First some housecleaning:

In last weeks issue I mentioned an example of 100 free half-hour massages costing you only $300. It was brought to my attention by one of our subscribers, Dr. Peter Gay of Maine that this would break down to $6.00-$8.00 an hour for a massage therapist. Not a very likely scenario. My bad. Fifty hours (100 ½ hour massages) at around $15-$16 an hour is closer to $700; however the point is the same. If you could give away 100 massages and convert only a few patients you’re still way ahead of the game. Thanks for the feedback Dr Pete.

Dr. Pete has also informed me that the lead generation boxes we spoke about last week are available in stock at Staples. He has also graciously sent me a script that he uses in order to get the boxes placed. You can find that here. Thanks again Dr. Pete.

Another reader mentioned the fact that I posted the flyer for Low Back Pain, however I neglected to post the report mentioned in the flyer. So here it is.

More comments from the fans. Thank You

Dear Lenny,

Week 5 and each one gets better and better!   I appreciate your comments about Reggie Gold and his willingness to give. I had the privilege of attending one of his Spring Valley philosophy sessions and I came to know him quite well when he established a school of chiropractic right here in Bucks County, PA. 

I appreciate how you identify some of the new and upcoming would be millionaire “gurus” without even mentioning their names.   Keep up the great work. There are so many in our profession who need what you are doing. I could name quite a few  other “couches” and “consultants” whose only real purpose is to profit on the fears and uncertainties of their fellow colleagues.

Thanks once again,

 Richard Hartman, DC

Lenny,

This is a GREAT thing you are doing; I have been through 3 coaching programs and have spent 5 figures of income over the last 5 years in practice on how to build a practice.  I want to help you in this cause.  Please let me know how I can help.

Thanks,

 Robert White

True Health Chiropractic

442 Morris Ave.

Springfield, NJ07081

Not only did Reggie host the monthly meetings at his house, but on more than one occasion he came to Newburgh to do lay lectures for me.   Without a doubt, if he gave up teaching and devoted 100% of his time and energy to his own practice, he would have had the largest practice ever seen in chiropractic.

                                                                                                    Jerry

Thank You Leonard! - You’re a breath of fresh air!This profession is made up of a heap of good people trying to do the 
right thing by their patients, practice & the profession! - Then 
there are the others. We must have more crooks and out & out greed 
mongers than any other profession! - I’m positive these people, give 
enough of a following could destroy this profession! I won’t mention 
any names but we all know who they are!

Internal Marketing. The Real Gold Mine. How to Mine the Gold

Do You Market To Your Existing Patient Base Every Month???  If Not, You’re losing a Great Deal of Money. It’s a hell of a lot cheaper to reactivate an old patient then to get a new one. Greg Stanley of Whitehall Management, one of the top management firms in the country estimates that it costs over $450 in advertising to get a new patient in the door, while reactivation costs less then one-third or about $150. So you decide, try to get a new patient to continue to fill the leaky bucket, or keep the bucket filled with existing practice members.

It’s NOT Enough To Attract New Patients!!!  You Must Stay In Contact With Your Existing Patients Every Month To Spark Referrals And Reactivations. It is What The Marketing Experts Call Top Of Consciousness Marketing. We talked about this in an earlier newsletter, we discussed how you should send every patient at least one piece of mail like the patient newsletter at least every other month, but what about the alternate months, the months that you are not sending out a newsletter? Well this is when you go through your files and look for all of those patients who you haven’t seen in months. What ever happened to them? Where are they? Do they know that their nervous system needs to be checked, that they might be subluxated? Most marketing experts will agree that the real gold is in your filing cabinet. Yes, gold. Have you ever counted how many files you have sitting in storage? We all have those 1-2 visit patients, the patient who for one reason or another never returned after their pain went away, even though we explained the benefits of lifetime chiropractic. However what if I told you that there is gold in those files, would you search through them? If I told you that just one of these files are worth thousands of dollars, would you give them more thought? Of course you would, and they are worth gold, you just need the right tool to reactivate them. You need to be in their mind constantly because you never know when the right day may be the day they need you again.I know that we are talking symptoms when we say “may need you again”, and I don’t want to sound incongruent, but in order to tell them that they need you ALL OF TIME, you need to get them back in the door.THIS IS WHY YOU NEED A GREAT DATABASE

The most common method used by chiropractors as well as dentists is the patient recall, reminder, reactivation post card. Most of the larger firms like Histacount, Practice Makers, Back Talk and others sell these. The problem with most of the material out there is that it’s boring. While a poster, promocard, sell sheet, or anything else that ANY company produces - CANNOT MAKE A PRACTICE. However well designed material, (and by this I don’t mean pretty colors and high gloss) that grabs the consumers attention can help form the foundation for a practice.

Four Seconds - That’s All You Get!  

