Mr. Personality

Step aside, Tony Little. Heads up, Carlton Sheets. Move over, Don LaPre.

Make way for Dr. Toby Mitchell, the newest, most enthusiastic face on cable TV. He’s not hawking something to make your wallet fat or the rest of you thin, but Mitchell has mastered the world of infomercial marketing. And just about every other kind of marketing. He’s taken the art of reaching the masses (well at least the ones he’s targeting) – and carved a niche he believes other chiropractors could and should follow.

How To Tap Into Leased Access Cable

There may be no other way to get more information to more people than through leased-access cable, Dr. Toby Mitchell says. Yet, it’s a promotional tool few people – including chiropractors – know much about.

The best thing is, cable access is available to everyone and it’s relatively easy to obtain and use, he says. Federal law stipulates that cable television providers must make 10% of their stations’ total airtime available for leased-access programming. It’s not something that is advertised and, according to Mitchell, they aren’t going to, ahem, broadcast it. “The cable companies don’t admit to its existence and they won’t respond to it over the phone,” Mitchell says. Instead, individuals must write cable providers a certified letter requesting information on leased access.

The FCC mandates that companies must respond within 10 days of the request.Through this tool, Mitchell has been able to lock up 40 to 45 half-hour infomercials per week at a cost of about $600 per month. This cost will vary by cable company and by market size, but still beats broadcast advertising from a cost-effective standpoint. “Airtime with an infomercial is 1,000 times greater then with commercials and I pay a fraction of the cost,” Mitchell says.

Airtime availability depends on the cable carrier. If a carrier is channel-locked, meaning it has a network on each available channel, scheduled programming would have to be bumped. This is unusual, though, as most companies will have stations set aside for just this reason. Beyond the airtime comes the cost of production, which can be as much or as little as the advertiser wants to spend. A high-end infomercial could cost $30,000 or more to produce. With the help of the consulting firm The Waiting List Practice, which specializes in producing infomercials for chiropractors, Mitchell produced his for about $2,000. The best part is, assuming the infomercial is a good one, production is a one-time cost. “The information and content are timeless,” Mitchell says.

Marketing: Where The Money Goes

Dr. Toby Mitchell says he has no set monthly or annual budget. However, here is a list of what he spends on some of his marketing efforts:

• Refrigerator magnets:13 cents apiece (no set number)
• T-Shirts:100 at about $3 each
• Printed Frisbees: 50 cents each (no set number)
• Newspaper inserts: $250 four times a year ($1,000)
• Printing cost of inserts: Apx. $500

Mitchell spends a total of about $250 a month on the marketing tools above, if spread over a year.

Other expenditures include:

• Misc. items (football programs, seat cushions, etc): $600-800 per year.
• TV Ads: about $900 per month
• Infomercials: $600 per month
• Yellow Pages ad: $58 per month

Mitchell has a website at chirochoice.com. He does not advertise on other sites on the Internet.

Return on Investment:

During the initial patient visit, Dr. Toby Mitchell asks patients to write down where they heard about his practice. The answers he receives include:

• TV ads: 84%
• Patient referrals: 43%
• Personal meetings: 38%
• Printed inserts: 24%
• Provider listings: 14%

The total adds up to more than 100% because many patients find out about the practice through more than one medium.

A practitioner for nearly four years in Southwestern Michigan, Mitchell has taken some of the marketing savvy he developed in college, along with know-how and ideas generated by his wife Kimberly Mitchell, and created a marketing machine, all – as one of the more famous infomercial barkers might say – “for just pennies a month.” Okay, it costs him more than that. But not much.

Bending corners, but playing strictly by the rules, Mitchell uses a handful of methods to get his name and face out there, without breaking the bank. Television, be it regular 30-second spots or 30-minute infomercials, just happens to be his specialty in terms of cost-efficiency.

Mitchell’s use of cable television and other marketing strategies has helped turn a three-year-old business into one that was projected to generate about $912,000 in gross billings (and about $748,000 in collections) in 2000.

Mitchell – who has offices in Niles and Berrien Springs, Mich. – has gone from 480 patient visits per month three years ago to more than 1,300 per month in October 2000. He has boosted his new patient visits from 20 a month to more than 50 per month over the latter half of last year.

