Rapport+Results+Retention=Referrals

by William D. Esteb

Regardless of technique, political persuasion, length of time in practice, or geographical location, the one thing that most doctors share in common is the desire for more new patients. How to get them eludes many doctors, especially those who still cling to the practice-building techniques that worked when insurance was plentiful and deductibles were low. Getting more new patients today requires new approaches. It's not business as usual.

First, recognize that having lots of new patients is a symptom. And not having lots of new patients is a symptom. Treating a lack of new patients medically, by treating its symptoms, would lead a doctor to squander time, money, and energy on everything from larger yellow page ads, mall shows, and free spinal exams to direct mail, giveaways, and bent pens! These approaches may generate people with spines, but they rarely attract the types of patients most doctors would like to grow their practices with.

Secondly, until you know why patients get great results in your office but don't refer others, your attempts to grow your practice will be a guess or a gimmick. Short term solutions that fail to address the underlying cause of a lack of new patients are destined to fail. Your patients know why they don't refer others. Until you know why and are willing to face the music, you're likely to continue sabotaging the natural referral process that produces the best kinds of patients.

When patients enter your practice, get great results, and drop out they are "firing" you. Unfortunately, you don't get a pink slip with an explanation so you can take corrective action. Today's patients vote with their feet. They don't owe you an explanation. They will rarely pull you aside during the rush hour to critique your report of findings or offer suggestions for eliminating capacity blockages. Don't confuse their nonverbal feedback as a lack of awareness! Patients are much more sensitive to how your office runs than you think. "He's a great doctor, but..." "She's a wonderful doctor, but..." That's what the referral dialogue in many offices sounds like. Are you willing to uncover and confront your patients' perceptions about you, your office, your procedures, your staff, your bedside manner, and millions of other "moments of truth" about your practice? Unless you're willing to get real, effortless practice growth will elude you.

A vital practice full of patients is the result of handling millions of details properly. Few of these essential details are taught in chiropractic colleges. It is a testimony to the power of chiropractic that thousands of practitioners have successful practices without learning the basics of successful practice in school! Instead of reading, 'riting, and 'rithmetic, the three Rs in chiropractic include rapport, results, and retention. It's the only formula that will generate the referrals licensed professionals seek.

Rapport. Rapport means more than just patient education and a meeting of the minds. It starts with personality. Do you have one? Frame all 21 diplomas and awards and hang them on your exam room wall and if you lack a personality, patients still don't connect with the office. While patients find it reassuring that the doctor graduated from these various institutions, what patients really care about is the reassurance, respect, and bedside manner that communicate hope and understanding.

An open communication style can even overcome sloppy clinical skills. How else can you explain classmates who barely passed the boards who have hugely successful offices? Until there is a course at chiropractic colleges entitled Tableside Manners 101, poor communications will sabotage some of the best chiropractic clinicians.

Results. It goes without saying that if you want an ample supply of new patients you must get consistent results with the patients that show up in your office. If you don't meet the expectations (pain relief) of your current patients, don't expect them to refer others. But it takes more than great results to have a successful practice. After almost 100 years of chiropractic history it's clear that if all it took was great results, chiropractic would be at the top of the health care heap.

Patients don't really have results until they understand what's happened to them. Otherwise, their lack of involvement won't precipitate the passion and enthusiasm necessary to prompt your patients to refer others. In fact, you must exceed their expectations (pain relief) to generate the top-of-mind-awareness necessary for patients to tell others about chiropractic with evangelical fervor. And while it's true that many of your "miracle" cases seem powerless to coax others to your office, at the root of their problem is often a lack of patient education. If your patients can't explain chiropractic, overcome the common myths and misconceptions about chiropractic, and defend their chiropractic decision, it's unlikely they'll reveal their chiropractic identity to others. This is pretty basic stuff. But ask most chiropractors what they do--and they can't tell you. "I align the spine." "I remove subluxations." "I adjust the spine." "I help restore a patient's natural inborn healing ability."

Huh?

Until chiropractors and their patients can adequately explain chiropractic without depending upon jargon, chiropractic will remain a second class, alternative, natural-form-of-pain-relief profession. Symptomatic improvement produces happy patients, but only patient education empowers patients to confidently refer others.

Retention. How long do patients remain under care in your office? How many understand chiropractic well enough to become chiropractic clients? Client relationships are much more enjoyable and create the environment that can better nurture the referral process.

A pain-relief outlook is generally short term. Medicine has taught patients that the objective of health care is to avoid pain or discomfort. If patients enter your practice with this myopic vision of health, your patient education efforts should be designed to reveal the benefits of a chiropractic lifestyle. Worse, is when chiropractors adopt this limited view and think they are doing patients a favor by quickly getting them symptom free and dismissing them. Without proper education to change their expectations, the reemergence of their symptoms from their underlying chronic condition months or years later leaves patients with the notion that chiropractic doesn't work or is merely an expensive short-term fix.

Don't misunderstand. If, after exposing patients to a wellness approach to health and it is rejected, honor the patient, willingly dismiss them, and thank them for the opportunity to participate with them in their symptomatic recovery. The crime is in not exposing patients to the benefits of the same chiropractic lifestyle you enjoy!

Long-term doctor/patient/client relationships are only possible when affordable wellness care fees are available and your procedures are efficient so as not to excise large amounts of time. Patients are not living to get adjusted! Patients get adjusted so they can go live.

When a patient refers a friend they are putting their friendship on the line for you. When they vouch for you, they are staking their reputation for yours. From the first impression of walking into your reception area to the last ditch reactivation efforts by your good-intentioned staff, your patients are sizing you up. The conclusions they reach will not only direct their own compliance, but will hinder or advance their willingness to tell others about their experience in your office. Perhaps more sobering, these conclusions will affect their perception of the entire chiropractic profession. Is it possible that today you're paying the price of the new patient gimmicks used in the past? What legacy are you leaving the next generation of chiropractors and chiropractic patients?

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My Report of Findings
Originally published in 1993
240 Pages
US $24.95

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