Why you need to specialize and how it can change your practice for the better.
Chiropractors receive a good, general breadth of knowledge in school. Most put up a shingle and welcome all patients with a wide range of issues, but they can’t always treat them.
Someone might walk into your practice with a concussion or want help with weight loss and you probably don’t have enough experience there to help them. Most chiropractors have to take continuing education courses in neurology or sports medicine or pediatrics to specialize in a particular area, which Amber Brooks, owner of Whole Child Wellness, champions.
“When you are looking at any profession, you’ll find that you can be the master of a couple of things but not everything,” she says. “I feel chiropractors need to be learning more outside of their basic education. We need more specialists.”
When chiropractors specialize in certain areas of practice, it can make the job more satisfying and your office more marketable, according to Brooks.
“There’s always someone cheaper than you or who takes a different insurance,” she says. “So, you have to figure out what sets you apart from those other chiropractors within a five-mile radius.”
We talked with Brooks and a handful of other chiropractors who work in different specialties to find out what drove them to work there, how it has benefited their practices, and how to move and market in that direction.
Russell Lamboy, DC, Lamboy Family Chiropractic and BrainCore Therapy of Farmingdale, N.Y.
Lamboy discovered a neurofeedback program after his son was diagnosed with attention deficit/hyperactivity disorder. At the time, he was doing well with his day-to-day practice. Then, one of his son’s teachers recommended the therapy for his son.
He drove an hour and a half from his home for each session because of the amazing results it provided his son. He contacted the founder of a neurofeedback company and became a provider of the service. Today, he has five machines in his own office and is part owner of the company, which offers therapy in 230 offices worldwide.
Lamboy says the program increased his income, helping him worry less about struggling to make his monthly target. Much of his chiropractic work is insurance-based, but neurofeedback has added an additional avenue of cash.
Neurofeedback, which helps re-educate brain waves and create new pathways, has also made coming to work every day more enjoyable, he says. The therapy lasts 30 minutes and is administered two to three times a week over about 30 visits.
“I have parents who come in stressed because their boy or girl isn’t eating, or they aren’t themselves or they don’t want to leave the house,” he says. “Then the kids and parents start coming in smiling and happier because they are getting better. It’s a good thing; I love it.”
Making it work
Lamboy started by making sure his whole staff had buy-in to the program. Then, he began offering it to his own patient base for a very reasonable cost.
“I basically gave it away — I made it cheap enough so patients could try it and see what was going on,” he says. “I started growing it from within and told people to tell everyone they knew who might need it about it. If the people around you don’t know what you are doing, how can anyone else?”
He also did newspaper and online advertising, and he used to go to street fairs and lecture at the library and local schools. He’s been practicing for 18 years and this past year was the first time he didn’t have to do these kinds of promotions. He credits neurofeedback.
“It’s everybody’s goal to hit a point where you don’t have to do those events anymore,” he says.
Wayne Carr, DC, Carr Chiropractic Clinic at five locations in South Dakota
Carr has always had a thirst for knowledge: during his career he’s received a certification in sports injury and a diplomate in rehabilitation. Then at one point, he noticed an increasing number of patients were suffering from various chronic illnesses. He began searching online for some of them and happened upon an online functional medicine class.
He enjoyed the class and started implementing some of it into his practice. Seeking more in-person training, he attended a functional medicine class five years ago.
“I sat in a room with 600 other doctors and 14 were chiropractors,” he says. “I got excited about it and continued to do their courses and became certified in functional medicine.”
Moving into this specialization was simple because it has a similar philosophy to chiropractic. You counsel patients to make lifestyle changes and seek natural care first.
Carr says the class he took would make a good starting point for anyone. There are many organizations that offer good courses, many of which are online and allow you to move at your own pace.
Before starting one of these programs, Carr recommends finding a nearby chiropractor or doctor who specializes in functional medicine that you can shadow or with whom you can discuss the work.
“You are going to invest a lot of time and money in education; you have to constantly be learning,” he says. “You have to have a passion for learning and improving patients’ overall health because it is going to be frustrating trying to get people to make lifestyle changes.”
Carr’s biggest struggle with specialization has been managing a busy musculoskeletal practice while simultaneously working functional medicine clients into his schedule. Moving from one room adjusting a patient with low back pain to the next where someone is dealing with a chronic condition can be challenging, he says.
He hired a certified health coach and has ensured that his staff has bought into the functional medicine philosophy.
