Practice Protocols Navigating the Challenging Economy

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Hey, greetings friends and colleagues, my chiropractic buddies, network members, all of you. I’m here with ChiroSecure, H.J. Ross, with our monthly update with some things I hope that’s gonna give you some incentives and maybe some tools to kinda continue to grow your practice. Let’s go to the slides. Let’s talk about practice protocols and navigating the challenging economy.

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No matter what that you are going through right now, you certainly are hearing the news and what things that are going on with the economy. So how does that really challenge- Our services, particularly if you’re a cash practice, even if you’re doing insurance, there’s always some cash. So there’s gotta be some way of navigating that in best ways to avoid the downturn, because certainly people are gonna hold a little bit tighter to the money, of course.

So when the economy tightens a chiropractic practice that depends on a cash pay patient, we need to pivot. You’ve gotta be able to pivot and make changes. Realize you’re not treading water here. We gotta stay above water. So we need to shift from a visit-based revenue model to a value-based relationship.

I think often sometimes we think of, just visits. I want the patient to think of, about the value, and this is something that I will say is what I call the need versus want. I’m saying I’m doing this. This is something I learned from my mom. She always noted that people buy what they wanted and beg for what they needed, and I found that to be true ’cause I can see people who will ask you to borrow money to pay a bill, and even though they owe you some money, later you find they have some new shoes.

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So we need patients to understand while we know they need this care, we have to make sure that there’s a want for it. So we’ve gotta create that value. Discounting alone is a weak lever. It compresses margins, can reposition your services as commoditized. In other words, just, “Oh, that’s just a cost. I don’t really need that.

It’s something I’m gonna eliminate.” Realize that when economy is tight and you go to the grocery store and you’re paying that much money, as a person, you’re thinking, “Hey, what else could I cut back on?” And so practices that hold well to this are gonna do things where they can retain, repackage, or differentiate what they do, in a sense creating that want.

I do think that’s what we always do, but it’s a greater need to do it now. The place to go, where are you gonna get the highest return on investment though, is not acquiring new patients. Acquiring new patients gets harder and more expensive with each downturn. Your existing patient base is your most reliable revenue stream.

They know you. They understand. Have you done anything to reactivate? Do you have an email system, a text system, anything like that might reengage them? I would suggest with starting with some type of reactivation. Identify patients who have been active for 60 to 180 days approximately. You can certainly go back further, but I would start there because those are the ones that have the most recent experience.

Use condition-specific outreach. Don’t just say, “Hey, come back in,” but things about, “How is your back holding up with more time at home or off wor- at work?” Maybe with athletics. Try to get them something specific, which means you’re gonna target your patients a little bit, not just targeting a group, but s- specificity.

What about patients that are athletes, high school athletes, club athletes? You can think of how many parents have their kids in club sports that p- spend a lot of money. They wanna keep them active, recovery, injuries. But what about CrossFitters, gym rats? Those are people that are looking for this type of care as well.

So use outcome tools, though. We’ve got a outcome. When they come in, you gotta have ways for them to see the value. So make sure you’re using some type of outcome tools that they are part of. Show them the scoring, whether you’re using the Oswestry, the neck disability, or the PROMER scale, general pain index.

I really don’t care which one you use, but show them the scoring, show them the change. It’s like putting a person on a diet, but never letting them see the scale or never letting them see something that they measure. The good news of what you do as a chiropractor is very outcome-based. Make sure there’s a way to see it beyond “Oh, I just feel better.”

Patients who see progress are less price-sensitive because they see the value. Define your care. Show the results. The phase of care. I’m going from acute corrective to functional. Notice it doesn’t say maintenance. It’s not maintenance, it’s functional. And avoid using those terms, which those feel discretionary.

“Oh I really don’t need it. I feel good anyway.” We want them seeing that there’s a benefit to maintaining that function. And remember, pricing for cash, pricing for a down economy is not a race to the bottom, okay? Understand that if it’s overly cheap, we don’t expect it to be of high value. Now, think of it this way.

You’re not the 99 Cent Store. Now, the 99 Cent Store, a cool place. You go in and buy things for 99 cents, but do you ever get anything of value? Not really. And I’m not saying this to be overly negative. I want it to be something of value. Your care has a value. The 99 Cent Store is one thing, but is that the place you would look for a doctor?

Probably not. So think of the same way. Being cheap is not the way. Creating value and creating it in a way that allows the patient to afford it, if you will. What about making a monthly auto-debit maybe for two to four visits, maybe at some preferred rate? Maybe there’s some other perks. By getting in this program, you get priority scheduling.

