Here’s how to combat these stumbling blocks to success – poor communication skills, our inability to define clear terminology and our inability to separate the business of chiropractic from the practice of chiropractic.
Marketing our chiropractic services goes far deeper than which newspaper or magazine to advertise in or how many mall screenings to participate in or sponsor, annually. Marketing means defining our services clearly, in such a way that anyone listening knows exactly what we do. Defining our mission statement is, in practice, what makes people say, “”Wow! It sounds like I could use your services.””
1. Market and define your mission statement succinctly in the open market place. When people ask, What do you do? you have the opportunity to make a favorable first impression. This is accomplished by allowing them to discover something they really need to know. Sometimes, knowing you don’t get a second chance at a first impression, you may panic: What do I tell him? I wonder why he’s asking? How much time do I have? What most chiropractors do, once they get the lump out of their throat, is try to get everyone under care, on the spot.
Now, this may sound like a good sales tactic, but it is poor marketing. They haven’t heard your purpose, only your words. You haven’t even answered their question yet. People will often come to you for reasons that you might never understand and therefore miscommunication is likely to develop. You wouldn’t expect a car salesman to put a contract in front of you if you are just shopping. Most of us are a lot better at doing what we do, than saying what we do. Let’s look at a solution to the problem of marketing your mission statement. Let’s say you have been a chiropractor for over ten years and it still bothers you that when you tell someone you are a chiropractor, they get that funny look on their face. You know, that fake smile that you really can’t read. So you start talking about spinal misalignments, nerve interferences and low force techniques.
However, in spite of your best efforts, they still don’t get it. Soon you feel like a snake oil salesman. Well, that approach represents just about every marketing mistake you can make. To solve this problem you need to do three things:
- You need to know specifically, what your mission statement is.
- You need to examine that mission statement through the eyes of your prospective patient, to discover what differences your mission will make in their life.
- You need to communicate that mission statement succinctly, so you can market your services and get past that “”moment of truth.””
In the book, “”Marketing Your Services”” by Anthony Putman, a perfect example in formulating a chiropractic mission statement was presented. The question is asked, what do you do? You respond by saying, “”I am a chiropractor. No, that’s what you are, “”What do you do? The point is, people ask what you do and expect you to hand them a label they can apply to you. Putman states that giving them your label, “”I am a chiropractor,”” allows them to impose on you, all the prejudice, ignorance or past bad experiences they may have had with chiropractors. In effect, you are telling them, “”Go ahead, drag out whatever image you have of chiropractors and slap it on me.””
Don’t tell people what you are, tell them what you do. Your job is to see to it that your services can make a specific, beneficial difference in their lives. After some thought, you might change your response to, “”I do chiropractic adjustments, for people who have chronic or acute back pain or who have other problems that failed to respond to traditional medical care.”” The above statement leads off with something the average person doesn’t understand, “”chiropractic adjustment.””
When you tell someone what you do, do it with words they already understand. This is not the time to build vocabulary skills. Secondly, this statement sounds like chiropractic can cure just about everything. To the average person this might actually lower your credibility. You must be specific, to hold their attention and trust. The public doesn’t know how most professionals get their results and frankly, they don’t give a damn. The public wants results, not the way you get the results. Therefore, you must learn to tell a person what you do, not how you do it.
Let’s summarize what we know thus far:
What do all patients have in common?
They all can benefit from chiropractic services.
What about them makes good candidates for your services?
They all can have some degree of spinal misalignments (subluxations). They all can be in some kind of discomfort. They all have spines and are subject to the normal destructive forces of nature.
What can you do for them?
You can correct their spinal misalignments (subluxations) which results in a better-functioning body.
What are the outcomes?
It gets rid of the cause of their problem, which allows them to lead healthful lifestyles.
What’s the Cure?
The next time you are asked, “”What do you do? try this response, as stated in Marketing Your Services, “”I help people lead a healthful lifestyle, free of discomfort. This simply answers their initial question. Now let’s add the label and the outcome. “”I am a chiropractor, I help people lead healthful lifestyles, free of discomfort, by removing the cause of their problem. Their response might now be, “”Wow, I can sure use some of that.”” At that point, you can now begin to educate them on the how and the why of your services.
