Rick: Welcome to the Tuesday webinar series, “Chiropractic Economics Webinar for Doctors of Chiropractic.” I’m Rick Vach, Editor in Chief of Chiropractic Economics and today’s webinar, “More Patients, Less Effort: How to Get Consistent with Marketing” is sponsored by Breakthrough. And as always, our program is being recorded and will be archived at Chiropractic Economics website, chiroeco/webinar for one year. Our expert is on board today to speak with you and when his presentation is complete, will follow with a Q&A period. You can submit questions throughout the presentation by clicking on the appropriate chat icon on your screen. Our presenter today is Chad Madden, PT, MSPT and co-founder of Breakthrough. He is also the founder of Madden Physical Therapy. And since opening his practice in 2003, Chad has scaled across 6 clinic locations, and was recently valued at more than $16 million. Through Breakthrough Chad helps hundreds of chiropractors and physical therapists scale and grow their practice. He is also the host of the “Grow Your Practice” podcast. Thank you for taking the time to participate in our webinar and for sharing your expertise. Before we get started, can you please give us a brief background of your work with Breakthrough?
Chad: Thank you, Rick. I appreciate you having me here and for the warm introduction. With Breakthrough, so very quick origin story, in 2012, I met the Head of Online Sales at Tesla Motors, Carl Mattiola. And at the time, he was looking to help conservative healthcare practices grow through online marketing. And so what ended up as a discovery call, we started hosting webinars very much like this. And at that time, I had been forced to…within physical therapy, we very much relied on physician referrals. So because of the immense competition that’s in my area here in Central Pennsylvania, we had to learn what chiropractic now has known for hundreds of years, for 120 years or so is marketing direct to the consumer is the best way to go. So yeah, that’s how we got started. We started hosting webinars, and then delivering courses, and now software and some other tools as well to help practices.
Rick: Thank you, Chad, for that background. And now we’re gonna hand it over to you for the presentation.
Chad: Awesome. So just as you shared there Rick, we’re gonna talk about more patients with less effort. Most of us have very little time to devote to growing our practice, because we’re busy treating in the clinic. And we’re gonna talk about that over our time together here today. So the big question that we’re gonna address in this webinar is how can you finally get consistent with your marketing. What many of us go through is, you know, the classic roller coaster, we need more new patients, we launch a marketing campaign or two, something happens, we get an influx of new patients, and then we’re busy treating, so we stop marketing. And then because our census falls down, our caseload falls down, now we need more new patients again, we go out and we start marketing, we get a small influx, and now we’re busy in the clinic again. And for the first three years of my private practice life, this is exactly what I went through and I found this as true, essentially in all conservative care. So not just chiropractic care, but also physical therapy, podiatry care, functional medicine, pretty much any conservative integrated practice across the board. So just out of curiosity, for those of you that are on the call right now, if you can hit in the chat, does this sound familiar? Is this what you’re doing? Do you feel time-starved, where you don’t have enough time to consistently market in your practice? You can type just a simple yes in the chat box.
Ideally, what we want to build towards is something where we have that consistency. And in order to do that, we’re gonna take a look at something called the flywheel. And this was popularized by Jim Collins of “Good to Great” fame, and a few other business books, “Built to Last.” But if you start up in the upper left hand corner, you can see, consistently attract more chiropractic patients, that’s the goal. So we go out and we buy market share. We buy online ads or offline ads. We do a direct mail piece. We do some sort of marketing initiative that generates more new patients and they come in and people respond to our ads. We have to be able to efficiently follow up with those leads, otherwise, we’re just wasting advertising dollars.
And for many of us, in healthcare, we’re tending to go to a spreadsheet, or my favorite, and this happened very recently in my practice, is we ended up having six different spreadsheets, which was absolutely insane, and a lot of inefficiencies there. But when we nail that, and we deliver it, and we execute on that the right way, and we efficiently follow up on leads, then what’s happening is we’re taking the ad responders and converting them over into paying patients. So the next thing that we want to happen, that circle at the bottom of your screen now, is we want to be able to track that, right. So we use performance and staff metrics to continuously improve and grow. And for us, we look at those metrics in three key areas of conversion. And the easiest way to think about this is, number one, what happens with your front desk, or if you have a marketing person, what happens…that person that’s having that initial conversation with those leads, your ad responders, what’s going on there? Are they converting well, are they getting them in for a first appointment, or is that just not happening? But we want to be able to look at that and track it.
