Specialists Win: Why the Future of Chiropractic Belongs to Specialists

Hey there, and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now. Hello, and welcome to the Practice Builders Podcast. I am your host, Dr. Vince Leone, and Dr. Pankinen, my partner in crime, is off today and getting a well-deserved Rest. I believe he's somewhere in Canada on a lake deep in the mountains, hopefully with no cell service. So, uh, we'll miss him this week. So we're gonna run this one solo and really excited about this one. And the title is Specialists Win: Why the Future of Chiropractic Belongs to Specialists. And I really believe the next decade of chiropractic can potentially belong— uh, beyond, sorry— will belong to specialists. And it does not mean that, you know, treating just one condition. It means becoming known, you know, for solving one or two very specific, valuable patient problems and doing it exceptionally well. Because right now, I talk to doctors every single week, um, obviously keeping track of the industry. And what I am seeing is chiropractic is really becoming commoditized, what I call commodity chiropractic. And— Yeah. Essentially, this is what that looks like. Many practices, they just look and sound the same, right? And so when patients cannot see a meaningful difference, they will choose based on, do you take my insurance? What do you charge? Location, you know, convenience. And when every chiropractor like looks interchangeable, chiropractic becomes a commodity. You can think of like soap. If you go to— now guys, I'm not comparing, not comparing you guys to soap. What I'm saying is soap is a commodity for the most part, right? You go and, you know, there's Dove, there's Dial, they're all about the same price, all kind of do the same thing. This is the trap, right? This is where you don't want to be. And if you're there now, that's okay, right? The— you are one of the small percent of the industry that is probably looking to the future, right? How do I improve my practice? How do I make it more How do I protect myself, my practice, my family into the future? How do I make my practice more valuable so it can be sold? All of these things are great, right? That you're tuning in now, you're looking to the future, but that is what I am seeing. So I talk to doctors all day, every day, and especially ones that are not in our program, that's what they come up against. Oh my gosh, will someone really pay $5,000? I mean, I can't even imagine that. I mean, they barely pay their copay. Well, Well, that's a doctor trapped in that commodity kind of, um, even could call it a prison, right? So the next component of this is being a great clinician is not enough. Now, it is a requisite, right, for, for transcending the commodity trap. And they obviously matter. We have got to deliver patient outcomes, but patients cannot evaluate that before choosing you. Right. See, that's the key. They judge what they can see, right? What is your messaging on, like in the marketplace, on your website, in your ads? What is your reputation on Google, et cetera? Your expertise, right? The problems you are known for solving. These are the things that they can judge you on. You need to be clinically excellent, but they just don't know that until they actually come into the clinic. So we have to, this really comes down to positioning. Yeah. And it has to be done in your messaging. And that's why marketing is so darn important, because if you're not actively marketing and positioning yourself clearly and differently, because everyone wants different and better, if you're not actively doing that in the marketplace, then you will get kind of jumbled in to everybody else, right? Um, so what does specialization really mean? Well, It does not mean abandoning general chiropractic. That is not what I'm saying. It means choosing 1 or 2 areas where you build deeper expertise, stronger messaging, and a better patient experience. So examples might include, you guessed it, spinal decompression and disc conditions, neuropathy, knee pain, headaches, sports injuries, functional medicine. So you can treat many things. You just should not be known for nothing. And so that's where you can have your car— like, you can have your cake and eat it too. In other words, like what we call practice nirvana. You have your core chiropractic practice, and that generates somewhere between $30,000 and $50,000. Um, and that's typically a referral-based practice. That's something that you've been growing over the years. And then you have your 1 or 2 specialties, right? So say your general chiropractic practice does around $50,000 a month. Well, then you could do another $25,000 in decompression and another $25,000 in knee. Now you're at that kind of vaunted $100K a month threshold. Um, and patients— and, and the, the general chiropractic practice feeds the niches, right? So now this is the— and this— and This is what we call practice nirvana, right? So we have you know an associate that's going to you know basically do the bulk of the adjusting in the general chiropractic portion of the practice. Then we have spinal decompression, for example, and that's where we're going to you know enroll say five to seven starts a month. You're going to be doing those high value evaluations and enrollment, or maybe you have a case manager. You have two to three techs that are putting patients