Patient Education

Time to Technologize Your Marketing?
Patient Education
Written by David Marcarian, MA and Nancy Miggins, DC   
Sunday, 25 August 2013 01:43
enerating new patients is a constant preoccupation for chiropractors. Unlike mainstream medical cohorts who enjoy a steady stream of sick and injured clientele, chiropractors must expend a tremendous amount of energy and resources to secure and maintain a viable patient base. 
techmarketingAccording to a survey conducted by Constant Contact, attracting new customers, engaging existing customers, and obtaining referrals are the top concerns for small businesses. The most effective means of accomplishing these goals required using e-mail marketing.1 As chiropractors, we too are small business owners.
Businesses across the board are changing their marketing strategies to focus on utilizing technology, the internet, and social media platforms. Relying on passive strategies (i.e., business cards or a Yellow Pages ad) worked extremely well in a thriving economy with a population of people who communicated verbally. This simply will not cut it in this tech-savvy smartphone era when patients trust information received electronically more than clever scripts born of the ’80s. The economy is no longer thriving, meaning it is time to adapt. 
The silver lining of our current economic slowdown is the innovation that can come out of it. Industry leaders are creating products and services that mainstream chiropractic into our high-tech, connectivity-dependent society. Do you want to be truly effective? Meet patients where they live: on their smartphones. If you do so in a professional, ethical manner by providing impactful information that the patient considers valuable, then respect and growth will be your rewards. 
The business card is dying, as are other print materials used for self-promotion. If people want to know who you are or find your phone number or address, they will Google you. In addition, direct mail is used less because the associated cost is higher, the return on investment is lower, and it is difficult to track the results accurately. 
The fundamental concepts behind social media platforms have transformed the landscape of marketing. Innovations in technology are driving powerful changes in how individuals engage in health care delivery.2 These marketing mediums, combined with industry innovations, provide the chiropractor with the ultimate power to engage patients in their health recovery process, building stronger, long-lasting relationships. This has enabled chiropractors to cater to the needs of their patients rather than trying to mold patients to fit their practices, thus leading to true patient-centered care. 