The second place that we want to look at is what is happening within the evaluation room. And oddly, there’s a wide disparity in conversion rates amongst clinicians, when we’re talking about what’s happening with that first appointment, and converting that over to a plan of care or a treatment plan, whatever terms or words you use to describe that. The fourth thing that we want to do here in the flywheel is we want to be able to hire and expand our practice. So when we’re successfully marketing and getting that market share, and patients are coming in, and we’re able to fill up our schedule and fill up the space, we want to be able to hire and expand the practice. What does that allow us to do? It allows us to buy more market share. So the reason this is called a flywheel is because once you put the effort in, the appropriate effort to get the flywheel spinning, it’s easier and easier to grow your practice. This is exactly what we followed in my own private practice. And, as Rick mentioned, in the beginning, we recently had a valuation at $16.5 million, we have 96 staff amongst 6 locations, and we’re opening 2 more here within the next 6 months as well. But this is exactly the same format that we followed. And we’ve helped hundreds of other healthcare private practice owners do the same thing.
So in our time here together, we’re gonna go through what gets in the way of consistent marketing. I’m gonna share three quick wins for you. So at the end of our time here today, you’re gonna have three steps that you can execute immediately to get more patients with less effort. And then we’re gonna talk about a patient demand platform and how it can help you consistently grow your practice without taking more time, then we’ll open it up for Q&A. So who is Breakthrough? What we do is our goal and our purpose is to help private practice owners essentially serve more people. So we do that through marketing. We work with thousands of practices all over North America, and four other continents as well, including Europe, Africa, and Australia, and Asia. So we work with practice owners everywhere. Yeah, you can see some of the things that we’re doing. Perhaps the most prominent thing I’ve mentioned, Carl Mattiola in the beginning, who was the head of online sales at Tesla Motors when we met in 2012, you can see him there above the Inc. 500, the picture on the right. But Carl was a master within Silicon Valley of email and online automation. And right now through Breakthrough, we’re sending over 8 million emails annually on behalf of practice owners. And we’ll talk more about what we do here in a second. So what’s the real problem that we’re trying to solve? Our healthcare system is backwards. And these are numbers that are just in from 2021. Presently, we spend in the U.S. $4.1 trillion and…well, that’s what we spent last year. It’s roughly 19% to 20% of our total GDP.
So $1 out of every $5 that is spent in the U.S. goes towards healthcare, and that does not include health insurance. So it’s strictly for healthcare. And if we look at where that money goes, it is not going to conservative care. It’s not going to chiropractic, physical therapy, OT, speech, podiatry. It’s not going to any of those. It’s going to pharmaceuticals, injections, surgery. So if you break that down, the $4.1 trillion, and you divide it by 340 or so million Americans, that comes out to $12,530 per person per year. What percentage of those dollars, $12,530, which is over $1,000 per month per person, do you think goes to any form of conservative care? You can type your answer in the chat right now. So $1,000 per month being spent on healthcare, what percentage goes to conservative care? The answer is 10%. So pretty anemic. And if we look at pharmaceuticals, so medications, injections, surgery, and if we throw diagnostic imaging in there, what percentage of those dollars do you think goes to medications, injections, surgery, diagnostic imaging, that number is 72%. So we essentially have $100 per month going towards conservative care, we have $720 a month plus going to medications, injections, surgery, diagnostic imaging, by way of healthcare system, or hospital system.
So we’re very reactive. We don’t focus on root cause. We don’t focus on prevention. And how’s that working? Well, if you look at any of the vital metrics for anything that has to do with longevity, or health of a population, we frequently rank last in terms of developed countries in the world. And we’re definitely not in the top 20 for anything around chronic care for cardiovascular disease or diabetic care, anything like that. So the system is definitely backwards and broke. So our purpose, our goal is to help flip the pyramid. And the best way for us to do that is to work with private practice owners. So the goal is that we understand where we’re at today. Ten percent of all the healthcare dollars that are spent in the U.S. goes to conservative care. In order to fix this, we’re gonna have to have conservative care be the foundation of our entire healthcare model, just as it is in other countries that have more affordable costs and healthier populations of people. So flipping the pyramid involves making conservative care the foundation for our healthcare system. And what typically gets in the way of that happening? Well, first of all, many healthcare clinicians, physical therapy and chiropractic included, will say things along the lines of not enough people understand what we do in chiropractic care, or not enough people understand what we do in dental care, podiatry, whatever it may be. And what happens is the clinician is trained to treat, they are not trained to market.
