Right from the start
New chiropractors are well advised to study those with more experience. But you can learn a lot from those who are just starting out of the gate, too.
By Laura Laing
The more things change, the more they stay the same. Well, almost. While the basic tenets of starting up a practice may not have evolved much over the last two decades, advances in technology and a poor economy present unique challenges for new grads and veteran practitioners alike.
In fact, old dogs might just learn some new tricks by watching successful new chiropractors enter the field. Lessons in Internet marketing and developing a cash-only client base can certainly boost the bottom line for even the most experienced chiropractor.
And addressing a highly competitive landscape in a depressed economy is critical for success.
But while chiropractic colleges are beginning to offer business courses and guidance to students, for most new (and experienced) DCs, these are on- the-job learning opportunities.
For the most part, changes center on three themes: the Internet and social media, a depressed economy, and heightened competition. Focusing on these three areas can help a recent grad get a great start or inject some much- needed energy into a flagging practice.
“Going into practice now is more different than it’s ever been,” says David Singer, DC, founder of David Singer Enterprises. “New chiropractors must graduate with certainty that they have the clinical skills to help people. It’s their obligation, not the school’s obligation, to make sure that they are proud to market themselves. It is not as simple as just opening the doors.”
But it’s getting tough for old timers, too.
“We no longer can depend on our reputations and how long we’ve been in practice,” Singer warns.
Chiropractors — new and old — must be proactive in order to compete in today’s marketplace. The landscape is changing and so are the rules.
When the Internet comes up in conversation, most folks envision websites, blogs, and social media. But the World Wide Web is a lot more than those great tools. Palmer College of Chiropractic has developed an online location-matching tool for recent graduates, much like popular dating websites that pair single people based on their personality traits.
With this tool, students are matched with practices all over the country. For associate positions, students then create and submit a video résumé. Students who wish to purchase an existing practice can be matched with chiropractors who are selling.
“We’re hoping that the job seeker and employer will have a better match because we’ve done due diligence upfront,” says Kevin Cunningham, vice chancellor of student affairs for Palmer.
But of course the Internet is useful in a variety of ways — not the least of which is marketing.
“When I was in practice 40 years ago, you had to be listed in the Yellow Pages,” Singer says. These days, the advice is different for the 1,000 practices he consults with each year.
“Patients don’t find you in the Yellow Pages. They find you on the Internet.” But this isn’t news, right? More and more people depend on social media and crowd sourcing to find solutions to their everyday problems — and that includes identifying good chiropractic care in addition to other medical needs.
“You would be surprised at how many established chiropractors have no website or don’t know what social media is,” notes Nona Djavid, DC. In
2008, she started two businesses: her own practice and MyChiroPractice Inc., a marketing and branding company exclusively for chiropractors.
After graduating from Life Chiropractic College West in 2007, she wasn’t quite sure how to start her own practice. “Marketing and branding weren’t things I was exposed to” in college, she says.
So she began doing her own research and met her future husband, a graphic designer. “I learned a lot from him,” she says. “We decided there was a need [for chiropractors] to really understand their potential patients and so on.”
As someone who essentially grew up with the Internet, Djavid instinctively knew that a virtual presence was absolutely necessary.
“The new generation of customers is looking for you online,” she says. “Having a blog or Facebook page is not enough.”
Internet marketing experts typically suggest building an online strategy like a wheel. At the hub or center is the practice’s main Web presence. This could be a standard website or even a blog. Along the edge of the wheel are all the other marketing efforts: Twitter feeds, a Facebook page, email blasts, a YouTube channel, seminars, guest posts, comments on others’ blogs, and even traditional advertising.
The point is to drive all traffic from the outer edge of the wheel to the hub. At the same time, the message from the center of the wheel radiates out to all other aspects of online marketing. At first, this may sound complex and overwhelming. Looking at this model bit-by-bit can help break it down into manageable pieces. And, in fact, having a strong message that is central to all marketing efforts can simplify the process. Djavid recommends that chiropractors first think about their target market.
“Knowing whom you want to see is the first step,” she says. “In order to be effective in your market, keep [your target market] narrow.”
Defining the target market simplifies the development of an online marketing strategy. It’s worth it to spend the time to get it right.
“Use all of the social media that is available,” advises Brad Chapman, DC, founder of Chapman Management Corp., which offers one-on-one personal coaching to its chiropractic clients.
An online investment can pay off pretty quickly. Djavid estimates that she gets 12 to 15 new patients each week from her website.
“If you get one new patient each month from your website, it will pay for itself,” she says. “Moving things online is not necessarily more expensive than what chiropractors were used to doing.”
