335- Marketing a Cash Based Chiropractic Practice

Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langman.

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode, we're going to talk all about marketing a cash based practice and cash based services. So even if you're not 100% cash, you probably have some cash based services in your practice. We're going to discuss how to approach this specifically when building referrals with other healthcare providers, what information you need to get out there proactively so you can reduce friction and barriers to to people utilizing your cash based services. And additionally, some tips to really bolster your practice. So whether you're 100% cash based, whether your portion of your practice is cash based, or whether you just have products or services that are cash based, I got a feeling on this episode you're gonna have some takeaway information that enables you to help more people and generate a little bit more revenue in your practice as well. But before we get started, I wanna say a few words about the smart chiropractor. The smart chiropractor can power your patient journey to provide you with more qualified leads, more new patients, better patient retention and consistent reactivations without spending any money on advertising. How do we do that? We do it through a philosophy and strategy of teach and invite consistently by getting your information out to as many people as possible, Free, organically, email, social, Google business blog posts, lead magnets on your website. We do all of that in an automated fashion. You can check it all out at the smart chiropractor.com Again, that is the smart chiropractor chiropractor.com but as I said at the top of today's episode, we're talking about marketing cash based practices. And this is a topic that has come up more and more as time has gone on. I was looking back and the evidence based chiropractor's been around for a decade, which makes me feel super old. But as the years have progressed, there's been a lot more questions around how to appropriately and effectively market a cash based practice and cash based services. And there's two sides of this. One is how do you do it in a B2B fashion? How do you market your practice, your cash based practice, business to business that's generally getting referrals from other healthcare providers, Sort of the core and essence of what we do at the evidence based chiropractor, the other side of that coin is maybe you're not 100% cash based practice, but perhaps you have supplements, maybe you have a tape that you sell, you have, maybe you have massage therapy, whatever it might be, you have cash based products and services. And they're two slightly different conversations, but there is a lot of overlap as well. So first let's just sort of set the stage. If you're a cash based practice, generally speaking, you're going to be referred to as out of network. And here's the thing, when I'm speaking with another healthcare provider, I'll probably hedge towards using the term out of network in terms instead of cash based practice. Just from a healthcare nomenclature perspective, many providers are going to be super familiar with that and they're going to understand, hey, that means you don't take primary insurance. So out of network is a great way to phrase it. The other thing is, 15 years ago when I first came into the profession, cash based practices, it was really, really difficult to build relationships, referral relationships with other health care provider. Now that is completely not the case. And so many medical providers, and I don't care what their credentials are, MD, medical med, spas, whatever it might be, have added on cash based services. Everybody has felt a supreme crunch of diminishing reimbursement, higher operational costs and just a supreme pain in the butt from a documentation perspective over the last, well, many, many years, but specifically over the last five to 10 years, we have seen more and more healthcare practices, what I would refer to as traditional healthcare practices now adding on cash based services, products, you name it. So coming in to build referral relationships or getting out there with cash based services in a cash based practice is totally different. And it is way better today than it was 15 to 20 years ago, as opposed to kind of looking like a weirdo talking about cash based or out of network benefits 15, 20 years ago. Now it is totally commonplace, even in some of the most conservative practices out there. Now, when you're going out and building referral relationships and you are a cash based practice, or you're just trying to promote some of the cash based practice services that you have, maybe it's even spinal decompression, whatever it might be, a couple of important things to keep in mind. One is with the evidence based chiropractor, we always talk about having a target list and those are the people that you're consistently reaching out to to build these relationships. And the expectation is out of your target List, we like to have a list. We recommend having a list around 50 providers that you're reaching out to. You should expect to build relationships with about 20% of that list. So there is a certain portion when you're a cash based practice, the same as if you're insurance based practice, that you find the quality through the quantity. So you need to get out there enough to, as I like to say, find who your dance partners are. There are many practices and providers that you all talk to that are not going to like your practice. That's fine. There's plenty out there that you're not going to like their practice. And