After the alarming text I got a couple of weeks ago from a state association director about the financial strain his chiropractors were experiencing, I spent a couple of days at the Las Vegas Parker Seminar tapping the brain power of my limited group of thought leaders and influencers, asking each one, "How would you help chiropractors who are struggling these days?"
Their answers were as diverse as this profession. Each suggestion had merit, and while I can't possible recreate the several hours of conversation here, I was especially taken by the observation of Dr. Patricia Gayman whom I've known for at least two decades and who shepherds a group of chiropractors through her consulting group Authentic Alignment.
“They have to cut their overhead and build on the patients they have, and do whatever it takes. They have to think and act like they’re in startup mode.”
I'm guessing that's not what chiropractors with a decade or more of practice experience want to hear. But her observations ring true. And I think I know why.
It's because in my 32 years of serving the profession I've noticed there have been at least three eras or "epochs" that have served to create the backstory of the predicament many chiropractors are facing:
1. The Insurance Era. Even when I self-published my first book, A Patient's Point of View back in 1992, I suspected the half life of generous reimbursement and lavish personal injury awards were limited. Back then, practically all you needed was a well-lit sign out front, the largest yellow page ad you could afford and a front desk CA who was good at taking the order and scheduling new patients.
2. The List Era. In the hopes of lowering costs (you!) there was a move toward HMOs and PPOs. The objective here was to get on the list, join the panel and take the limited reimbursement in exchange (supposedly) for a constant stream of new patients. Providing care at less-than-it-costs-you reimbursement was justified as a way to “educate” patients and convert them into wellness patients. Too bad that theory didn’t pan out.
3. The Familiar Era. These days, with the advent of the Internet, Facebook and a chiropractor on every corner, the strategy is to become familiar; known. And this is where many experienced chiropractors seem to balk. Combine this with the fact that most patients are unaware they have a $2,000 deductible for their unplanned bout of back pain and chiropractors need to adapt with high levels of creativity.
Why do chiropractors reject the adaptation required for success in the Familiar Era? I imagine there are at least three barriers, and thankfully, they all can be overcome:
"I'm a Doctor. I Shouldn't Have To…"
This is the entitlement-I've-paid-my-dues justification. These are perfectly great chiropractors who have successfully avoided the "I-feel-stupid" learning cycle required to use email and acquaint themselves with social media. This level of pride and arrogance prevents experienced chiropractors from "lowering" themselves to do the marketing, schmoozing and outreach programs necessary to become familiar. Newly minted graduates are not so proud.
"I Have a Life. I'm Busy!"
After a decade or so of helping people, you're in the grove. Congratulations! But you don't encounter many strangers these days. Atrophy sets in. Your ability to explain chiropractic to strangers is diminished. The result? You're just a name. Just one more undifferentiated chiropractor in town. This "social cocoon" you've created makes it scary for prospective patients to feel confident in consulting your practice. Prospective patients wonder, “If he’s not keeping up by at least having a website, I wonder what else he isn’t keeping up with?” Encounter more strangers!
“I Want to Keep What I Have."
I know what it's like to switch from offense to defense. (I have the T-shirt and DVD to prove it.) And based on my own experience from back then, I can guarantee that it produces a flat, wide, level path to... mediocrity. Instead of trying to capture new ground, you’re in defense mode, trying to discourage the new graduate from opening up down the street, while making the “safe” choices you hope will best assure you’re ability to pay the mortgage, keep the car leased, maintain the club membership and keep all the plates spinning. I know. You were hoping to coast into retirement. Not going to happen. Time to switch back to playing offense if you have any hope of having something worth selling.
If this is convicting, because you see yourself in one or more of these profiles, it’s time to get back to work. I promise there are plenty of people who want natural, drug-free results, and have the money to pay for it. But they don’t know who you are. (Even after your most enthusiastic patient gushes about you to her friend, the friend wants personal confirmation. “Does this chiropractor of yours have a website?”)
It’s time to fish or cut bait. Decide. (Which comes from the Latin root word meaning to “cut off from.”) Get in, lock, stock and barrel with both feet. Don’t hold back. You're in start up mode, remember?