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Dynamic Chiropractic Canada – April 1, 2012, Vol. 05, Issue 04
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Walk in Your Patients' Shoes

By Jenn Sommermann, LCMT

Editor's note: The following appeared originally in our sister publication, Massage Today. Due to its universal applicability to health care practitioners, we thought it appropriate for the DC Canada readership as well.

Have you ever wished you could experience your own care? Over the years, I have yearned to know what it feels like on the receiving end of one of my treatments. But of course, that's impossible. The closest I came was receiving work from my friend, Maryann, who several people said was exactly like me. Afterward, I was disappointed ... not in her work, but in the idea that we were alike. You see, you can never really tell what it feels like to be your own patient. But is that really true? When you consider your patients, technique is probably the first thing that comes to mind. After all, isn't that why they come to you? But the truth is, technique only makes up a small percentage of your retention.

The Rule of Thirds

Sure, you have to have good hands and solid technique, but I don't think it tells the whole story. I am emphatic when I say, "Retention and success are one-third business skills, one-third marketing and one-third hands-on skills." I really believe this to be true, yet health care professionals flock to technique and modality seminars, thinking the advanced and increased skill set will guarantee a steady stream of patients.

It may add more to your bag of tricks (and I am an advocate of having a varied skill set from which to draw), but it won't necessarily increase your numbers (patients or revenue). A solid focus on business skills and marketing is what makes a chiropractor successful.

Interestingly enough, when I present at a convention, my marketing and business classes tend to have a smaller number of attendees compared to the technique classes next door. It is often my attendees, wildly successful already, who are seeing the maximum number of patients they are already capable of seeing. However, they recognize the benefit and necessity of adding more business skills to their repertoire.

Furthermore, when polled for the number-one reason people frequent an establishment, location topped the list. You've heard it said before: it's all about location, location, location. But it may not be possible to change your location. Does that mean all is lost?

Think of other reasons why you may frequent an establishment. Consider your favorite restaurant. Why do you return? Location certainly has something to do with it. But how about parking, wait staff, atmosphere, customer service, pricing and value? And of course, the food plays a big role. The main idea here is that all of these factors spell loyalty to your favorite restaurant.

The same is true for your practice. What this means is that the actual treatment is only part of why patients return or come in the first place. There is so much more that goes into patient satisfaction, retention and your overall success.

If You Are Replaceable, You're Doing It Right

I know this to be true first-hand. I lived in Boston for 22 years and had a thriving practice for 12 of them. My clinic occupied a quintessential New England house that was converted to commercial office space with 15 practitioners on staff. I was earning a very comfortable living and saw 85 percent retention of patients. The office patient list was more than 8,000.

The practice started with just me; it was my name on the door. As the practice grew, I hired more practitioners, building each one's practice from scratch. When I moved, I sold the practice to another provider in the office. She retained 100 percent of the staff and 90 percent of the clientele.

Even without me, the patients stayed. Truth to tell, this hurt my feelings (for about a minute), but of course, I wanted her (the practitioner who took over) to be successful. Not only did she need to make monthly payments for the sale, but she was nurturing my "baby" and I wanted it to live on and thrive.

The bottom line was that I was replaceable. Another provider had assumed my patients and the practice went on as if I had never there. Though my ego was a bit bruised, this experience proved to me, beyond a shadow of a doubt, that technique is only part of the reason why patients frequent a practice.

How to Experience What Patients Experience

There are countless ways to "experience" your work through your own eyes. In fact, I encourage you to do so on a regular basis. Put on your "patient glasses" and view all of the elements of your practice; that is, everything but your hands. Having the opportunity to experience your work is a great way to discover areas for improvement.

It is the savvy practitioner who learns from being their own patient and makes the necessary changes. How you go about this task starts at the beginning of the relationship.

How You Can Walk In Their Shoes: Step One

Put yourself in the position of a new patient coming to you for the first time and run through the following:

