How To Scale A Chiropractic Clinic

A lot of chiropractors aren't taking the time to really orchestrate that whole experience. From the moment that you walk in the door all the way through to the consultation. We get too clinically focused if I, you know, here's what I could do with the exam and the history, but I forget the human experience. And so that's the next part that really needs to be worked on after the attraction phase.

Are you a chiropractor or do you know one? You are going to love this episode. We're going to continue our deep dive into various different industries and niches, connecting with industry experts to identify the most critical systems that really make those industries tick. So today we're going to be focusing in on the chiropractic space. I'm joined by Dr. Angus pike from Angus pike dot com. He's been in the industry for over 25 years. He's run his own practice for many years before getting burnt out and then really doubled down on the processes and turned things around. And now he helps other chiropractors fill their calendars with clients and he helps them with their marketing conversion systems. So he's going to be the perfect person to chat with. He runs a podcast. He's a longtime lover, supporter of systemology, so I couldn't be more pleased to have him. Welcome, Angus.

David, thanks for having me. I've been very much excited to be chatting with you over this last week.

Yeah, awesome. Well, maybe just to start, if we can just outline who we're talking to here. The chiropractor that hears this, I want them to go, oh, yeah, that's me. How would you describe the person, this chiropractor, and a little bit maybe about their practice.

Yeah. So the chiropractor we're talking to is somebody that owns their own practice and have been in practice a little while. By that, I mean probably at least 10 years. They have one other chiropractor and associate that's working with them and usually have anywhere between kind of two and four admin staff. We call them chiropractic assistants, reception staff with a bunch of different roles from there. Do you want to talk a little bit about the frustrations they have?

Yeah, let's do it.

Yeah. So this person often feels really tied to the practice. So they have a job rather than a business there as well. So the practice is really dependent on them. And when they're not there overseeing everything, then it tends to dip down. It's hard for them to go on a holiday. There's not a Lot of predictability in their practice in terms of anything retention, conversion and new patient attraction. So there's a real frustration overwhelm. So bills are often being paid week to week, but the predictability is not there in their practice.

Yeah, perfect. I think a lot of chiropractors can definitely relate to that. Almost like they probably grow and get to a certain ceiling as well, where this whole business is heavily dependent on them.

Yeah, Yep. So they bought themselves a job, that classic thing, if we kind of think of it from an E myth point of view.

Yeah, perfect. Well, with that person in mind, I'd love to. And like, normally when I do the critical client flow and I'm working with clients, I always say to them, well, let's capture what you're currently doing, because sometimes you can get some tremendous wins just by making what you're doing repeatable and delegating some of those tasks down. But when we've got an industry expert such as yourself, and I'm going to go ahead and share my screen just here, I love to really dive into what is industry best practice and what have you seen really works. So I'm going to just walk through this with you.

But perhaps we identified that chiropractor, if we think about who their ideal client is, you know, the dream client who pays advertised prices, refers friends and family, is a pleasure to deal with. If you were to pick that dream client with maybe some of the different chiropractors you're working with, what's one that stands out for you?

Yeah, so let's pick lots of the practices I work with. Again, a little left of centre here are family practices. And this is something that maybe some of our listeners, I mean, if they're chiropractors, they will associate that chiropractors see people of all ages there too. But we tend to think of chiropractic a little bit like kind of back care for people. But chiropractic can be wonderful for kids and so many of the chiropractors that I help are family practices and so often the first patient to enter in is a child and. Or a baby. And so they're a tricky target market. So we don't actually want to be talking to them, we need to be talking to their parents and very often it's the mother who's the decision maker. So we're really talking to mums in this situation.

Yeah. So it's mums with young families?

Yeah, Yep. Typically, yes.

And then, I mean, to go a step beyond that, not that I'll Capture it on the critical client flow. But are there any other characteristics that would help identify this? Like I'm assuming, I don't know, affluent or.

You know, I'm assuming chiropractors also are very geographically bound so it has to also be in the area where they are 100%.

You know, perhaps the most common thing in, you know, in line with most chiropractors practice members is geography. And so we tend to be depending on where you are. If we're in an inner city area there too, as a general rule it's somewhere between 5 and 10 kilometers. Yeah, we have a practice, my wife over in Lara and so it's a little bit more rural and so we can kind of spread out to closer to 15 to 20 kilometres. So we're doing advertising. But let's. That's your kind of range. If we tend to be more city based, it's probably five to 10 kilometres and closer to five, head to a more rural and we can start to expand from there. But these, you know, they tend to be kind of middle class. There's also what's in common. If a mother's going to choose chiropractic for her family, she probably has a more vitalistic, naturalistic, holistic and conservative way of thinking about health. Which means she's much more likely to be shopping at the natural health food store. She's much more likely to have exercise habits. She's open to, you know, alternative natural type sort of therapies.