According to Eye Scan Research, the average recipient will scan a postcard and decide whether or not to turn it over, all in about four seconds. A seductive, appealing photograph presents an outstanding opportunity to capture the recipient’s interest - whether a new patient or an existing patient - and invites them to read the offer or message on the rear of the card. 

I want to tell you about some awesome postcards I found on an obscure website. These are the best freaking postcards I’ve ever seen, I haven’t seen them in any of the catalogs, however their effectiveness in getting patients to return to the office has been unbelievable, and I don’t tout products lightly. I have used their FEELING A LITTLE STIFF card. These are fantastic. Now of course, your marketing gurus and their flunkies might well tell you that the card could be offensive or disturbing to some people, maybe to graphic, (there is a photo of a cadaver in a chiropractic college dissection lab) and it might be, however I will tell you this, I’ve used the card and the response rate from my inactive patients has MORE THEN DOUBLED. Why? Not because they were disturbed by the card, but because they found it so fascinating that they actually read it.  Additionally, the card has become a great source of referrals. Why? Because practice members are so intrigued by the card that they actually show their friends and family, this in turn stimulates conversation about chiropractic and about YOU, the doctor who sent the card.

Now if you’re afraid to send the cadaver card, and some of you may be and I understand, you know your patient population better then I do. If this is the case you must get the other cards that these guys have. They are the bomb, these are chiropractic reactivation cards that feature the 3 STOOGES. THEY ARE GREAT.

Not only do baby boomers and Gen X’ers recognize the 3 STOOGES, but even younger practice members are being introduced to these comedic geniuses. Recently even NASCAR has gotten into the STOOGES, when Darrell Waltrip put them on his No. 17 Toyota Tundra driven by David Reutimann in the Craftsman Truck Series. There are millions of people who collect 3 STOOGES material. The bottom line is…. THESE CARDS WILL BE READ, and many will be saved and shown to friends and relatives, and although they are simplistic in their message, if you have done even a fair job of educating your patient about chiropractic, they will be able to take the simplistic message on the card and explain chiropractic to their friend or relative. YOUR OFFICE WILL BE TALKED ABOUT CONSTANTLY. And trust me when I tell you, the first thing a practice member will say when they return to your office will be, “doc I loved the card you sent”

All of you should be familiar with the term top of consciousness marketing. TOC marketing is the ability to keep your name in the mind of the consumer, the ability to have them correlate an outside event with you. After using these cards, every time the 3 STOOGES are mentioned, anywhere, anytime, you will come to the mind of that person; they will remember the great card you sent. They may go into a car wash and see the famous photograph of  3 STOOGES in their golf regalia on the golf course, who will they think of? YOU.

Now you can continue using BORING patient reactivation cards, or you can use cards that work. While the prices are slightly higher then the junk that is sold by other marketing firms, (this is apparently because licensing fees are extremely expensive) they are worth every dime. How much is a reactivated patient worth to your practice? Certainly a great deal more the cost of 100 postcards. So why pay $20-$30 for 100 cards that get you $0 return on your investment, when spending $45 will no doubt get you back thousands of dollars? These cards are all available at www.imagearchives.com

One more thing on this subject, PLEASE, PLEASE do not use printed labels when mailing reactivation cards to your practice members. Believe it or not a simple hand written message above or below the printed message works the best. Something like “Hey, we’ve missed you.” Then just your name, just sign it Dr. So and so. Make sure that the name is legible, or print your name instead of signing the card. (Don’t worry they will know you are the chiropractor that they saw just from the card) Because the cards have a gloss back, use a Sharpie pen, as this work the best on the gloss paper and doesn’t smudge when dried. Sharpie actually sell a fine point as well as their standard fat pen.Don’t confuse the purpose of a monthly Newsletter with patient reactivation. One is, (the newsletter)  a “remember my name” the other, (patient reactivation) is a specific call to action.

How To Structure Fees

One of the most important things in any business, (that is what you are operating, never forget it), is setting fees that are fair and affordable. There is a great deal of debate out there as to ethics of pre-pay so let me start with that issue. When I graduated ChiropracticCollege back in the stone-age there was really only one marketing guru out there, Jim Parker. Because of my medical attitude the “I was a doctor after all” and as such I shouldn’t involve myself with the money aspect of the office. That was the job of the “front end girls”. Yes that’s what CA’s were referred to as.  Coming from this medical model belief system I was appalled when I heard about case fees and pre-pays. What doctor did you know that wanted their money up front and charged you by the case? The exception at the time was maybe the orthodontist. If a patient came in with a back pain, maybe it would take 2 visits how could I say it would take 25 visits? What I failed to understand was the concept of corrective care, the concept of nerve interference, that concept of what chiropractic was and the most important concept that I failed to grasp was the value of what I do, the value of the adjustment and the difference it makes in peoples lives. Many of you have just started your practice and have not grasped these concepts, what’s sadder is that there are doctors in practice 20 years or more and still don’t have an understanding the reality of chiropractic, IT IS NOT MEDICINE, it is a completely different healing art, we are not, despite what some colleges would have you believe Doctor of Chiropractic Medicine.