on and off the table, on and off laser, etc. And then you have knee pain, which all you know a lot of times correlates very close. Mostly to disc conditions. You know, you've got a bad back, you got a bad knee, um, and then you— and then you segment them over to knee. Do you see what I'm saying? So it's like they start in chiro and then they're like, you know what, I had a car accident, now I have a disc injury. Or you have a patient that's been seeing you forever and they're like, you know, I've heard about this decompression, or I've seen your mess— you know, your marketing, or I see the signs around your office or whatever. I think I may have a disc. Okay, well, John, no problem. Like, let's get you set up for a decompression-specific exam. I'm going to figure out, is this really a disc? And if so, whether decompression would be right for you. And lo and behold, it is a disc. And then you put them into the decompression protocol. They're thrilled. They're like, oh my gosh, I didn't think I was ever going to get rid of this. I was even thinking, am I going to have to go to surgery? And then they're like, by the way, I, I've had this knee issue, and then you talked about that. Well, let's get you set up for a knee exam. Well, they already trust you, right? They trusted you from the chiro. You've done a good job, you have a good service. Then you, uh, continue to gain that trust by delivering on the disc condition, and then the knee is an easy sell. Do you know what I'm saying? So, and then, you know, all of a sudden you're at $100K a month, you're like, well, shoot, That wasn't that difficult. While when you're back at 50 and you're just doing chiro and kind of like a lot of other doctors, it may have seemed out of reach. So that's what we call Practice Nirvana, right? It's set up beautifully. You have the, the owner owning that key position of the specialist, right? Focusing on those high-value cash services. Associate running the bulk of patient care in the chiro portion. You have 2 to 3 techs. You have a great office manager who may also double as a case manager where They actually do the, you know, the closing. So this is, you know, this is the model, right? This is the specialist model. This is what I've been talking about in specialized practice for years, only because I saw this happen to my father. You know, he had practiced for— when I entered in '07, I mean, he'd probably already been practicing 20 years and had done very well. Yeah. Right. But it just doesn't last. It's a reverse flywheel. In other words, the more patients you see, the more your body gets broken down, the more insurance headache that you deal with, the more frustrated you get. You feel like no one values my services. And it's just like, why am I doing this? You know, can I sell this practice? How long am I going to be able to practice like this? Am I actively building my retirement? And so that's when doctors say, hey, I need to add a high-value cash service. Right. So next, specialists create authority. So the more focused you become, the more of those cases you'll see. Have you ever— tell me if you ever had this happen to you— you buy, say, a red car, all of a sudden you see tons of red cars, or you buy, you know, a Porsche, and all of a sudden you're seeing Porsches all over the place? Well, that's what happens when you specialize. So in other words, if you say, hey, I'm going to become a specialist in disc conditions and, and treat it with spinal decompression, great. Now, what happens then, especially doctors that go through our program because they do the advanced clinical training, all of a sudden they start thinking, oh my gosh, I have so many of these patients in my, in my past patient base. Like, I remember John and Susie and, you know, this person and that person. I bet those are disc cases. I'm going to reach out to them and chat with them, see if they still have the condition, and if so, I'm going to invite them in. All of a sudden, doctors are Enrolling all these patients from their current patient base because they already know, like, and trust the doc, right? So the, um, the more focused you become on a specific condition, the more of those cases that you'll see. Now, this is— now, this is a positive flywheel. The better your protocols become. Hey there, it's Dr. Vince, and if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And if you know another doc who's ready to grow their practice, share this with them. It might be exactly what they need right now. Thank you in advance. And now back to the show. In other words, as you start to put patients in your protocol, you start to see, hey, you know, this number of visits work. And by the way, this is why some doctors even join specialized practice, because they're like, I don't want to figure out the protocols, just, just tell me what, what works, right? But if you're figuring this out on your own, you're like, hey, no, I found 24 visits works best, or I found 30 visits work best for my table. Every table is a little bit different, right? So protocols become better, then the marketing becomes better, right? Because it becomes more clear. You're like, hey, I don't want to— you know, I don't want every Tom, Dick, and Harry coming in here because a lot of them, they just want to— you know, they woke up, slept wrong, and they just want an adjustment. They, they leave, right? Versus