A patient-centered care environment inspires causal motivation that results in patients who want to comply with treatment programs and be the best they can be. People will work their hardest for something or someone in which they believe. Causally motivated patients tend to be advocates for their chiropractor and are great referral sources. 
The “cause” in causal comes when providing patients with spinal specific data that they can use to justify the need for care. How often have you seen patients agree with your “paper and pencil” treatment recommendation yet never return or follow through? Too often for most, which is why it is critical to provide prospective patients with the evidence needed to overcome their fears and establish objectively the need for care. This is now commonplace and expected since every other venue of health care does it. Would you seriously let a dentist drill based upon his or her intuition or cleverly scripted “fear tactics”? Of course not, and neither will your untrusting prospective patients. Sadly, chiropractors ranked tenth in a recent Gallup poll rating honesty and ethical standards.3 Now you can use modern technology to combat this image.
Patients benefit greatly from evidence-based communication technologies, whether focused on general patient education, sEMG findings, specific condition information, or health and wellness topics. These tools reinforce the “why” of seeking chiropractic care and put this information in the hands of your advocates so they can easily share the information with others. Mobile devices present a tremendous opportunity to provide patients with even greater access to these powerful tools that support the current dynamic in healthcare delivery.4
To technologize your practice, consider implementing the following:
1.  Retire the posters hung with tape or thumbtacks and invest in displays that can run a continuous loop of health and wellness
information oriented around your specific practice paradigm. Customize the reel to include video snips of the doctor and staff, simplified results of research studies, and pre- and post-exam results from devices like digital x-ray or static sEMG.
2. Incorporate technology into your examination, report of findings, and patient education efforts. Evidence-based, patient-centered tools will boost your credibility and provide your patients with the validation they need. Immediately integrate digital x-ray and sEMG/computerized range of motion. High-tech has become the expected norm within the evidence-based healthcare model. Providing objective data to substantiate treatment is an integral part of modern day health care.
3. Meet your patients where they live: on their smartphones. Take advantage of recent advances designed to help you connect on an entirely different level. Several consumer-friendly mobile applications have bolstered the chiropractor’s technology toolbox, including new applications that automatically send test results directly to patient’s smartphones. 
4. Employ the efficiency of technology in your screenings, either in-house or at an event. By using modern technology like static sEMG to quickly show prospective patients their potential spinal concerns and then sending test data directly to their smartphones with your contact information, you increase the yield from screenings tenfold because they know how to reach you. Furthermore, you can utilize this technology to obtain e-mail addresses for further follow-ups and scheduling. 
5. Make your website simple and clean, but most importantly “smartphone friendly.” The second patients hear about you, they go directly to your website on their smartphones. A site that is not smartphone friendly will be almost unreadable to the patient, possibly ending their interest with frustration.
6. Opt for practice management software that provides patients with a “portal” where they can complete patient forms, access their medical records, make appointments, and pay co-pays. Utilize practice software to the fullest with automated appointment reminders, newsletters, practice announcements, and e-vites.
Our society eats, breathes, and believes in technology. We don’t trust information unless it has been “blessed” by a computer of some sort and 80% of us are visual learners. So it’s understandable why the patient needs and wants visual confirmation. If you do so in a web- and smartphone-friendly manner, your practice will flourish. 
Technology can be your best friend or worst enemy. By finding the best product and support for your needs, you will have a great partner in building your practice. Follow some simple guidelines and you will enjoy all the advantages of technology without the stress.
1. Dornaus, Erika The Health and Wellness of Small Business, Constant Contact White Paper, May 2012. 
2, 4. O’rourke, K., Heckman, J., Elwood, D. Development and Exploration of a Multifaceted Social Platform to Improve Patient Education, Communication, and Activity, Medicine 2.0 ‘12:Boston, USA, September, 2012.
3. Gallup Politics. Congress retains low honesty rating: Nurses have highest honesty rating; car salespeople, lowest. Newport, Frank. Dec 3, 2012
Dr. Nancy Miggins has over 25 year’s clinical experience as a chiropractor. She excelled in the areas of procedures, ethical business practices and management.  After spearheading the development of a integrative health and fitness center, she spent 6 years as director of this clinic.  Although her main focus was in family practice, she also has aided Olympic Athletes and professional cyclists with optimizing sports performance through chiropractic. She is currently the Director of Clinical Applications & Product Development for Precision Biometrics, Inc. Contact at : This e-mail address is being protected from spambots. You need JavaScript enabled to view it or visit or call 800-969-6961

David Marcarian, MA, founder of Precision Biometrics, and inventor of the revolutionary MyoVision 3G Wirefree PhysioMonitoring™ System. A former NASA researcher, Marcarian was awarded a $450,000.00 NIH grant to develop the MyoVision.  As an expert witness, Marcarian was credited one of the largest PI awards in US history, and established the validity of sEMG in a major State Superior Court Decision. Recently the AMA selected his 3G Wirefree System as the “tool of choice” as presented in the medical text  “The Practical Guid". Contact at : This e-mail address is being protected from spambots. You need JavaScript enabled to view it or visit or call 800-969-6961
How I Turned My X-Ray Room into a Profit Center With My iPhone
Patient Education
Written by Adrian Raphael, DC   
Friday, 25 January 2013 03:16
ne might read the headline of this article and wonder if I somehow developed a miraculous iPhone App that allowed me to take digital x-ray pictures right from my phone. While that technology clearly doesn’t exist, I’ve done the next best thing: Using the digital camera on my iPhone, I’ve made my entire practice digital without owning a single piece of digital x-ray equipment.
iphonedigitalxrayAllow me to take a step back for a moment. Before transferring to a new location, my previous practice benefitted from having access to a complete digital x-ray system – no film, no chemicals, no storage issues. Having the ability to take x-rays and have the results in seconds, and being able to annotate those x-rays, was simply part of how I worked with my patients on a daily basis. 
Once I moved to a new location, I lost access to the digital x-ray environment – and the difference was nothing short of astonishing. Can you picture going out with friends and whipping out a Polaroid camera to take a few pictures? Well, that’s what it felt like losing access to digital x-ray technology. It was like being thrown back into the dark ages! 
Speaking from direct experience, I know that once you’ve gone digital, you simply cannot go back – it’s just one of those technologies where you wonder how you ever got along without it. And yet, there I was with my new practice, sans digital technology. 
While this didn’t seem like a big deal at first, it quickly became a source of frustration because I had become reliant on having the ability to quickly show my patients exactly what their diagnosis was, and then being able to just as quickly illustrate where they could be with proper chiropractic treatment. Without seeing the annotations, the patients no longer had the “a-ha” moments I had become used to seeing, and instead I would take up valuable practice time having to explain everything. 
As we all know, starting up a new practice is an expensive endeavor, and the cost to bring a full digital system into my practice just wasn’t realistic because I was new to the area and just getting my practice off the ground. And while costs associated with implementing a new digital x-ray system have dropped considerably, adopting a full digital system is simply beyond the scope of some practices – especially a new one. That, however, didn’t stop me from finding a digital solution for my practice.
I thought that there must be a hybrid-type solution that would allow me to bring the power of digital x-ray technology back to my practice, but without the added expense – and that’s when it hit me: Why not just take digital pictures of my film-based x-rays with my iPhone and import them into a digital x-ray software program? I also realized that once I had digital x-ray software in my practice transitioning to a full system, complete with hardware, would be that much easier.  
After downloading the software (which took all of a few minutes), I was able to work just as I had in my previous practice, annotating the x-rays and using those annotations as a way to communicate with, and educate, my patients. In fact, I started using my iPad and iPhone to share the annotated x-rays with my patients (something I hadn’t even done when I was using a full digital x-ray system) and it made a huge impact on patient perception. 