Tell your prospective patients what you do, not what you are. Tell them the realistic benefits they can expect from your service, right up front. Then tell them how you achieve your results. It’s simply a matter of proper marketing strategies, congruent with your mission statement.
Define clear terminology free of semantic incongruencies that communicates what we do and why we do it.
The second reason to develop professional marketing strategies is because of communication incongruence and the errors created by semantics. This problem is more fundamental than our mission statement. In the fourth article on “”Communication,”” by Gene Tannery, D.C., in Share No 5129,
A person communicates verbally and non verbally, in accordance with their functional state of mind, their mental and emotional attitude, their posture, movements and expressions, as well as the tone, rhythm and pitch of their voice. Your functional state of mind is what you are in the statement, “”What you are speaks so loud I can’t hear what you are saying.”” Saying one thing in practice, then nonverbally communicating another, people will understand the nonverbal messages rather than the words, nearly every time. This conflict is called, communication incongruence and is the major cause of patient dropout.
During your initial patient exam or report of findings, it is easy to imply, verbally, that correction of their spinal misalignments will improve their condition. However, your body language, tone of voice and facial expressions might be saying, “”I really don’t know what your condition is and I’m not sure if this will really work.””
What’s worse, the patient might read from this, that you will cure everything that’s wrong with them, since you might be their last hope. Since your verbal and non verbal communication did not lead to total initial understanding it’s only a matter of time before your real or perceived promise begins to fracture. The result is obvious. The incongruencies in communication have lead to a shallow doctor/patient relationship which will last only as long as the terms your patient has created. In other words you have developed a revolving door practice that is controlled by patient perception.
Simply mean what you say and say what you mean. You need to be what you want to communicate, so your patient will perceive what you are and what you will deliver. Once you begin to use words congruent with your belief system your verbal communication will captivate your patient while your nonverbal communication will offer genuine comfort, not empty promises. You will truly be understood. There is another component to proper communication with patients. Semantics are also important. Joe Strauss, in his “”Pivot Review”” describes semantic confusion in our profession. “”How many of us, in practice, routinely interchange words on patients. For example, at times you will say you are adjusting their spine while other times you will accept a patient’s description of what you do as a manipulation. This is classic semantic confusion by omission. No, you didn’t say manipulation but you didn’t balk when your patient did. Our profession is not only full of confusing terminology but confusing ideology as well.””
Examine the following statements to find the evidence of semantic confusion.
1. Chiropractic is an alternative to medical treatment. Chiropractic is not and should not be considered an alternative to medical treatment. The word “”alternative,”” as described by Webster’s Dictionary, means, An opportunity for choices between two things, courses or propositions but not both.
The implication of the word al-ternative is that patients must choose between chiropractic and medical treatment. Therefore, if a patient has to choose between medical treatment and chiropractic for a particular condition but the patient really doesn’t know much about the condition, medical treatment will usually win out or the patient may choose neither. Chiropractic is a distinct and separate branch of health care.
2. Congratulations Mrs. Adams, you are now at maximum medical improvement.
How can your patient be under chiropractic care long enough to achieve maximum medical improvement? Is this simply semantics or stupidity? We have accepted the generic lingo of the medical profession, to comply with insurance parameters. Your patient received no medical treatment from you, so what’s wrong with maximum chiropractic improvement? If maximum medical improvement is simply generic lingo, wouldn’t it be as easily generic for a medical patient to achieve maximum chiropractic improvement, if that patient received no chiropractic care? If not, then let’s eliminate the semantics and call it like it is.
3. Are you a Chiropractic Physician or Doctor of Chiropractic Medicine?
In my opinion neither is appropriate. Talk about confusing terminology! A physician, according to The Readers Digest Great Encyclopedia Dictionary is, one who is legally authorized to practice and/or dispense medicine or engage in general practice. A doctor, is a teacher or One who is trained to practice medicine in any of its branches, as in a physician. My point about communication incongruence, in this profession is vividly supported by Mr. Paul Lambert the Florida Chiropractic Association’s general legal council.