“I always looked around at other businesses that were successful and at why they were successful,” Mitchell says. “I saw (chiropractors) who had crude adjusting technique that had outstanding practices, and some who had outstanding adjusting technique whose practices weren’t doing as well. The difference was the way they presented themselves. I knew I wanted to harness some of this underlying ability.”

Mitchell began blazing that trail while still in chiropractic college. It was then, while helping out his father-in law, who was also a chiropractor, that Mitchell began developing his various marketing techniques. Those techniques included, among other things, stickers. Mitchell soon figured out he could produce these types of marketing tools on his own and save substantially on the cost.

This led to Mitchell starting his own company, Chirostyle, aimed specifically at helping chiropractors market themselves. “It was a lot of trial and error,” he says. “Once we started doing that, we started looking at other products and where we could get them inexpensively. People started calling and wanted our products. We kept modifying them and making them cheaper.”

By the time Mitchell, who was president of his class, graduated from Life University in June 1997, he had much of this down to a science. One month later, he opened his own practice.

Over the years, Mitchell has expanded his marketing strategies. He has found cable television to be the most lucrative medium to market his practice, in terms of cost-effectiveness and potential audience size. Through the use of infomercials and regular 30-second ads, Mitchell says he can reach his market for a relatively small cost.

He uses cable television to the fullest. A cable company in a given area has so much airtime it must sell, much of which is underutilitzed by advertisers, Mitchell explains. Simply put, there are a lot of time slots when cable channels don’t have enough advertisers. In order to get rid of that time, providers will package it with more marketable time. Mitchell finds this the best route. “You look for promotions that are going on,” he says. “I look for package deals. If I buy some time during prime time or an NFL game, I get a package of commercials for a rate of $1 each to run the rest of the year.”

Then, whenever the cable company has a gap to fill, a spot for Mitchell’s Clear Choice Chiropractic and Holistic Wellness Center might appear. Mitchell says his deal stipulates 400 spots will run in more desirable times. He can also specify certain channels that can and cannot carry his ads. He spends about $900 per month on this type of advertising, roughly the cost of one 30-second spot of one prime-time ad on a major network.

Mitchell isn’t just about TV, though. There are other means he has found as effective that might reach a different audience. He doesn’t spend a lot advertising on display ads in newspapers, but he does use newspapers as a means of getting the word out about his practice. He doesn’t do a lot of direct mail (he picks and chooses), but he does do plenty of direct marketing.

Rather than buying display ads in the local newspaper, Mitchell places inserts, at a fraction of the cost of an ad, in regional editions; he says this is a very efficient means of promotion. He can insert 11,000 flyers into a local newspaper for about $250. By comparison, mailing just 1,000 flyers could cost $330, using regular mail (Mitchell notes that special bulk metering rates are available, but still costly.)

Mitchell often produces his own flyers, and his wife, Kimberly, generates the content. For approximately 18 cents each, a quality four-page color brochure can be printed.

“She comes up with unbelievable ideas and I research them and try them out,” Mitchell says of Kimberly, who came up with the idea to do the infomercials.

From a direct-mail standpoint, Mitchell primarily uses his list of active patients. But he does branch out in one specific area. Because many people in his area carry Blue Cross/Blue Shield as their PPO, and because it normally includes a high rate of coverage and no co-pay, Mitchell wants people who have that coverage to know chiropractic is available to them. He reaches people though the local chamber of commerce, whose directory lists companies affiliated with BC/BS. “You’re talking about tens of thousands of people who have that kind of insurance,” he says.

Mitchell also spends a small sum advertising in the Yellow Pages, but mostly to make his phone number available to existing patients. “It’s important to be in the Yellow Pages,” he says. “But it’s not important to be the biggest guy in the Yellow Pages.” Mitchell pays $58 a month for an ad that includes both his offices and adds that the longer he stays in practice, the smaller that ad is likely to be.

Perhaps Mitchell’s favorite marketing tool is old-fashioned face-to-face meetings. He has had a booth at the county fair each year, an event nearly everyone in the area attends. He also takes part in Niles’ annual “Anything that Floats” parade, held along the St. Joe river, right behind his office. His practice enters each year with a themed float. “We have fun and we let people know we have fun,” Mitchell says. During the event employees throw Frisbees with the practice’s name and phone number on it. “People acted like it was gold,” Mitchell says of the embossed discs.