that's potentially even more important information to know because you need to be able to guide and direct your own patients to similar providers, complementary to providers when they need it. So the Expectation is about 20% of your target list are probably people that you can build relationships with. So if you have a target list that's over 50 people, well, you do 20% of that, if it's under, your aggregate number will be a little bit smaller, but you can expect about 20%. There's some variability in that. But that's a general rule that I've seen over the last 10 years is if you have a target list, you should be able to find about 20% of them are good partners for you. It doesn't mean they're necessarily referring 50 people a month or anything like that, but, but you should like them, they like you. Some cross referrals go back and forth and that's a great, great place to be. The other thing about that to keep in mind is you're trying to find your dance partners. You don't have to get along with everybody. This is about finding who are the most appropriate people for you to build relationships with. So that could be anybody under the healthcare spectrum as far as I'm concerned. Cash based practices, you're very likely to find easier partners with concierge type physicians because they're cash based as well. So it's just reducing the friction. But very well can, and many people do build great referral relationships with a cash based practice with insurance based providers. Now how does that happen and how do you get over the hump? Let's discuss that right now. One of the most important things to consider is medical people have no idea about cost. So cost perception of high cost, I should say can be a friction point and you can knock that down super, super easily by giving a framework of your cost. So I'll explain what that framework is, then we'll go into a little bit more detail. If I'm going out and talking about a cash based practice, cash based services to a provider that is insurance based, I might say something to the effect of just so you know, because we're a cash based out of network provider. Our typical evaluation cost is around X and our follow up visits are around Y, whatever that might be for you. Our initial visits are around $250. Our follow up visits are $100 each. No provider is going to hold you to the exact dollar amount. So don't get stressed about giving a specific number. But they literally have no idea. They think about how little other health care providers know about what you actually do, never mind what you bill and charge for it. So this can be a major source of friction. If they have fear of having egg on their face or feeling silly by referring a patient over and they have no idea they are this is the land of $80,000 20 minute decompression surgeries, $200 aspirins. Medical providers have a bizarre notion of cost because it's been built into their bill charges. So us as chiropractors in this case it's an advantage. Our costs are going to be super low. Almost no matter what your cash based cost is, it's going to appear to be low. So don't be afraid to let the doc know, hey, our initial exams, our evals are round X, our follow ups are around Y or our spinal decompression packages are around X or Y or whatever the cash based service that you're providing or product is. Just give them a framework. It is going to help reduce friction dramatically and it also is going to just set the stage for a nice relationship moving forward. Now as we talk frameworks of cost, you also might be curious to say, okay, you know you mentioned I mentioned concierge doctor earlier in this episode, but how do you find some of these other providers that you can build a relationship with? And the number one thing that I have been saying time and time again over the last eight months to a year, lean into your local imaging reps so your local CT MRI facility. I'm sure somebody stops by your practice trying to solicit some business from you. They have marketing reps on the road all day every day. All all these reps do is walk into doctor and lawyer offices, shake hands, learn about the practice and keep moving on. They are relationship capital type people and there is no reason that you cannot leverage that relationship capital. I recommend going about this in a really, really straightforward way. Don't overcomplicate it. So you might have a rep that comes in every week or two into your practice. Great opportunity to have this conversation then. Or if you don't know who your local rep is, literally call the imaging center today. Bring hey, this is Dr. Langmaid over at Langmeid Chiropractic. I was curious if the rep that services our area or my practice could swing by. I have a few questions for him or her. That simple. Somebody will probably be out there today or tomorrow because that's their job is being on the road and building relationships. When that person comes over to your practice, and the reason I say get them over to your practice is specific. I want them to physically see you. I want them to physically see your practice. What does it look like? Is it a big open space? Is it smaller? Do you have a huge rehab space? Do you not have that? They being able to see your practice is a huge, huge benefit. When you ask the question, the question is, thanks for swinging by today. We're going out there and building some relationships with other healthcare providers in the community. I know you have some great relationships. Could you make three or four introductions to other providers that you think would resonate with our practice? Super simple. Ask straight up. Can you provide me three or four