Most chiropractors didn't choose our profession because they wanted to be in sales, but the reality is sales is part of running a business. It's important to promote our business and continue to gain access to the majority of the public who may not otherwise consider our care. This requires medical outreach or a "sales" approach to the profession who holds the largest piece of the musculoskeletal market.

Sales in the basic, traditional sense is often epitomized in many popular movies with sales focused on numbers and being "sold" to conjures up on an image of being persuaded to buy something you don't really need. That is far from the type of sales we want our profession to represent. Chiropractic services are needed and our level of professionalism requires a higher ethical standard and sales approach.

Much of what I write about and teach, helps break down a conversational method designed to understand physician need, build mutual respect and uncover objections so that they can be addressed immediately and the foundation to MD/DC relationships can be strengthened. 

One of the most important components of sales is closing, but before you can do that you need to trial close. Trial closing involves asking specific questions to understand the level of engagement or interest a physician has in your clinical approach and it can start on your first visit to the physician. This type of closing allows physician's to voice an objections, ask questions and enhance their understanding of what chiropractic care can do for their patients in need of our services. When properly asked trial closing sounds nothing like a "close" in the traditional sales sense.

Failure to address objections, concerns or simply to estimate the value the physician see's in your services often leads to a lack of referrals for what felt like a very good meeting. Rather than be frustrated, learn to ask questions that help you understand exactly where you stand in the physician's treatment algorithm enabling you to uncover and overcome objections on the spot.

If you need help understanding how to ask these questions or need more insight on a professional level sales process please consider joining our monthly members only blog memebership or taking my e-course series for a deeper dive into the process.  For more information click here.

As many physicians have had to pivot multiple times during this pandemic, so to has our marketing. One thing that hasn't changed is knowing the conditions  you love and excel at managing. While your marketing message may change, your reach and target market hasn't. Every practice has a niche. 

Do you know who your patients are? I don't mean in the sense of knowing their name. I mean do you know who your patients are that you want to treat? What are their conditions? What are their needs? What services do you provide to meet those needs?  

We work in a high burnout profession. To improve your professional quality of life target your medical marketing to  appeal to the patients who have the conditions you want to treat? This means if you have a love of managing migraines - find the specialists in your area who also manage migraines. Love workers comp? Great, look to reaching out to occ. med, orthopedists and other specialists who would be likely to have these patients. 

This might seem obvious but I talk to so many chiropractors who try to appeal to everyone and fail to really specialize in one or two specific niches - often trying to claim patients with all sorts of ailments. From a marketing perspective this doesn't help direct or steer your target market in any specific direction.  I'm not suggesting that you can't be "family" practice oriented. Of course you can, but even this has a special focus and more generalized conditions to talk about in your meetings with MD's. 

Look to your own strengths and passions to appeal to the patients who have the conditions you excel and enjoy treating. Not only will you be more targeted in your outreach but you'll be less likely to suffer from burnout by making yourself available at all time to all patients to ensure your practice remains stable. 

That's the magical opportunity in marketing to medical professionals - you can really be selective and find the MD's in your area to build the practice of your dreams and enhance your professional quality of life! 

Has a medical doctor ever said to you "You are comparing apples to oranges?" It's a common phrase so what do they mean?

It means that what you are trying to compare maybe similar but not so similar it is fair to compare them. In medical outreach, this would usually come up during a conversation where you try to compare one research paper to another to make a claim. 

For example: You have one research paper that shows chiropractic is effective for managing headaches in 80% of patients treated.  In another research paper it shows that physical therapy is effective for managing headaches in 50% of patients treated. 

If you try to make a statement that chiropractic is more effective than physical therapy for managing headaches the doctor would rightfully state that you are comparing apples to oranges. 

For comparisons to be made correctly, they must stem from the same research trial or be a meta-analysis otherwise you're just comparing apples to oranges. 

Maintaining consistent contact with MD’s means you remain in the forefront of their mind for possible services for their patients. But how do you maintain appropriate contact without being a pest? We’ll try to capture some of our more popular ideas in this tip of the week.

