New Practice Marketing

By John Whitney


Over the past year you have been presented with the process of locatinga place to practice, after graduation. Be your choice, Associateship, Purchase,Sublease space, or Scratch-Start, you are now faced with the familiar refrain,"where will the new patients come from?"

All new patients come to you as the result of some form of "marketing".Marketing has a very broad definition and includes referrals. From establishedclients-patients to frank advertising; it is all marketing. In your caseyou will be thinking of external marketing and internal marketing.

These two definitions have fuzzy borders but generally one tends to thinkthat internal marketing has to do with marketing activities originatingwith or confined to your present patients of record. An example of internalmarketing would be you doing health carte classes for your present patientsand urging these patients to refer their friends and acquaintances. Authoritiesin this field say that approximately 63% of your new patients will comefrom present patients of record. The best source of new patients is fromcurrent patients. External marketing examples are, direct mail, telemarketing,Yellow Page, mall screenings, and newspaper ads. Almost any marketing willhave some positive effects; at this point you need to know what works best,for the least amount of money.

One of the great benefits of purchasing a practice is that you can do alot of internal marketing for cheap as opposed to external marketing whichis often costly. when using external marketing expect to have costs of approximately$200 per patient. My friend Roland Ashby tells me he can reduce that costto $98 per patients. I don't doubt that he could do that but it is uncommon.

In order to approach this whole business of marketing a chiropractic practiceyou need a plan- "a marketing plan". Too many newbies spend allof their families money just getting into practice and give little thoughtor budget to how they will promote or market the practice. It is conventionalwisdom among new graduates to believe that placing an ad in the local newspaperand sending opening announcements to the neighborhood will start their phonesringing. Naivete is charming in children, deadly in an businessperson.

A marketing plan really begins with a self assessment and an assessmentof what you can offer your market. Who are you.? Why would someone callyou and not the DC down the block? Can you offer any unique factors thatare beneficial? Please don't answer by saying, "well I'm the only onearound here that uses ABC technique", assuming that your technicalabilities have anything to do with how busy you will be.


THE PLAN

When attempting to develop a marketing plan, the first order of businessis to analyze your market; so that you understand, "who is out there"?

The market segment you go after must be large enough in its totality, tosupport your efforts. You may want to develop a "women and children"practice. However you may have to be around for a while before your practicedevelops to the point where you can restrict yourself to that small niche.In the interim, you accept anyone who can fog a mirror.

How many other people just like you are serving the same market (competition)?And yet another consideration: how well qualified are you to pursue thetarget market you've chosen? These questions are all part of the marketinganalysis.

It is a sad fact that most health-care marketing projects fail. They failbecause the fundamentals are neglected. Too often there is a headlong rushto go out and "do something" to pump up a practice, without goingthrough what has proven to be effective.

Step #1:
Analyze the population within your catchment area. That area is often describedas a five mile circumference around your office. If you are in a rural orisolated area the catchment area is much larger. However you determine yourcatchment area you should get a demographic profile of the area.

Obtain demographic profiles by zip code. Check the yellow pages under marketingor demographic information for a company who will provide this service.Many demographic companies have a "doctor package". This packageprovides all the basic information you require for marketing the practice.If you choose to seek out the information yourself you can go to the libraryand ask for help. If you are on-line with CompuServe go into American Demographicsfor the information.

The information you seek about your demographic area generally is:

#1. Projections: for your area, how many people will be moving in or outof your area over the next 3 years.

#2. Income: detailed information about the income for your area, high tolow.

#3. Population by Age: the "median" age is not important to you.You need to know the percentage from <5 years old to 75+.

#4. Race: to determine the possibility of ethnic marketing.

#5. Housing: the percentage of owners and renters of condos, and homes.The number of renters, prices of homes, condos, cost of apartments, areall important.

#6. Employment: type of employment by category.

#7. "Lifestyle": this can be very significant category in andoff itself. Often called "psychographics", it has to do with avery broad range of characteristics possessed by the population.