Maybe they get access to same-day visits or drop-ins, or they can get discounts on other things, if you do supplements or anything of that nature. Focus on the access and continuity, not necessarily cheap. Think of it, when you’re getting something for your guest, do you get them the cheapest things or get the best things?

Now, that doesn’t mean you don’t necessarily want things that have good value, but not necessarily cheap. Tie this pricing into a package that’s more specific with goals to a diagnosis, not just simply “Hey, we’re just gonna treat.” What about a lumbar stabilization program? Maybe eight visits over four weeks or a headache program, whatever you might come up with.

But anchor value to outcomes, not the per cost. Not the per visit cost, but to the value of what they’re gonna receive. I think this is where prepay packages can be really used well. Realize in every state you can do these. Some states like Florida and others, you have to put money into a trust account or you’re limited to the amount.

But bottom line is, it can be done. Just keep it compliant Make sure the patients understand what they’re purchasing if they’re doing a prepay. There’s a financial understanding. What are the expectations to both sides? What about if you miss visits? What about refunds and so forth? We’ve really gotta make sure that the patients understand what’s going on and create that value.

By doing a clinical differentiation, don’t make a condition and purpose, make that… That’s why the price matters. It’s your condition. It’s the purpose. Maybe you’ve got a desk worker program, a back program, maybe a runner’s hip program, or how about athlete biomechanical optimization? Things you can do to make them function better.

And again, when you think of it from a athletic standpoint, particularly for high school and younger athletes that parents are really putting through a lot of programs, think of how many friends you have, their kids play four soccer games a week. They’re playing seven-on-seven football and so on. They’re putting their body under a lot of stress.

This program here is one patients will pay for. If they’re paying that much money for that club sport, what about keeping the kid functional? And integrate it. Pair the services with other things in the office. Maybe there’s an exercise protocol you help put them through. Maybe there’s massage or manual therapy.

Maybe there’s a stretch protocol, or how about sometimes just putting them on some passive s- services? What about some heat services or just passive intersegmental traction, the roller table? Patients love those things. They can feel good. Maybe you throw in a laser. But anything that can be there that they can see the value add to it.

Realize at the end of the day, though, it’s outcomes and objective measures that patients look for. Give them measurable gains, things they can really see. Obviously, adjustment makes people feel better, but I want them to see beyond “Oh, I feel better,” but achieving certain things. I can feel pretty good if I’m not doing anything, but what if I bend and touch my toes?

So what we wanna do is make that objective that they have a better outcome. What about making sure there’s just other cash-friendly services? Soft tissue programs. Maybe you’re doing instrument-assisted. Maybe you’re doing the Vibracussor or that style. Maybe guided exercise in a small group or sessions, or how about just short tune-up care plans?

Maybe a three-visit, four-visit, or five-visit. What you wanna start to think of is, “How do I make sure to attract these patients back? They understand the services.” And it doesn’t mean you’re not marketing for new ones, but I wanna make sure we understand where is the value. You want to avoid across-the-board discounts.

When you just th- make things cheap, you’re gonna attract price shoppers, low retention. “Come in. Let me see what the visit’s gonna do.” That’s not the patient that I necessarily want. I want someone that’s more committed to care. Think of function and necessity, not wellness. I’m gonna suggest avoid the term wellness.

Look more about what they can do as a result, maybe their ability to work. How about sleep? Their just daily function. And again, I’m gonna emphasize athletic function and recovery with the emphasis again on club sports. I think there’s a place there because let’s face it, parents are willing to pay whatever they need for their kids.

That’s gonna be a good revenue source. Bottom line is your proof. Measure your outcomes Okay? Now, what I mean by this, proof is our proof, not proof to the patient. Measure your outcomes. Start tracking visits. Start to see, “If I market or do these things, does it work out? What is my visit average? How many visits are they coming?

What is my revenue per visit? What is my retention?” Like any business, think of it, this is like taking it on Shark Tank and seeing, does this work? Realize you’ve gotta do things to control supply and costs, and underperforming services should be eliminated. So if you find, hey, the packages didn’t work, maybe something else might, you’ve gotta be able to pivot and adapt.

Your goal is to keep your practice growing and expanding. Even in a down economy, it can. With H.J. Ross, we’re always here to help. ChiroSecure as well. If you’re a network member, reach out to me. Network members, let’s get into some details of what you can do. If you’re not a network member, figure out how that can happen, because we can work one-on-one together.

Until next time, my friends, I wish you well.