• Topping the list - patient reports. Why?  Nothing sings your praises louder than results in a patient that an MD has seen struggle. Your discharge report should be limited to one page if possible and produced in a timely manner.  Try walking the report in and in under a minute you should be able to summarize the care directly with the MD. A phone call also works, but nothing beats a face to face interaction and it provides an excellent excuse for personal outreach. 

• Grand Rounds. Google your local hospitals “Grand Rounds” or lecture series which take place anywhere from daily to monthly to quarterly depending on the size of the hospital. These are free lectures open to the health care community where you can sit shoulder to shoulder with the medical doctors in your community enhancing professional relationships.  This is a great way to maintain contact and to establish new relationships. Even better – consider presenting a lecture or case report of your own.

• Literature. It is always a plus to point out pivotal research. It places you as the expert in your  field, illustrates your commitment to continued education and underscores that chiropractic is a research based profession. Whether you simply send a paper or visual aid referencing research via mail or email, it’s one avenue for maintaining contact between face to face encounters.
  

• Holidays. The holidays are an excellent opportunity for face to face interactions where physicians are more likely to be relaxed and open to casual conversations and rapport building. Small gifts (branded or not) provide the opportunity to arrive unannounced - just make sure it's during a time where you can get a quality hello, such as the beginning of lunch. Gifts aren't a guarantee you'll get time, so make sure you are prepared and have a personal card attached.

There are multiple ways to maintain contact. Find what works for you so you don't find yourself 8 months down the road with lackluster results and  awkwardly trying to reestablish contact.

It's important to maintain contact with medical doctors to reinforce patient outcomes and rapport. One of the easiest ways to achieve this goal is to provide a release from care summary report. Reports are also a great opportunity to foster new referral relationships. While all health professionals are inundated with paperwork (electronic or otherwise) the thought of sending a report once a patient has completed care may almost induce a tear or two. Not to worry, non medical legal summary reports for the purposes of informing and updating a physician on a patients results isn't as bad as you think.  Here is a quick outline of how to make it consistently easy. On your letterhead include:

Date

Patient Information

Physician

Physician Address

Dear Dr.:

Below you will find a brief overview of Patient’s Name progress with our office.  

Paragraph 1: Overview of initial symptoms emphasizing the impact on ADL's and pain qualities - bring the patients pain and disability to life. For most patients this can be completed within a few sentences. (members may log in for an example on how this might be easily phrased)

Paragraph 2: Summarize your findings and treatment, home care and work place modifications. Again, this is simply an overview. You're not listing every positive exam finding or how many times a week etc.. It's an overview, a summary.  (members may log in for an example on how this might be phrased as an overview)

Paragraph 3: A simple sentence indicating final results. 

For more detailed information regarding "patient name", please feel free to contact me at the above  number. 

Sincerely,

Your name & specialty

cc: any other physicians who may have been involved with this patient for this particular condition

This is a very basic summary for the purposes of providing an update to a referring physician or at the patients request. Hint: You should be asking every patient for permission to correspond with other primary care or specialists who have a need to be updated on that particular patients care.  It takes minimal effort if done on a daily basis. 

Being competitive doesn't mean you need to bash the competition. Rather it is understanding a problem or weakness of a particular competitor and knowing when your services meet the competitors while resolving an identifiable problem. In sales this is known as the  "Meet and Beat".  For instance both NSAIDs and spinal manipulation can help with pain - this is the "meet", however, SMT does so without systemic side effects - the "beat". 

"Seeds of doubt" can help introduce a competitor without bashing them. For example, medication works on pain which may be a motivating factor for prescribing it, but they typically have side effects or aren't appropriate in certain subsets of patients. These problems can be utilized as a "seed of doubt".  For instance "I understand NSAIDs work well to control pain, what about your patients with GI concerns?" (or at high risk for cardiovascular events etc....).  

Now you can utilize research as a neutral talking point - show the MDs what the research shows on how manipulation acts on pain.  

A seed of doubt can help you professionally position your care as perhaps a more ideal starting point (aka - meet and beat) that maybe hadn't been previously considered.

