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Push, Pull or Drag

used_car.jpgA popular advertising technique for automobile dealers is to entice customers by suggesting that their used car has more trade-in value than it actually does. As in, “Do whatever you have to do to push, pull or drag your car in, and drive away in a brand new car.” Apparently, this suggests that if you have some clunker that’s not even running, you have something that the dealership values that will help reduce the purchase price of a new car.

Most of us can see through this ruse. We know that the purchase price of the new car is either inflated or there are such strict credit restrictions that few can actually qualify for the low monthly payments that are advertised. These types of sales overtures tend to seduce only the naïve and least discerning.

Do you use similar low-rent techniques to attract new patients?

Probably the most common approach used by chiropractors is to offer new patient “specials” that include a complete neurological, orthopedic and physical examination ($250 value!) for $49.95 or something equally ridiculously out of proportion.

Those with even the most rudimentary analytical skills can see through this come-on. There are at least three possibilities:

Either the examination has little value
The price has been artificially inflated so it can be reduced
It’s a come on for something else

My guess is that in the practices that employ this tactic, all three are possible. The examination “price” was something that only third parties, accustomed expensive diagnostics of the allopathic world would pay and that cash-paying patients rarely pay. Naturally, the come on is for the three-times-a-week-until-your-insurance-company-stops-paying. And the low entry fee is merely the inducement to begin care, with the profit made on the back end.

This strategy demonstrates a profound disrespect for the intelligence of the consumer. In fact, it’s symptomatic of the way far too many chiropractors, even those who don’t use this approach, think of patients:

Patients are basically stupid.
If given the choice, patients will do the wrong thing.
If I don’t sell on price, patients won’t begin care.

If this is your perception of patients, no wonder the various manipulative techniques that are taught at management seminars seem palatable. You think you’re doing patients a favor by using scare tactics (so they’ll do the right thing), employing a semantical sleight of hand to get patients to say “yes” throughout your report of findings (so they’ll do the right thing) and your emotional, “close” to your lectures and reports (so they’ll do the right thing). These sales techniques are justifiable because you’ve convinced yourself that the goal is honorable.

Based on who reads these blog posts, I’m probably preaching to the choir. However, even if you don’t succumb to these overt techniques that dishonor the sovereignty of each patient and the free will God entrusts them with, many chiropractors practice manipulative techniques that are far more subtle, but equally unsustainable, differing only in magnitude:

Pressing patents to “get” chiropractic.
Using your social authority to manage patients.
Thinking what patients do can reflect poorly on you.
Refusing to discuss how to discontinue care.
Scolding patients for their poor health care choices.
Valuing new patients over reactivating patients.
Making patients feel guilty for not valuing their health.

Providing leadership and inspiring patients to assume appropriate responsibility for their health is a good thing. The breakdown occurs when the practitioner uses predatory methods that overpower patients, producing buyer’s remorse, or who choose to define themselves, their validity and their worth by what patients choose to do. Cross that boundary, investing your life spirit in something you can’t control, and it causes a slow leak of your “emotional checking account,” eventually manifesting in burnout and a cynical resignation.

Perhaps even worse, it reduces referrals from otherwise delighted patients and suppresses reactivations from them when they have the inevitable relapse. Which, in a strange, ironical way, creates the very circumstances that prompt many chiropractors to resort to inducing patients with freebies, deals and new patient “specials.”

Comments (3)

Tony Russo:

Man Bill, where do you get this stuff? Right - as Dave Ramsey says, "freaking" - on! I don't discount anything to get the "fencers" to fall on my side. They don't. They only fall for the loss leader/cheap deal and then they're gone to a cheaper loss leader. I draw a short beard of experience when I say the practice success is accomplished through sincere diligent work and by applying the principles you have graciously accumulated for us to apply. I may not share our first respondent’s religious convictions, but I quote, "He who hastens to get rich will not go unpunished" (or something along that line). Though I do agree that no one should be allowed to graduate any Chiropractic school without having successfully passed your course... with a 99%. I've seen firsthand what not applying these principles has done to my colleagues and ME! I'm a Peer Reviewer and I hear their concerns. What can I say in response? You hastened to get rich. Now your haste is posting its dividends... with interest!
Thank you Bill, thank you.

Mithra Green:

While I understand where your coming from, I disagree with you. Loss leader advertisments are a time honored way to introduce yourself to those who may not otherwise consider your services. I sure took advantage of your free samples policy to look at brochures.
Sure I could use high pressure sales pitches, been there done that, or maybe by lowering the barrier of entry I prompt someone sitting on the fence to start a relationship with me. Sure, a low percentage actually become patients, but that's where your postcards and newsletters come in.

Bob Wagner:


No student and or chiropractic college should allow a student to graduate without you saying to them what you say. In my MBA program we just studied inbreeding in education. That is where schools hire in a narrow fashion and usually only their graduates. This leads to a diluted education and very dogmatic! I almost fell over when I realized that is chiropractic. I went to National and they never hired outside their box. Similar things continue to happen in practice management also. I see a guy out of Florida. who is still at it and with the same techniques he preached 25 years ago!

Keep up the good work because no one and I mean no one in this game is playing at the level you are. Keep blessing us with your wisdom!

Bob Wagner

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From June 1, 2008 7:23 AM

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