If attempts to grow the practice seem to produce only a temporary bump, returning to the previous “set point,” it could be that you’re relying on tactics—without a cohesive strategy. 

Tactics are things like discounted first visits, Facebook ads, patient appreciation days, and all the rest.

Absent a strategy, these become isolated, unconnected actions. Relying on the “tactic du jour” is stressful. You’re constantly second-guessing yourself.

Once the novelty fades or the market becomes saturated, momentum stops, and the scramble begins for the next shiny object.

But with a clear strategy—a patient-centered theory about how you’ll win, tactics become tools of alignment, multiplying their effects.

Strategy defines why the practice exists, who it serves best, and how it differentiates itself from others. Then, appropriate tactics are chosen to express that strategy, building brand equity, reinforcing trust, and creating lasting, organic growth.

Without strategy, tactics become relentless survival busywork.

The lack of a cohesive, over-arching strategy is often the result of two common, but wrongheaded beliefs: 1) you can somehow appeal to everyone, and 2) differentiating your practice will reduce the number of people you attract.

Granted, if your strategy is to work with lefthanders or owners of blue pickups, then sure, the opening to your practice is inappropriately and needlessly too small.

Instead, strategy is a theory describing how you’ll resonate with your “tribe” of patients in such a way that they will drive past other practices to get to yours. Which is unlikely if you’ve chosen to round off all the sharp corners, showing up beige, neutral, and attempting to be all things to all people.

Examples of common strategies:

Becoming the area’s acknowledged leader in headache resolution.
Focusing on prenatal and pediatric care
Recognized as a refuge for those disillusioned with medical treatment
Restoration for those injured in automobile accidents
Rehabilitation and optimal performance for athletes
Whole body health and wellness experts

Strategies that may work in larger, more densely populated areas, may not even be necessary when you’re the only chiropractor within a 20-mile radius.

However, lacking a clear identity or an unwillingness to plant your flag for what you stand for often leads to an energy-draining chameleon practice. Keep in mind, that to be attractive, you must be willing to repel. Attraction tends to polarize.

Practices that don’t appear to have a strategy, yet seemly enjoy a constant stream of new patients, have a strategy. It may be as simple as turning listening into a superpower. Or honoring each patient’s health goal—regardless of how limited. Or avoiding being emotionally invested in patient choices. Or simply loving all—without judgment or expectation.

More broadly, strategy is an element of playing the long game. Seeing patient relationships as eternal. Adjustments as transformational, reverberating outward influencing countless others you may never get to meet.

Generally, the long game (strategy) puts patients first. The short game (tactics) often puts the practice first.

Bill Esteb, a passionate chiropractic advocate since 1981, brings a fresh perspective to the profession as Patient Media’s creative director and co-founder of Perfect Patients. With 12 insightful books examining the doctor-patient relationship, he inspires chiropractors worldwide as a chiropractic speaker, through his chiropractor coaching program, and consulting. Since 1999 Monday Morning Motivation has been emailed weekly to over 10,000 subscribers, sparking breakthroughs across the chiropractic community.

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