Your competition, even those outside your discipline, e.g. PTs DOs, Acupuncturistswho target the same market as you do, bears investigation.

Describe in general and in detail what your "marketing objective"is. What are you trying to do, with and for, this group of people you havechoosen as your market? Describe what you are trying to accomplish.

By analyzing your demographics and psychographics you will know who youare dealing with. You must also know who you are and what you are capableof.

Marketing Strategies and Tactics:

The "strategy" is the all over plan; for example you may decidethat it would be an excellent "strategy" to go after the elderly."Tactics" are the activities you employ to carry out the strategy,e.g. giving discounts to people over a particular age or having a van pickup your patients. These are "tactics"; the actual action step.

There are almost an infinite number of strategies to choose from. Some willappeal to you, and some won't. Generally speaking, this is where you muststep out of your comfort zone and become a little more gonadal than yournormal self. It is rare to meet a doctor who takes easily to marketing.

Too many new DCs opt for "cream-puff marketing"; the kind thatis so bland as to have no worth. Generally health care providers are onlycomfortable with what is classified as "public relations".

There is nothing wrong with "public-relations" as a form of promotionexcept that it does little to increase your practice. It may increase yourprofile, but at this stage of your practice life you need new patients morethan a lofty image. The image stuff comes a little later. Right now youneed cash flow.

When it comes to marketing there is one primary question to keep in mind:"what is the hard cost of bringing a new patient into the office andwhat will be my ROI", period. It all boils down to ROI, return on (marketing)investment. There will be a few surprises. It will become obvious that ifyou are in a competitive market your cost per new patient is rather high.

How Effective?

You have heard that "country music tells a story", well in marketingit's different. Numbers tell a story.

Here are the common marketing numbers to keep. You should become as familiarwith them as your telephone number.

#1. Case Average Size: This is the gross number of dollars generated bya new patient during the first year in the practice. It does not includerevenue generated by their personal referrals.

Once you know what a new patient is worth to you, you can determine whatyou will spend generating more new patients.

If a new patient brings in an average of $1200 per, in year one, how muchcan you afford to spend? If your overhead is 50% you could spend up to $500.00per new patient (you won't get rich that way!) More appropriately, $50 to$200, should be considered.

In order to determine your present case size, pull every tenth file from your last years new patient list and get an average dollar amount. Well run chiropractic offices collect approximately $1200 per new patient in the first year.

#2 Old Dollars or New Dollars:
Of all the money collected last year in your office, how many dollars camefrom new patients that year.

If you are around 60% new dollars, that is about average. As you can seethis number tells us something about your practice. For instance if thefigure was 75% new dollars, it would appear that your retention was questionable(compliance) and that you run an acute care practice. If the new dollarswere 40%, it would indicate high retention but perhaps a problem in acquiring new patients. Once again a random search of your files, coming to an averagenew/old dollars ratio is your route.

#3. Response to Promotion:
--"how did you happen to choose our office" Posed by the receptionist or physician will help you track where the new ones come from. This tracking is essential to determine (in the future) what marketing you will repeatdue to acceptable ROI.

What has worked best for other DCs? : Yellow Page advertising, Spinal Screenings,Patient Appreciation Days, Marketing to inactive files, Val Pac, DirectMail Brochures, Community Health talks, Chiropractic Orientation (in house)talks, personalized coupon handouts, Back Schools for Industry, and several other less known methods.

Marketing Chiropractic is a highly specialized endeavor. Amateurish, ill-conceived planning and execution will not draw people. Dont even think of creating your own brochures, handouts, direct mail, Yellow Page ad, or any creative graphics or promotional text. You dont know what you are doing. It is tough enough for the professionals. Would you go to a graphic artist for an adjustment? Use what has proven to work. Keep away from goofy things like putting your name on supermarket receipts, placing an ad on the plastic cover of telephone books, putting your name on bus stop benches.

You aspired and were trained to become a Chiropractor. You will discover that part of practice is the easy party. The business and marketing aspect of practice will occupy much of your waking moments. That is just the way things are.


