Most advice on growing a chiropractic practice starts with getting more new patients. Twenty-five years in practice, and the years spent coaching practice owners since 2011, taught me the opposite order: growth is what happens when the practice underneath is sound, and the place to start is retention, not reach.
That is not the exciting answer. The exciting answers are the ones with a funnel diagram and a promised number at the bottom, and I am not going to give you one, for reasons I will come to.
Why retention comes before marketing
A practice that loses patients faster than it should is a bucket with a hole in it, and marketing poured into that bucket buys you the same problem at a larger size. More new patients arrive, meet whatever was causing the others to drift away, and drift away themselves. The owner concludes the marketing did not work. Usually the marketing worked fine; it delivered people to a practice that could not keep them.
I have never seen marketing fix a retention problem. I have often seen retention work make marketing look better than it is.
So before you spend anything on being found, answer this honestly: of the people who started care with you last year, how many finished what you recommended? If you do not know the number, that is the first piece of work, because you cannot manage what you have never measured.
What I changed in my own practice
In 2004 I moved my own practice onto a membership model, at a time when that was an unusual thing for a UK chiropractic practice to do. I did it because the conventional arrangement seemed to me to serve nobody well: patients faced an unpredictable per-visit cost, and the practice faced unpredictable weeks.
I am deliberately not telling you what it did to the numbers, and the reason is the same reason I would give a patient asking what a session will achieve: your case is not my case. What I can tell you is what the change required, because that part transfers. It required knowing our figures cold, being able to explain the offer in one plain sentence, and a team that understood it well enough to answer questions without me in the room. The model was the visible part. Those three things were the work, and they are the same three things almost every practice decision turns on.
Where practice owners actually lose ground
The owners Jo and I work with rarely arrive saying "our marketing is weak". They arrive saying some version of "the practice runs me". Nobody taught us the business of it at college, and most owners are carrying every decision themselves: clinical caseload all day, then the rota, the recruitment, the numbers, at night.
The pattern underneath is nearly always the same. The practice depends on the owner being in every room at once, which caps what it can carry and exhausts the one person it cannot function without. The work that changes it is unglamorous: deciding what only you can do, building the team and the systems to hold everything else, and measuring a small number of things every week rather than everything once a year.
What about marketing?
It has its place, after the above, and done in a way you can measure. I have set out how I approach practice marketing separately, and the longer treatment is in the practice-building books.
One warning belongs here. This corner of the industry is full of income claims, and the advertising regulator has upheld complaints against business coaches for making them. You will find no revenue promise on this page or anywhere else on this site. Anyone who promises you a number does not know your practice, and the promise tells you more about their marketing than about yours.
Where to start
Measure retention. Know your figures. Decide what only you can do. If you want a working partner in that rather than a slogan, the work Jo and I do with practice owners explains what it involves and who it suits.
Steve Davison is a chiropractor registered with the General Chiropractic Council. He has been in practice since 2001 and has worked with practice owners since 2011. About Steve Davison.