And so when the clinician tries to remove themselves from the practice and go out to market, they don’t have time, they’re not efficient enough. They’re very efficient in the clinic, but they’re not efficient creating marketing campaigns and knowing which media to buy and how to select media types and create messaging. So that’s big problem number one, we’re not trained as clinicians. Number two, is it’s unclear that once we run a marketing campaign, you know, if we buy a direct mail piece, or we buy a print ad, a radio or television ad, a billboard, we do online marketing, social media posting, it’s unclear what’s working and what’s not. And when most owners talk about attribution, what they’ll usually say is, “I deliver high quality of care. And we rely on word of mouth referrals.” And that usually just screams, we have no idea how to market and we don’t know how to track what’s going on. Number three, the systems are really complex. So there’s a lot of software out there, a lot of options available. Even if you’re looking at just email campaign, email campaign software, or conversion software, it gets really complex.
And again, we’re trained as clinicians, we’re not trained as marketers, so easy to waste a lot of time there. So what do we do about it? Well, not enough time to create marketing campaigns. Again, this is very common. If you feel this resonates with you, don’t worry, you’re not alone. Many of us go through the same thing. So when it comes to time, you know, what do we need time to do? Well, we have to develop and distribute content. If we’re focused on emails, we have to actually write the email and set it up within the automation software so that it goes out. When people respond, we have to be able to, you know, to have the time to respond to those emails coming back in. Paid advertising, you know, how do we select…how do we choose between Facebook, Instagram, TikTok, YouTube or Google Ads and how do we track that? Again, all involve time, money and resources. Hosting live events, if you’re doing that, how do you set it up the right way? How do you make sure that you’re getting maximum conversion from the time, money and energy that you put into executing that event? Same thing with social media. So we know that we need to do it, you know, but it takes time and effort. And again, most of us have degrees on the wall and licenses that have nothing to do with marketing. I’m sure there’s an exception, as there always is.
The second big thing that gets in the way is it’s hard to know what’s working and what’s not. This is probably one of the most frequent things that comes up when we’re talking with practice owners. Again, you know, we have email marketing systems, I sent out an email, I’m not sure it’s working, or the most common is, we have an online newsletter and I email that out, people say that they see it, but I’m not sure if it’s actually driving patient volume or not. You know, there’s a ton of different advertising platforms, hard to figure out what’s working the best there, Google Analytics, and SEO, SEM, patient engagement platforms, or reputation management, review tools, EMR integration, etc. Most of the time, practices, they’re pulling their data, and they’re putting it into one spreadsheet. And, oddly, if you talk to anybody within software tech, especially Silicon Valley, anybody that works for a tech company, they quickly realize, and they will tell you that that is one of the most inefficient ways, working out of a spreadsheet is one of the most inefficient ways to manage your marketing. So right there, we can save a lot of time, as clinicians, if we switch simply from a spreadsheet over to a software system.
The other thing that happens with spreadsheets is, frequently, and again, this comes from experience, is things will drop through the cracks. So I shared before what… So we have a software system here at Breakthrough, our group was using it, and then they created one little workaround. And what a workaround means is something that they didn’t like how the software was handling it, which has now been fixed. But rather than fix what was going on in the Breakthrough software, they created a workaround within a spreadsheet. And within two or three months, that became six different spreadsheets that were being handled by four different people. And when we went back, and we audited, we just had all of these ad responders who were just completely dropped out of the system. So we call it a leaky funnel, where we had advertising investment and then ultimately that person wasn’t…those ad responders weren’t making it to a plan of care, because we were keeping track of them in a spreadsheet rather than an all-in-one software.
The third thing that gets in the way of creating consistent marketing results is the systems are overly complex and time-consuming. So I’ve talked with owners that use just about everything over here on the right, from ClickFunnels to ActiveCampaign, Mailchimp, HubSpot, Salesloft, which is Salesloft, what I usually say there is, it feels like we’re buying an Apache helicopter just to go get our mail. You know, it’s an overkill. It’s not designed for you and I as clinicians. And unfortunately, none of these…you know, yes, they’re very feature-heavy, but they have too many unnecessary features. There’s no plug-and-play campaigns, and there’s nothing really designed for us, for you and I as healthcare practitioners.