SAMPLE MARKETING PLANS FOR CHIROPRACTORS

Sample Market Plan: Senior Citizens

Objective: Generate 5 additional geriatric patients per month.

Target: Seniors living in well-to-do retirement village 1 mile away.

What they Want: Expertise, bedside manner, a practitioner others already trust.

Who You Are: Chiropractor 0 Years in community, prolific author.

Competitors: 5 chiropractors who receive some referrals from primary care MD's. None promote.

How to Compete: Establish strong image in community as expert. Emphasize experience and my conservation approach.

Budget: $1000.

Strategy: Promote directly to this closely knit community. Give free seminars through their recreation and education program. Advertise in their newspaper. Raise awareness to generate particularly strong word-of-mouth often found in senior groups.

Timing: Seminars every month on geriatric & wellness topics.

Execution: Schedule seminar by Jan. 10 so Rec. Dept. can promote.


Sample Market Plan: Gaining Referrals

Objective: Within 12 months, 5 additional referrals per month from other practitioners.

Target: Primary care medical doctors .

What They Want: An expert they can refer to who will reflect well upon them, and someone they feel comfortable with.

Who You Are: Chiropractor, 0 years experience.

Competitors: 2 other Chiropractors -- low key. 3 Orthopedic Surgeons who court primary care MD's.

How To Compete: Establish self as an expert. Don't compete for referrals against others since they don't seek referrals. Differentiate from Orthropods by emphasizing specialization in non-invasive and natural approach for quicker recovery and lower costs.

Budget: $1000.

Strategy: Publish quarterly newsletter on spinal info important to primary care MD's and DPMs. (Print establishes my credibility.) Follow up by phone to introduce myself and establish personal relationship. Emphasize he/she can call me with any questions or refer patients with confidence.

Media, Copy, Commercial artist designs newsletter
Graphics: masthead and layout. Format -- 11x 17" printed 2 sides, 1 color, & folded down to 8 1/2 x 11". Write newsletter articles about people and from the case establish a principle. Short articles best. Send cover letter with first copy to introduce newsletter.

Timing: Publish Jan. 15, Apr. 15, Jul. 15, Oct. 15. Make follow-up calls 1 week after mailing.

Execution: I write. Hire editor to assure top quality. Commercial artists lays out each issue. Quick printed. Office staff mails bulk rate.


Sample Market Plan: Recalls

Objective: Increase recalls by 35% within 6 months.

Target: Existing patients.

What They Want: To only return when they perceive there's a strong need.

Who You Are: Chiropractor, urban area, 0 years experience.
Competitors: Competing for recalls are other discretionary expenditures- and other DC's promoting their services.

How to Compete: Inform patients of necessity for recall and risk to health if they don't return. Need for wellness.

Budget: $0

Strategy: Take them psychologically out of market to shield them from alluring claims of other DC's by setting recall at time of last appointment. -- even if 6-12 months away. Position as a convenience to patient to set aside hard-to-get appointment. Times now. Confirm by postcard two weeks in advance. Reconfirm by phone the day before. If no show, send a letter emphasizing what may happen if patient doesn't come in. If no response, have front desk call with same message and ask for appointment. Repeat contacts until no longer profitable.

Media, Copy, Postcards, phone calls, letters.
Graphics:

Timing: Start immediately.
Execution: I write copy. Whitney Management Group to critique.


Sample Marketing Plan

Objective: Generate 20 new patients per month.

Target: Families and those persons interested in wellness care. InitiallyI will accept all cases.

What They Want: Expertise, bedside manner, a practitioner others already trust.

Who am I: Wellness oriented chiropractic practitioner, 3 years associated with Cleveland Clinic, strong "natural health" advocate.

Competitors: 3 other MD's practicing similar techniques in the area. One homeopath.

How to Compete: Establish strong image in community. Give free seminars through organizations interested in health. Advertise in the yellow pages. Raise awareness to generate particularly strong word of mouth throughout.

Timing: Monthly seminars on wellness.