He stated, in the August 1995 F.C.A. Journal, that, “”It is appropriate to use the term, doctor of chiropractic medicine to refer to a chiropractor, since a chiropractor is a doctor of chiropractic, using chiropractic medicine. He qualifies the term “”practice of medicine”” as the universe of diagnosis and treatment of human diseases, injuries or conditions. Is this simply a matter of semantics or are we allowing those non-chiropractic entities to dictate what we should call ourselves? What’s wrong with Doctor of Chiropractic, anyway?
I’m sure you can now name a few other communication incongruencies, leading to semantic confusion for our patients. Please remember, that confusing terminology breeds inconsistency of thought. Who is really being affected by these statements? The very people we are trying to educate, the lay public. Let me show you where this problem can lead to and what can be done to correct its outcome. I received a radiology report from an MD, who stated, “”This patient displays mild degenerative changes throughout the spine but there is no evidence of fractures or subluxations present.”” I wrote a letter to the radiologist, in response. “”Thank you for your report but are you aware that the word “”subluxation”” has both medical and chiropractic meanings?
Since in the medical sense, a subluxation is of little consequence, it yielded minimal value to this report. In the chiropractic sense, however, the subluxation is the basis of my analysis and is the specific focus of my corrective procedures. Insurance companies do not recognize or even know that there is a difference in semantics and therefore denied my claim, based on your report. I respectfully request that you refrain from the use of the word subluxation, unless you indeed have medical necessity in mind. Please refer to his reply, which appears as Figure One on previous page.
What’s the Cure?
Say what you mean, act on your professional convictions, refrain from confusing linguistic jargon that leads to communication incongruencies and finally don’t be afraid to confront, and if necessary, challenge those who add to the confusion. You’ll be happy you did.
3. Separate the business success of chiropractic from the practice of chiropractic.
One obstacle that you may encounter is fear of success. The fear I’m referring to comes in many forms. Fear of failure, fear of malpractice or fear of non acceptance, are just a few. Fear can easily separate the business of health care from the practice of health care. Fear is often euphemistically disguised as burnout or stress but as the saying goes, a rose by any other name… For those in our profession who haven’t checked lately, national loan officer statistics, reveal that one in four chiropractic practices fail, due to poor business planning. It’s no wonder that start-up money is tight and survival money is tighter. This is only true however, if your mental attitude is that there are a finite number of patients to share with all the existing chiropractic offices in your area. This leads to a smaller piece of the pie for all and of course, less financial rewards.
For some of us, however, the vision is much different. According to the loan officers, three quarters of all new practices thrive. That means there is an abundance of new patients available and therefore, my financial rewards can be tapped into at any level I choose. The difference between these two mind sets is fear versus vision. There is only one thing that separates the inventor from the user, the risk taker from the passbook holder or the high volume practitioner from the twenty-five-patient-a-week chiropractor; that thing is fear, whether real or perceived. How can you stay focused, starting out in practice, when all you think about is practice deficits and all you learn about is malpractice insurance, liability coverage and managed care groups. Fear destroys your vision and is the one anti-success entity of any practice. We are taught to practice defensively.
Our risk management seminars are most depressing to sit through. We have succumbed to the business of health care, the way our medical friends have. The list of compromises we’ve endured for the sake of ease of acceptance, is endless. It was once illegal to have multiple fee systems yet with managed care, workers’ compensation and medicare, no two fee reimbursement policies are the same. The average chiropractor, however, fears reprisals when offering creative fee structures on his own, as an entrepreneur.
Instead, we look elsewhere to soothe our financial heartburn. Companies that offer creative diagnostic procedures in our offices, machines and software that are guaranteed to dazzle your patients and gimmicks by the truckload are available, all priced to suck us in while we anticipate the magic to begin. Have any of you actually exhibited this practice behavior yet? I know I have. I took a certain portion of my advertising budget and tried a whole variety of practice-building gimmicks. The result was always the same; 1-2% response on my investment. Then I was told this was average and normal. What a deal!