The other thing that happens is we need multiple systems. So we need something for email, we need something to manage our landing pages, we need something to manage the leads, once they come in. So there tends to be redundant features where we’re paying for some of those features more than once, because we’re having to duct tape together three or four different tech solutions. So we know that we need a system, but most are designed for full-time marketers, not private practice owners, and specifically, not you and I as clinicians. So I’m gonna give you three quick wins here. Just as a reminder, we will have time for Q&A. So what you can do, there’s two ways you can interact. The first one is there is a Q&A tab within your Zoom control panel. If you have a question as I’m going through this, just type your question in the Q&A and we’ll make sure we answer it here at the end during the session. The other way is you can type comments into the chat section. So three quick wins, for getting more patients with less effort. And you’re gonna want to write this down if you haven’t written down anything so far.
So when we look at consistency, and we compare practices that are consistently growing, where they have predictable scientific growth of 20%, year over year or more, the one thing that they share in common is they have a marketing calendar. And the easiest component of that to replicate or to start off with, is give yourself an email marketing calendar, what’s the most valuable asset in your business? For most businesses, it’s the past patient list. So if you have a chiropractic clinic, and let’s say you’re right here in Harrisburg, Pennsylvania, and in the office that I’m in right now, in a 10 mile radius, there might be 100,000 people. So out of those 100,000 people, who is most likely to be reactivated as a patient and come in for additional care, treatment services? It’s the people that already know, like and trust you. They’ve been treated by you in the past, they’ve paid you in the past, they’re the people that are most likely to come in for additional care out of those 100,000 people. So if you’ve been in practice a few years, and you’ve treated 3000, or 5000, or 50,000 people, they’re the people that are most likely to be reactivated. How do we want to reach them? Well, the easiest way is via email, right? You’ve already paid for that patient acquisition.
Simply keeping track of an email list, and delivering, and we think about this in two forms, or a very simple formula, which has two components. The first is you’re delivering valuable goodwill to that list. The second is you’re making them offers.
So what you want to do is every month, and we do this as well, you want to block out at least 1 hour in your calendar to write 12 emails for your past patients and schedule one per month. And again, you want to use that formula, one valuable goodwill and content, right? Think about if you were receiving an email from somebody, what would you consider valuable if you were on your patient list? It might be, you know, top three exercises for plantar fasciitis, or whatever it is that you specialize in, you know, a simple stretch for sciatica, something like that is what you want to focus your email campaign on. And then for people that respond…and this is how the Breakthrough email campaigns work, for people who respond and open up the email and interact with it, and download or click on a link, whatever it may be, that’s who you want to make an offer to. So it could be an offer for an appointment or an offer for perhaps a book, if you’ve written a book or anything like that. But what we see is owners will make one of two mistakes here. One, is they will never email a marketing list. Two, is they will do only goodwill, or only offers. And if you do only goodwill, you’re never gonna get conversions. If you do only…you know, there’s no harvesting there, with goodwill, if you’re only doing offers, you’ll burn your email list out pretty quick.
So, again, you can see some of the campaigns that we’ve run, we have a lot of data, again, we’ve sent over 8 million emails within the last 12 months alone. So the second thing that you can do is you want to start tracking key metrics. And there’s something that we talk about when we’re doing business analysis, and it’s called date coincidence. So many times we’re unsure if something’s happening or not. And at the very minimum, you want to have four key metrics that you’re tracking for your practice, and we call these vital metrics. And they are new patients, or whatever you call new patients, clients, total visits, your gross revenue, so the amount of cash ultimately that you’re collecting every month, and your attendance rate. And when you and I are treating a patient, there’s some key vitals that we take depending on…key objective measures that we take depending on what the patient’s pathology is. But if you think about it, if you go to the doctor, what are the vital metrics that they’re taking? So they’re taking heart rate, respiration rate, they’re doing some sort of BMI with our weight and our height, right. So they look at that first. And then if there’s an outlier, if I weighed 160 pounds last year, and I weigh 180 pounds this year, then they’re gonna dig deeper, they’re gonna take a look at my cholesterol, they’re gonna, you know…if they have a bad blood pressure reading, they’re likely gonna have a blood panel, you know, done just to see what’s going on and why my blood pressure is elevated. So then they dig deeper. At the very least, as a practice owner, you want to keep track of these vital metrics.