introductions with docs that you think would resonate with our practice? Now why do I say resonate with our practice? Because they get to see who you are and what you do. If there's a bunch of young people in a big open rehab space, okay, that can be a tickler for them to match you up with somebody who has a similar patient base. If they see you're taking care of a lot of geriatric individuals, whatever it might be, they can pair you up based upon their Rolodex with people they believe are most likely to be great referral partners for you. So lean in to your imaging reps to leverage the relationship capital that they've built. They are there to use it. And you should not be shy about asking. This enables, especially when you have cash based services and a cash based practice, this enables you to accelerate that progress because you can leverage what they, these people know about other practices and that is a powerful way to go about it. Whether it's a concierge medicine doctor or you know, I've seen a ton of advertising here in the Tampa Bay area lately for a company called Forward. I came across them in San Francisco maybe a half decade or so when they were first, first starting out. And they provide membership, cash based primary care Services totally outta network, no insurance. So this is permeating and they are set up, I believe in a dozen or two dozen cities. And it is. Competition's only gonna get hotter. So there will be cash based services. There has never been a shortage of cash based services. If you're a doc out there thinking about going cash, I might not be the world's greatest expert in it, but I, I would say it is one really, really important way to consider and think about your practice. Because people will pay. When the value is there, people will pay. And in the absence of value, all that matters is cost. I'll never forget that because when you can establish value, cost becomes secondary and people are subscribing by the thousands to services like forward primary care services, et cetera, that have insurance benefits. They're paying 100 to $200 per month for access to a primary care physician with no discernible ongoing deliverable. You as a chiropractor can give a discernible ongoing deliverable. Think about the membership services, the cash based services that you can provide in your practice. It might be gym space, it might be ongoing care as necessary. It might be ergonomics and movement assessments on a monthly basis. Potentially you're diving into the product categories such as everyday, everybody supplements. There is a plethora of opportunity and the best part about it is it should resonate with who you are as a provider and your ideal patients. Because when it does, now you're not selling anything. Now you are showcasing how you personally live a healthy life. What are the things that you do that you would recommend? Your brother, sister, wife, husband, mother, father, children. What would you recommend they do for their health? And do you offer any of that in your practice? If you do, you really should take a look at can I offer this to my patients? And I love monthly recurring revenue. I think that is absolutely the way most chiropractors should start thinking, thinking about their practice not exclusively, but as a portion or a diversification of their revenue stream. That's going to be more and more detailed out in the payday practice upcoming book coming out, but that is how I would approach. I hope you've gotten some good takeaway tips, maybe some phrases and strategies to get out there with cash based practices and cash based services in your community. The opportunity for it has never been greater, the market has never been more wide open and more people have never been paying more for cash based practices and cash based services. So get out there, reduce friction, ask those good questions, find your dance partners, be upfront with the pricing, have some fun with it and find that success. Before we wrap up, I want to say a few words about PowerStep Power Step. Orthotics are what my father personally uses and I have seen them make a tremendous difference in his ability to comfortably get up and around. And Power Step as a partner of the Evidence based Chiropractor is providing you yes you with a free sample pair. You can get yours@pro powerstep.com sample Pro powerstep.com sample Check it out today and also if you are a doc looking at the next step in your career, visit us@cairo matchmakers.com we have over 100 open job positions. And please if you are thinking about hiring a DC or ACA this year, don't do it on gut. Utilize a system that chat with us, ask us some questions. We are happy to be a resource for you. So if you're looking for to hire, head over to chiramatchmakers.com, schedule a complimentary call. Let us answer some of those questions, support that for you or if you're a doc looking for that next step or that first step for that matter in your journey. We have over 100 open positions and we do not accept jobs that are figment salaries. So there's a lot of $85,000 plus salaries out there right now. It is an associate driven marketplace. So if you are looking to make a change chiromatchmakers.com docs have an awesome week in practice. If you have not left a rating or review for this podcast, please do. I would greatly appreciate it. Have a fantastic week and I will talk to you soon.

Thank you for joining us on this episode of the Evidence Based Chiropractor. If you want to grow your practice, come back for next week's episode. If you want to grow faster, visit theevidencebasedchiropractor.com and join our MD Marketing membership today.

Sam.