Execution: I perform seminars and meetings. Contact local organizationsto arrange a presentation.
*Community Seminars
*Resident and New Resident Program
*Networking the Neighborhood
*Direct Mail
*Industrial/Corporate Penetration
*Weekly Health Care Class
*Market to area Physicians
*Newspaper Column
*Network patients
*Yellow Page ad
*Special Days
*Recall old patient


Direct Mail

Objective: To present myself to the community at large.

Target: White collar families who show an interest in health care, people who frequent:
*Local gyms and health clubs
*Health food stores
*Health organizations or support groups (Lung, Heart, etc......)

What They Want: Information regarding health optimization and an incentive to begin care.

Strategy: Send out mailer with a coupon for a free consultation.

Timing: In the late spring or mid winter.

Execution:
*Obtain demographic information from library
*Contact a designer
*Contact a printer
*Get a reverse directory from the library
*Contact health food stores for a directory of clients
*Contact health clubs for a directory of clients
*Contact health organizations for a directory of clients
*Contact post office for postage

Cost:
Designer 2000
Printer 1500
Postage 200
Total 3700


Yellow Page Ad

Objective: To present myself to the community at large.

Target: Any individual reading the yellow pages.

What They Want: Information regarding health optimization and an incentive to begin care.

Strategy: Have a well designed ad focusing on wellness and gentle conservation health care.

Timing: Subject to publication.

Execution:
*Contact local yellow page company
*Contact a designer

Cost: Designer 2000
Ad space 2000
Total 4000


Resident and New Resident Program

Objective: To make a formal introduction to the neighborhood within a 5 mile radius of the practice. To establish myself with the new residents of the area.

Target: Residents within a 5 mile radius of the practice. Particularly those in new subdivisions and areas lacking an MD within 4 miles. All new residents of the community

What They Want: Quick introduction of self and a feeling of comfort.

Strategy: Be brief and to the point. Contact a minimum of 1500 residents in the area, before opening the office. Monthly continuum in regards to new residents.

Timing: Contact 30-40 residents per day, starting June 21 and running unti l5 days before opening. New residents will be contacted immediately. Hours of introduction will be done after 11:00 am and during dinner time.

Execution:
*Obtain demographic information from library
*Obtain copy of "Reverse Directory" from library
*Obtain solicitors license from city government ($20)
*Get 1000 door hangers printed up for people not home
*Obtain address from persons to send an opening announcement to their home.
*Follow up any conversations with a personal letter or phone call (whichever was promised in the introduction)
*Send out opening announcements to those addresses one week prior to opening
*New residents will be contacted as soon as information is available from.
*Dress appropriately

Projected Cost: Solicitors license 20
door hangers 300
stationary 50
announcements 20
Total 570


Community Seminars

Purposes: To establish a familiarity, for my skills toward conservative health care.

Target Market:
*Women's organizations
*Local gyms and health clubs
*Health food stores
*Health organizations or support groups (Lung, Heart, etc...)

What They Want: Interesting presentations concerning conservative ideas towards health maintenance.

Strategy: Contact the above organizations and offer to do a brief presentation to the person(s) in charge of speakers.

Timing: Initially contact the organization and find out when they meet. Then contact the organization and offer my services two months before they have a significant meeting.

Execution:
*Obtain slide presentation($200.00)
*Practice presentation until know fluently
*Shorten presentation to 5 minutes for introduction
*Obtain pamphlets on health promotion
*Develop a presentation covering the philosophy of health
*Send out introductory letter
*Follow up with a phone call 5 days after sending the letter
*Meet with organizations leaders to go over the presentation
*Hand out pamphlets to audience
*Future subjects: nutrition, aerobics, stretching exercises, meditation, guided imagery, proper foot wear for various sports(obtain information from Reebok or Nike reps), stress management workshops.

Projected Costs:
*Slide presentation 200
*Slide projector 200
*Screen 0
*Pamphlets (?) 100
*Stationary 50
Total 550


Industrial Corporate Penetration

Objective: To establish myself as a consultant to local industry in regards to the well being of their employees.

Target: Local industries associated with providing a service to the community. Companies of any size, located within a 5 to 10 mile radius of the practice.

