New Patients From the Inside Out

by William D. Esteb

What many chiropractors forget is that new patients are an effect, a symptom, a result. “Treating” the lack of patients with a short-term, outside-in therapy is a bankrupt idea, whether you’re trying to eliminate a patient’s headache or relieve the painful symptoms of a scarcity of new patients.

Just as the government does, it’s tempting for some chiropractors to throw money at the problem, in this case by advertising. Yet once the campaign is dropped, so does the number of new patients. With the fundamentals necessary for referrals missing, the business has become a “promotion” with the practitioner on an endless treadmill, searching for new patients. And while “taking chiropractic to the streets” to share the “big idea” sounds great, it’s rarely an altruistic effort. These community outreaches are considered failures if they don’t produce sufficient quantities of new patients.

If the advertising war chest is empty, it’s tempting to blame something outside the office rather than looking in the mirror. The usual scapegoats include shortsighted insurance companies, the invasion of HMOs, the economy, the weather, the new doctors who have moved to town; and if those aren’t factors, you can always blame the “stupid” patients. And while it’s true that you don’t provide your services in a vacuum, it’s also true that for every practice that blames these, there is usually another office in the same environment, thriving. It’s not them.

It’s you.

If you have the desire to help more people, here are some things to consider that occur within the four walls of your office that can thwart the natural referral process:

Stop thinking about yourself. If you lack new patients, you’re also spending a lot of time and energy thinking about yourself. You’re thinking about the shame of paying your bills late or not being able to pay them at all. You’re questioning your career choice. You’re worrying about you instead of patients. It may require an Academy Award-winning performance on your part, but focus on serving patients. Your ability to pay your bills is a symptom of the value you’re adding to the universe. This can be difficult to do if you’re having a private pity party of one.

Admit that your practice isn’t patient-centered. Along the same vein is the common blockage of shepherding a practice that is about something other than patients. Among the more common is the chiropractic-centered practice. Here, the objective is to recreate and perpetuate a pure, if not outdated, model of chiropractic. Or the adjustment-centered practice where the focus is technique driven. The third-party-centered practice sees patients as insurance policy delivery systems. The subluxation-centered practice is about subluxation detection and reduction. These and other models share the common denominator of being something other than patient-centered.

Discover if you have the capacity to help more people. Here, the biggest blockage often comes from allowing patients to think they’re buying your time, not your talent. Sometimes the blockage is environmental in nature, including everything from too few reception room chairs to inadequate staffing, wasted steps from poor office layout or something as subtle as not being proud of your office location or furnishings. Rather than trying to fill 10:15 AM or 2:30 PM, the key is being able to help more people when they want to come in.

Visualize new patient abundance. This may sound a bit metaphysical, but those who lack new patients often focus on their lack rather than on the abundance they desire. Their secret mantra, repeated over and over to themselves is simple: “I need more new patients, I need more new patients. I need more new patients.” As is the case with all things, the universe manifests what we put our attention to. The result? The practitioner has a constant need for more new patients!

Create extraordinary patient visits. Distracted by bills and embarrassed by their lack of success, many doctors find it difficult to stay in present time consciousness when they are with the few patients they do see. Instead, look for ways to focus on the patients. Ask them about their health, their hobbies, their pets, their family and their work. Find something to compliment each patient on—their hair, their clothing choice, cologne, their promptness to appointments or their progress. As you touch each patient, visualize how this patient, renewed by better health, will affect countless others, setting off a chain reaction in your community and around the world.

Find out the language your patients use to refer others. You’d be surprised by the language many patients use to tell others about chiropractic! One reason you may not be enjoying the referrals you should is that patients describe their visits to your office with words like cracking, popping, wrenching, twisting or worse! In a casual, I’m-just-taking-a-poll tone, ask your patients, “I was just wondering, when you tell others about what we do here, how do you describe chiro-practic?” If you don’t like their choice of words, gently coach them.

Do patients perceive the practice as full? In some offices, referring friends and family can result in longer waits and less attention from the doctor. Keeping your office a “secret” can be a naturally selfish motive. Ask your patients, “Tell me, on a scale of 1 to 100, with 100 being so full you couldn’t pack another patient in, how full do you perceive our practice to be at the time you usually receive your care?” My experience suggests that referrals start falling off at about 80-85% full.

Let current patients know you’re accepting new patients. It’s obvious, but if you want to help more people and you’re in the running for an Oscar, many patients won’t know that you’d like to be helping more people. Let every patient know! The caveat is, you’re accepting new patients on a referral basis only. Rather than the general, “If you know someone we could be helping, make sure you get them in here,” this is about a partnership. The only way in is through someone already in.

Ask your current patients to bring their children in. You could probably double your practice in a matter of weeks by encouraging parents to bring their children in for care. Just be sure you “own” the idea that children should be receiving chiropractic care. If not, it’s just a self-serving gimmick.

Conduct in-office presentations. It’s a well-known fact that offices that conduct health care classes, lay lectures and spinal care classes enjoy lots of new patients. Relying on the “buddy system” in which active patients bring a spouse or friend with them to your program is an effective and inexpensive way to introduce chiropractic to new people. Expand this concept with programs on specific topics such as Ritalin, bedding, nutrition, backpack safety or other subjects of interest. Host programs co-taught by other practitioners such as naturopaths, acupuncturists and others in the vitalistic domain. Attract ideal patients by offering information.

Take your best patients to lunch. Create situations in which you can pick the brains of your patients. Buy lunch and ask a trusted patient or two how you could improve your new-patient procedures, office visits, new-patient acquisition and other aspects of your practice. Rather than seeing your request as a weakness, they’ll be impressed that you wanted their opinion. With their newfound emotional investment in your practice, stand back for a flood of referrals!

Keep in touch with your inactive patients. Simply put, the people most likely to come to your office are those who have already been to your office. It’s tragic how many offices who need more new patients practically ignore their trophy case of inactive patient files! Send postcards, letters and newsletters. Keep in touch. Many are in the midst of a relapse or know someone who should be seeing you.

The instant gratification that makes drug therapy so attractive to patients also makes new patient gimmicks attractive to struggling doctors. And if you’ve ever heard a patient express frustration at the slowness of their recovery, you realize that like so many inside-out processes, change takes time. Stimulating the referral process from within your practice is a lot like chiropractic. It’s a way of life, not a one-time fix to clear up an episode of pain.

Excerpted from
What a Patient Wants
Published in 2002
240 Pages
US $24.95

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