like a referral from your, you know, really strong chiro patient base. Well, then when they come in, they know they're They're coming in to fix the problem, right? It's not a disc. It's, you know, just a straightforward chiropractic issue, but it's not a one-visit deal. You know, it's a 12-visit, 24-visit plan that you're going to put them on and really get to the root of the problem, bring them into the chiropractic family, etc. So, but the marketing, you're like, hey, no, I want to target people with disc problems. And, and then you're like, well, how do I do that effectively? And like, when you look at a marketplace like 3%, have the condition and are ready to take action. About 17% have the condition, they're in research mode. Another 30%-ish have the condition, they're not really sure what to do about it. And so then you're like, well, how do I reach all those people? You know, that's, you know, that's about 50% of the marketplace-ish. So how do I reach— it's 40 to 50%. So how do I reach all those people? Well, now you need to get into education-based marketing. You got to get PDFs or ebooks out there to start educating people about who you are, what you do, how you're different, how you're better, right? So your marketing becomes clearer and you kind of lean into that because you're like, well, I like these high-value cases. You know, they are less price resistant. They, they, you know, they respect me more. They see me as an expert. Like, this is fun, right? In fact, I was talking to a doctor last week. He's like, man, I just love these high-value cash services. It's so fun. Because, you know, every time a patient comes in, I know, well, one, it's going to create tremendous cash flow for the practice. Um, two, it's just more exciting and challenging. So, and I hear that all the time, right? Doctors, when they add a cash, you know, like disc or knee or neuropathy, they're like, I really enjoy this. I'm, you know, I'm, I'm a great chiropractor, but, you know, it's just become ho-hum. It's just what I do every day. But now I get to kind of sink my teeth into a deeper you know, clinical, um, uh, problem that I can solve. And I got, you know, I can invest in the tools to do that and really deliver great outcomes. And then finally, as your outcomes become stronger, then referrals go up, right? So then you need to do really less paid marketing because you're getting referrals as well. So that's a positive flywheel, right? So it creates a cycle. You get specialization, then the patients have a great experience, then they get great results. Like, in other words, they have a great experience while under care, they get great results on the back of it, they send in referrals, and then that creates more authority for you because you have all these people out in your marketplace talking about how great you are with solving disc conditions. Okay, so specialists create authority. Now, generalists compete on price Specialists compete on value, right? So generalists often have nothing else to compete on but insurance and price, right? Whereas specialists compete on expertise and trust and outcomes and experience. Now, that last one, experience, is really huge, and I'll tell you why. It's because when patients— our doctors invest Right. So they invest in themselves, right? Hey, I'm going to work with a consulting company like Specialized Practice so I can deepen my expertise and, and learn more about this condition and everything that goes along with it. Then I get better at it. Then I get great outcomes and I get more and more patients under care. So I have more revenue. And then they reinvest. They invest in better equipment, in better staff, in a better, like, they may upgrade their office. I mean, I remember one of our past wonderful clients, Dr. Jeff Abrams. He was just— he was the absolute pinnacle of this. He went from $30,000 a month, zoomed up to $90,000 in like 8 months. But then, you know, I think he's— it doesn't matter. He's always been around, you know, $80,000, $90,000. Back then, that was, you know, probably a year or 2 ago. He could be beyond that right now. I don't know. But the point being is He had all this extra money. He totally redid his office. He put beautiful signs on the wall. He had lights under the decompression table. He's doing all these videos. He redid his, um, uh, reception areas, those beautiful, like, uh, dark green, like, uh, you know, some type of glass or something. I mean, it was— it's like the Taj Mahal, right? And he reinvested, and it all is a positive flywheel. That's the experience. Right? But it starts with competing on value, right? And becoming a true specialist, expertise, et cetera. So patients, when you kind of develop that flywheel and it really starts humming, patients stop asking stuff like, do you take my insurance? And they really then shift to, you know, how do I get in? When can I get in? You know, can you help me? Those are the questions they're asking. And that's when you know, when, when the, when the phone, like the, when your receptionist stops having to ask, answer that question, well, you know, do you take my insurance, all that type of stuff, and they're, they're booking you out a week, 2 weeks in advance, that's when you know you have that flywheel really, really going well. So next, now here's the thing, uh, doctors see like, oh, these high-value cash