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Six Methods to Build Your Practice

Chiropractic Economics December 21, 1996

What is the number one method medical/dental professionals use to build their practices? Referral cards.

What is the number two way? Employee referrals. John Gay explains why they work. You may ask this noted consultant, Dr. John Gay– “How can I increase my referrals?” The best established strategy is to put existing patients and staff to work for you!

If you think that building your practice is always an expensive proposition that makes use of aggressive advertising techniques, you’re in for a big surprise. In fact, you can develop a strong, profitable practice by putting to work your two best resources–your patients and your staff.

Once you make the decision that you need to do some marketing to build your practice, you must decide what form that effort will take. From what we’ve experienced, internal marketing is the most efficient way to enlarge a practice, and that is best accomplished by maximizing referrals.

Your patients are the ones who hold the key to increasing referrals. A satisfied patient will gladly refer his or her friends to you. In over 80,000 patient interviews we have found that most doctors (less than 3%) do not overtly ask for referrals from their patients, and this is an enormous untapped source of marketing–for over 97% of the patients interviewed were willing to refer.

As a medical/ dental consultant, the primary (#1) practice builder is the patient referral card. It looks like a business card but it includes a message such as the following: “Dr. (your name), Please give ______ the same good attention that I have been receiving. Sincerely, (your patient).”

We suggest that you say to your patients, for example: “Mrs. Backe, would you mind doing me a favor? I would like you to take two of our patient referral cards and give them to two of your friends or colleagues who would like to receive the same good chiropractic care you are receiving.”

If patients do not mind (and 97% of them do not), give them the cards. Then ask your patients to place their name on the cards so that when individuals they referred come in for an appointment, you can personally thank them for passing on your name.

I strongly recommend that you, the doctor, make this request yourself rather than delegating the job to a staff member. Our surveys indicate that practices will get a 70 to 90% referral rate if the chiropractor does the requesting, compared with only 20 to 40% if it is done by ancillary staff. Making that request takes only 10 to 30 seconds of your time, and it is the cheapest marketing tool you will ever find. With a referral card system, the size of your practice can be doubled within 12 to 18 months.

Of course, maintaining a professional image in your office is also an important consideration for retaining and enlarging your patient base. The dress and demeanor of your staff should communicate competence. Staff members working with patients in technical areas should wear lab jackets with name tags, while those in the front office should wear upscale street clothes with name tags.

The second best practice-builder is employee referrals. Patients feel good about a recommendation from an employee because they know it comes from someone who knows the practice inside out. Try using an employee incentive card, which is simply a business card with a short message on the back inviting the prospective patient to come into the office with or without an incentive. The card should also include a place for the employee making the referral to sign his or her name.

When a new patient comes in with the card, you can reward the responsible employee $5 or $10 per patient. Every employee sees and talks to at least one person per day who is not a part of the practice.

Think of how many referrals you can get from just one employee’s efforts.

Of course, building your practice only goes so far. You also have to be able to retain the patients you have, and the best way to do this is by pre-appointment. When appropriate, schedule regular exams in advance. To accomplish this, it is vital that the patient be educated about the need to be seen on a regular basis. We try to encourage chiropractors and their staff to use two words: need and concern. For example, you might say to a patient: “Mr. Foote, I need to see you because I am concerned about your problem.” These are important words in patient retention. If your staff is knowledgeable about your field, they can help educate patients, too.

Another way to keep your patients coming back is by aggressive recall. Take the time to scan your patient base and call those patients who have not been seen for some time or haven’t shown up for their scheduled appointments. We suggest sending out a reminder in the mail, then following up with a phone call.

It may be necessary to hire a person to make those calls. Put him or her to work from 10 am to noon and from 5 to 7 pm during the week, and from 10 am to noon on Saturdays. We have found that telephone recall is 70 to 80% efficient compared with mail recall, which has an efficiency rate of 15 to 40%.

Another means of retaining and gaining patients is to make their visit to your office as convenient as possible. Depending on your relationship with other professionals, you may want to consider opening your own massage, rehabilitation or therapeutic center, thus offering your patients “one-stop shopping.”

And for the benefit of all patients, new and old, consider keeping your office open outside the normal business hours for a portion of your office hours–either some evenings or weekends. Many patients have difficulty taking off work for a whole or even a half day. If you want to attract and retain patients, you must be willing to serve them at their convenience.

It is critical that you communicate with patients through newsletters or short notes on a regular and timely basis. If you have added a service, increased your skills, hired new staff let them know. Make sure your literature is up-to-date and easy to read; patients are more likely to read a one-page letter from the doctor than a brochure of several pages. These materials should be available in the “welcome room” of your office and should be updated at least quarterly.

Another good practice builder is to start your own preferred provider organization (PPO) or industrial plan (IP). Look for groups of employees of 20 or more in the community where you can offer a chiropractic health plan. Someone from your ancillary staff should set up appointments with the personnel director or chief of such groups as the sheriff’s department, schools, banks, or small industries. Prepare a brochure of the services you can offer at a discounted fee and get the endorsement of your chiropractic health plan from someone in authority at the organization. We have found that without a letter of introduction from the owner or a person in charge, for example, the plan will not be utilized.

Once you have set up your own PPO or IP, you will have a foot in the door when a large HMO or PPO moves into the area. Since you have already established rapport with a group of employees, they will likely negotiate to have you as part of their health care plan or panel group.

Remember: Putting these techniques to use will prove invaluable in enhancing patient revenue and patient referral and, thus, leading you to the true pathway of practice success.” “John W. Gay II, LLD, RFC, CIS, President of the Denver-based consulting firm of John Gay & Associates, has assisted more than 2,600 medical professionals with the management of their practices for over 16 years. Dr. Gay, a Registered Financial Consultant and a Certified Investment Specialist may be contacted by calling John Gay & Associates, 303-690-2727.

Filed Under: 1996, issue-05-1996, Magazine Issues

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