By William D. Esteb

New patients come from basically two sources: external marketing (screenings, advertising and promotions), or internal marketing (word-of-mouth and referrals). What internal marketing often lacks in quantity is compensated in quality. In short, new patients who are “pre-qualified” by someone who vouches for you, tend to be more cooperative, engaged and responsive.

Do you have a referral-based practice? Would you like one?
See the referral process from a patient’s point of view and discover new ways to stimulate referrals. But, what is a referral?

Ask and you shall receive?
You’ve most likely attended at least one seminar in which the charismatic speaker has urged you to ask patients for referrals. And, while this ploy seems doable from the safety of the hotel ballroom, in practice many chiropractors lack the fortitude to make such a seemingly self-serving request of their patients.

The good news? Patients generated via this method aren’t referrals. These guilt offerings may produce those who need — and benefit from chiropractic care — but they’re not referrals!

A referral is unsolicited. It is spontaneous and it occurs beyond the walls of your office.

A referral’s power and influence are derived by virtue of your apparent inability to control what’s being said (good or bad) about you and your practice. That’s why an endorsement from a delighted patient carries more weight than paid-for advertising. A persuasive patient tends to attract better patients than yellow page advertising, coupons or complimentary exam offers.

So while a referral is out of your direct control, you can do many things indirectly to increase the number of referrals you get. Here are just a few of the tactics employed by busy, referral-based practices:

1 Deliver the goods. It goes without saying, but it’s unlikely to inspire patients to refer others if your adjusting technique is rough, your tableside manner aloof or your office environment shabby. Patients encounter literally dozens of “moments of truth” during their course of treatment that can boost — or bust — referrals. Communicate well and make your presence as a chiropractor positive and uplifting.

2 Add capacity. Practitioners sitting on their thumbs at
10:50 a.m. or surveying an empty reception room at 2:45 p.m. assume they have excess capacity they could fill with new patients.

The problem is that few patients want to come in regularly at those times. Do you have the ability to see more patients at the times patients want to come in? If not, referrals dry up. Patients think — or may even say to you — “If I tell my friends about you, I’ll have to wait even longer for my own care.”

If you add capacity during peak times, you will have to reduce the amount of time you spend with patients, delegate nonclinical responsibilities to others or hire additional help. If you’re unwilling to increase capacity in any of these three ways, you may find that your practice is as large as it’s going to get and you can stop torturing yourself about growing it.

Since referrals are controlled by the perceptions of your patients, it may be helpful to find out how “full” patients think your office is. Ask. During the course of your palpation, leg-length checks or other visit preambles, pose this simple question: “Hey, I was just wondering, how full do you perceive our practice to be at the time you usually receive your care?”

Most patients have never thought about it and will respond with, “Huh? What do you mean?”

“Okay, let’s say there’s a widget factory somewhere,” you respond. “This particular widget factory has the capac-ity to make 100 widgets a day. Days they only turn out 80 widgets, we’d say they were working at 80 percent capacity. If they strain and put out 110 widgets, we’d say they were working at 110 percent capacity. At what capacity do you see us working at?”

Most practices find referrals get choked off when patients report that they see the practice as 85 percent full, or more.

3 Let patients know. Your patients may not have a clue that you have an interest in growing your practice. Often just periodically alerting patients that you have “room for a few more people who are health-conscious like you” will generate the awareness necessary for an uptake in new patients.

To create awareness, some offices place a referral-oriented poster or place a small sign at the front desk that reads something like, “Thank you for your referrals. The ultimate compliment is when you tell others about our office.”

4 Rehearse the referral dialogue. Do your patients ever tell you, “I tell all my friends about you, but I can’t get them to come in”? The problem may be that your patients lack the language to explain chiropractic in a compelling way.

Again, sometime during the course of a typical office visit, ask patients you’re most interested in receiving referrals from, this simple question:

“I was just wondering, when you tell your friends and family about our office, how do you describe chiropractic to them?”
Questioning patients is not rocket science. It just requires the courage to ask and the discipline to listen. If you ask this question and you’re greeted by a long silence then you know one of two things: either they’re not telling others or simply can’t. On the other hand, if you hear language that is less than inspirational, you suddenly know why so many patients can’t seem to get their friends to come in.

If patients — even after all your patient education overtures — are unresourceful at explaining chiropractic, use the opportunity to gently coach them with some better language. Of course, before you can coach your patients, you have to know how you want chiropractic and your office described. You can’t expect your patients to become referral ambassadors until you are able to clearly describe your mission to them.

5 Become a referral source. Chiropractors who don’t enjoy a steady stream of referrals share one thing in common: They rarely refer their own patients to other types of practitioners in their communities or to the businesses owned by patients.

Chiropractors who get a lot of referrals give a lot of referrals.
Whenever appropriate and when it’s in the best interests of the patient, make a referral to a good lawyer, an open-minded medical doctor or other practitioner. The referral process works in a similar way to a fireplace: you have to put fuel on the grate before you can expect heat from a fire.

This is based on the rule of reciproc-ity — creating a subtle form of indebt-edness that calls others to return the favor. It’s the underlying strategy behind the countless free samples given away Saturday mornings at the grocery store.

And, while you may find a certain crassness of “giving to get,” like it or not, the “you scratch my back and I’ll scratch yours” has a rich history that has produced powerful alliances between people, businesses and even countries!

Master these simple distinctions and you equip your patients to spread the word about chiropractic, giving them the deep satisfaction of helping you help the ones they love.

William Esteb is a chiropractic patient and provides innovative patient communication tools through Patient Media, Inc. Contact him at www.patientmedia.com or by calling
800-486-2337.