Talking about inactive patients always feels a little dark. So much so, many practices turn a blind eye thinking that a good percentage rate, often examined through retention rates provides the justification to turn that blind eye. I think that's a mistake.

We often hear that losing a patient is the most expensive patient to lose and I would agree with that for two reasons. The first is reputation and the second is not adjusting your marketing strategy between inactive and active patients. 

When did you last take a deep look at your inactive patients?

There is a lot your inactive patients can tell you and even if your stats are good, you should still want to know what they have to say and you should still be tracking that statistic for early warning signs. 

You should also be marketing to them differently because what they have to say is invaluable to knowing how to improve your statistics and protect your reputation.  It's this last point that ties the importance of this issue into medical referral marketing. 

Your reputation is everything when it comes to medical outreach and patients who don't return for care have a lot to say about that reputation, even if they are a small fraction of your practice. Examining your patient reviews on social media and on review sites like Yelp won't necessarily raise a red flag, only a small percentage of your inactive patients will take the time to post a negative review - the others do it by word of mouth and sometimes their audience is their MD, maybe even the MD that referred them to you in the first place.  A correlation you may see when an MD stops or slows down what was a good referral relationship.

Most practices try to reactivate or market to their inactive patient base in the same manner as they do their active patient base. For example, many offices simply keep them on the newsletter list, the birthday card list and assume social media posts will keep them engaged but it fails to address the reason they left. The needs from a marketing perspective are different than the needs of your active patient base and this should be factored into your marketing strategy. 

Think about this way -  you have 1,000 patients and 30% have not been to your practice in over a year for a variety of reasons. Maybe they feel fine, maybe they don't have any pain, maybe they had a bad front desk experience or find your office hours or billing procedures inconvenient. Maybe they didn't think your care or the experience in your office was exceptional. What are these 300 patients saying about your practice? 

Take the time to find out and change how you're marketing to this practice demographic. 

I'm not one to pose a problem without offering a solution. If you think you this situation applies to your practice, consider joining our membership blog for only $4.95/mo,  for solutions and additional insight. Your reputation is everything when it comes to building medical referrals and a successful practice. 

This is a really popular question I often get! The realistic answer is that there is no finish line to cross because you should always want to meet the physicians in your area. It's similar to asking how many friends you should have - do you ever really stop trying? Of course not. It's the same with medical relationships - you should always want to meet physicians in your community, to know who to refer to, to know who not to refer to and to just be a part of a professional community. 

What does vary is the phase of practice you are in. If you are new, you will be actively reaching out to and meeting as many MDs in your community as possible, looking for ones that you align with both in therapeutic approach and in part personality wise.  As you become more established you will transition from actively knocking on physician doors, to meeting physicians through activities such as hospital grand rounds and introductions by other physicians and through reputation.  

There is no magic number or equation that says if I meet this many MDs I'll get X referrals. There are a lot of variables that come into play. How outgoing are you? Are you more shy and introverted or are you a natural born sales person? What is the climate in your area relative to physician attitudes towards alternative care - the same could be asked about the area you live in and economic pulse all factors that drive how patients seek care and are referred. What's the competitive environment - how many of your competitors are also seekind medical referral relationships? Do you have established networks - maybe a family member or good friend that is in the medical community? How likely is it that the first physician you meet will refer you 100's of patients?

With so many variables the only accurate answer is there is no number - you should always want to meet and mingle with the physicians in your community - and degrees don't matter - you never know what specialist is an influencer in the medical community or can escalate you into the hospital system if that is your end goal. 

If you think in terms of numbers the intent is lost - is your intent numbers based for what MDs can do for you or is it relationship based upon which referrals are a benefit? Which one do you think is better for a stable source of new patients that spans the life of your practice? 

It’s clear that Covid19 will forever change our lives and this is especially true of healthcare.  Telehealth will likely be here to stay and from a business and marketing perspective not offering Telehealth may be the discriminating factor between you and a competitor. 

