develop and refine.

Click on the link below to check webinar times and register for this FREE event.

http://www.netofficetoolbox.com/app/?Clk=4287445

Have you set up your 2012 chiropractic marketing calendar yet?

I know it’s already 2 weeks into the year, but if your holiday season is anything like mine, it takes the first week or two in 2012 to actually relax and catch up from the end of the previous year.

One of the things you must do is write down all your plans and goals on a yearly calendar.You can not just wait until you need new patients, and then figure out what to do. This is reactive marketing and you want to be proactive this year.

For years, I used a monthly calendar on the wall that my staff and I could write marketing events down and see what was coming up.

But the furthest you can see on these types of calendars is only 30 days at a time. What we need is a “year at a glance” type of calendar.

Well thankfully this year I found the NeuYear Calendar, which is a complete year at a glance. This will hang great on the wall or back of my door.

I recommend you grab one too, and start planning your monthly marketing events, promotions, ads, etc.

Here’s some benefits listed on their site, which led me to buy one immediately:

• It’s big, coming in at 27″ x 39″ this means you can see the whole year at once. “You no longer have to page through a traditional calendar (or on your small computer screen), to see the whole year. You can layout your goals for the year, set future deadlines, and clearly see the passing of time. Also, it has bigger squares so you can write more.”
• No space between months. “The week is the currency we think in, so this calendar focuses on presenting 52 weeks, rather than 12 months.”
• Brilliant aesthetics. In Making Ideas Happen, author Scott Belsky says “the design of your productivity tools will affect how eager you are to use them; attraction often breeds commitment.”
• 2 calendars in 1! It has a horizontal orientation that fits perfectly above your desk, or you can flip it over for a vertical orientation that fits perfectly on your door.

Now that I shown you which calendar I think is best, what do you do with it?

Call a staff meeting one day during lunch. Start by explaining your mission for your practice and the goals you have for this year.

Then begin brainstorming with your staff about the different types of marketing ideas they have. Make sure to give them room and freedom to talk. Even if they have a bunch of bad ideas, just write them down. You never know when they’ll say something you’ve never thought of.

My staff would often come up with many successful in-office marketing procedures from the past that I had totally forgotten about.

Once you have written down, everything you can think of, start prioritizing your list. Put a “1″ by the most effective, “2″ be second most effective, and so on.

Side note: Do not base effectiveness on what feels like it did the best last year. Feelings do not turn into dollars. Measure effectiveness based on your return on investment numbers you recorded for all marketing last year. And if you didn’t keep good records, go back and see if you can figure it up now. Remember, ROI equals the amount you brought in from a given marketing campaign divided by the money spent on it.

You might want to throw in something new for 2012 that you haven’t tried before. A few suggestions would be:

• Neuropathy or decompression newspaper ads
• Google Adwords
• spinal screenings (but with a caveat, see here)

Then begin writing on your calendar all the 1′s, 2′s, etc. spread out somewhat evenly throughout the year. So you don’t want all your ads to come out in March and have the rest of the year empty.

If you wanted to do it according to budget, you should write the amount to spend beside each campaign to. For example, on February 20th you might write “Run Neuropathy Ad for $1000 or less”. (To see how to save money on running your monthly newspaper ads, watch this free webinar.)

If a month get’s too busy, slide things forward into the next month. You should be marketing every month of the year, no exceptions.

Now you have a marketing calendar set up. Try to stick to it as much as possible. You may need to edit and change things throughout the year. That’s fine, but make sure you take a look at the big picture before making rash decisions.

Do you have any other good ideas on planning your marketing calendar? Let us know in the comments below.

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.

There’s a little-known formula that you should use in all the marketing you do. This formula should be used when speaking, running newspaper ads, sending direct mail, on your website, and more.

It was officially put into writing in 1898, and has been used in almost every industry since. (It’s really been around since the beginning of creation, because the way humans think has not changed!)

This formula has proven successful for many, many decades, especially in direct response marketing. It’s called the AIDA formula. Let me show you how it works…

A = Attention. Your advertising should grab the reader’s attention. The best way to get someone’s attention is with your headline, if an ad, or your opening sentence (if you’re speaking.) John Caples once said that the headline is 80% of the ads effectiveness.

I = Interest. After you’ve grabbed their attention, you want to continue to making it interesting. What we’re doing here is not just putting up big, bold words in the headline just to get their attention.

You may have experienced advertising in the past that did something crazy and shocking to grab your attention, but as soon as that was over and they started talking about their product. You were no longer interested.

There’s advertising that uses words just to get your attention, but then the ad has nothing to do with that word. It almost feels like a bait and switch, where they’ve baited you, you go to look at the ad and it has nothing to do with the headline.

D = Desire. After the reader is interested in your ad, then you want to arouse their desire. The desire of your prospects are simple: they want to be rid of this annoying health problem. They want the benefits you can offer them.

