If you have heard, “I can't afford it,” more than a few times from a patient, you may have, as a knee-jerk reaction, actually believed what you heard and begun to adopt financial policies in your practice to meet everybody’s limited financial status—like let’s make a deal, or unlimited care for a fixed fee, you pay and all your family is free, kids are free! I don’t remember the time I agreed to operate a charity or applied for non-profit status! Do you?

The cash-like practice is a practice that emphasizes the benefit of care first, and how your patients are going to pay only as a way to receive the care they have decide they need.

It is never the money, or lack thereof; this is the richest country on the planet and people do have money, they just don’t have a priority for spending it on health care. Because of the lack of understanding regarding chiropractic, and not knowing how it will ultimately benefit the person, it is my opinion that people don’t want to pay for care because they don’t believe they will get well anyway. After all, if you review the statistics for medical care, the chances are slim they will get better. So why would someone want to part with their hard earned cash and still not get better? It seems the financial risk is less if a third party springs for it.

I want you to adopt a new policy right now! If someone ever tells you, “I can’t afford it,” rather than believing this excuse, interpret their saying, “I don’t see the value in what you are offering, and how will I benefit from spending my hard earned money for that service”. Then adopt procedures which clearly outline the benefits and value from your service.

Insurance is a crutch and will cause you to practice in ways you may not want to. While chiropractic boasts that we look for the cause not the symptom, insurance is a total symptomatic pain relief model—the exact model we campaign as a profession against. But, in times of our own financial need, it is easy to succumb to the thought that, if the patient had insurance, then they could afford the care and we wouldn’t have to take the time to “sell” the care to them. So we change our model to an insurance-based practice and advise the patient not to worry about anything financial.

You now have a patient that is coming to you with no worry of money, so the visits you recommend are of no other consequence than time. It all seems very good! Two months into care, the first EOB’s return paying ten cents on the dollar, and the next day you receive a request for reports and chart notes stating you will not receive any more of the drastically reduced reimbursements if you don’t comply! (This is not fun!) Additionally, if a patient’s insurance quits or changes, so does the patient. Need and desire for care is based on a third party’s willingness to pay. The patient sees no value and you are now practicing at the whims of someone else’s willingness to pay.

YUCK!

So, you scream, “I hate insurance!!!!!! I am just going to go cash.” This, again, is knee-jerk reaction, and an adoption of yet another emotionally made decision.

There is no place for Emotion in your business decisions.

Emotions are for your personal life and are appropriate in a loving relationship. In business, decisions made from emotion are not appropriate and will almost always end up poorly.

Decisions are made from facts and analysis!

Analyzing facts may take the zest out of your love life, yet it’s critical in your business life. If you are a chiropractor operating a practice, you are in business. Run your business from emotions and you will suffer every up and down associated with the ebb and flow of life. You will become almost manic, as you judge how you feel each day by how many new patients you received, who accepted care, and how many checks arrived in the mail! This is the fast lane to burn out!

The solution is to focus on the “Benefit” you provide your patients, and the consequence to your patients of NOT receiving your service! Financial arrangements are NOT the secret to your success!

A cash practice is a metaphor for the state of mind one must have as a doctor in not only recommending care to a patient, but for the entire package. It's about how you present yourself, how you educate and motivate a patient, how you demonstrate “Why Chiropractic,” as separate from any other health care discipline, and non-duplicate-able by any other health discipline (i.e., physical therapy is not the same!). These are all small factors which build up to an overall I’m-in-the-right-place or Get-me-out-of-here perspective for those you potentially serve.

With the above well in order, your recommendations must be focused specifi cally on how your service will ultimately benefit the prospective patient. With zero attention on fees, and all attention to benefits of service and consequences of NOT having the service, your personal certainty of your recommendations will be what dictate your case acceptance…not the “deal” you offer.

My favorite phrase is, “Change your thinking; change your life.” So you may find it very helpful to think of all new patients in these terms. A prospective patient enters your office with a real complaint that has been affecting their ability to have a normal life. They had consulted others or even tried other procedures which failed, and now they arrive in your offi ce. What they are looking for is a solution to get their life back…not a deal! I recommend you adopt this mindset; you will then understand how benefit trumps deal every time!

The cash-like practice is a practice that emphasizes the benefit of care first, and how your patients are going to pay only as a way to receive the care they have decided they need. If they have insurance, we will help them and bill the portion that an insurance company will pay. The important thing is that this reimbursement is not payment in full; it is payment toward the recommendation, and the patient will pay the difference. Our fees are our fees, and we will assist them in receiving money from any source to do their part, but we do not change the recommendation by judging their financial means. If they truly need charity, we do a few charity cases a month by case importance, as long as they attest to their total lack of funds.

Now, ask yourself, if a person really had a life altering problem and totally believed you were the solution, do you think—in a society where people rely on labels for status, set goals for more and more adult toys, take lavish vacations, and spend $260 a pair for blue jeans—a little money would actually stop them from doing whatever they believed would get their life back, and increase their health and vitality?

