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Dynamic Chiropractic – July 29, 2008, Vol. 26, Issue 16

Beyond Charisma: 10 Tips for Building Patient Loyalty

By Shelley Simon, RN, DC, MPH, EdD

What motivates some patients to remain with a chiropractor for many years, while others leave after only a visit or two? Why do some patients refer, but not others? These two questions have puzzled chiropractors for decades and every practice-building seminar claims to have the answers.

Having attended your share of weekend seminars over the years, you probably employ many techniques designed to build patient loyalty and result in better retention and more referrals. Some of these include having a pleasantly appointed office, placing an emphasis on convenience for patients, sending thank-you notes and birthday cards, making follow-up phone calls to patients after an initial treatment, and using referral-appreciation programs. These practice-building tactics, along with the ability to skillfully ask satisfied patients for referrals, are all effective to some extent when used consistently.

However, chiropractors who have a truly dedicated patient following know these practice-building ideas take them only so far and just being personable and charismatic - while a plus - does not result in sustainable practice growth and success. Building patient loyalty requires a deep understanding of what patients want and need, an ability to deliver high-quality service on a consistent basis, and providing clinical care that results in positive outcomes.

In this column, I propose chiropractors augment these tried-and-true tactics with interpersonal strategies that can deepen relationships with patients, establish greater levels of trust and build stronger patient loyalty. Here are 10 tips for you to consider if you are sincerely interested in having a practice that is notable for patient loyalty and referrals.

