Open for business

Kyra Proctor just spent two years as an associate chiropractor at a busy downtown chiropractic clinic.

Kyra Proctor just spent two years as an associate chiropractor at a busy downtown chiropractic clinic. She recently moved to the suburbs to open her very own clinic. After finding what she thinks is a suitable location for her practice, she begins to daydream about all the new patients who will come lining up to see her as soon as she opens for business. When she wakes from that dream a few months later, she finds herself staring at her clinic waiting room filled with empty chairs.

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This scenario would sound too familiar for many new chiropractors venturing out on their own or relocating their practice to a new community – and bring back not-so-fond memories to the veterans who braved through those growing pains of practice.

Whether starting a brand new practice or relocating to a new community, chiropractors are bound to face real-life challenges that years of top quality education could not have prepared them for.

“(One of the) struggles is certainly just getting an understanding of what reality really was,” says Dr. Elizabeth Anderson-Peacock, a chiropractor of 28 years, recalling her first few years in chiropractic practice. “People won’t just gravitate to you because you opened your door and put your shingles outside.”

The real wake-up call, she says, is the realization that a chiropractor, especially one who’s in the early stages of his or her practice, really needs to go out to the community and promote the practice and what chiropractic is all about. Forming relationships in the community and establishing that trust with the chiropractor is half the battle won. Once people get to know you and like what you’re telling them and what you’re doing, they start to trust you — and this will form the foundation of a great practice, says Anderson-Peacock.

It’s what she calls the “know, like and trust” funnel. This formula has worked really well in building her practice in Barrie, Ont., which she ran from 1988 to 2009. The practice is now run by her children, who are both chiropractors. She is now focused on life and leadership coaching, nationally and internationally. Although she still sees patients from time to time, she is now only focused on pediatric and maternity cases.

“I really built my practice from the inside out, and it’s really engaging patients about the story (of chiropractic) and (the chiropractors’) ability to help other people by telling the story.

“If you know something that could help another person and you have the ability to help them now, why wouldn’t you want to tell them?” she says.

Dr. David Leprich, who has been a chiropractor since 1977, agrees the key to practice success is getting out and talking to people. Immediately after graduating from the Canadian Memorial Chiropractic College, Leprich started to scout for a potential location for his brand new practice.

He eventually settled in St. Catharine’s, Ont., purchased a building that previously housed a convenience store and three apartments. He moved into one of the apartments where he opened his practice.

Sounds easy? Not so much in this day and age, says Leprich, as the economic picture is very different today than when he started out 36 years ago.

“I did not have a lot of student debts, so I was able to do anything I wanted – I was able to buy a building. For new grads today, that’s really difficult to do because of the debt situation,” he says.

Even venturing out to start a solo practice right from the get-go may prove difficult these days, he adds. New chiropractors may find more success by doing a little bit of research, talking to established DCs and looking for opportunities to start an associate role at an existing practice.

Financial prudence will go a long way in contributing to one’s success, cautions Anderson-Peacock. Too many new chiropractors make the mistake of indulging themselves financially too soon once they start their practice. So you might want to hold off on making a down payment on that brand new car you’ve been dreaming about.

“I see a lot of chiropractors coming out – which is one of the things I did – and it’s like, ‘Now I want to get a car, and this and that.’ All of a sudden, you’re in this position of having to play catch-up every month,” says Anderson-Peacock.

Being in that kind of financial situation could affect the way they practice chiropractic, she says, where financial interest may tend to come first before a patient’s wellbeing.

Making sound financial decisions will put a chiropractor in a position of authority where a treatment plan is dictated by the needs of the patient – not of the pockets.

“This means letting a patient go because you are wanting to do the right thing with them, not something where you feel like you have to (treat them) because you have to make that income to pay the bills,” says Anderson-Peacock.

Her advice: “Personally spend after graduation the way you would as a student. Live still in that student mentality of spending so that you can pay down debt and then put your money into your professional career in building yourself and your knowledge base. Keep putting your money into your professional career until a lot of your personal debt is paid off, then you can start spending on yourself.”

Medium is the message
When it comes to marketing the practice, both Anderson-Peacock and Leprich believe the chiropractor is his or her best marketing tool. Sure, traditional media ad buys, as well as newer promotional vehicles like a website or social media sites, will help provide that short-term boost and even succeed in giving a new practice that needed head start.

Longer term business planning, however, will involve more than just pouring hard earned money on a marketing campaign. Relationship building is key to establishing a successful practice that can last your professional lifetime.

Consider some of these practice-building suggestions that have been time-tested and proven to help raise your profile as the chiropractor of choice in your community.

Know thyself. Reflect on what is really important to you as a chiropractor and health-care practitioner. What do you stand for that is unique in the health-care market? What can you offer that other providers don’t?

“It’s not coming from a standpoint of being negative in any way to what other providers do,” says Anderson-Peacock, “it’s a matter of telling the story of what you are for, what you do and what the approach is, and how that approach is different.”

Setting yourself apart from other health-care providers – even other chiropractors for that matter – can give you the edge in your practice. This is especially important if the practice is located in a community crawling with other established chiropractic clinics and you’re the new kid on the block.

In Ontario for instance, where nearly half of Canada’s more than 7,000 DCs have set up shop, there is so little room for trial-and-error, says Leprich.

“With new grads, with the debt load that they have and the competition, there’s not a lot of room for them to make mistakes. They have to hit the ground running and basically do things the right way right off the bat,” Leprich says.

Get out there. Remember the movie Field of Dreams which popularized the phrase, “If you build they will come”? Reality check: not going to happen. If you want patients to come to your practice, go and get them.