And then what we do is when we have the marketing calendar, and if we get a spike in new patients, we can go back and look at the marketing calendar. And we can see what we did exactly before, just before we had that spike in new patient visits or total visits or revenue. Right. And we call that, again, date coincidence. So once you have… And this is an example, but for new patients, we break that down into four or five categories. So we think about that in terms of physician referrals, right? Especially if we have other healthcare providers that are referring to us, other clinicians, we just loop it all under…lump it all under physician referrals, we have reactivated past patients, and word-of-mouth referrals from your past patients. So we’ve seen this already. Here’s an example. But a few years ago, we tested something called the arthritis workshop. And the arthritis workshop was not good for cold traffic. So people that did not know our practice…you know, that had no idea who our practice was, they did not follow through with the arthritis workshop. It had a pretty low response. However, when we promoted this, even though we were promoting on Facebook, and Instagram, and in the local newspaper, and on television, we had a huge influx of reactivated past patients and word of mouth referrals. And it took us a while to figure this out. But people who suffer with arthritis, they’re bombarded with a ton of different marketing messages.
However, our patients who already know, like and trust us, that when they have arthritis, they would be reactivated. So even though it was a cold traffic campaign, or patients saw the campaign, we had a record number of patients come in, I think it was like 112 past patients reactivated in a single month to our main office, so single site office in one month, just from this arthritis campaign. And then we went back and figured some stuff out, had conversations with patients who were reactivated and understood a little bit better what was going on. So what did we do in the future? We repeated that same campaign. And we did that by way of breakdown. So the other thing is, you know, you have that cold traffic or, in physical therapy, we call it direct access patients, in chiropractic care, you’re likely just calling it cold traffic or direct to consumer. Number three, is ditch the spreadsheets or get out of them as quickly as you can, if possible. So you want to not pay for systems you’re not utilizing, right. So in healthcare in general…so most of us have small margin businesses. A few years ago, I had the opportunity and privilege to work with Greg Crabtree, who is a CPA. He wrote a book called…oh, I’m blanking on the name of it. Big profits…something about big profits, Simple Numbers, Big Profits. There we go.
And so Greg Crabtree has studied literally thousands of healthcare service provider type businesses. And when we were working through, he said, “You know, the margin in the typical practice is between 10% and 25%.” So, somebody who’s doing a million years in revenue, they’re…we know that usually they have about 10 employees, so $100,000 in revenue per employee full-time equivalent, and that their margin is gonna be between $100,000 and $250,000. And I said, “Well, you know, that’s a pretty big difference. What’s the difference?” And he said, “Its utilization of space and personnel.” And, you know, this carries over to the systems as well. So he said, “You know, once the practices that have the best margin, 25%, they tend to utilize everything.” So they utilize all their space, they utilize the clinicians and people that they have really, really well, and they utilize all of their systems. So anytime that we’re not utilizing a system and it’s not contributing to our consistency and flow, we typically want to eliminate that. You want to be able to track everything in one place, so you don’t want to…I know for us, years ago, we used to…when we were duct taping solutions together in our practice, we had to go through two or three different spots to find like one source of truth for our metrics, what was going on in our practice.
And the third point here is you want to eliminate complexity, right? Essentially Occam’s razor, the simplest answer is usually the best. So you want to think about using the best performing platform or get all-in-one software, as well. So here’s how patient demand platform can help. We’re gonna revisit the flywheel again. But this is essentially what we’re trying to do as clinicians and healthcare practice owners. We start in the upper left quadrant or one-third there. We have a tract, right? So, what do we want to happen? We want people in our community. When we’re buying market share, when we’re advertising, we want them to raise their hands. How do we do that? Well, we do it through online advertising, perhaps offline advertising to complement campaigns that are successful and working. And the easiest way to convert from advertising is through landing pages. When we talk about that, once people raise their hand, and they respond to our marketing, what’s the next step? Well, if you look in the upper right, it’s convert, right. So we need to manage our leads. Some people are going to be appropriate for chiropractic care and your services immediately, some of them are gonna need more nurture time, that’s lead management, where we treat people we meet people where they’re at, and ultimately help them develop relationships and trust with us over time, so that they’ll become a paying patient. Email automation, two way texting, we want to be able to communicate with them in at least three different ways.
So for us, it’s email, two way texting from a platform, and also phone call, right? Pretty simple. You can add in snail mail, depending on the area and the country that you’re in, but we have attraction first, then we convert those ad responders over to a paying patient. What happens after that? Well, that’s where that measuring comes in. So we want to be able to have that ROI intelligence. You know, if I have five different campaigns running, one is on TV, we typically run the 30-minute infomercial length ads, which has worked really well for our practice. If we have another campaign on the radio, if we have one in print, and one on Facebook, one on Instagram, maybe another one on Google or YouTube, we want to see what’s happening with the dollars that we’re spending, what’s happening with our marketing investment, ROI intelligence gives us that.