  1. Understand the true purpose of marketing. Effective chiropractic marketing is largely about building trust and developing relationships. The purpose of marketing, according to Tom Asacker, author of A Clear Eye for Branding, is to "create and maintain a strong feeling with customers so they are mentally predisposed to continually choose and recommend you." Successful marketing also requires being relevant and unique. Asacker says, "You want to be important to people's lives, to make a difference, and be the only one who can deliver it the way you can." This brings us to tip #2.
  2. Identify and build your brand. We're not talking about your practice logo, marketing "look," or tagline, although you should have those tools in your marketing kit. Branding that builds genuine patient loyalty goes beyond what the eye can see. It's branding at the emotional, sensory and gut-feeling level. Your brand is what your practice is known for, how you engage with patients and what people can depend on you to consistently deliver. It's a compilation of your most important strengths. What would a patient referring someone to your practice say about you? "He listens better than any doctor I've ever been to see." "She goes out of her way to find resources and solutions for me." "The staff is warm and caring; you can feel it the minute you walk in the office." Identify your brand and leverage it to see patient loyalty and referrals increase. Don't be shy about showcasing your uniqueness and strengths.
  3. Tap into what patients want. In order to appeal to a patient's needs or desires, you must first understand their motivations, values and priorities. As human beings, we gravitate toward people who make us feel valued, hopeful and connected. We want to associate ourselves with people who inspire us to be the best we can be. We want to feel respected and trusted. You'd be on safe ground assuming your patients want these things, too. But beyond that, each patient is unique and has needs and wants as individual as they are. Being tuned in to what patients want and being sensitive to their evolving needs will help you become more resourceful and innovative as you care for them over time. This is an excellent way to set yourself apart from other health care providers and help you build memorable, lasting relationships with patients.
  4. Understand what patients actually are paying for. Chiropractors like to believe patients are buying their expertise. Yet most people cannot evaluate your expertise and/or they simply assume you are an expert by virtue of your credentials. What patients can assess is whether they experience positive outcomes; if the relationship they have with you is meaningful, if they feel valued, and if they receive a high level of service. Interestingly, patients tend to assume doctors who are genuinely caring also are highly competent - but not the other way around. What do "caring" doctors do? They listen more than they speak, ask great questions, answer questions in ways patients understand, remember what is important to each patient and always put the patient's agenda ahead of their own.
    According to internationally known branding expert and author Harry Beckwith, "If you're selling a service, you're selling a relationship." Practitioners who have been to too many seminars take this idea and run with it, but at a superficial level. Some even come away thinking practice success is based on their own charisma, dynamism or extroversion. A little charm never hurts, but remember that a good doctor-patient relationship is not built on you being entertaining, engaging in casual chitchat, asking about grandchildren, or complimenting a patient on his tie. A relationship means communicating authentically and from a place of curiosity about what a patient really needs and wants and keeping the focus on why the patient is in your office (i.e., for quality care and their own needs, not necessarily to be friends with you).
  5. Outcomes matter. Practicing good interpersonal skills and maintaining solid doctor-patient relationships are important for developing patient loyalty. But what really matters to patients are outcomes and results they can feel, count on and talk about. Patients might come to you a few times because you are caring and pleasant, but they won't keep seeing you for care based on your winning personality alone. Patients must trust you to help them improve their health, see results, and learn something from you in order to make it worth their while to continue as your patient. Remember, patients refer friends and family members with comments like "I've never felt better," not "He's a great conversationalist."
  6. Integrity » trust » relationship. Integrity involves fundamental behaviors like keeping your word, being honest, providing a consistent level of service and being reliable. Chiropractors who demonstrate a high degree of integrity are seen as genuinely trustworthy. Building trust requires the practitioner to continually put the patient's interests ahead of their own and display a genuine "other" orientation. You demonstrate this by being interested rather than interesting and by not treating every interaction as an opportunity to share your message. You do this by being caring, empathetic and compassionate, and by listening. All of this adds up to practicing with integrity. Without integrity, there is no trust, and without trust there is no enduring relationship.
  7. What have you done for me lately? One of the most common mistakes chiropractors make is focusing primarily on the early part of care. They wrongly assume that once a patient is happy, they will stay happy and continue to utilize the services of the practice. Each patient's experience is the sum of every small experience they have while in your office and in your care. Ask yourself, "If I were this patient right now, what would I really want in terms of education, care and service?" Remember, your patient is always thinking, "What's in it for me?" What you do (or fail to do) at every point during a patient's course of care makes an impression.
  8. Never take loyalty for granted. A successful external marketing campaign will encourage people to try you out, but only good clinical outcomes and an authentic relationship with you will keep them coming back. A patient's willingness to return to your office for continuing care depends only partly on their need for your services. They can easily choose another provider or even a different modality for care if they are not happy with what they experience in your practice. A patient's decision about what to do next in terms of seeking care might well be based on their most recent experience in your office. Never take loyalty for granted. Never underestimate the power and value of the one-to-one relationship patients have with you and your staff. Patients return to practices where they feel connected, have a sense of belonging, where there is mutual esteem, where they are treated with respect, and where their care results in positive outcomes.
  9. Word-of-mouth marketing isn't new. Third-party endorsement or patient referral always has been the foundation of chiropractic marketing. What is new is that the bar for what patients expect in the way of service is higher today than it's ever been. Being good isn't good enough to get patients talking about you. Outstanding is the new good. Polls repeatedly show the quality of customer service is on the decline across industries. If you've tried to reach a real person by phone about your credit card statement or flown a major airline lately, you know this is true. And yet, consumers - your patients - continue to expect high-quality service. When you consistently exceed expectations, patients become what author Ken Blanchard calls "raving fans" - individuals who would not dream of taking their bodies anywhere other than your office for care. These are the patients who refer their friends, relatives, neighbors and co-workers.
  10. Know and appreciate your ambassadors. In his bestselling book The Tipping Point, author Malcolm Gladwell says people who refer fall into one of two categories: Connectors or Market Mavens. Connectors are social. They have a gift for knowing people and naturally make connections among their network. Market Mavens are people who have "the goods." They have a desire to be of service and influence others. Data banks of information, they know how to get the best deals and the best service and they share information with enthusiasm. According to Gladwell, "Word-of-mouth begins when someone along the chain tells a connector or a maven." Learn to recognize these patients in your practice, cultivate them and express your appreciation accordingly.

Build Your Practice With Greater Ease

Cultivating long-term relationships with patients is best achieved by developing and using superior interpersonal skills, understanding each patient's experience, establishing a brand identity and delivering a "wow" level of service. The most effective techniques and tactics in the world will not take the place of focusing on patients and putting their needs first. Being the most charming, delightful and witty doctor within a 100-mile radius will not replace delivering outcomes that matter. Patients are not loyal to your personality. They are loyal to results they can feel in their bodies and that make a difference in their lives.

Many chiropractors will read the tips in this article and say to themselves, "I do all of this." Some probably do, but my experience suggests even practitioners who understand the principles described in this article often do not deeply embrace or apply them on a regular basis. Re-read the tips, share them with your staff, and work on developing the skills necessary to make these methods part of your overall practice-building strategy. Use your tried-and-true tactics and these 10 tips consistently to enjoy a new sense of ease and confidence in growing your practice.

Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.

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