Mitchell and his staff also pass out other items, like high-quality T-shirts and refrigerator magnets. “You can do it all for a very low cost,” he says. “Magnets are something people never get rid of. I wouldn’t say people come (to the practice) in droves because of my refrigerator magnets, but they keep them forever.”

All those items, the magnets, the T-shirts, the Frisbees, are done at minimal cost. Bought in bulk, the Frisbees cost about 50 cents each. Magnets cost about 13 cents apiece, while printed T-shirts can be done for around $3 apiece, depending on the number. Most importantly, though, people take this stuff home with them. Then they’re exposed to the name of Mitchell’s practice repeatedly, and it doesn’t cost a thing for the additional exposure, he says.

While Mitchell says he hasn’t documented exactly how much each different marketing investment translates to in terms of patient numbers, he does keep track of the response to his marketing efforts to some degree. Patients fill out forms upon their initial visit. If they don’t fill in the blank that asks them how they found out about the practice, Mitchell’s staff members are directed to talk to the patients to find out more. Many patients list more than one source.

Mitchell tries to stay connected with his patients through community support. Whether that means buying an ad in a local high school program or placing a reference to his practice on a portable seat cushion, he never turns down a patient who asks him for reasonable financial support. The minimal cost is a drop in the proverbial bucket and well worth keeping folks happy, Mitchell says.

Mitchell encourages patient referrals by offering literature and educational materials for patients to take with them. “That is one of the most cost-effective things I do,” Mitchell says.

Mitchell does not fancy himself any type of Madison Avenue genius. In fact, he has had his failures when it comes to promoting his practice. He cautions that not everything that worked for him will work for other doctors; but, like one of the state lottery ads says, “You can’t win if you don’t play.”

“Try something on a small scale and test it,” Mitchell says. “Maybe it’s not the ad (that’s bad); maybe it’s the periodical it’s in.”

Most important of all, Mitchell says almost any price is worth it if something works. “Who wouldn’t pay $100 to get a great auto accident case out of it,” he says. “You have to do it with dignity. You can’t make it a carnival. I don’t say, ‘Here’s a certain amount that I’m going to spend and that’s all the money I’m going to use for it.’ How much does it really cost if you get just one patient out of it?”

Vital Statistics

Dr. Toby Mitchell
Clear Choice Chiropractic and Holistic Wellness Center
70 East Main St.
Niles, MI 49120
Phone: 616-683-6000
Fax: 616-683-6350
9046 U.S. 31, Suite 2
Berrien Springs, MI 49103
Phone: 616-473-5000
Fax: 616-473-5026

Doctors:
Dr. Toby Mitchell, owner
Dr. Luciano Giovannucci, associate

Massage Therapists:
Niles Clinic: Julie Smalley,
Erin Allen, Beth Mitchell

Berrien Springs Clinic:
Emma Rogers, Bernita Smith

Office Administrator:
Kimberly Mitchell

Office Manager:
Michelle Wesner

Chiropractic Assistants:
Missy Hamilton, Kristi Steele,
Christina Hartman (part time)

Office Hours:
Niles:
Monday-Friday: 9 a.m.-7 p.m.

Lunch/Paperwork, etc., from
12:30-3 p.m. (a doctor is
always available between
9 a.m. and 7 p.m.)
Saturday, by appointment only

Berrien Springs:
Monday-Friday: 9 a.m. – 6 p.m.

Revenue by Payment Type:
General Insurance – 72%
Personal Injury – 11%
Medicare – 7%
Workers’ Comp – 5%
Cash – 4%
HMOs – 1%

Gross Billings:
2000 – $912,776 (projected)
1999 – $390,000
1998 – $314,000
1997 – $112,000 (last 6 months)

2001 – Projected Gross Billings:
Apx. $1.25 million

Collections:
2000 – $748,776 (projected)
1999 – $314,000
1998 – $226,000
1997 – $86,000 (last 6 months)

2001 – Projected Collections:
Apx. $950,000

2000 Monthly Patient
Visits/New Patients
Jan. – 586/20
Feb. – 678/23
March – 738/43
April – 1,045/38
May – 1,024/38
June – 959/42
July – 801/34
Aug. – 975/51
Sept. – 1,079/50
Oct. – 1,341/63