For those who have my chiropractic ads, you’ll notice many of them describe what the reader will experience once they’ve improved their health…like more energy, more golf, etc. (You should continue this type of”conversation” with them during your report of findings.)

A = Action. Action is where you make the offer and then tell them how to place the appointment. In our case, how to schedule the appointment. The prospective patient must be given a reason to come and see you over all the other offices in town.

This formula that has been effectively working for over 100 years. Unfortunately, many chiropractors are not following this simple strategy with their marketing.

There aren’t too many books published specifically for chiropractic marketing, so I was very interested in seeing what Dr. Reizer has to say in his new book CHIROPRACTIC MARKETING TOOLS THAT WILL ABSOLUTELY GROW YOUR PRACTICE. According to his site, Dr. Reizer “is a former associate professor of Sherman College and has taught numerous graduate level courses in chiropractic technique, x-ray analysis, diagnostic interpretation, chiropractic philosophical applications, and chiropractic communications.”

Dr. Reizer has published numerous other books on chiropractic (which I have listed at the end of this post), as well as three science fiction novels.

The subject matter of Chiropractic Marketing Tools ranges from simple business cards and newspapers to more advanced strategies like writing your own newspaper ads, developing a weight loss campaign, and marketing to health clubs. The book is only 133 pages, but packed full of ideas. I counted at least 24 different marketing tools mentioned. Dr. Reizer spends about 3-6 pages on each of the marketing tools mentioned. In most of the chapters he briefly explains the tool and how to use it, and sometimes gives an sample piece that you can easily use in your office.

One Amazon reviewer said,”Every morning our staff reads a few pages to get everyone thinking about how to promote the office.” This is actually a pretty good idea, as these are mostly marketing tools that your staff could do for you (or setup for you.) So to have them thinking about marketing each day is vital to your practice. Also, many of these strategies your staff has never heard of before, so you can provide a quick and easy manual of marketing ideas for them to use.

I do have two critiques of the book.

The biggest critique is that while the tools mentioned are useful and will “absolutely grow your practice” if done correctly, one of the most effective marketing tools available to chiropractors is only mentioned in passing: direct response marketing. These exact words are not found in the book, but Dr. Reizer does spend a few pages talking about lead generation marketing, which is a form of direct response marketing. He then provides a sample free report, which well written. But no mention of long copy newspaper ads or direct mail pieces. Seeing as one of my Decompression Marketing Elite clients just notified me that they got over 300 new patients this year from my ads, I think newspaper ads are pretty important!

The other critique is related to the first. Overall the book is a great summary of marketing ideas for every chiropractor to use. But the book is going to be used most by those who are new to practice or operating on a low marketing budget. For example, all of the strategies in the book could be done each month for less than $500 (there is no mention of radio or TV marketing). While this is a great place to start, and even marketing veterans should be doing some of the things Dr. Reizer mentions, there is much more that can be done in the way of effective marketing strategies.

Overall I think it’s a book every chiropractor should have in their arsenal. For those in practice less than 2 years, or for doctors struggling, it is a must read ASAP. For others, this book will be very useful for your staff and as a reference guide for ideas.

Dr. Reizer’s other chiropractic books include:

• 15 Secrets to Becoming a Successful Chiropractor
• Up and Running – Opening A Chiropractic Office
• Teaching Your Patients Chiropractic
• Depression – Proofing Your Chiropractic Career

Do you know what demographics you want to be marketing too?

The term demographic is defined as “a single vital or social statistic of a human population.” What this means to you is that you can use demographic information to make sure you’re spending you’re money where it will have the best effect. Here are just a few demographic measurements you should be looking at:

• Number of people in a household (which tells you if you’re dealing with families or singles, homes or apartment complexes)
• Median income per household
• Racial and ethnic information (helpful in marketing to a foreign language, etc.)
• Education level
• Median home value

These statistics can be used an various ways to help you get a better return on your investment. One example has to do with direct mail. If you’re going to spend $500, $1000, or more on a direct mail campaign, you want to focus on the right area of your town or city. Are you going to mail to a business district where your mail will likely be trashed, or to a neighborhood with high median home values?

Another way to use this information is when you have multiple newspapers in your area targeting different areas of the city, you can compare the demographics to the paper distribution. This can also help when you are running inserts in the paper by zip code.

I once had 10 different newspapers to choose from, ranging from a very small neighborhood newspaper to the large Dallas Morning News. With the right demographic information, I could target and test very specific areas of my town, plus surrounding towns, to find out which performed the best. Some of the 10 newspapers I could quickly dismiss as useless because their distribution went too far or hit areas I was not interested in marketing to. To have this information meant a huge amount of time and money could be saved. (One thing I learned is don’t always trust the newspaper’s own demographics, as they can be slanted to make that newspaper look good!)

