Q: Dr. M First let me thank you for your newsletters.. They are both informative and enjoyable. I am in practice for 16 years. I've never reached the level of success I had envisioned for myself and have found practice building very frustrating. I have attended seminars, utilized management consultants etc. I contact attorney's only to be told send me cards and when a case comes in we'll be sure to send them to you. I have done numerous posture screenings most resulting in mediocre results. I speak before groups/corporations however setting up these seminars is extremely difficult not to mention time consuming. I have done marketing to MD's and again have attained mediocre results. I can assure you that my "lack of success" is not due to not being out there doing and trying all types of marketing etc. I used to see 120-150 visits per week. That was many years ago. I currently see 80-100 (100 on a good week). I am sure you can hear the frustration from the tone of this email. It seems that no matter how much or for that matter how little effort I put into a project the results are basically the same. I am not looking for some new idea or the best thing since sliced white bread. I know better than that. I know that patients, money, success (however you want to define it) comes from us not to us. I have a library of tapes and books on success and philosophy, sales etc. I study these things almost daily. So where do I go from here. To be quite honest I have had thoughts of a career change however the truth is on some level I enjoy being a chiropractor and secondly given that all my training is in chiropractic I have no idea what else I would even do. I look forward to hearing from you. A: I met with a DC friend the other day who I haven't seen in awhile. He has been practicing for 22 years and never took it upon himself to save or protect himself from business and financial ups and downs. This may be you as well .. I am not sure. As we spoke it became clear that his recent divorce just placed another dagger in his already weakened spirit and his finding out that his ex-wife didn't pay taxes for two years and lots more isnžt help either. His practice has suffered and he is seeing half of what he did over a year ago. This was all news to me and I wished I could wave my hands and all would be better. By alas this is not the case. He too asked if I had any wise ideas to jumpstart his practice. So much to discuss .. sensitive issues for a DC veteran with pride and me trying to offer advice that he already knows and did but has no desire to now at this stage of his career. Business is business and there are ups and downs sometimes so down that companies are literally out. Yes .. we have a great product and there should never be a need for us to advertise .. do workshops .. screenings or network with allied professionals .. you are right .. people should instinctively come to us and pay for the privilege. But .. again this is not the case. We have always swam upstream like salmon trying to create awareness and business. Nothing has changed except the climate. Although there are many DC's failing and thinking or changing their career paths .. there still is a better environment for alternative healing and the medical professionals feel the pinch like never before due to their limited entry into managed care. The time is ripe to make a difference and establish yourself within your community. I agree .. it would be a drag to start hustling for new patients as you had to do when you were fresh out of school but guess what .. you have been downsized no less that AT&T or other corporate giants. They have to restructure stay afloat and wait out this economic storm. Smart companies are starting from scratch and rebooting their business. Same for us. We need to forget about our pride and when we're down and go we have to bite the bullet and go back to the basics .. caring for those we have and asking them who they know. Sending a few letters to allied professionals and the attorneys within your community. Networking is the key and no one knows who or where you are unless you tell them. Begin a campaign of gathering names of potential targets from the outside the same time you create resources for further external marketing. If you can spare a few bucks my books are a great resource as they are easily written and how to's are great for you or a PR person you may wish to hire. There are many consulting and management firms itching for your money because many DC's lack the creative ideas to stimulate a thriving or steady clinic whether from within or without. Have a Great Day Dr. M Reply2 I have never stopped "promoting" my practice. I've been doing screenings, lectures, networking for all 15 years in practice. Just as an example, just last week I contacted over 25 companies and faxed out to approximately 15 of them information concerning various lecture workshops that I provide. I promise you that my lack of "success" has nothing to do with not marketing. I market my practice all the time. The frustration is when these activities produce little results. I have no problem going out there, meeting people, networking, etc however, how long can one keep doing something if they get no closer to their goals? At what point do you say this doesn't seem to be working? I am not one to give up easily so "hanging in there" is something I am good at. If chiropractic care is so terrific ( I'm not suggesting it isn't) then why are so many of us having such difficulties, struggling to pay our bills. I am very aware it's not just me. Why have so many DC's gone on to other careers after pouring years of hard work into school and practice? Why does it seem that chiropractors are the only professionals who have to constantly do lectures, screenings, etc just to stay in business? Why does it seem that there are more management/patient consulting firms for chiropractors than there are actual chiropractors? Doesn't that seem odd? I was on the phone with a colleague last night and he told me he goes door to door to the local MD's introducing himself. Could you see the local MD's or dentists coming into your office introducing themselves looking for business? I can tell you that it doesn't happen in my neighborhood. While I'm thrilled that it works for him my initial thought was, "how sad that this is what he needs to do in order to make a living." I look forward to hearing from you once you get back. A2: Thanks for the reply. I was not expressing your lack of PR or willingness to go out there and pay your dues .. overtime .. just attempting to get across the idea that chiropractic is a business and rather than you lose the vision of the big purpose and how much it helps many people .. and as a business there are the ups and downs and often the downs stay that way. People are always moving on to new jobs .. retraining .. and new careers. As a DC we have the ability to reinvent ourselves time and time again .. we just need to be more creative. If I were you .. I would focus my attention with my present patients .. use surveys .. create e-mail newsletter lists .. determine if you can offer new workshop topics and attempt to get them to invite others to them .. begin quick lunch workshops concerning ergonomics and stress management for local mom and pop shops and corporate and civic employees. Possible spend a few bucks and offer a dinner with the doc in a local restaurant .. I know terrible to buy patients .. but what is mailing costs or advertising fees if not buying patients .. invite patients to this special workshop dinner (try to keep the dinner fees within $10 a piece) but they have to invite a guest (adults only) for this special get together .. or have it in your office and order pizza and sandwiches etc. Create special days these coming months .. a theme a month .. in other words create new energy in the office. Have your staff get involved and create a bonus number as a goal and for their work getting to it .. have them reach small goals for small bonuses at first .. and DO NOT EXPECT RESULTS quickly but expect your best attempt. This is just the beginning of turning things around. You know as much as me that when a marketing venue is not working you have to try something else. You PR activity is to be admired .. you walk the walk .. trouble is the road is bear or needs to be cultivated differently. Check my webpage: www.chirosmart.net under Practice Tips for tons of great ideas just take your time scrolling around. Have a Great Day Dr. M