The other thing that happens is because…and with Breakthrough, we work with hundreds of practices in conservative health, we can take a look at benchmarks and gain insights from that. And I’ll share… So this happened within the last 60 to 90 days is we… So I’ve been doing workshops, forever. We’ll talk more about that here in a second. But it’s basically an in-house event, where I give a lecture or discussion on a specific topic. And I’ve been doing that since 2001, even before I opened in private practice, and just found it was a really good way to market my services. So I’ve done this now over 200 times, I thought I had a pretty good system in place, like an excellent system in place. And one of our therapists and clinical directors, what she did was she put a different spin on the last 5 or 10 minutes of the workshop. And we noticed, so she went from $0 to $20,000 a week in about 1 year in patient revenue. And that’s not what we were billing out. That’s actually the cash coming into the business.
And when we looked at what was driving that, she was hosting workshops as well. And she’s been with us now for three or four years. But she did this little different thing at the end. And what was happening is 100% of the people that were showing up to her events were scheduling a full plan of care. I was like, “Wow, you know, what is going on here?” So I talked with our marketing team, and I said, “Hey, what is Jen doing that the rest of us aren’t?” And they said, “Well, you know, she’s following everything step-by-step. There’s nothing going on.” And I said, “No, can we please record what she’s doing?” Because we had these metrics, I could see how well she was performing, and I didn’t understand. So we took a look at her. We recorded her workshop, and at the end she did something very different that I’d never seen anybody do before. And what happened again is 100% of those people who came to her workshop ended up scheduling a full plan of care. Now we’ve rolled that same close out, we call it a workshop close, out to all of our other practices and they’re having the same success. So that’s what you can do with data. And we take a look at, you know, 200 plus practices, practice locations, and what they’re doing. And we can see what’s working best for advertising, what’s working best for phone calls, what’s working best in the exam room for converting over to a full plan of care. And then we share that all together as a group through the training and coaching that we have there, as well.
So again, this is another flywheel when we think about a patient demand platform, this is the patient demand platform flywheel. Yeah, so here’s an example of within the Breakthrough software, Breakthrough online, you can see what a marketing calendar would look like. That would be the attraction, right, for a past patient list. We then have the conversion where we can see, you know, what exactly is happening with our flow as we’re going through. And there’s lots of insights around email, the different campaigns we have, etc.
And then you get to see how you’re performing in terms of a funnel, relative to the other practices that are within the system. So most of us, you know, tend to be a little bit competitive. And if that’s the case, you know, we can do peer-to-peer review, we also get to see who’s doing the best, as well, because all of the software captures the data within one place. So here’s an example. This is Dr. Tonya, owner and chiropractor at MultiCare Medical. So she hosted an event, and Tonya’s first event, and she did an awesome job recording everything that she did here. She had $45,000 in revenue from her first event. So five people booked out full treatment plans. She had a successful second workshop. And now she’s planning…because she has that consistency in attracting patients, she’s confident moving forward that she can open up another location. So there’s gonna be a poll that’s coming up on your screen right now. Are you interested in learning how Breakthrough can help you with the same exact system that Dr. Tonya uses in her practice, and also that I use in mine and hundreds of other practice owners use all to consistently attract more chiropractic patients? If you’re interested in seeing what this system can do for your practice, just click Yes in that poll that came up on your screen. So you can do that now. And then we will open this up for Q&A. Great, so, Rick, if you’re on.
Rick: Sounds good. Thank you for that great presentation. Those are some great campaigns, and especially those numbers, bringing in lapsed patients are pretty incredible. Let’s see, we’ve got a few questions here. Question number one, what’s the best way to attract patients, and where should I start?
Chad: So that’s probably the most common question, Rick, and I’ve done some podcasts with this, episodes as well, specifically in the chiropractic space, and I agree with what has been discussed there. And it’s, you know, as clinicians, we frequently chase the shiny object, which is I’m gonna go to the completely unaware market, complete cold market who doesn’t know, like, and trust me yet, and I’m gonna try to generate new patients there. All the while we’re stepping…we’re walking on acres of diamonds, just passing all the gold that is underneath us, which is our past patient list. So the easiest place to start, and what we do when we work with a practice owner for the first time, who’s kind of been throwing spaghetti at the wall, for lack of a better term, in their marketing, is we try to help them get a win with their past patient list. Because quickly they’ll realize when they market to their past patient list the right way, in an effective manner, in a way that has been proven in the past, if they do have very goodwill with their patient list, those past patients are gonna come back for additional care. They’re gonna send their friends and family to them as well.