This would be a good time to brush up on your public speaking skills. Talking to the people in the community about who you are and what you do is the first step. Speaking from experience, Anderson-Peacock says speaking to people or groups of people is the best opportunity to promote chiropractic and what it’s all about. When going out and speaking to people, it’s a good idea to talk about the profession and the practice of chiropractic, and by doing so, you are promoting yourself.

“Any time I went out and speak to anybody… there are times when I will be talking about what I would do, and then there are times when it would be more of a promotion of the profession,” she says.

If the opportunity comes up, talk about chiropractic as a profession, its principles and, maybe a little bit of history. Then discuss what people can expect from their chiropractors – how they would approach a health problem and why.

“It’s helpful for people to hear things that their chiropractor is doing, so that makes them feel good about themselves, and so they are going to remember you. The reality is that if people like you, they’re going to refer to you or they will see you themselves.”

Know thy neighbours. It’s a good idea to get a sense of what your community is all about, especially if you plan on serving them. Communication is a two-way street, so while you’re out there giving a talk about chiropractic, try to engage in a conversation, ask them about their health concerns, what their expectations are of their health-care provider, and other things that would give you insight on how you can best serve their needs.

A good way to get patient insight is by polling them, says Anderson-Peacock. And one of the basic questions you could ask is, “What is it you are looking for in health care that you’re not currently receiving?”

“I learned a lot just by asking people that question. And then I really fine tuned my practice to deliver the essence of what they were really looking for,” she says.

Start talking. If you think you’re not ready for public speaking or you have not one oratorical bone in your body, get over it. Leprich says it is through constantly talking to people and making connections in his community that made his practice the success that it is today.

“One of the things I learned is that if you think you might be able to help, there’s no harm in introducing yourself and offering your services,” Leprich says. “The worst thing that can happen is they tell you they’re not interested or they already have somebody doing it.”

“A lot of people just don’t take the step because they don’t think it’s going to work out. So, people just have to get over that idea.”

Throughout his career, Leprich has approached people and organizations about chiropractic and conducted numerous company safety talks about low-back care. It’s a lot of hard work at the beginning, but 36 years later it’s still paying off. Leprich is now the “preferred chiropractor” for several companies and organizations in his community and that happened only because he took the time to come out and talk to the employees.

Another food for thought, says Leprich: just because there are other more established chiropractors in your area it does not mean there is little room for you to make yourself known to the community. You’ll be surprised what you can learn just by talking to people.

Leprich recalls a time when he decided to visit a local baseball team in St. Catharine’s. He just decided to introduce himself to the trainer, while assuming he’s probably not the first chiropractor or health-care provider to approach the team. Turns out, he was the first chiropractor provider to offer his services to the team.

Public speaking may not always come naturally to most people and it takes lots of practice to get better at it – and it will get better, says Leprich.

“You just have to get out there and do it – it gets easier every time. Book the talk and then you’re kind of forced to put yourself together. Even if the talk is not very good, you’re still going to gain from it, and as you go along you’ll get better and better at it.”

It’s whom you know. Sometimes, great opportunities come from unexpected places – or in Leprich’s case, a patient. In 1989, a patient – who was an administrator for the Shaw Theatre in Niagara-on-the-Lake, Ont. – asked him if he would be able to come out to the theatre and help out with some of the actors who were in great need of care. It was difficult for the actors to go and see a chiropractor outside the theatre, so a chiropractic house call was ideal.

“I went down and ended up going for that first season every week for half a day, and that’s what I do to this day. It just worked out for everybody,” says Leprich.

This goes back to establishing yourself in your community so people trust you enough to know they can count on you when the need arises.  “It’s almost like you attract those sort of things to you.”

Within a few months of getting involved with the Shaw Theatre, Leprich got a similar request from a fellow chiropractor, who was based in Toronto. That chiropractor had been travelling regularly to Welland, Ont., to work with employees at a manufacturing facility, and asked if Leprich could take on the patients as he was finding the travel too much to handle.

“That ended up being a 10-year relationship where, for one day a week, I would go to Welland and actually treat folks right in the factory,” Leprich says.

He stresses, though, although good things may sometimes happen out of the blue, it does not usually happen unless you’re working towards that goal.

Find your niche. While it may not be for every practitioner, specialization could enable a chiropractor to carve a niche in the community. Anderson-Peacock did just that and it made a huge difference in her practice.

Through her years of practice, Anderson-Peacock developed special interest in pediatrics and that is what she pursued. Today, her practice is focused mainly on pediatrics and pregnancy.

“My advice is to get really clear with what your heart is calling you to do, because some people are going to gravitate towards one direction and that’s their specialty. Other ones really want to get their feet wet or get some experience under their belt, and then make a decision from there,” she notes.

It was through her day-to-day experience at practice that Anderson-Peacock came to realize pediatrics was going to be her specialty so she worked hard at getting great at her chosen field.

“I just want to be very clear on knowing where my red flags were and how to manage some of the very complex pediatric cases,” she says. “For me, it was a matter of (getting) a higher level of certainty and more tools in my toolbox and to really come from that place of ‘I know what I can do, and I know when I have to co-manage.’”

In pursuing her pediatrics focus, Anderson-Peacock became one of the first chiropractors to undergo the diplomate program through the International Chiropractic Pediatrics Association (ICPA). This certification opened up new doors for her career: she began consulting with other chiropractors on complex pediatric cases and teaching courses for the ICPA. From there she started doing more public speaking engagements – initially talking about pediatrics – but gradually transitioned into more leadership and business topics. Today, her speaking engagements focus on transformational leadership.