Why not just take digital pictures of my film-based x-rays with my iPhone and import them into a digital x-ray software program?

While certainly not as convenient as a true, end-to-end digital x-ray system, taking pictures of x-rays with my phone and importing them into my annotation software was a snap (pun intended).  Also, the software I purchased is fully compatible with a complete hardware system, so I knew transitioning to a turnkey digital x-ray system would be much easier when the time came.
The digital x-ray software I use gives me the ability to export images to multiple formats (more on that later), and I often export the image to JPG without the annotations, and then with them – so I can “reveal” them to the patient right on the iPad. This takes literally seconds to accomplish and allows me to tell the patient’s story back to them in a powerful way, revealing the diagnosis first, and then the prognosis.

Armed with my new digital x-ray “system,” I immediately began seeing increased patient visits, and fewer missed appointments as well. The visual impact of what annotations can do for both a chiropractor’s ability to communicate problem areas with a patient, and a patient’s ability to truly “get it,” cannot be overstated. Most individuals respond to visual stimulation, and if they leave with an annotated picture in their head of what’s causing their issues (or better yet – if you give them the actual annotated picture to take home with them), they are most likely to come back for continued treatment. Please allow me to stress this point: This is not conjecture. The difference I saw leaving a chiropractic practice empowered with digital x-ray technology, and starting one without it, was striking. Once I showed a patient an annotated x-ray, I could count on them returning.

In addition to the benefits listed earlier, having the annotated images increased my capabilities as well. I was also able to mark images and save the markings on storage media. I could also store the images or burn them on DVDs or CDs to give to the patient, or send them via email. And the images could be saved in nearly any format, such as JPEG, JPEG2, GIFF, TIFF, BMP and PNG. Digital images are also easy to send over a network, and I can make as many copies as needed with no additional expense.

Patient perception is one of the most important aspects in patient care, and because I am able to communicate with them in a way that earns their trust, I’m able to better help them. It is obvious that my use of annotations, combined with illustrating those annotations on a mobile device, delivers a clear message to my patients: You are in good hands.

Since I’ve been using the iPhone and digital x-ray software in my practice, I’ve realized a significant increase in patient visits, and referrals have increased as well. This has put me in a position to now consider a transition to a full, turnkey digital system complete with x-ray generator and a flat panel. Stay tuned!