An awesome new tool I recently discovered can be very helpful in determining the demographics of your area (if you practice in the U.S.) It’s called the NY Times Mapping America Project. If you go there and put in your city or zip code, you will be able to select many different demographic maps. Here’s one I created for the North Dallas area.

When you mouse over the live version, you can see each census tract’s median household income and it even shows you what percentage that has changed since the 2000 census! If you understand the true value of demographics, you will know this tool is going to be very useful to you.

I would highly recommend you visit the website, check out your area, and bookmark it for future use. Consult this site whenever you are making decisions about where to run different marketing campaigns. Also, make sure you check out the different maps and how they relate to your area by using the blue button at the top right that says “View more maps.”

Speaking of demographics, here is a neat video on the world demographics since 1810.

What business books will you be reading this summer to improve your practice?

Reading is one of the best ways to learn. For your practice growth, you should be consuming a steady stream of new ideas and strategies that can help you excel. I’ve had numerous breakthroughs in my life. Many of those breakthroughs began with a small sentence or thought on the printed page.

Reading is an acquired skill. Few of us are born with the desire to read a book a week. I hardly ever read non-fiction books until my practice began to struggle. Then I started reading every good marketing and business book I could find.

Each month I read 4-6 books on a wide range of topics like: history, biography, theology, marketing, business, philosophy and good classical fiction (read aloud to the kids). Here are the top 4 books in the business/marketing category that I look forward to reading this summer. Grab one or two to read while you’re sitting on the beach or enjoying a break from the summer heat.

What books are you reading this summer? Let us know in the comment section below. (If you’d rather read books digitally, Amazon just recently dropped the price of their Kindle to $189.)

Dr. John Reizer, CHIROPRACTIC MARKETING TOOLS THAT WILL ABSOLUTELY GROW YOUR PRACTICE. This book has been on my to read list for awhile now. But it has finally made it to the top of my stack and should be a fast read at only 130 pages. There aren’t too many books published specifically for chiropractic marketing, so I’m looking forward to seeing what Dr. Reizer has to ad to the discussion. The bio says Dr. Reizer currently teaches as an adjunct professor at Sherman College of Chiropractic. The subject matter of the book ranges from the simply business cards and newspapers to more advanced strategies like writing your own newspaper ads, developing a weight loss campaign, and marketing to health clubs.

William Poundstone, Priceless: The Myth of Fair Value (and How to Take Advantage of It). The name and concept of this book fascinated me, especially when we consider that many chiropractors may soon be flocking to the cash practice model in light of recent health care reforms. In Priceless, Poundstone looks at how prices are set and how we don’t really know how much anything is worth. The inside flap reads:

“People used to download music for free; then Steve Jobs convinced them to pay for it. How? By charging 99 cents. Prada and other luxury stores stock a few obscenely expensive items — just to make the rest of their inventory seem like a bargain. Why do text messages cost money, while e-mails are free? Why do jars of peanut butter keep getting smaller in order to keep the price the ‘same’? The answer is simple: prices are a collective hallucination.”

Arthur C. Brooks, The Battle: How the Fight between Free Enterprise and Big Government Will Shape America’s Future. Being entrepreneurs like we are, and realizing the government already affects our business in many ways (and will do so even more in the future), this book should be on every chiropractors ‘to read list’. I added this book to my Amazon wish list when I read that WORLD magazine ranked it as their book of the year.

“Honoring a book on current political and economic questions is unusual for WORLD. Our books of the year in 2008 and 2009 were The Reason for God and The ESV Study Bible. We generally rate timeless higher than timely—but sometimes we have to pay attention to the immediate. Samuel Johnson said, “Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.” As the United States careens toward a crucial fall election, The Battle is concentrating minds.”

Robert V. Levine, A Geography of Time: The Temporal Misadventures of a Social Psychologist, or How Every Culture Keeps Time Just a Little Bit Differently. I’ve always heard that other cultures live at a slower pace than western cultures do. But I’ve never given much thought to how that affects business and society. Dr. Levine is a psychologist who’s spent much of his life studying time. The book description says, “Levine raises some fascinating questions. How do we use our time? Are we being ruled by the clock? What is this doing to our cities? To our relationships? To our own bodies and psyches? Are there decisions we have made without conscious choice?”

I first heard of this book, which is about 12 years old, from the following video.

One of the best ways to “wow” new patients and get patient compliance in your treatment plans is to be recognized as an expert in your field. Getting more letters in the form of degrees after your name can help some. But there is a better way.

Do you know the fastest way to become an expert?

The answer is to become a published author of a book. As soon as you write a book on any health problem and how to solve it, you will be seen as an expert.

Imagine every new patient who comes into your office receiving, as a free gift, a nice copy of your newest book. By the time you get to your report of findings, this patient is going to feel very comfortable trusting you with their health.

Also, realize that people will quickly loose or throw a business card away. But how many will throw away your professionally published book?

Having your own book will set you apart from all the other chiropractors in your town.