Knowing what you know, no matter which school you graduated from how can you honestly think that you just need to relive patient’s symptoms? Do you just put them on a decompression table and you’ve done your job as a chiropractor? Everyone of you no matter what your philosophical background understands the long term effects of degenerative disc disease, how can you have a patient with severe DDD come in and adjust him 3-5 times get rid of his symptoms and tell him to come back when it hurts? To me this is where the lapse in ethics is occurring, not with the doctor who is telling the patient “their truth” about the devastating long term effects of subluxation.

So this brings us to a very interesting subject, how does one stay congruent, true to his/her belief that everyone needs chiropractic care and that they need it for their lifetime and still be fair monetarily to both doctor and patient? The answer is the case fee. The case fee is not a dirty word, the confusion is that many, and it actually could be the majority of the doctors out there can not shake their medical model mindset. When a chiropractor is setting a case fee, it is not for the relief of pain, it is for the overall correction of the patients spine and nervous system, that is why you must take the time to educate the patient, tell the truth, give the patient the option. If after hearing the truth about subluxation and spinal/nervous system health the patient decides he/she doesn’t want the care that you are recommending then you have done your job. But if you have done even a mediocre job of explaining the chiropractic truth then most patients will accept your recommendations. So now come the part that everyone wants to know, how much do I charge? Well I don’t have the answer as to what you should charge, I can give you my belief and recommendations in this area, I’m sure there are many of you who will disagree, but here it goes. First of all you need to have options available, not a Chinese menu, but maybe 3 options. An acute care option where the patient pays a fee as they go, this should be a reasonable amount (I call reasonable $28-$40 an adjustment without modalities) Those patients who choose (remember, every patient is given the chiropractic story, even the acute patient) to have corrective care can be offered a discount of 10%-15% if they pre pay for all of their care up front, so maybe  after doing your analysis you determine they need 30 visits over the next 3 months at $40 a visit this would be $1200, you could offer to have the patient the opportunity to pre pay this fee and save $200. If you have done a good job in explaining the benefits of care and correction most people will accept the case fee pre-pay. In cases where people have insurance, determine the case fee, then estimate what insurance will pay based on their benefits and have them pay the remainder up front. This might only come to $100 but it keep the patient committed to care when they have made a financial investment no matter how small. For this same reason if you have determined that a patient needs 30 visits and their plan only pays for 20 visits, get the difference up front. You can discount this fee if you would like, I’m not a lawyer but in most states you are allowed to offer a discount to patients for bookkeeping savings, as always I have to tell you to check with your state board or your lawyer if you have any doubt. The next issue is lifetime care plans. These are basically plans that allow the patient to visit weekly for an adjustment, essentially wellness care. Here you have a great deal of lead way, in essence you are offering the patient 50 visits a year, in my opinion since most insurance plans do not pay for wellness care this must be affordable, a fair fee in my office for 1 year of wellness care if paid up front is $1100, if paid over 2 payments of 6 months it is $650 every 6 months. Again the disclaimer, some states may require you to escrow a portion of this fee, so please check with your state board. But remember the converse is also true, just because a patient has a benefit plan that allows 30 visits, that doesn’t mean that you have to adjust the patient 30 times, be honest to the patient and yourself, if they only require 20 visits then 20 it is. If you start to make deals with the devil you will never stop, it only gets worse. To have a comprehensive study on the issue of fees would require an hour or more of writing, I will try to put out a CD on this issue in the next few weeks and go over things in more detail, make sure you have signed up to be on our mailing list to receive your free CD’s as they are produced.

Because we ran so long with this issue, I will discuss how to ask for money in next week’s issue.

Marketing Tips

Many of you receive referral from medical doctors. Some of these referral are relationship referrals and some are what I call technical referrals. Technical referrals are those referrals that have been generated by the patient. The patient in essence has told their primary care office that they would like a referral to Dr. So and So and the office then generates the referral in the system. This is not really a referral, but most marketing systems will tell you, and they are correct, that a nice short report to the primary physician is a good way to market and develop a relationship, even if it was a “technical” referral. In our office we have gone one step further and have found that the response has been a great generator of new medical referrals. We prepare a thank you card to the primary physician, even for technical referrals for the patient to sign thanking him/her for being so open minded and progressive and recommending them to see us. There is nothing any of us love more then a little ego boosting and gratitude from a patient, well the same is true for the medical doctor. Click here to see a sample of the letter.