  • Listen to your outgoing message. Is it friendly, warm, unrushed? Does it offer a call to action?
  • Access your Web site and go through the "Request an Appointment" process. Was it easy to schedule? If it was, it's easy for your patients, too.
  • Call your office staff and make an appointment or ask for information. How quickly did they answer the phone? Did they have a "smile" in their voice? Was the call rushed? Did they sound distracted? Did they have answers to your questions? Keep in mind that they may recognize your voice, but we have an answer for that later.
  • Fill out your intake forms. Are they current? Are they easy to complete? Is there enough space for the answers? Is there anything that should be changed?
  • Enter your office with fresh eyes. Is it clean and organized? Is it well-lit? Are there materials available? Is the bathroom spotless and stocked with enough supplies? Is there enough seating or too much? Side note: Too much seating sends the message that you don't run on schedule and patients need to wait.
  • Note what things look, smell and feel like. Is it quiet? Does you smell any odors that might offend someone? Are there stains on the chairs, walls or carpet? Are there fingerprints or scuff marks on the walls? Are the magazines tattered, out of date and/or irrelevant?
  • Lie on your exam table and look at the ceiling and under the table. Do you need to dust, paint or replace the carpet?
  • Use all of the facilities and equipment in your office. Is everything in working order?

This is not an exhaustive list, but it gives you some ideas to get started.

Step 2: The Restaurant Reviewer Tactic – Use it

Have you ever wondered how restaurant reviewers, the legitimate ones, manage to get a "real" meal instead of the very best the chef has to offer? After all, a restaurant's reputation can be destroyed by a bad review, and owners know the name of the person who writes for the important media in their town. Reviewers do their work by being anonymous customers. Someone else makes the reservation, they never tell anyone at the restaurant who they are and they keep their picture out of the paper.

No, I'm not recommending you wear a disguise. You won't look good in a fake nose and mustache. Instead, solicit the help of a good friend, family member or colleague and ask them to run through the process from beginning to end.

Sometimes called a "mystery shopper," this person goes undercover to find pitfalls or accomplishments. Choose someone who will be brutally honest with you.

The point is to learn possible areas of improvement, not to learn how wonderful you already are. Have them call for an appointment at some random time. See the process through, all the way to rescheduling another appointment. Once completed, ask them:

  • Was your call returned promptly?
  • Were the directions to the office clear?
  • Did you find the information you needed on the Web site?
  • Were you greeted in a professional manner?
  • Did you know what to do once you entered the office?
  • How long did you have to wait to be seen?
  • Did you and your time feel valued?
  • Was the facility clean and uncluttered?
  • Did everything smell and look clean? Was the temperature of the office comfortable?
  • Did you feel comfortable with the entire process?
  • Did you feel "listened to or ignored?"
  • Was there a place for your belongings (purse, etc.)?
  • Was there anything that made you feel uncomfortable or uneasy?
  • Is there anything that could have been done to improve the experience?
  • Did you think the pricing was appropriate?
  • Was there inherent value in the experience?

Note that neither of these lists has anything to do with your technique or the hands-on experience. These are business applications that can make a patient's experience wonderful or miserable.

You have the power. If you take the appropriate time to test the waters, then you can learn and make the necessary adjustments to improve your practice.

It's Competitive Out There

When you think of your own experience with health care professionals, I am sure you can conjure up a good memory and a bad one. With a myriad of health care professionals to choose from and the competition stiffer than ever, the average patient won't stick with someone if they've had a bad experience.

I waited for a medical consultation for three hours ... once. I never saw that doctor again and in fact, never went back to that group practice. The staff was unapologetic and the doctor made me feel like his time was more valuable than mine. He was a world-renowned surgeon and I didn't care. He wasn't getting a piece of my shoulder.

Conversely, my chiropractor makes me feel like she has no one else to care for except me. She tends to run a little late, but it is perfectly OK with me because I know she will give me her undivided attention. Her staff is fun and it is always joyful to go to her practice.

Take a minute now and consider your own experiences with health care, whether a fellow chiropractor or a different health care professional. Recall one you liked and think about why you liked them. Do the same with the negative experience. Now take this information and duplicate it in your own practice.

Annual analysis of your practice is an absolute must. More frequently is fine, but at least once a year, try to be your own patient. This is even more important and valuable if you have staff, which most offices do. In fact, if you have staff, a semi-annual review is imperative. All of this takes time and doesn't actually make you money, but the importance of doing it can't be underestimated with respect to your future growth.

Retention is the name of the game. If, after completing this exercise, you would return to your own practice, chances are your patients will feel the same way. When I look at everything that goes into a successful appointment, I realize that the comparison to Maryann had little to do with my hands. Our demeanor, office set-up and business acumen are very similar. Being compared to her is actually a compliment, and nothing for which I should be disappointed.

Jenn Sommermann is a licensed massage therapist, educator and business consultant. She practices in New York and is the owner of Massage by Land & Sea. Jenn continues to reach a broader audience, offering continuing education in practice management and ethics throughout the country. She can be contacted at

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