355- Overcoming New Patient, Retention, and Reactivation Problems

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 Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Langmaid. On today's episode, we are tackling maybe three of the most important nonclinical topics out there. How to overcome issues with new patients, active patients, and proactive patients. What are issues? That could mean a lack of new patients, it could mean a lack of retention. So you have active patient issues or you don't have reactivation systems built in. We're going to touch on the second symptoms associated with each. So you can identify if you have holes in your bucket, as we like to talk about, where are those holes in your bucket? And then what are some items that you can utilize to fill that hole so you can have a better and stronger practice and help more people in your community? That's what we're gonna break down on today's episode. Before we get started, I wanna say a few words about the Payday Practice. The Payday Practice is a book that I recently wrote with my business partner, Dr. Jason Deitch, and it is all about how to build monthly recurring revenue in your practice. You can pick up a free Digital copy@thesmartchiropractor.com I'll drop that link down in the show notes. Additionally, it is available on Amazon. It was the number one new release in chiropractic on Amazon a few weeks back and it's still going very strong. So if you'd love to have a physical copy, head over to Amazon, type in the Payday Practice. Literally every single copy helps. We poured our heart and souls into it and it has helped hundreds of docs at this point start to build monthly recurring revenue in their practice. So regardless of how you approach practice, your philosophy, your niche, this is a system and a framework to do it and to implement. That's what the Payday Practice is all about. But as I said at the top, we are going to talk today about new patients, active patients and proactive patients. We think about this in terms of a patient journey, or we call the smart patient journey. And what does that mean? Well, well, every patient in your practice is going through some form of journey. The question is, do you know it and do they know it as well? If they don't, that can lead to issues. What are some of those issues? Well, it could be a patient acquisition problem. That's a new patient problem. It could be a retention issue, that's about active patients. Or it could be that you don't have reactivation systems built in as what we like to call proactive patients with their career. So we think about this in the journey of three phases of a patient journey. New patients, active patients, and proactive patients. And if you're having issues in any of these phases, we'll talk about what the symptoms of those issues might be. Then chances are you have holes in your bucket. I think of a practice like a bucket. Water in the top are new patients. Some of us don't have enough water in the top. That's a new patient issue. Right. But for many practices, especially if you have seen 100 patients, you've seen 500 patients speaking with the doc earlier this morning, 5,000 patient records via email, never touched them. That is like, you know, there's not only. I said to him, you know, you don't only have a hole in the bottom of your bucket, you don't have a bottom of your bucket. So everything you're pouring in the top is flowing right out the bottom. So if you have a new patient issue, I think of it like not enough water going in the bucket. If it's a retention issue, that's like a hole in the side of your bucket. People aren't completing their active care plans, or if you have no reactivation systems really of note, then you don't have a bottom. And that is a huge, huge issue. And for many practices, you could become 20%, 50%, sometimes 100% of your schedule could become more full just with what you already have, not with going out there and having to source, quote, unquote, new ones all the time. So what are some symptoms? Let's break this down three phases. New patients, active patients, proactive patients. So now that you know that, let's talk about what some of the symptoms under each phase are that can trigger you to say, I might have a problem with that phase of my patient journey. Because you have to identify what the issue is before you can have the fix. Right. So what are some new patient issues or symptoms of new patient issues? Well, one's pretty obvious. Not enough new patients coming in. That tells you that you got a problem with that phase of the journey. Journey. What are some others? Running deep discount ads. That should be the last thing I say. That's the icing on the cake, not the cake. So if you're gonna run advertising, I really never recommend really running deep discount ads. However, if you're gonna run advertising, that should be the icing on the cake. It's not the cake. So if that's your entire marketing plan, you have a new patient issue. Because you shouldn't have to rely on deep discount ads as getting 80% of your new patients, 90% of your new patients, that should be the icing on the cake, not the cake. Another symptom associated with new patient acquisition challenges are daily practice