So we always start there. Start with the warm traffic. Most of us don’t like to, you know, sell in terms of trying to convince somebody that…to do something they don’t want to do, we don’t like that effort put on us, but we’re really comfortable with people who already know, like and trust us. So we start there first. And then we build eventually, over time, as the competency develops, to marketing to cold traffic. But start with the warm traffic first, a simple patient email. And we teach something else called the grinning clatter, which is a handwritten direct mail piece campaign. They do really well at getting quick wins for the owner, who has just had toe-in-the-water, spaghetti-at-the-wall marketing so far.
Rick: Thank you for that. It’s funny, you mentioned that because we had DC write an article for us. The article was titled, “Shiny Object Syndrome” and he basically addressed a lot of what you just said. Another question, why is measurement that important? And it seems impossible to find the time for all this measurement.
Chad: Yeah, so great question. Early on, and then we validated this with the owners as well, what I would do in the very beginning, so it was just myself, and I had an assistant, original business plan was for 48 visits a week. And within 6 months, we hit, I remember, it was 108 visits. So it was at a time I was treating 80 hours a week. I was in a new marriage, newborn at home, happy ending to the story, we ended up with six kids, so everything worked out. But what I would do is I would get very busy treating, and I would ride the roller coaster. What I was doing in terms of marketing is I had very poor front desk control, an ad rep would walk in who was selling me some form of marketing. Curtis was my favorite one. And Debbie, who was running our front desk would just let Curtis through or whoever the rep was. And I would just want to get rid of them and go back to treating. So I would say okay, I’ll, you know, buy something. I have the market, I know I have the market as a business owner, so I would buy an ad. And then, you know, four months later…or four weeks later, Curtis would say “Okay, so it’s time to run that ad, what do you want it to say?” Well, I had no marketing background. I had no idea what to do. So I would say, “Well, you know, can you help me out?” And you know, Curtis would write something, we would end up running that ad, and then he would come back three months later and he would say, “Okay, it’s time to buy another ad. How did that last one work?” Well, I had no idea. And I had no idea how to even think about tracking that. So we started with the vital metrics.
And then once I caught on to the vital metrics, then I started breaking each one of those down. So I shared, you know, the four or five that we do, and new patients right now are clinician referrals. We also do from partners, so they’re look-alike businesses within our community who refer patients to us, past patients reactivated, word-of-mouth referrals. And the final one is cold traffic advertising. But if you’re not tracking, you can’t possibly make good decisions in the future around what to do. And it’s, you know, the same thing for you and I as clinicians, we may be on to a treatment that we think is working, but if we’re not objective…you know, let’s say we’re treating a shoulder patient, and the first day they come in, they’re at 120 degrees, and then we treat them for a month or so, and now they’re up to 155 degrees, if we’re not tracking that objectively, how do we know whether our treatment is effective? Is it just simply based on the subjective input of the patient? I hope not. Right, because we’ve all seen the patient that they get that full range back, they went from a 7 out of 10 to a 1 out of 10 in pain, but yet, if we don’t have that objective data, we have not nothing to rest on. When we do have it, we can say, “Hey, by the way, when you came in day one,” and the best case scenario is you took a video of it, “here’s how you were moving, here’s how you’re moving today. Do you see the difference?” Right, so we want that objective data so that we do more of what works in the future and less of what doesn’t.
Rick: Thank you for that. And a related question, can you go a little more in depth on those most important marketing metrics?
Chad: Sure. So we want to think about when we’re looking at new patients and if we’re…so if I go too far down the rabbit hole here just stop me, Rick, but there’s leading and lagging metrics. Lagging is looking at what happened, leading is looking at what caused what happened. So lagging metrics are new patients, right? We take a look at last week, how many new patients came in the door, first appointments, and then we break those first appointments down into attributions. So where do they come from? They come from our past patient list, and they’re simply a reactivated patient, that would be category number one, or a submetric number one. Number two, would be word-of-mouth referrals from another patient. Number three, would be clinicians that are referring to us. So maybe it’s a physical therapist who sends to you, or a podiatrist or somebody who is referring to you as another clinician, that would be category number three.
