Chiropractic + Naturopathic Doctor

The elusive patient referrals

Anthony Lombardi   

Features Business Management

How to make people like you

Photo: Fotolia

Patient flow determines practice sustainability, but new patient referrals drive practice growth. There are essentially two reasons patients refer you to new patients: Patients like you, and patients love your product. These reasons are outlined in the NY Times bestselling book Word of Mouth Marketing – How Smart Companies Get People Talking by Andy Sernovitz.

I first interviewed Andy back in 2012 for a piece I wrote called, “Creating a Stir.” However, since that time the importance of mastering how to obtain patient referrals has elevated because there are now more chiropractors than ever before. The competition for new patients is so great that some chiropractors are in business while others are not. Natural selection economics is taking over and only the strong practices survive when the patient flow of their peers dries up.

I’ve also become more assertive with my advice in the last five years. I feel that I have been able to practice what I preach. From 2012-2017 I have attracted over 3,000 new patients to my practice – a model of consistency. I genuinely enjoy helping other DCs. The problem? Other DCs, in many instances, are unable to help themselves. I believe that in 2017 the greatest limiting factor to chiropractors’ success will be their unwillingness to listen to those who can do it better than they can.


Many times I observe chiropractors new and old who are in need of help. However, they find it very difficult to let go of their old way of doing things. Clinically speaking, those who are in the know can make assessment or treatment suggestions – but those DCs in need tend to revert back to what made them unsuccessful instead of applying new ideas.

Those 3,000 new patients I attracted didn’t happen by accident. It came from countless hours of studying, shadowing and having conversations with the likes of Dr. Alejandro Elorriaga, a sports medicine specialist and program director in contemporary medical acupuncture at McMaster University, Dr. Andrew Dunn, DC, and Dr. Mark Scappaticci, DC. I was a blank canvas and I modelled myself after what they did until I had matured enough to begin expressing my own individuality. If they recommended to do something a certain way – by golly I did it that way. I did not ask questions, or modify the recommendation – I did it that way without reservation.

So do you really want to be successful? If so, it is essential to listen to those who have accomplished what you aspire to attain.

Make people like you
Patient care is a social occupation. It’s a continuous exercise in public speaking to an audience of one – your patient. Patients need attention and they need to feel that they are special. One of the greatest compliments a patient ever said to me was that out of the thousands of patients under my care, when they come in for a visit I make them feel like they are my only patient. No matter how good your clinical skills are, if you cannot carry on an interesting social interaction with your patient then they may never stick around long enough to realize that you can help them.

In plain language, if you are not a good conversationalist, outgoing or personable, then chiropractic may not be for you.

But there’s hope: In 1936, Dale Carnegie wrote an award winning book: How To Win Friends and Influence People. In it he outlined key ways we could stand out and, in essence, become more likeable. I have encapsulated the most important points for clinical practice:

  • Be genuinely interested in other people.
  • Remember names. According to Carnegie, a man’s name is to him “the sweetest and most important sound in any language.”
  • Encourage others to talk about themselves.
  • Make the other person feel important.

The incorporation of these points will not only make you more personable but it will make you more comfortable with conversation and social interaction.

Make people love your product
In the unedited words of Andy Sernovitz: “If your product or service sucks, no PR campaign, clever TV ad, or announcement on your website will make patients believe that it doesn’t.”

The most important ingredient you’ll need for people to love your product is for it to be interesting. Ask yourself one question: What makes my product more interesting than those of other chiropractors they could go to instead of me?

In order to be interesting, your approach, delivery of assessment/treatment, and the overall patient experience need to be special. In my practice, the goal is to make sure the patient experiences a significant clinical improvement after the first or second visit. This means they can honestly say that compared to all of their previous attempts at therapy they have never had such a significant improvement in such a short period of time.

One limiting factor which could prevent patients from loving our service is that our skillset could be too limited. For instance, 100 per cent of all chiropractic college graduates are trained in spinal manipulation but only a small percentage are proficient in two or more assessment and treatment techniques in addition to spinal manipulation. This means that on the surface, most chiropractors look all the same to prospective patients – save for the ones that have more interesting resumés and better patient reviews.

This is also reflective in the types of jobs one-dimensional chiropractors can attain. In the Greater Toronto Area, job postings looking for chiropractors in busy adjustment-only clinics are offering a salary of $40,000 to $50,000 per year. For some, it’s the best paying work they will get offered. On the other hand, more interesting, better-educated candidates can attract more lucrative financial arrangements and more patient referrals.

In short, if you want your patients to love your product and refer new patients to you, ask yourself: Am I giving patients the results they want in a time frame that will impress them?

Patients who like you and love your work will talk, leading new patients to your door.

Dr. Anthony Lombardi, DC, is consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic in Hamilton, Ont. He teaches his fundamental EXSTORE Assessment System and conducts practice-building workshops to health professionals. Visit for information.

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