stress. If you're constantly stressed out at what the books are going to look like and what your schedule is going to look like, it's not a great place to live day in and day out. It's hard to show up and be your best when you're constantly stressed out. And it's usually indicative of a new patient challenge or, and this is a tough one, I'll admit this right off the bat, but it can also result in some resentment towards colleagues or resentment towards the profession, or just being generally unhappy with the way things are going. You can often trace that back to issues with new patients. There's a saying in the marketing and business world of sales cure all ills, and quite frankly, chiropractic practices are no exception to that. So chances are, if you are super stressed out if you're resorting to discount ads as really your primary way to generate new patients, if you you have some resentment building, even if you don't want to admit it, or you just look at your books and say your KPIs, and you're like, hey, I don't have enough new patients coming in. Those are all indicative of new patient challenges. We'll talk about the fixes for that in a moment, but let's move on to active patients. How do you know if you have a hole in your bucket that is in the active phase? Let's define what the active phase is first. Active phase is somebody's come into your practice and you've delivered an active care plan, but they haven't completed that active care plan yet. So everybody that comes in, right, you're creating a care plan based off of two things, your findings and their health goals. And if somebody's not completing their active care plan, that's a problem. You gave them that plan for a reason because you thought that was best. I don't care whether it was 2 visits, 4 visits, 6 visits, 24 visits. Whatever it was, it's based on what you believe to be the best thing for that patient. So if you have high patient dropout, meaning 10%, 20% aren't completing their active care Plans, that's indicative of an active problem in that phase of the journey. If you have non compliance with recommendations, that's an issue in the active phase. If your referrals are not optimized, that's an issue in the active phase. People should. The experience while being an active patient is what generates referrals. And quite frankly, it's not results, it's the experience. And for a lot of docs that's hard to hear because it's like, and that's not to say you, you don't provide fantastic results. But here's an example. Outside of chiropractic, if you go to a hotel, you could have a, you know, they do everything they say they're gonna do it. Meaning, you know, there's a restaurant, you stay there, there's no problems. That doesn't mean you're referring everybody there. But you could have issues along the way with a faucet, you know, with something else. But if your experience is top notch, they're in tune with you, they're communicating, they're nice, they, they're accommodating. You could have quote, unquote, not the optimal result, meaning something's broken or something to that effect. But if they are taking care of you each step of that way, you're probably more likely to refer than if you stayed there. They did all the things but didn't go above and beyond. So if your referrals are not optimized, it's about experience. And experience mostly happens during that active phase or there's no clear path towards what's next. When somebody completes an active care plan, they should know what's next in very clear terms. And quite often this is an issue for chiropractors especially, I'm going to say in more of the pain relief based practices because there's a little bit of ambiguity sometimes in terms of when they should come back. Well, come back when it hurts. Come back when you have to be really, really. I'm gonna encourage you to be really clear in your definition of when somebody should come back. And quite frankly, with the habits of the modern world, with stressors, lack of exercise, long periods of sitting, my opinion, for me, you make your own decision. But in my opinion, a monthly visit is a really good idea to check ergonomics, check movement patterns, hold accountability to people to be healthier. They want that, they like that. And that can be a very, very high value. But you have to explain that to patients. And if you have no clear path forward, you, you have a problem in your active phase. Finally, in the proactive phase, this is where reactivations happen. But in the proactive phase, here's where you identify you have issues. Here is that if every month you're starting collections at zero, your best month ever, awesome, your worst month ever, and you start the next month at zero. In other words, if you're 90% fee, 99% fee for service, you have an issue with the proactive phase of your journey. We'll talk about that in a moment. If you have thousands of past patients and empty space in your scheduling book, have an you have a defined issue with the proactive phase for sure. Or if you have patients that should just like ghost your practice, like you can't get a hold of them, you don't know what's going on. That's an issue with the proactive phase. Now let's dive into some solves because now we identified the