Number four, is we call it look-alike businesses. So for example, we host in-house workshops, and then we also go out into the community, and have workshops hosted for us where somebody will promote us. And that could be like a SilverSneakers program at a Gold’s Gym, or it might be a major employer, that we have a very good, long-standing relationship with a local credit union, they promote us to come in and do…they’re called lunch-and-learns, which is essentially a 30-minute lecture. They’d book three of them back to back, they record it, and then they actually pay and reward their employees to watch the lunch-and-learn, which is kind of insane. But they…it’s amazing, they professionally record it and everything. But that would be category number four, and fifth is cold traffic advertising. So that is for people who are not on our past patient list yet. They haven’t been referred to us by another clinician or another local-alike business, business with a look-alike list. And they’re responding to a print ad that we ran, or a radio or television ad, or most likely something that they saw online. And that fifth category, just as an aside, when those people come in from advertisements, they’ll typically say…we’ll ask, “Well, how’d you hear about us?” and they’ll just say, “We see you everywhere.” And it’s funny, because when we go into brand new markets, and we open new clinics, and we’re ramping it up quickly, we’ll have…by nature, we have to do a lot of cold traffic advertising. And the person will say, “I see you everywhere,” even though we’re only advertising on one or two media.
Rick: All right, thank you. And our last question, can you talk more about how you market and run your workshops?
Chad: Sure. So the first workshop I ever did, 2001, was at Bishop McDevitt High School. The reason that’s significant is because you’re an NFL fan. It’s where Ricky Watters and LeSean McCoy both graduated from. So I was running a shoulder workshop for their team, and it was basically, here’s how to treat and what you can do as a football player to protect your shoulders moving forward. Oddly, I’m still friends with five or six people that were in high school at the time. And, you know, now we’re in our 40s years later, but it’s great. So what a workshop is, is essentially a lecture, a talk that you’re giving, an educational…you’re giving educational goodwill and value to people in your community. And this, while it has many origins, and I’ve heard…some people have introduced me already that I invented workshops. Workshops have been around, again, for a long time. So Elizabeth Longfellow was the first one that I know of, in the 1860s, I believe, she was the first female physician in the United States, and she was in New York City. And just as a reference point, New York City had about 60,000 people, population of 60,000 people, it’s nowhere near the New York City of today. But she was trying to start a practice. You know, there was tons of oppression and many other problems that she had to face as a female physician, including the AMA forbid her…or the AMA predecessor forbid her from advertising for her services as they did for all physicians.
So the way that she got around that is she hosted something called lectures, and she actually ran a lecture series. It helped her build her practice very quickly. And she ended up having an amazing career around this. And it was all because of her creativity. So with my early success in 2001, and then when I opened in practice in 2003, and I just hated relying on physician referrals solely and I wanted to market direct to the consumer, that was the natural place for us to go. And we had tested a lot of other data points with, you know, giving out reports or helpful videos or books, I’ve written two books on back pain as well, but by far the best conversion was the workshop. And what that is, is a 45-minute to 1-hour event that we host here in-house or somebody hosts for us, if we’re going to…like I said, like the credit union, for example, and I’ll talk on a specific topic. So our most popular topics for our practice are rotator cuff and shoulder pain, back pain, and sciatica. And number three for us is on knee pain. So we’ll talk on that topic.
And then at the end of that…and we advertise for it through Breakthrough, online specifically with Facebook and Instagram, driving registrants to the workshop. We host the workshop, and then we convert those people over to a first appointment where they sign up for a plan of care. So we have lots of training on this. We’ve learned a lot not only from our own clinicians as they’re hosting these but also the hundreds of other clinicians that we’ve worked with. It’s a very replicatable model. You saw Dr. Tonya and her success with her first workshop, she was a natural, and the quick wins that she had there as well. But we’re using the Breakthrough system for advertising and ultimately converting by way of the workshop.
Rick: Thank you for that, sir. That was our last question. Are there any points you wanted to touch on or give any bullet points before we log off?
Chad: I think, you know, in terms of creating consistency, realize that you don’t have to reinvent the wheel as a clinician. There are other clinicians that you can learn from. Whether it’s Chiro Economics, within your ecosystem, or you know, at Breakthrough, but there’s lots of help out there for you. You don’t have to be on an island, you don’t have to struggle and be overwhelmed as a healthcare provider. Figure out people that have already created the wheel or at least have it spinning quickly, and then duplicate their efforts and what they’re doing there, and you can grow, you can have that predictable growth, and create the practice that you’re ultimately looking to create.
Rick: Well put and thank you. At this time, we’d like to thank our sponsor, Breakthrough and Chad Madden for today’s webinar. And thank you all for attending. Remember, this webinar, including our speaker’s PowerPoint presentation, has been recorded. We will alert you via email when the webinar is available online, and that email will include Breakthrough’s special offer. Thank you again for attending, and we look forward to seeing you next time. Have a great day.