Cheeseburger, Cheeseburger, Cheeseburger
Practice Management
Written by Chris Peetros   
Sunday, 30 November 2003 00:00 Read : 1325 times

A friend of mine, a chiropractor, was listening to the tail end of a talk I was giving in Florida, and after the talk, asked me to explain this cheeseburger thing to him.  I told Mike, (that’s his name) that the cheeseburger phenomenon is something we coined to explain the product problems that we encounter which causes us to redesign our existing product line.  “Explain,” he said. 

Well it’s like this:  You have fifteen chiropractors on the same block and all of them do basically the same thing.  How most of them try to differentiate themselves is by word speak, technique, marketing, hurt and rescue, and other various strategies.  It’s like when you go in the bathroom and see the poster, “As the twig is bent so grows the tree.”  We call that a symptom of product problems. 

“Product problems?” Mike replied. 

“Yep, product problems,” I said.  “Take that cheeseburger analogy thing, replace the fifteen chiropractic offices with cheeseburger stands.  The owners of the cheeseburger stands try to differentiate themselves by rearranging the items between the buns.  The first guy sticks the meat on the bun first, then the cheese, then the tomato, lettuce, onion and ketchup.  The second guy has a better idea.  He puts the cheese on the bun first, then the meat, next the lettuce, ketchup then onion.  Of course, the third fourth and fifth guys do their own arrangement and all feel like they are unique compared to the other fourteen cheeseburger stands. 

“You know, just rearranging the items on a display doesn’t make a new product.  If it was a new product, the cheeseburger stands would be able to charge much different prices and, like the chiropractic office, it seems to me the prices all are about equal.  Equal price, equal value.  Imagine that.  No real way of differentiation.  In our business, we call this a product problem, and, when it emulates the cheeseburger example, it’s time to look at our product and figure out how to really differentiate from the competition and re-engineer what we offer the customer.

“You call them  patients; we call them customers,” I said to Mike. 

Here’s another analogy.  The patient or customer who walks down the street has a wallet with two twenty-dollar bills in his or her pocket.  The money doesn’t care where it gets spent, but the owner of the money evaluates all their spending options.  Pizza Hut, the department store, overdue bills, a gift for someone special, or the chiropractor, and so on—all are options available to spend the money on.  How all of those products stack up is what we call purchase hierarchy.  Which one of those items or combination of them wins out is based on the value the customer places on them.  This is where the tricky part comes in.  How much value the customer places on it is based on their satisfaction index.  We gauge the satisfaction index by the response the customer has to our product without a “sales pitch”.  The duct tape test.

“The duct tape test?” Mike asked.

“Look at it like we do, Mike,” I said.  “If you place a piece of duct tape across the salesperson’s mouth, (this can be a doctor, CA, etc.) and if the product is not accepted by the customer without the pitch, or the customer cannot be convinced to come back and purchase more product without a pitch, you have to start looking at your product and asking why the customer doesn’t perceive value.”

Now I had Mike right where I wanted him.  “Do you have one of those As-the-Twig-Is-Bent-So-Grows-the-Tree posters?” I asked. 

“Yeah,” he said. 
(Don’t tell me, it’s in the bathroom!)

Dr. Mike was pretty quiet by this time, but I asked if he did things like nutrition, electrotherapy, ultrasound, traction and other treatments in addition to his adjustments. 

He said, “Yes.”

Now for the real tough questions.  I asked, “How many minutes do you apply electrotherapy on the patient during a session. 

He replied, “About 12 minutes.” 

I replied, “Oh the electric aspirin.”  I explained to him that there are dozens of treatment options other than the “electric aspirin” that will really send the customer—I mean, patient—home really feeling great.  How about traction? 

Do you do real traction or just rollers. 
“Just rollers” he replied. 

“Just  babysitting the patient,” said I.

“When you do ultrasound, do you treat only three times the ERA of the crystal or do you paint the wall?” I asked.
This is when Dr. Mike stopped answering my questions. 

“Well, Mike,” I said,  “the good news is you’re a perfect candidate for product repair.  Just imagine, if we fix your product offering in all aspects, the patient satisfaction index will go up and your practice will truly be different than the others in the neighborhood.  In fact, the better your product gets, the more of those tacky posters you’ll be able to remove.” 

“Great,” he said.   “They really make the place look pretty unprofessional.”

My advice to Dr. Mike was the same advice I give to all of the chiropractors I meet in my travels worldwide through my work.  It hasn’t changed for twenty years.  When you fix the product, the sales come.  When you do the same thing over and over and expect different results, you have a problem. 

Think about this example.  If we sent twelve employees from the local McDonald’s to an Anthony Robbins seminar for a weekend, do the cheeseburgers taste different on Monday morning?  Are the Happy Meals any better than they were on Friday?  The fact is enthusiasm is a wonderful catalyst, but you need a new product together with the catalyst to really get all the benefits.  Imagine, if we took those same twelve employees and, in addition to the “head repair” they get with Tony Robbins, we gave them an entirely new improved product.  Instead of just “supersizing” every order, they were turning on all the customers to the “new product line”.

So here was my prescription to Dr. Mike:
When you offer adjunctive therapies in your office, they are only as good as the research behind them.  After that, you need to purchase all of your “non chiropractic” additions from reputable companies and knowledgeable distributors.  The lack of training you get from the salesperson hurts your practice and product more than you will ever know.  Only buy from a company that supports the product with in-office training for you and your staff, and backs it up with clinical data from accepted publications, not anecdotal information.  Remember, the only one that loses is you, because the product you offer the public is not as great as it could be.  Demanding excellence from the people you buy your therapies from will help improve the product you deliver to the patient.  Most importantly, if the claims sound too good to be true, they are.

Second was the most important advice to Dr. Mike.  It was the advice about the risk to his license.  I explained to Dr. Mike that taking the information the salesperson gives them on billing codes was like lending his license out for someone else to use.  It is crazy to take the billing advice the salesperson or manufacturer gives you at face value. 
Improper billing of CPT codes is insurance fraud.  Billing codes for therapies that do not have the effect the codes imply is also fraud.  When a salesperson gives you billing advice, remember to always call your billing consultant to make certain you aren’t creating a situation in which, under an audit, you will have to pay back thousands of dollars you probably spent a long time ago.  Let’s face it, “Whose license is it anyway?”  Do you think that salesperson has as much at risk as you do?

Well, Dr. Mike was mumbling something about, “I don’t even eat cheeseburgers, I’m a vegetarian,” while he walked away. 

But I think he learned a valuable lesson about product and the value the customer places on it. 
As he walked further down the hall, I said, “You know, Doc, your patients will appreciate all the changes you make because, when you fix the cause, the symptoms go away.”

Chris Peetros has spent the past 20 years developing products for the chiropractic profession. Currently, he is the National Sales Manager/Specialty Products Division and Chiropractic Products Division Manager for the Chattanooga Group in Hixson, Tennessee. Chris has spent the past 10 years developing the Ergostyle Adjusting Table product line and his most recent project, the Triton DTS Spinal Decompression System. Chris can be contacted through the Chattanooga Group, Inc. He can be reached at 800-592-7329.


 
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