services. Well, Hey, I'm going to add this and that. I'm going to do functional med, I'm going to do decompression, I'm going to do weight loss, I'm going to do stem cell, I'm going to do this, that, and the other. You really don't need all those modalities, to be honest with you. I recommend just choosing really one initially and build that up and get really good at it, and then add a second one, add a second high-value cash service line, and then build the complete model around them, right? So you have your clinical delivery, You have the marketing, you have the patient education, you have the conversion. Your staff is trained up so you're not the bottleneck and they're doing the bulk of daily patient care. You have follow-up for all those leads that we talked about, right? That, you know, they just, they have the problem, but they're just not ready right now. And that's okay. You know, everyone has their own path. And that's, you know, the old saying, fortune is in the follow-up, right? So you have a good follow-up system and then you have really strong systems of what happens on a daily basis. from the moment the door opens to the, uh, when the door closes. Um, and that, that machine is what creates, you know, a true kind of specialized practice. So in my experience, um, neuropathy taught me this lesson, right? So I was, you know, an associate for 2 years, and then I said, you know, obviously I knew more than my dad, 2 years into practice. He had been in practice for 30-some years. Um, I said, I'm gonna go out on my own. And I tried to do basically, you know, what everyone else was doing. I was trying to do high volume, PI, you know, weight loss. I did fibromyalgia. I mean, it was just— I was shooting in the dark. And then at the time, my coach was like, I don't know what the heck you're doing, but you're dying. Um, he's like, go learn from my friend, Dr. Joe DeDuro. Um, how to do neuropathy. And so that's what I did. And I just specialized in that, right? And I stopped treating it like another therapy and just went all in. And so then, you know, we ended up— then my father and I ended up merging, and I took everything I learned, you know, building the neuropathy niche to decompression, because he had just one table and he was kind of bouncing back and forth between chiro and decompression. And neither one was, you know, one would go up and the other one would go down and vice versa. So, I took everything I learned with neuropathy and then we applied it to decompression. Then we pretty soon were at 4 tables and doing, you know, multiple 7 figures. So, but it was bigger than neuropathy, right? In my experience, doctors win when they become known for solving high-value problems, right? Uh, I don't know who said this. I think it's a pretty famous saying, but you can have anything you want in life if you get enough, um, or if you help enough people get what they want, right? So business essentially is just solving problems, right? So for us, we're solving health problems, and the bigger the problem, the more you get paid. And that's just the end of the— that, that's the, that's the end of the story right there. So Um, here's a practical takeaway for you. I want you to ask yourself, what 1 or 2 problems do we want to be known for solving? Number 2, does our marketing clearly communicate that? And number 3, have we built a complete system around those services? So let's go through those one more time. This is the TL;DR. That's what the kids say, right? What 1 or 2 problems do we want to be known for solving? Does our marketing clearly communicate that? Now, I'm not just talking about Facebook ads, right? This could be your website. It could be signage in the office. It could be your email. It could be street signage. It could be signs on your window. It could be a paper newsletter. It could be a newsletter. You know, newspaper articles, it could be radio spots, like all of the marketing that you do. And by the way, um, Jim Parker said the more people that know about your practice, the bigger your practice will be. He said that back in the '70s. So, you know, all the, you know, the, you know, old school godfathers of our profession all promoted marketing. So does our marketing clearly communicate that? And then have we built a complete system around those services? So, you know, in closing, I strongly believe the future belongs to doctors who— they stop trying to be everything to everyone and they become exceptional at solving, uh, specific high-value problems. And just remember this: generalists compete, specialists differentiate, and that's why specialists So I hope this has been valuable for you. I know this is a little less tactical than we may generally talk about on this podcast, but in terms of value and importance, I don't know that there's a more important thing that we can kind of wrap our heads around and lean into to plan and protect the future of ourselves, our practices, and our families. Okay, so that's it for this episode. If you got value out of this, please share it with a friend or a colleague, and we'll see you on the next episode of the Practice Builders Podcast. Hey, it's Dr. Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients, then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support. And it's all guaranteed. Spots are limited. Head to www.decompressionaccelerator.com to learn more.