issues. Let's talk about some of the solves. So, and these are going to sound relatively simplistic, but they are new patients. If you have any of those symptoms, we what do you need to do? How can you solve that issue? You can solve that issue by you've heard probably hear me say this before, but I'm going to drill it in and be really, really straight up with this. This is about teach and invite consistently. When you teach, you showcase something educational, inspirational, engaging. When you invite your call to action come into the practice, click here to schedule, comment down below, share with a friend and you do that consistently. That's daily. You will, you will. You will acquire more new patients and you'll even more so you'll acquire more of your ideal patients. Why? Because you're teaching and inviting consistently. You can see that this doesn't say advertise and hope for the best. It doesn't say run a newspaper ad and hope for the best. It does not say it is about teaching and inviting consistently. When you do that and you take that to heart, undoubtedly more new patients will come into your practice. It's just the way it is. Now you can apply this in a variety of different ways. You could do it on social, you could do it via email, you could do it via a webinar, you could do it via an in person event. Right? All of those give you the opportunity to teach and invite, but the consistency part is key. You have to do it consistently. Now you might not hold a webinar every single day, but if you're on social, you want to do that every day. If you're doing webinars you want to do those at least every two weeks. If you're doing in person, I would just say at least two weeks, maybe once a month. But those are the areas when you take it seriously, of teaching and inviting consistently, you will acquire more new patients. The second phase here are in the active phase, you want to educate and retain. Those are really the two key words. Patient education, educate and retain. Now, what are the friction points here and how do you do that? Email onboarding is one of the key aspects of here. So having a new patient email onboarding campaign is one of the most important things you can do. Why? Because. Cause if you're relying on your team to do this, number one, you can have team turnover. And number two, even if you have the best team right now, I guarantee you they're not saying it the way you'd hope they say it if you actually listened and recorded. I've seen some very interesting examples of this online where it's like, I coached and trained, this is an A plus team member, and I coach them. Exactly how we go about, you know, speaking with patients, onboarding patients, and what comes out is so dramatically different. It's like totally cringeworthy. So we. How do you solve that? You solve that by having email. Why? Because when you build it via email doesn't change unless you change it. And it can run 24, 7, 365, no matter who's sitting at your front desk. And patient education is key. So what are you showing in your reception area? This is active phase of the journey, right? What are you showing in your reception area? Please don't tell me it is the news playing on your television. This is an opportunity for patient education. So showcase great things. What are you showcasing for handouts? Do you have things people can read that are in tune? Maybe it is a magazine, but it's a magazine that ties into what they're into and what your practice is about. Not something like generic like people. Maybe it's a golf magazine. If you're into golfing and your patients are into golfing. So that's the education component, Patient education, it's as old as time, but then the retention ties into the automation. If you do not have automated email onboarding for your new patients, there's gonna be friction. An email sequence should be 6, 7 emails over the course of that first 10 to 14 days that do a few things, welcome them to the practice, it showcases any frequently asked questions, it builds the value of what you're doing. A great email campaign does all of those things. We of course do all of that and everything that we're touching on within the smart chiropractor. But this is a critical component that you need to take really seriously or else you're going to have a big hole in your bucket. And as we tie into the third phase here with proactive patients, this is about reactivation and enrollment. This is about reactivation and enrollment. So proactive patients, I think of this like a loop on the back end of your practice or if you want to think about the bucket, this is the bottom of your bucket. And you should be reactivating quarterly. And that does not mean just a missed appointment reminder, that is that takes place in your ehr or something like that. But you need to have a marketing system that does at least quarterly reactivations within the smart chiropractor. We do weekly email newsletters. We're building in, letting the cat out of the bag here a little bit, but some monthly campaigns on some upgrades to the smart chiropractor over the course of the next quarter before the end of the year. And also quarterly reactivation campaigns. That is absolutely critical to fill in that hole on the