Not on their life!

Dr. Bruce Parker was a pioneer in practice, establishing five offices in his first six years of practice. He has now personally owned thirteen clinics. Through this experience, he developed what he now calls “The Practice Freedom System.” He feels his strongest attribute is communicating the need for lifetime care; his history of patient retention would validate that fact. Dr Parker, president of Bruce Parker Consulting, teaches his “Practice Freedom System.” For more information, visit www.BruceParkerConsulting.com.

How important a role does credibility play in the marketing of your chiropractic clinic? Surprisingly, answers will vary depending on whom you talk to in our profession. A doctor who uses gimmicks, freebies, and deeply discounted fees to lure patients to his or her practice may have one perspective, while another doctor who utilizes a marketing strategy that charges reasonable/respectable fees, and reinforces the value of his or her care, may have an entirely different perspective.

In general, the chiropractic profession is continually striving to enhance its credibility and, thus, boost acceptance to achieve greater numbers of new patients. While research, more exposure (experiences with chiropractic), and more education are often thrown out as the solutions to building chiropractic’s numbers, a few points of interest stand out that are worth your consideration.

As has been reported many times over, the percentage of the population that has experienced chiropractic care is far less than is acceptable. Yes, there may be some external factors at play (bad press, less than enthusiastic recommendations from other healthcare professionals, pharmaceutical marketing, etc.), but for the sake of this discussion, let’s just focus on our own backyard and any potential credibility issues in the eyes of the public at large.

Credibility is a byproduct of repetitive action. To suggest that you can make yourself credible (like flipping on a light switch) is amusing, at best. How you position yourself in your community is a starting point, but the real fuel for building your credibility is the community’s perception of you, your staff, and your clinic. Without question, passion is important. But passion dressed up in a cheap suit will only take you so far. Understand that how you present your practice to your community is the tipping point that can translate into expanded credibility. This is crucial for building a practice that doesn’t have to rely on gimmicks and games.

On a larger scale, how you market your practice (and, thus, affect your credibility) is dependent on your choice of marketing and practice management direction. An important factor in basic marketing strategy that is commonly dismissed in chiropractic practice management is assumption. In most areas of life, assumption has a negative connotation; but in marketing, it’s a MUST! You must assume all positive, as well as all potential negative outcomes for every action you take in building your practice.

There’s no question that a new patient chiropractic examination of the human nervous system that is valued at $350.00, but on sale for $17.50 (a 95% discount) "for this week only," will probably attract more than a few takers. What must be assumed (even if it’s hard to go there mentally) is the potential negative perception associated with deep discounting of such an important service. To put it another way, you may want to consider how your fire sale on examinations could hurt your credibility and the value of the care associated with your practice by those who did not take you up on your most generous offer.

Albert Einstein kept a sign in his office that read: Not everything that counts can be counted, and not everything that can be counted counts. Looking at the first part of that saying, one should consider factors that may not be measurable, but are still significant. And, when considering the second part of that saying, remember that twenty new respondents to your deep-discount promotion might seem like a big win until you consider the potential harm to your credibility.

Unfortunately, the common response to using these kinds of tactics is one of defensiveness. Instead of considering the negative side to using these kinds of gimmicks, the angry reaction typically involves (a) a slap to the hand of the person who dared to even mention the fact that there could be a downside to something like a 95% discount on a new patient chiropractic examination, (b) a round of applause for those respondents who did become patients, and (c) the all-too-familiar, "You’re just a negative person, and what we need now is positive affirmations and positive thoughts."

What’s so funny is that, if you were to sit through a discussion in the conference room of a large marketing/advertising firm (as I have done many hundreds of times since the early 1980’s), one immediate consideration that is brought to the table is, "How can this marketing strategy come back at us?"

There’s no doubt that discounted exams and gimmicks have made many chiropractors very wealthy but, with an average annual salary below $90,000, those strategies haven’t made everyone wealthy. There have always been and will always be takers, regardless of what you do and how you do it. The two questions that should be considered are: (1) Could you have hurt your credibility to the point that it outweighed any short-term gains, and (2) If gimmicks and deep discounts are the key to chiropractic’s proliferation in the marketplace, then why, after all these years, are we still seeing such low numbers?

Finally, I do realize that other healthcare professionals (like some dentists) also use introductory gimmicks to get new patients through the door. The difference is that, right now, today, dental care is not considered an IF by most—but a MUST. Perhaps a different overall approach that boosts our credibility is what’s needed so that chiropractic becomes an automatic MUST, and not an IF.

Dr. Marc Swerdlick is a 1998 graduate of Palmer College of Chiropractic and is the president of S Group Inc. and PracticeCentral.com—Chicago-based companies that offer marketing strategies and systems to health and wellness professionals, as well as to businesses outside the health and wellness arena. Dr. Swerdlick presents his Pre-Sale Strategy, New Patient Acquisition, and Patient Reinforcement Seminars in conjunction with Integrity Strategies LLC. For more information, go to www.integritystrategies.com or call 1-608- 865-0466.