Dear Bill | My Patients Aren't Staying

Posted by Bill Esteb on Feb 18th 2021

Dear Bill,

My marketing company has me offering a $23 voucher good for the first-visit exam and adjustment. I'm getting new patients—but they aren't staying. How do I get these patients to embrace chiropractic as part of a long-term healthy lifestyle?

You probably can't.

When the grocery store offers Coke at half price, they know you're likely to pick up a loaf of bread, some milk and other groceries. They've run this promotion so many times they know exactly how to price the Coke (and where to place the in-store display) and make money.

"But Bill, I don't sell colored sugar water. I provide the most comprehensive examination around and deliver a high-quality adjustment."

Of course, however the principle is the same. For a loss leader to work, you must upsell enough patients to something more profitable. Even if your salesmanship skills are top shelf, there are serious problems with this approach, particularly in health care:

1. It attracts the price conscious. Instead of attracting those who value their health, such offers tend to attract those for whom the price of the service, or how the bill is paid, is more important than the service itself.

Worse, anyone with even a limited amount of common sense knows that a visit to a licensed professional should cost far more than $23. Thus, they automatically assume you're going to apply pressure to get them to upgrade to something more ambitious. So, with shields up and phasers on stun, they enter your practice ready to repel just about any sales overture they might encounter.

Their objective is "beat the house." In other words, hope to get relief in one visit without succumbing to your sales pitch. Clearly, your motives and their motives are incompatible.

2. You're admitting a lack of differentiation. Selling on price is the last resort for the unimaginative or when forced to sell a commodity. But it frequently works, producing warm bodies. When you attempt to seduce customers based on price, you've surrendered the high ground. Reserve it only as a last resort Hail Mary.

True, selling on price has been successful for corporate-run clinics who have commoditized chiropractic. However, they rarely employ a loss leader.

3. You're immediately unprofitable. What makes this approach to new patient acquisition even more serious is that the time required to do a consultation, exam and adjustment simply can't be delivered for $23. If you lose $100 on every new patient, it's almost impossible to make it up unless you can convert a significant number of prospects to more profitable long-term care. That's a lot of pressure to bring to bear on someone whom you've just met!

I'm guessing if you raise these concerns with your marketing company, they'll claim they're simply delivering what they promised for their fee: warm bodies interested in chiropractic care. It's your responsibility to convert them into something more profitable.

You'll want a different marketing strategy if you wish to attract new patients who hold the promise of becoming practice members using chiropractic as a long-term lifestyle adjunct.

A more promising approach would include some or all the following elements:

Update your website
. Most new patients, even those referred by a trusted friend, will check you out by visiting your website. Make sure it speaks to a wellness-oriented individual. Most chiropractic websites focus on pain relief and even functional improvement, rarely speaking the language that resonates with the health conscious. Granted, it's usually a symptom that prompts people to pursue chiropractic care, but does your website explain the value of some type of ongoing supportive care?

An effective landing page. If you employ pay-per-click advertising on Google or Facebook, send prospects to a landing page—not your website home page. A properly configured landing page can better enter "the conversation going on in the prospect's mind," significantly improving conversion.

Front desk training. It's staggering how many new patients are lost at the front desk. Back in the day when everyone had low deductible insurance policies, the telephone skills of your front desk role were more modest. "Would you prefer morning or afternoon?" These days they must be able to field questions, provide reassurance, be persuasive and effectively counter objections. In other words, sales. All this is happening (or not) while you're often out of earshot. If you suspect new patient "leakage" at the front desk (and even if you don't), install call tracking and record every phone call. ("This call may be recorded for training and quality assurance purposes.") Then, listen or read the transcript of every call. Have smelling salts at the ready.

Find your tribe. There are likely other non-chiropractors who are already serving individuals who have high body awareness and an interest in maximizing their health and well-being. Those who have an interest in true health and the financial resources to pay for it. Your mission is to get out of your practice and befriend the health food store owner, the Pilate and yoga studio instructors and all the others. Join the running club, contribute, refer and become familiar. This is a long-term play. Rush the process or show up hoping to immediately snag some new patients and the opportunity will evaporate. Without exception, chiropractors who complain about the quality or number of new patients they get are often recluses. They don't do speaking gigs in or out of their practice and simply don't encounter many strangers anymore. They haven't handed out a business card in months.

Measure the nervous system. If you're not going to pander to short-term pain relief, you'll want a way to show the need for continued care. X-rays may show gross structural distortions, but rarely demonstrate significant changes in 12 visits—or sometimes even in 12 years. And negative orthopedic exams can still conceal nonsymptomatic nervous system deficits. If you want to attract (and keep) the health-conscious crowd, you may want to invest in sEMG and even heart rate variability. Then you'll have objective technology on which to justify your recommendations for continued care.

Think global, act local. With obvious symptoms no longer the basis of your care, you'll want to be far more mindful of the goings on in each patient's life. How's their job satisfaction? What are they reading? What family activities do they have planned? Are they living their purpose? What are their dreams? The key is to help every practice member appreciate that an optimally functioning nervous system doesn't merely improve their spine, it improves their life.


I understand the temptation to employ marketing strategies that promise to produce quantity rather than quality. You simply want to help as many people as you can.

But if you really want to address the root cause of not having enough people to help, decide to fall in love with marketing. Make no mistake, it is a decision. Read some marketing books, blogs and subscribe to some YouTube marketing channels. Commit to learning the art and science of marketing. Chiropractors who have, have produced profitable practices with no more than average adjusting skills. Imagine what could be possible with your extraordinary adjusting skills!

Thanks for the question.

Email Bill with your question or comment.

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