Dr. Raphael has an extensive background in science, health and wellness. He has had formal training in nutrition and wellness at the postgraduate level, as well as a deep engagement in study of leading health and wellness research. He uses digital x-ray software from ImaSight ( In addition to his full time Chiropractic Wellness practice out of Port Credit, Ontario, he also maintains his Certified Strength and Conditioning Specialist with the NSCA, and is a CrossFit L1 Trainer. He is one of twenty Paleo Physicians in all of Canada, and one of a small handfull in Ontario who is a member of the Wellness Council with the ICA.
Get With the Times—Get Visual
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Patient Education
Written by D Fernandez   
Friday, 24 September 2010 15:20

Get With the Times—Get Visual

by D. Fernandez


Imagine using X-ray equipment from the 1960’s. Imagine a modern farmer using tractors from the 50’s. Imagine a computer from 1970 handling all the billing and keeping track of your statistics today. Sounds ridiculous, I know. As time marches on, new products are created and invented to make our jobs easier. We can now have digital moving x-rays with incredible quality. Farmers can harvest twice as many fields in the same time as did their 1950’s counterparts. Computers are now lightening-quick, with massive amounts of memory. All these improvements are making jobs so much easier and effective, while yielding better results.

So, why are so many chiropractors using methods from forty years ago to educate patients? As the times have changed, so have your patients’ ways of receiving "education." Have you ever wondered what your patients see when they come to your office? Do you really think that your patients read posters printed back in the 80’s? I’ve seen chiropractic offices hand out literature that has been photocopied so many times, some words are unreadable. Then, with your words, you try to educate your patients about the benefits of chiropractic care; they’ve tuned you out after about nine seconds. Remember, your patients are living in today’s times. This is a time when texting and instant messaging are daily habits, a time when a cell phone doubles as a computer to surf the web. Obviously, we live in 2008—not 1978. My point is this: What current methods are you using to maximize your ability to educate and retain your patients?

In 2002, the British Broadcasting Corporation issued the following statement: "The addictive nature of web browsing can leave you with an attention span of nine seconds—the same as a goldfish." So, as you ramble on about "vertical subluxations" and "dis-ease vs. disease," your patients have already thought about checking their Blackberries, not just once, but two or three times.

In May, web usability consultant Jakob Neilson found that the more words you add to a page, the more people skim it. In other words, our short attention spans cannot handle long articles, and we end up just skipping to the bottom. Keep this in mind as you provide your new patients with brochures about chiropractic care. Are they REALLY going to read it?



So, what can you do? How can we keep patients’ attention on chiropractic? How can you convey the benefits of chiropractic in a few words and in under nine seconds? Be visual! You need to do something different to get different—yet better—results.

Just the other day, I was at the Advanced Spine & Wellness Center in Rockville, Maryland. There, Dr. Brian Paris has implemented a fantastic way to create not only enthusiasm for chiropractic, but better education. His patients eagerly wanted to have their pictures displayed alongside their seven- to twenty-word testimonials, posted on three flat screen plasma and LCD monitors. What I saw was amazing. Patients are not only seeing their pictures, but dozens of other patients’ pictures, both young and old, exclaiming about how Dr. Paris has helped them with their ear infections, headaches, asthma, and a variety of other complaints. Retention will definitely improve, and the infectious nature of enthusiasm will almost certainly bring in new patients.

Doctors of Chiropractic, as you prepare for a busy morning, remember who you are talking to: a patient who respects you, admires you, and appreciates what you do for them. Also, remember that these same patients think they know what you do—but they don’t. In order for them to improve their understanding, something must change. I suggest you get with the times and discover ways to inspire your patients—visually.


D Fernandez has extensive experience working with chiropractors throughout North America, specializing in bringing in new patients, as well as increasing patient visit averages. Today, people are growing more accustomed to being educated through technology. D gives you a wake-up call on how people perceive chiropractic care and illustrates the importance of not simply educating patients, but transforming their thinking. To learn more about D or to inquire about him speaking to your group, call 1-860-514-8668 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Communication Leads to Better Results for Practice Growth
Patient Education
Written by Dr. Steven J. Kraus, D.C.   
Friday, 24 September 2010 09:02

Communication Leads to Better Results for Practice Growth

by Dr. Steven J. Kraus, D.C.


In today’s economy, doctors are constantly seeking low-cost methods to market their practices, retain patients and promote referral activity. Many look for traditional options, like advertising and networking activities, which can be effective but tough on the balance sheet.