bottom of your bucket. Stay top of mind. You're not forcing anybody. You're not discounting. You're showing up and you're teaching and inviting and staying top of mind. Absolutely critically important that now you might be saying reactivate. Got it. Okay. 90 days quarterly. Makes sense. What's the enroll word all about? The enroll word is tying back to the beginning of this when I was highlighting the payday practice. This is your opportunity to build monthly recurring revenue. So what are. Who's your ideal patient? What are the services, health and wellness products that they're already buying, or the gaps and deficiencies that they have that you can solve for with monthly recurring revenue? Or specifically, I'm a big fan of E commerce in your practice. So let me get super tactical and tangible with this. If you know that 70%, well, you should know 70% of chiropractic patients take at least one supplement per day. For many of us out there, we have kind of our core supplements and it might be different for you, but a multi magnesium fish oil, those sort of things are typically core supplements. People are buying really, really crappy stuff online a ton of the time. And I had this experience in my practice, I brought it up before, but patient asked me, hey, what do you take for a multivitamin? I like poorly describe something. It takes me 10 minutes. They come back the next week with the wrong thing. And I'm like, this does nobody any good here. So why don't I have my favorite things, what I actually use, take, recommend available in an online store. So that when my patients ask me, hey, what do you recommend for this? Or what do you take for this? I can say, great question. It's available in our online store right now. We have a QR code right here on the desk or at the front desk. You can hop on over, pick it up, it's delivered right to your door. Now, the reason that hasn't happened in so many chiropractic practices is the technology. Technology is a bear on this stuff. But that's why we developed the Smart Care Store system, is to streamline that 10,000 products, all that inventory ships direct. So you don't need to have any of the inventory in your practice. Out of those 10,000 products, you get to curate which ones you want in your store. Supplements, physical goods, hard goods, all of that. The money of profits deposited into your account every single night at midnight for any sales. So it is a really, really way and you can connect it to your website. So Smart Care Stores, our e commerce system, is by far the best way to build monthly recurring revenue in your practice. Because people who already know, like and trust you, who are coming in, why wouldn't you extend that relationship in a meaningful way? And here's what I'm if you're thinking about, I don't want to sell anything. I agree. If you feel like you are selling, that tells me one of two things. You either have a product curation issue or you have a patient identification issue, meaning you haven't defined your patient avatar, or the product isn't really what you'd recommend, that's when selling occurs. But when you have your patients and you're like, man, I know the people coming into my practice have this issue, this issue, this issue, and they are looking for and already utilizing this product, that product and this product, and I make those. And that's what I care about too. And that's what's available in my store. Now I'm being super helpful. I'm creating deeper relationships. I'm actually extending the patient centric nature of my care and the relationship and side benefit. You're creating monthly recurring revenue, especially if it's a consumable, of course, like a supplement. You're creating monthly recurring revenue for your practice, which decreases the stress, increases a heck of a lot of the fun. So that's a ton of information to throw at you. But there are some keywords here you need to identify. I'm gonna encourage you as you're looking to build and grow your practice in the fourth quarter of this year. You know, if you have an issue with new patients, take a look at those symptoms. If they match up, get to teaching and inviting consistently. If you have symptoms associated with the active phase of the journey, think about what you can do to educate and retain. Or if you have, you know, proactive issues, then think about reactivations and enrollment. If you need help with this, hit me up, shoot me an email. I'm happy to provide, you know, let you know how we go about it. You can check out the Smart Chiropractor of course as well. But before we wrap up, I want to say a few words about Power Step, Power Step or the Orthotics. I personally use and recommend they support this podcast. You should support them and and they are willing to hook you up with a free sample pair. What can be better than that? Pro.powerstep.com sample pro.powerstep.com sample use the code EBC evidence based chiropractor EBC to get a free sample pair. These were developed by a podiatrist over 30 years ago. Fantastic quality, awesome product, great people. Check it out. Pro powerstep.com sample Other than that, I hope you have a fantastic week in practice and I will talk to you soon.

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