“You need people to assist you and get them as much training as possible,” he says. “Finding a staff person that is passionate about these things is important. It has to be in their blood.”
About 25 percent of Carr’s current patient load is in functional medicine, but his goal is to get to about 50 percent. And he uses these principles with all his patients. For instance, he counsels patients with neck and back pain to use relaxation and breathing to manage acute episodes.
Jason Strotheide, DC, founder and CEO of ChiroNutraceutical
Even as a child, Strotheide struggled with his weight. He tried pretty much every weight loss program out there, but when he got to the “maintenance stage” the pounds always came back.
Then he decided that — armed with his training in physiology and biochemistry — he would create his own solution. He worked with professional formulators to create a nutritional support formula that helped stabilize blood sugar, increase metabolism, and promote detoxification and he began to quickly lose weight. His patients took notice and asked if they, too, could use the product.
“I had always been an aggressive marketer and saw this interest in it and there wasn’t anything like it out there,” he said. “Nothing existed that was turnkey, that chiropractors could just put in their office.”
Finding a niche
For Strotheide, it was his own interest in weight loss that sparked his specialization, but he says a good place to start for others may be identifying patients’ pain points. For instance, a friend of his wanted to work in pediatrics. When he realized there was a need to assist moms with babies with latching issues, he partnered with La Leche League to work in that space.
“Identify the top two or three things that negatively impact patients in that niche and sit back and figure out, ‘How does what I do help make their life better and improve their health?’” he says. “Then build a marketing system that addresses that.”
Strotheide knew weight loss was a big pain point for a lot of people. About half of all Americans want to lose weight, and while body mass continues to rise in the country about one-third of people are always actively trying to lose weight, he says.
One of his best marketing weapons is email lists, which he says are phenomenal performers. The open rate for emails is directly related to whether a person is interested in that subject, he says. If you manage your email, you will know who is opening what note and can create a database based on interest.
“You can have a list showing those that open every email about latching disorder, cold and flu prevention or head and neck pain,” he said. “An email database list is gold and so many people don’t recognize that.”
Amber Brooks, DC, CACCP, BCIP, RN, owner of Whole Child Wellness, in Flower Mound, Texas.
Brooks has worked with children since she was 12 and the only reason she didn’t go to medical school for pediatrics is because, as a child, she was often ill and she felt doctors had failed her.
When she came upon pediatric chiropractors, she knew that was the route she would take. She did her post-graduate work while she was still in chiropractic school and has worked in that specialization her entire career.
“I did it concurrently knowing what I wanted to do when I left school,” she says. “Going into pediatrics makes me feel like the doctor I wished I’d had as a child.”
When Brooks graduated, she, like most other chiropractors, had taken one nutrition class and had very basic knowledge of X-rays and blood work. Now her patients come to her for most of their primary care.
She received her pediatric certification through the ICPA while attending Parker University. While she recommends the program to others, she concedes that the certification was also relatively basic. Brooks ended up doing a lot of self-teaching. She attended functional medicine conferences and other pediatric events to learn much of what she uses daily in her practice.
Aside from working in pediatrics, she specializes in treating children with special needs. Many parents of children with autism come to her after seeking help from other doctors who “therapy them to death.”
“A lot of patients come in who can’t speak and I am confident I can figure out what is going on with them in a way that other doctors aren’t finding,” she says. “Being able to turn things around fairly quickly is probably the best feeling in the world.”
Brooks has tried about every marketing trick available and has changed over the years as technology has increased. But she has always fallen back on what she loves most: speaking and education.
She opened her practice in an area where she had no connections, so she went to mom groups and met with people in the special needs community. She offered free consultations to new patients and in 2013 wrote a book. While she wrote it with her patients in mind, she said it made for a great business card.
About three years ago, she moved to online marketing and now strictly does that. It has worked so well that it’s more uncommon for her to treat someone nearby than it is to help patients who drive or fly to her office for treatment. She establishes a care plan and they return home, where she connects them with a local practitioner.
While some chiropractors may think specializing constrains the number of patients they can treat, Brooks says it does the opposite—it opens doors.
“It’s actually easier to market and puts you in a good position, long-term, to stay around,” she says. “There is no surviving in this economy and with insurance unless you are setting yourself apart. And what better way to do that than to find something you love and be really, really good at it?”
Tammy Worth, a freelance writer based in Kansas City, Missouri, specializes in business and health care subjects. She can be contacted at firstname.lastname@example.org.