However, doctors can begin to immediately implement one very effective and cost-conscious marketing approach which, when used correctly, will improve patient compliance and increase referrals. The method involves a very basic activity in which humans engage daily. So basic, in fact, that we often overlook it. The activity: Communication. Communication through strategic dialogue, an extremely productive marketing an today’s economy, doctors are constantly seeking low-cost methods to market their practices, retain patients and promote referral activity. Many look for traditional options, like advertising and networking activities, which can be effective but tough on the balance sheet. However, doctors can begin to immediately implement one very effective and cost-conscious marketing approach which, when used correctly, will improve patient compliance and increase referrals. The method involves a very basic activity in which humans engage daily. So basic, in fact, that we often overlook it. The activity: Communication. Communication through strategic dialogue, an extremely productive marketing in today’s economy, doctors are constantly seeking low-cost methods to market their practices, retain patients and promote referral activity. Many look for traditional options, like advertising and networking activities, which can be effective but tough on the balance sheet. However, doctors can begin to immediately implement one very effective and cost-conscious marketing approach which, when used correctly, will improve patient compliance and increase referrals. The method involves a very basic activity in which humans engage daily. So basic, in fact, that we often overlook it. The activity: Communication. Communication through strategic dialogue, an extremely productive marketing technique, is predicated on listening.




By listening to your patients, you can begin to ask questions based on the information provided. Through these questions, you can lead patients on a path to accepting your care by addressing their concerns more directly and helping them understand the overall treatment goals. Think about this example: Upon being presented with your treatment plan, the patient says, “I don’t think I want to have so many required visits to your clinic.” You may feel compelled to further justify your treatment plan by saying these repeat visits are necessary for the patient to see improvement. This is a one-way communication approach and leaves the patient out of the dialogue equation. And, by not asking why the patient feels this way, you are also jumping to conclusions. Perhaps the patient agrees with the treatment itself, but has scheduling issues that would make it difficult to attend so many appointments, or has concerns over the costs associated with the treatment. Instead of trying to convince the patient to accept the treatment plan as recommended, you can ask the patient, “What concerns you about the number of visits in your recovery plan?” By engaging the patient in this dialogue, you are better able to understand the underlying issue for the objection, and then work with the patient to identify a solution that is amenable to everyone. Ideally, you will continue asking carefully-crafted questions that ultimately lead the patient to suggest an appropriate solution on his or her own. How a product, service or treatment plan is presented is critical. If the topic feels forced or confuses the patient, he or she will likely reject it. But if the patient has the opportunity to express concern and then begins to understand the reasoning behind a recommendation, compliance increases. Consider if your patient actually suggested that he or she would like to engage in a course of care over the next month with a dozen treatments, and then follow up with a progress examination to see what further care might be needed; wouldn’t that send the message that the patient understood your report of findings? Yes, because the patient was empowered through your ialogue to accept the treatment plan on his or her own terms. The best marketing comes from listening more and talking less. Doctors tend to over-sell because they over-speak. They keep talking and talking, long after the patient either has understood the issue or tuned out. And what happens with overspeaking is that, often, issues are brought to the forefront that the patient hadn’t considered. This creates more questions, more confusion and less engagement from the patient. When a doctor listens to the patient first, focusing on carefully constructed questions to elicit a solution suggested by and acceptable to the patient, the relationship is tronger and more productive. Now, I am not suggesting that doctors allow patients to create their own treatment plans or determine what services they need but, rather, open up a dialogue that can lead patients to adoption of a recommended plan and better compliance. In summary, by asking follow-up questions to a given objection, the doctor can identify the true issue, and then begin to guide, not direct, the patient to resolution. Let the patient talk. By listening, the patient’s real concerns are revealed, and you and the patient can work collaboratively to reach a resolution. When patients feel they are part of the solution and are allowed to arrive at their own conclusions, a sense of control and satisfaction results. And a satisfied patient pays, stays, and refers.


Dr.Steven J. KrausDr. Steven J. Kraus is CEO of Future Health, Inc., a company that partners with chiropractors to deliver a comprehensive clinic management solution, including fullyintegrated EHR. Dr. Kraus is a recognized expert in building successful clinics, having developed and sold 18 practices of his own and provided strategic consulting services to more than 400 healthcare businesses. He offers leadership to numerous industry associations and currently serves as the Chairman of the Iowa Board of Chiropractic. Contact Dr. Kraus at skraus@Future- for more information.