What They Want: Information regarding decreasing worker down time and maximizing to show them how to save money on health care costs on the future, through a healthy work environment.

Strategy: Contact the manager of the personnel department (or whoever might be in charge) to set up a meeting. Perform a presentation to show them how to save money on health care costs in the future, through a healthy work environment.

Timing: Contact the companies as soon as possible. Set up meetings in the early morning.

Execution:
*Obtain a list of companies from the Chamber of Commerce.
*Contact them as soon as comfortable with the presentation.
*Obtain slide presentation
*Rehearse presentation until comfortable
*Shorten presentation to 5 minutes
*Follow up meetings with a thank you letter and a letter of concern.

Cost:
List of companies 5
Slide presentation 200
Stationary 50
Total 255


Weekly Health Care Class

Objective: To educate my patients about health promotion, personal responsibility and how it relates to their health. To promote the idea of wellness and monitoring care.

Target: All new patients and their guest, preferably spouse and family.

What They Want: Brief explanation of why they should go to a doctor when they are not sick and what can be expected as a result of using me as a"health coach"

Strategy: To educate them with examples of successful people who changed their lifestyles for the better.

Timing: Every Wednesday night from 7-9 PM, regardless of turn out.

Execution:
*Obtain presentation materials (not yet known)
*Practice presentation until know fluently
*Make this mandatory for patients to begin and continue care.
*Provide pencil and paper on each chair for note taking
*Ask patients to refer 2 people to be called to begin care

Cost:
*Pencil and paper 10
*Presentation 100
Total 110


Thematic Marketing

Objective: To communicate to current patients the need of health maintenance care for every person that they may know. To tell the office success stories.

Target: All persons known by current patients.

What They Want: To be a positive the idea of health promotion and maintenance in a 1 minute conversation, each time the patient may come in. To develop a "patient of the month" program. (success stories)

Timing: Each time a patient comes in.

Execution:
*Develop a list of topics to be discussed each day with each patient that day.
*Make a 1 minute presentation regarding that topic, using examples and experiences
*Practice presentation before any patients are seen.
*Develop a "word of the day" billboard to be seen by patients in the reception room.
*Follow up letters to patient for referrals (thank you, 1 week, 1 month progress reports)
*Designate a front desk person to be in charge of the patient of the month program.
*Design a format of information for the patient to fill out.
*Develop a patient of the month bill board and photo album to be displayed in the reception room.

NOTE: This material was written pre-HIPAA. Make sure you get patient written permission before using and testimonial information, pictures etc.

Cost:
Polaroid camera and film 30
Stationary 3
Posterboard 20
Photo album 10
Total 63



Newspaper Column

Objective: To associate myself with conservative methods towards healthcare to the community at large.

Target: Those members of the community who reads the health section of the newspaper.

What They Want: Conservative definitions and answers to health questions.

Strategy: Present a column (300 words or less) defining and discussing solutions to basic health questions of the season.

Timing: Begin monthly and hopefully move to biweekly.

Execution:
*Contact local paper, health department editor
*Write up a 4 columns to present to the editor
*Purchase a Merck Index to get definitions and descriptions of topics
*Write each column two weeks prior to publication.

Cost:
Merck Index 30
Stationary 10
Total 40


Market To Area Physicians

Objective: To establish a working relationship with area medical doctors.To promote myself as a knowledgeable Chiropractor, for their consideration in patient referrals.

Target: Family practitioners, neurosurgeon and orthopedic surgeons within a 10 mile radius.

What They Want: Promote through a journal publication.

Timing: Bimonthly, as to the journal publication.

Execution:
*Contain "The Chiropractic Report", for subscriptions.
*Obtain a list of physicians from area hospitals, patient referral centers and phone book.
*Send a cover letter introducing myself and offering to send them a complimentary issue.
*Conduct one follow up phone call to make sure they receive it.

Cost: The Chiropractic Report 300
Stationary 10
Total 310

There are other materials like this at our Chiropractic Assistant (CA) Page

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