Yeah, love it. And if we had to pick one because obviously the chiropractor will see a variety of different conditions and challenges. If we had to pick one just because it will help us kind of optimise the critical client flow for that, where would be a great starting point? I know you mentioned perhaps with their child or something like that, what would be one of the first things maybe that the client comes to them to get addressed?

Okay, so let's just say and we'll carry on, obviously this chiropractor is going to be seeing many different things, but let's just say that they've got a colic in you. Born that's, you know, six to 10 weeks old, is having difficulty feeding, is not settling, is crying a lot. That's the presentation of the child. The mother's been along to the maternal health nurse and probably a paediatrician and the advice that she's been given is that the baby will probably grow out of this. You know, there's nothing nasty organic going on. It's like your Baby will grow out of this. With time, it might be 12 weeks, it might be 12 months, but we've got an unsettled, colicky baby.

Yeah, perfect. And generally, if we go again for best practice here, what are the ways that the chiropractor would try and grab the attention of those mothers? I'm imagining probably referrals would be a big part of it or word of mouth. Like what other channels?

Okay, so typically one area where chiropractors are great at is internal referrals. So this is letting their own patient base be aware of what they do and why they do it and how they do it. And particularly too these mums, once they've come in and had a result, are really strong advocates. If I've had a little one that wasn't sleeping and then I came along and I got some care with you, David, and my little one started sleeping, you can bet that I'm going to tell the world about it. So internal referrals is a really big one. The next one we would talk about is really relationships with key professionals. And probably the number one here would be with maternal health nurses. And so we want to see if we could build up some relationships with those. Because maternal health nurses are often a little bit more open minded in terms of where they might see solutions. There's still a number of those in traditional medical care that might not be open to referring a baby to a chiropractor just because of a lack of understanding in terms of how a chiropractor is going to work, perhaps thinking they're going to crack a baby's neck, which is not what they're going to do. So there's key professionals there too. The third one that we would want to be doing here as well is perhaps having a good digital presence. And I'll break that up into two areas, but certainly a website that reflects family care. So if I come over to a website there and I'm thinking of bringing my baby in there, and your website really reflects back pain and neck pain and headaches and stuff like that too, that just doesn't match, it's not a brand match there and then that should be kind of parlayed into a social media presence, that there's a branding there, which when we think about branding just being the heartbeat, what is all the fingerprint of it? That fingerprint really needs to say, I'm a family chiropractor, we see kids, we're perhaps a little different from what you've seen before. So we can think of that's certainly four big areas that we can use for that attraction side of things.

Yeah, perfect. And then typically, how do those inquiries come in? Is it maybe it's a combination of a phone call, a web inquiry.

An email referral, like, how do they. Or all of the above. What's.

Yeah, all of the above. The vast majority of them are going to be a.

Phone call coming in there too, depending on a more sophisticated chiropractor through some of their digital marketing is going to have in place kind of, you know, top of funnel, middle of funnel, bottom of funnel things. So they might have, you know, a content upgrade which might be, you know, anything from a little online workshop they might come to. To. It might be a guide for mums to be looking at what foods and how to choose a formula or tips for breastfeeding and things like that as well.

Yes.

But most of them are going to via those things in and come for a phone call saying, hey, listen, I'd like to organise an appointment for my little one, please.

Yeah, perfect. And then on that phone call is probably just a little bit of qualification to make sure that they're right. And then, like you said, it's. It's booking for some sort of consultation.

So if I understood that correctly, that's kind of like some sort of book a consultation here.

The consultation process is really broken down into two parts. The initial part, and this is pretty consistent across healthcare, the initial part is very diagnostic. What the chiropractor is wanting to do here is are you in the right place to get the care that you need? And so it's going to be a lot of history and evaluation and examination. And then at the end of that, and often on a separate visit, there's a report of findings. So it might be. I'm going to run these tests and we're going to get back together again tomorrow. I'm going to report these tests to you and we're going to lay out a plan of what we need to do to get your little one sleeping and feeding better. And so that sequence is two very distinct visits and I might.

I'll pop some of that maybe down underneath the.

Sort of potentially the onboard or the delivery. So it's almost like they book the consult and then.

Maybe they get sensitive information on where to arrive and then the person.

Is there anything that goes on maybe in the background as far as like before the consultation actually happens, where anything are entered into a system or anything, or is it totally.

So there'll be some key data that will need to be taken from the patient on the consultation. So they're things like phone call, sorry, phone number, address, names and things like that too.

And does that happen in that first consultation session? So let's say they've called up and said, hey, I want to. These are my problems. Great, let's book you in for a consultation then. Is it just that the person comes in for the consultation and then they collect that information, or is it on that first phone call?