To be sure, no one is suggesting
that online marketing is easy. “It does take a lot of time,” Djavid says. “Once you have the basics done, you’ll spend a good hour a day on marketing.”
All of that said, the Internet is certainly not the be-all and end-all. Both Djavid and Singer note that word-of-mouth advertising is a more powerful tool in rural areas — which is a testament to the importance of knowing your target market.
Rules of the new economy
The great recession has certainly made it harder for most professionals to earn a profit. Chiropractors are no exception.
First off, it’s tougher for a new practitioner to get financing.
“The banks are more cautious in lending,” Chapman says. “They evaluate the doctor deeper than ever before. Unfortunately chiropractic has a bad rap with failed practices over the years.”
Chapman advises new practitioners to find an experienced accountant to help develop a business proposal and complete the financing paperwork. To keep costs down, he also suggests targeting existing office space that has already been designed for a doctor or dentist. And then there’s equipment.
Chapman suggests leasing with an option to own the equipment after five years, “That way the doctor is not spending all his working capital up front.”
But the economy affects practices in a variety of other ways too, including patient retention.
“For the majority of the country, the average American is a lot tighter with the money he or she spends,” Singer notes. At the same time, insurance reimbursements for chiropractic care are becoming less common and less generous. Unfortunately, many chiropractic patients view their treatments as a luxury, rather than an essential part of staying healthy.
“The consumer doesn’t place a high value on chiropractic care compared to, say, neurosurgery,” Singer says. For that reason, chiropractors must learn to talk about money.
“There’s a greater need in knowing how to collect cash,” Singer says. “Most students have a lot of issues with this subject. They not only don’t know how to discuss it, but they don’t know how to arrange it.”
He estimates that 20 to 30 percent of patients cannot afford to pay $50 per visit three times a week, but they will do it to relieve pain. Helping patients develop a budget for their chiropractic care, as well as working with third-party entities to collect payments, are ways to keep them coming in. This is also where patient education plays an important role.
“Every patient has a goal to eliminate their pain,” Singer says. But when the pain is gone, patients may have no plans to continue treatment. “They look at us like an auto body shop. You go to a chiropractor to get fixed. You go to an MD to get a diagnosis.”
Chiropractors must work proactively to change this mindset, so that patients consider their care long-term.
“The chiropractor really needs to outline for the patient clearly what needs to be done to treat the condition,” Chapman says. “Patients don’t care how much you know, they want to know how much you care for them. If you can demonstrate to a patient that you really, really care, you have a patient for life.”
Still, new chiropractors may not feel the pinch of the economy in the same way that established DCs do. Djavid started her practice at the beginning of the great recession. As a result, her patient base is largely cash-only.
“I didn’t know any better,” she says. “Hopefully that will pay off.”
Competing for patients
With more than 20,000 individual practices in the country and physical therapists now doing manipulations, DCs know firsthand that competition is tighter than ever.
“They’re all going after the same market,” Singer says. He worries that some chiropractors are adhering to the Field of Dreams mythology. “They will not come, unless they know you’re there. There’s a very simple formula for success in the marketplace. The more people who know you, the more people will go to you.”
Singer recommends an old tool to help address competition: the survey. Sending out a questionnaire to 200 people in the community serves two purposes — getting insight into what the community needs and marketing your practice as a solution to those needs.
“Using surveys is more important today,” Singer says. “It worked 40 years ago, and it works now.”
These surveys can be done online, saving money and time. In fact, the Internet can help new doctors cut through the competition in a variety of ways.
“For those who are Internet savvy, it’s very easy to dominate the Web,” Singer says. “The Internet is the level playing field.”
While medical doctors dominate new and more traditional advertising, a chiropractor with a strong online presence can end up at the top of search lists — before the MDs.
When used in combination with an effective Web strategy, the more traditional marketing tactics can seal the deal. In other words, “don’t live in isolation,” Cunningham says.
“Go out and meet three people a day,” Chapman suggests. “If you’re practicing in the community, you want the community to know you.”
Singer advises setting an even higher goal of 30 people per week. But the message is the same: the Internet won’t replace attending seminars, expos, and networking meetings.
Whether you’re new to the field or a long-timer, adapting to the current business climate is a winning strategy. Cunningham believes that new chiropractors are essential in this adaptation.
“Today’s students have better business acumen,” he says. “They can bring that into the practice and help the practitioner get up to speed. Adding a new graduate to an existing practice can really revitalize the practice.”
The marriage of old and new could very well be the key to conquering a challenging business landscape. Sometimes, a fresh perspective is exactly what you need to find the winning solution.
Laura Laing is a Baltimore-based freelance writer and editor. Although not a chiropractor, she contributes regularly to Chiropractic Economics. She can be reached through lauralaing.com.