Word Power! Newsletters Keep You Connected With Your Patients
Patient Education
Written by Dr. Len Schwartz, D.C.   
Friday, 24 September 2010 08:52

Word Power! Newsletters Keep You Connected With Your Patients

by Dr. Len Schwartz, D.C.


Patients who love you and understand what you do and why you do it will refer like crazy to you. And referrals, as youiStock know, make the best new patients.

One of the best ways to nurture a close relationship with your patients is through a monthly newsletter. Your newsletter earns you instant credibility, keeps your name (and face) in front of your patients, and provides the readers with life-improving information on a regular basis. The newsletter can be fancy, but I recommend a simpler approach. Just make sure it is laid out in a way that is easy to read.

Here are some things to consider if you decide to publish a monthly newsletter:

1. Content

What will you say in your newsletter? I recommend you always include information on three different topics: news, information and updates about your practice; chiropractic health and wellness news; and marketing information.

• News and information about your practice. Share news about taking a seminar, new things happening with you or your family, hiring a new staff member, adding a new piece of equipment, new services, etc. Let your patients know about your continuing education efforts as well.

• Chiropractic health and wellness news. Always provide your patients with information they can use to get and stay healthy. Include chiropractic research that supports information about health and function, a particular exercise, vitamin or supplement or another aspect of their wellness.

Americans are hungry for information on how to live healthy, drug-free lives, without depending on medical intervention. We are the leaders of the wellness and holistic movement and you are in a perfect position to be the provider of this information.

• Marketing information. Announce your marketing events for the month. If you host a special health talk or a special event at your office, use your newsletter to let your patients know about it and invite them to bring a friend.

2. Format

A. Print: Slick, four-color newsletters with pictures look good. But color and a sophisticated layout is no guarantee that your newsletter will enjoy a greater readership than one that is done simply.

The most popular word-processing programs (such as Microsoft Word) come with a variety of templates, including a template for a newsletter. If you don’t want to invest in additional software or newsletter services, use your word-processing program to get you started in the "newsletter" business.

Word-processing programs have their limits, however. You may want to consider purchasing a desktop publishing program, such as Microsoft Publisher or PrintShop. These are relatively simple to use, not expensive and offer more creative options. (You can use them to design cards, business cards, banners and flyers, too!) B. E-mail: If you are going to deliver your newsletter via e-mail, consider HTML format. This allows you to use graphics, pictures and color, and you are able to create a much more inviting publication. (Although, I admit, I receive some "plain vanilla" e-mail newsletters and I read them from start to finish! What matters most is content!)

Many of the desktop publishing programs allow you to create HTML e-mail without having to master HTML code.

Don’t want to go to that bother? You can always contract the project, or, use an online e-mail service, such as Microsoft’s These services provide easy-to-use HTML templates and send out your e-mails for a monthly fee.

3. Distribution.

You can send your newsletter by mail and/or by e-mail…but I definitely recommend e-mail. It’s very inexpensive, instant, track-able, and you save some trees. And, you should always have them available in your reception and adjusting rooms.

Who should get it? Current, inactive and prospective patients. Also, when you give health presentations, collect mail and e-mail addresses. (Make sure you include a question: "Would you like to receive our newsletter and other periodic mailings?" in order to obtain opt-in permission to e-mail. This is important, for HIPAA compliancy, as well as to avoid being accused of sending out SPAM.)

You may also want to consider sending your newsletter to the local media, especially if you are in a smaller community.

Build up a database full of active, inactive and prospective patients. Send out your newsletter and "breaking news" and you will become known as your community’s wellness expert. You will find that newsletters stimulate referrals, reactivate inactive patients, and keep you connected with your patients.

Len Schwartz, D.C.Dr. Len Schwartz is a Fortune 500 trained marketer as well as the President and CEO of ChiroPractice Marketing Solutions,LLC, a marketing company that has been helping chiropractors build their practices since 1999. CPMS offers chiropractors over 65 turn-key, practicebuilding products and services, which nclude a fully research-based monthly patient newsletter. For more information, go to or call 1-866-655-8502


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