A lot of that should be actually got on the first phone call. You know, certainly the basics of it there too. And then there's some more details that have got. You know, most of us are aware that when we go in and see a doctor that we're filling out a history form that has more details on it. And some of those are done when you come in. But often nowadays we have online versions of those and they might be, hey, listen, do you want us to link to the form or would you like to fill that in when you get here? So there's a preference there too, but there really should be. The other thing that should be happening too is that when the practice member actually gets there, there really should be a welcome series that should be happening as well before they even get their way through. To see the chiropractor, like best practices is to know that when I see a mum coming in at 10am there too, to probably say, you must be Susie. And this must be your little one, Mackenzie. Lovely to meet you. Welcome to our practice. Come grab a seat over here. Here's the forms to filling.

Oh, hey. I know you're tuned in right now, so I'll keep this super quick, but you like awesome YouTube videos, don't you? Well, there's not really that many YouTube channels that create great content about how to systemize your small business. So I want to make sure that you catch every video that I publish. So if you haven't already, firstly give this video the thumbs up and then go ahead and subscribe to my channel. You can even hit the bell notification and to make sure that you're the first to know when I publish anything. So go ahead, do it right now, I'll wait a sec and then I'll transfer you back to the video.

Yeah, perfect. And is there some sort of, you know, because sometimes there are little sub steps underneath here, like you said, the, the phone call, we might collect some info and then they might even, you know, set them up in the system so that sends out the information about the actual consult as far as where to go, where to Be send any.

SMS that will trigger off often a reminder. SMS as well.

Yeah, reminders.

And then they come in, they'll have the welcome. There might be the questionnaire and.

Introduction to the practice and then they have the first consultation. Is there any taking of money at this point or does it always happen at the end of that consult?

Almost always. There might be exceptional circumstances for when it might be taken beforehand, but in 99% of times the taking of the money is going to be something that happens at the end of the visit.

Yes. Yeah.

Collect the money and also like there's going to be a range of things in that consultation. Meets with the chiropractor, ask the questions. Like you said, this is probably more the diagnostic history and exam. Yeah, yeah, okay.

History.

And then exam.

And then.

And then after that they'll collect the cash and.

Rebook that second session. Where they would then effectively prescribe is that.

Yeah, you could kind of think of it like that, that we. That second visit there's often referred to as a report of findings. So in the second visit there, here's what we found on our first visit. And that's really when we lay out what our plan of attack is going forwards here too. Here's what we're actually going to do. And that's when we would begin care.

Yeah. And it's almost like the rebook.

So collect the cash and the rebook and that would happen back in with probably the admin staff. And then some of these other things with reminders and things like that would get obviously triggered off again. And then they come back for that second consult.

Which is the report of findings.

And then they begin potentially care. And then they would maybe do some of that in that session as well.

Correct. Yeah, Usually they start in that second session there too. And so, you know, an adjustment is. Is delivered at that stage.

Yeah.

And then a program of care is laid out of, you know, usually a plan for anywhere between the next, you know, four to 12 weeks.

Yeah.

And then after that, that's equally. They would probably go back and do similar where it's. They collect the cash for that session and they rebook in for the next session.

Yeah, correct. And several practices might have different ways of managing the cash flow with regards to that. Some of them might have prepayment options. Many practices are heading towards a, you know, you can just store your credit card on file and it will automatically just pay at the end of each visit. Bit like we do with Uber and many of those types of things as well. So there's Several different ways that they could. They could do the cash side of things after ongoing consultations.

Yeah, perfect. And then having a look at this, where do you see the most common problems or where do most chiropractors struggle? Because I'm imagining a lot of them know how to do the technical work. I mean, they're chiropractors, they're trained to do that, so I'm assuming they're probably good at running the consultations. Are there any bits where you just, you know, and even, you know, reflecting on some of the clients that you work with? Yeah. Where do people usually fall down the most?

Yeah, probably right back at the very beginning. Yeah. If we go right back to the attention phase, that you've got it there, what they tend to have, there is no redundancy built in. And so there's one area that they're very effective with, and often it's internal referrals. But beyond that, there's no other avenues for attention or attraction. And so that's the first thing when things kind of fall down. And that's when I go back to this chiropractor before that. Because there's no predictability in there, because they've only got one avenue for attraction or attention.

Yes. Yeah. Are there any other ones where it's very obvious balls get dropped or mistakes happen?

Yeah, the next ones kind of tend to come in, really, what looks like that new patient experience.

Which really happens from the moment that the patient walks in the door.

Yeah. Okay, that welcome bit here.

Yeah, yeah, it was interesting. I'm teaching a class next week, David, on the speed of trust. And in that, there's a fascinating psychologist who.