Because many rules and regulations have been lifted temporarily by the government there are many opportunities to add Telehealth to your practice immediately without investing in Telemedicine software to see how it is received by your patients.  This would include options such as Zoom, FaceTime and similar options.  It cannot be emphasized enough that you must first check with your State Association to see any restrictions and regulations on implementing Telehealth which would include options such as Zoom and FaceTime. 

The good news is that many insurance companies are reimbursing providers and according to the Illinois Chiropractic Society, it does appear that this is limited to in-network providers. It’s also been noted that Telehealth usually offers more benefits with shorter treatment times, allowing physicians to see more patients in a shorter period of time while offering a new and convenient patient service. 

Chiropractors often see patients with severe pain and Telehealth allows the patient to remain at home without the painful ride and walk to a clinic office.  The full health history can be completed and some orthopedic tests can be observed as well. Instructions on acute pain management, icing, exercises can usually be delivered by example and explanation and in the presence of red flag warnings patients can be referred for appropriate emergency services.   

Be aware that there are forms that need to be filled out and I again emphasize the absolute need to reach out to your particular state to see what you have to do to offer Telehealth in your practice. 

Members may log-in for more resources and a marketing list on how to market these new services in your office as well as suggestions on what to look for in a Telehealth software solution. 

Communicating during a health scare falls under many boxes of responsibility  including marketing. Here are some tips and resources to help with your patient communication regarding Covid19:

1. Make sure your staff knows how to answer questions. We are a hands on, face cradling nation of chiropractors. Understandably that will cause some concern with patients who will likely call to reschedule or cancel appointments.  What are you doing to maintain the spread of virus in your office to protect your patients?  Educate your staff on how to answer these questions to help patients feel more confident when going face down on your table! Finally, make sure your staff does not report to work with any symptoms!

2. Share on social media, through emails and on your website how you're cleaning your office including the cleaners that you are using. Illustrate cleaning of office door handles, including the front door, arms of the chairs, treatment equipment, light switches and bathrooms. Provide santizing hand gel in your waiting roomand front desk  Be a leader in disinfecting!

3. Share on social media, emails and your website proper hand washing techniques. If you sell products and it's part of your practice share immune boosting supplements, botanical and herbs that are supported by the literature. 

4. Consider spacing patient appointments further apart so that you limit the number of patients in your waiting and therapy rooms and have time to disinfect between patients.  Let patients know you're taking this approach! They'll appreciate the effort. Another great option is to offer patients the ability to text you or call when they arrive, allowing them to wait in their car.  Your office staff can then let them know when to come in. 

5. Leverage slower office times by offering them to patients who are at higher risk so that they are not exposed to other patients.  Imagine an older person who feels like the office is open just for them!

6. Communicate with your patients asking them to consider rescheduling non essential appointments if they are experiencing any signs of illness. 

7. Do not make statements or claims that are not supported by evidence based literature! This can lead to heavy fines and I think it is reasonable to expect that agencies will crack down on fear mongering and misleading claims during a pandemic health scare.  I was told yesterday that someone saw a chiropractor claiming that spinal adjustments could boost the immune system by 200%.  This simply is not supported by the literature. 

8. Keep your office clean! Now is not the time to have overflowing garbage cans, old and dingy magazines and dusty shelves. Maintain a clear committment to cleanliness not only during a health scare but at all times. 

9. Update your website and leverage social media to communicate with your patients on any changes in hours or closures, especially in geographic areas with current closures.  Create a page or box on your website on Covid19, the early symptoms and your measures to keep patients safe while visiting your office. 

10. Resources:

Your State Association!

Handwashing: https://www.cdc.gov/handwashing/when-how-handwashing.html

OSHA and Covid19: https://www.osha.gov/SLTC/covid-19/controlprevention.html#health

EPA's Approved Disinfectants:  https://www.epa.gov/sites/production/files/2020-03/documents/sars-cov-2-list_03-03-2020.pdf

CDC Information for Healthcare Providers: https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

World Federation of Chiropractic Covid19 Information: https://www.wfc.org/website/images/wfc/Latest_News_and_Features/Coronavirus_information_2020_03_12.pdf