These companies, who base their ability to succeed on your ability to fail, are usually around long after we are gone. Think about it, they succeed 90 – 100% of the time if you can succeed only 2%. If gimmicks really worked, who would need the gimmicks after the first try? The fear of not doing it enough or maybe that the next time will yield the “”big”” return, is how we get hooked. Fear becomes the great equalizer in business. If you really want to know how fear affects business, read about the lives of Henry Ford, John Getty, Steven Spielberg, Sylvester Stallone, Nap-oleon Hill or even Clarence Gonstead, B.J. Palmer or Hugh Logan. Each of these people faced great odds against success but all succeeded anyway because they never resorted to gimmicks when the going got rough. These are men of vision, not fear. I can name at least fifty men and women who are successful due to boundless vision; can you name just one successful person who got there through fear? It’s almost a no-brainer for us to ponder; yet, we still entertain fear before the correct approach. In my opinion, some of the chiropractic principles and issues of the past have been converted to almost unrecognizable dimensions.
Why are there so many chiropractic practices bent on expanding their scope of practice to be all-inclusive or to be just as good as medical practices? For one thing, it has little to do with better chiropractic, but has a lot to do with insurance reimbursement. To be clear about a profession’s worth, simply keep removing one item or procedure from your vast resources until you are left with only those procedures that, without which, you would cease to exist. You would quickly find that without the adjustment itself, as it relates to the subluxation complex, we are nothing more than a duplication of pseudo medical procedures; even if we could perform them better.
Why then would we be needed? I’m sure the insurance companies and our patients would rather seek medical attention for medical procedures. In December of 1994, the Agency for Health Care Policies and Research (AHCPR), presented a landmark document for our profession as it relates to the correct management of acute low back problems. In the past, Doctors of Chiropractic were encouraged to refer patients to other health care providers at relatively early stages of care. Now, the “”AHCPR”” guidelines seem to make it very clear that doctors of chiropractic are the first line of care in the case of acute low back problems. Contributing research from the Manga Study concluded that interventions like ice, heat, diathermy, massage, ultrasound, cutaneous laser therapy and electrical stimulation, were identified as not recommended. For those practices who utilize these procedures, the impact will be profound. Simply put, insurance will no longer cover them. The term “”not recommended”” is a nice way of saying that the business of your practice is about to take a major hit. The point to be made here is, if your business depends on “”non essential”” procedures or gimmicks, your fear factor should be rising.
What’s the Cure?
The only way to protect your practice from fear or failure, is to develop your essential practice skills, until they become indispensable and non-duplicating by any other health care profession. Smart businessmen and women always know the difference between their practice hand and their business hand. There is a simple concept that crystallizes these issues. It’s important to get paid for what you do, but don’t do what you do for the money. When your vision is motivated by money instead of service, you become enslaved to the money source, rather than your mission.
Success is not measured by six-digit incomes. Ask any prominent MD about what’s happening to their managed care incomes lately and you’ll see why there has been such an influx of doctors into private, home-based network marketing groups. You’ve got to “”bullet-proof”” your business because with the stroke of a pen or a shift in research data, your practice and business could be doomed to failure. Only committed individuals, who know their uniqueness and capitalize on its strengths, will break the shackles of fear and begin to chart the steps to their success.
“Sal Martingano, DC, who is in private practice in Palm Bay, Florida is a motivational speaker who recently finished the production of his first television series, designed to educate the general public on chiropractic care, entitled, Unraveling the Mysteries of Chiropractic. He also hosts a weekly talk show, Straight Talk on Chiropractic. Dr. Martingano is a graduate of Sherman College of Straight Chiropractic where he received numerous awards in clinical excellence, x-ray and the prestigious ‘BJ Palmer Chiropractic Philosophy distinction. He holds BS and MS degrees in education and has published many articles on effective communication in chiropractic.