Not important what her name is, but she's done several interesting things. One study of which was to show people, a university lecturer, now, she showed just 10 seconds of the clip there, but without any sound whatsoever. So the people that were reviewing this were just looking at body language from this person. And then after watching 10 seconds of this clip, they were asked to rate this person in terms of, you know, give them feedback, like as if they'd sat through kind of a whole 12 weeks of their course. And it was interesting. The same scores, after 10 seconds, the same scores were achieved for this person, as if the person kind of sat through 12 weeks of their lectures. So we make these opinions really, really quickly. We come up with an idea of this person, trustworthy or not, based on many things, have very little to do with verbally what we're saying. Their body language, their posture, the way that we move and Often we're not conscious about these things. We think it's just a matter of me coming up to you and saying, hi, David, welcome to the office, or not even doing those things most of the time. Over this last 12 months, I've had several checkups after turning 50 and I walk into a medical practice. I'm no regretted by name. I'm kind of just acknowledged, often with a grunt of that I don't know where to sit. I kind of sit down in the corner with a person who's sitting behind a desk, you know, so all of these things here that make us feel uncomfortable don't elevate trust, you know, don't build connection as well. And so a lot of chiropractors aren't taking the time to really orchestrate that whole experience from the moment that you walk in the door all the way through to the consultation. We get too clinically focused if I, you know, here's what I do with the exam and the history, but I forget the human experience. And so that's the next part that really needs to be worked on. After the attraction phase, do you ever.

Come across a book called Building the Happiness Centered Business by a guy called Paddy Lunn and he ran a dentist surgery, I think, maybe up in Queensland?

Yeah, it was. Yeah, it was on the Gold Coast, I think.

No, I haven't read that particular book. I've listened to and done a lot of Paddy's different courses and I've heard Patti speak beforehand. And 100% of what I'm talking about is a lot of what Paddy talks about as well. You know, he had, you know, wonderful teas and different things that he would have in his practice. You know, he purposely did things like when you're a new client, he gave you. The only way to become a client of his was through an internal referral. And each new client got given three internal referral cards and that was it. You've got three people you can send here and after that. So it was a really interesting way that he went about it, but it was part of what's, you know, sometimes I'll refer to as the Disney experience. It's an experience that's very conscious that we want to have. What can we do to create an environment that builds trust and health, you know, creates connection, where we're realizing a lot more in terms of healthcare, in terms of co regulation. And this means that if you come into my practice, and understandably, if you're even with a headache or back pain, they too have a nervous system. That's really stuck in safety. It's very hard to heal when you're in that. I actually want to get you into a state of openness and trust and out of a sympathetic fight flight drive into a parasympathetic heal and repair. And it's my job as the chiropractor to help to lead you towards that, to make you feel safe. And a lot of that is done not by my adjustment. It's how I show up and who I am. And they're all real important things for a chiropractor to be aware of if they want to maximise the results in their practice.

Yeah, I love that. I feel like we got a good insight into what you consider best practice. And I always work with our clients in the medical space and I kind of go, hey, step number one, capture what you're doing, make it repeatable. Sometimes just looking at it, you realize, oh, wow, I don't really have a process here or where the big holes are. And then when you're kind of ready to go to that next level, you go to someone like Angus, who then knows best practice, and you go, well, here's what I'm doing. And then you can just go, oh, yeah, well, this is broken. This is broken. You should install this system and it'll completely sort of change the way that your practice is working. And I kind of already start to get some insights on that thinking as people then get clear on, well, here's how I'm currently welcoming people. Then you start to go, okay, and how do we supercharge that? So, yeah.

Yep. And so, because so much of that is. And as you'd be aware of, is that we tend to think that people are making decisions logically and they're not. They're making decisions emotionally. But we set our practices up for logical efficiency. You know, we have this kind of dance between left brain, which tends to be linear logic, and right brain, which is more emotionally driven as well. And we should be in that right brain a lot more. Now, there are times when I'm assessing a patient doing those things. I also want to be logically driven through that as well. It's the dance between those things there that are really important in the success of any business.

I love that if chiropractors listening to this or if someone knows a chiropractor. And where is the best place to send them to find out more about your work?

Probably the podcast, which is called the Marketing youg Practice Podcast. I mean, we're over 400 episodes deep into that where I share, you know, what does it take to have a practice of impact, which is meaning and income? It's profitable and is enjoyable. And so we go through, you know, attraction and conversion and delivery and systems. The conversations we have in this, some of them are just me rambling on and some of them are me talking to interesting people like you.

Perfect. Well, thank you for, yeah, sharing your insights today. I'll pop a link over to the podcast so people can keep following along. And yeah, appreciate your support and looking forward to chatting again soon.

Thanks, David. Thanks for your brilliant work.