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July, 2010

Caring Between Care

By Lawton W. Howell

One harsh reality of growing your practice is that people don't know how much you know until they know how much you care. You exhibit how much you care and your professional expertise on each and every patient visit, but the vacuum between each adjustment is an opportunity for you to show how much you really care. This vacuum begins at the end of an adjustment or office visit. This is your period of vulnerability. You cannot afford to be out of sight, out of mind - until the next adjustment.

Post-cognitive Dissonance

When humans make a decision, they will seek validation. This social phenomenon, post-cognitive dissonance, is particularly important to you in terms of improving patient loyalty and increasing referrals. Post-cognitive dissonance begins on the first office visit and becomes even more pronounced over time, depending on other influences such as the spouse questioning why so many chiropractic adjustments are needed. Friends, relatives, co-workers and the media can exert influence over the patient's decision to begin or continue care. You must offset this influence with your side of the story.

Embedded in post-cognitive dissonance is the desire to validate one's decision. People will actually tend to hone in on messages that reinforces their decision. In other words, they are highly receptive to positive reinforcement. One study revealed that people who selected a new car would seek out and focus on the same model and ads about their new car, thereby ignoring and pushing aside competing messages that differ from their decision. You deliver care with certainty, but you also must provide a consistent and continuous stream of communication between each adjustment.

Patient communication is really marketing. Think of marketing as everything that you do that can be seen or heard by your patients or the people in your marketplace. The time between adjustments is an opportunity to deliver a message crafted to build a relationship with the patient, show how much you care and increase patient-based referrals. During the time between adjustments, you must validate their decision for selecting your brand of chiropractic. If you don't fill the void between adjustments, you risk losing a patient and countless referrals.

Touch Points

There are literally hundreds of touch points occurring between adjustments. In fact, they begin within seconds of an adjustment and continue until the next office visit. You should map these touch points and then develop your tactical plan to provide the right stimulus that will validate the patient's decision for continued chiropractic care and to share their experience with their relatives, friends and co-workers. Begin by role-playing a patient. Get an adjustment and then map out the patient's journey:

  • Sitting up, the patient will most likely see a door/wall.
  • In the hallway, the patient will see ___.
  • During checkout, the patient will encounter ___.
  • Exiting the office, the patient will view ___.
  • Driving back to the office or home, the patient will view/hear ___.
  • Arriving at work/home, the patient will perform the following ___.
  • Until the next office visit, the patient will be influenced by ___.
  • When the patient returns to the office they will ___.

When you map out each of the patient's touch points, you can determine how to fill the void; i.e., caring between care.

Strategic Tactics

The more you fill the void between adjustments, the greater your ability to create a lifetime patient and increase referrals. In order to maximize your time-based marketing strategy, you must understand two critical components of effective and impactful communications: the stated message and the unstated message. The stated message is simple. It is the actual, physical message. For example, a poster, advertisement, and brochures are all examples of a stated message. Since marketing is everything that you do that can be seen or heard by your patients or the people in your marketplace, you have a stated marketing strategy implemented.

However, unless you combine the stated message with the appropriate unstated message your marketing could be working against your desired outcome. For each stated message, there is an unstated message. This is the message behind the message, and it has more power to persuade than the actual stated message. The unstated message is the one that requires the most thought and execution. Your ability to get past buyer's remorse will, in a large part, be based on how you present your messages. You must carefully plan the unstated message, as this will be the message your patients or the people in your marketplace will store in their subconscious. This perception will determine their level of confidence and trust in your brand of chiropractic.

Here are some quick tactics you can use to show how much you care between office visits. It is not intended to be a comprehensive strategic plan, but, to demonstrate how simple it can be to implement time-based marketing.

First Patient Visit: The patient form is pre-completed and a welcome letter is provided upon arrival. The patient is seen by the doctor within seven minutes. They are presented with portfolio containing appropriate content and testimonials. Offer bottle of water and/or fresh fruit. Send a welcome e-mail message with home care tips.

New Patient: When the patient accepts your recommendations, add them to your e- mail list for healthy tips focusing on how they can enjoy a healthier and more active lifestyle with your brand of chiropractic. Before their first adjustment, you should call the patient to let the patient know what to expect from their first adjustment. This call will help stop any concerns the patient may have about their decision to begin care by alerting them as to what to expect.

Lifetime Patients: The ultimate strategy for overcoming post-cognitive dissonance is having a structured campaign for communicating with your patients. Even your external marketing will influence patients, as they will actually spend more time with your advertising than non-patients. You should, at a minimum:

  • E-mail daily/weekly tips to your entire patient list.
  • Mail a printed newsletter monthly to your entire patient list.
  • Promote a monthly theme.
  • Host special events for your patients.
  • Have a planned and structured patient reactivation program.
  • Perform random acts of kindness supporting the patient's aliveness.

Each touch point will build on the previous one. The more you fill the void between visits, the greater your potential for achieving your desired outcome. Peak your practice when you show how much you care between care.

Lawton W. Howell is the founder and chief executive officer of WellnessOne Corporation, a chiropractic alliance marketing group based in Las Vegas. Direct questions and comments regarding this article to 877 WELNES1 (toll free), send an e-mail to , or visit

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