By John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)
Recently, I asked the office manager of my clinic to accept only three new patients a day as opposed to the usual five I have routinely seen for over 25 years. With my very busy lecture schedule taking me around the country on a weekly basis, I felt reducing my practice intensity would assist both my professional and personal life.
However, as Mark Twain pointed out in Tom Sawyer: just when someone can't have something is when they want it the most. As a result of my accepting fewer new patients, it appears there is more demand than ever. The acupuncture practitioners in my community love it, of course, as we refer an increasing number of patients their way.
I was fortunate enough to begin my chiropractic practice in 1971, with acupuncture as a principal modality of treatment. As a result of my early entrance into American acupuncture, my practice grew at a steady rate as more people sought acupuncture as a result of frequently seeing a seemingly miraculous clinical response. Not only did people seek me out for acupuncture, I also saw people for chiropractic care. These people would never have sought out a DC had they not come to me for acupuncture, which has always had much better press than chiropractic has ever had.
By 1974, my clinic had become one of the largest and most successful acupuncture practices in North America at a time when "voodoo" was a word most often associated with its practice. The medical profession regarded acupuncture as quackery or hypnosis, and acupuncture as a profession was more than 10 years in the future. Today, there is more potential than ever to achieve a busy, referral-based acupuncture practice for literally all practitioners, as acupuncture's acceptance has become established with both the general public and the scientific community.
In the U.S. alone, millions of patients seek our service, but there are fewer than 35,000 practitioners who employ acupuncture (including chiropractic and medical doctors). The current number of practitioners available for the number of people who wish to see us is staggeringly off balance.
What is the difference between a practitioner who sees just a handful of patients compared to one who is booked weeks in advance? I know of an acupuncturist who boasts he is booked three weeks out; however, he only sees a maximum of four patients a day. The last I heard, he was having major financial difficulties. Can you see more patients? Should you see more? It's a matter of technique and style. Interestingly enough, the percentage of patients who achieve remarkable clinical success is just as high in the practice that sees 60 patients a day as the one who sees six patients a day.
Did you ever have to wait an hour or more in a restaurant for a table? It is typically not some "greasy spoon" in the middle of the block, or a restaurant with poor food or service. It is usually an upscale spot with unique surroundings, or an established restaurant with great food. The busiest restaurants are not the ones that generally advertise the most, but are the ones that achieve "fantastic results."
When was the last time you referred a friend or family member to a less-than-adequate restaurant, while your enthusiasm for the unique one came with your highest accolades? The same is true of a clinical practice. However, I learned early that a little help in getting your patients to refer is certainly legitimate, just as the restaurant owner might say on your leaving, "If you had a great experience, please tell your friends."
Achieving good results in many of your patients is oftentimes not enough of a motivating force to get them to refer. Being clean, neat, brave, trustworthy, kind, reverent and every other adjective for the perfect person as spelled out in the Boy Scout/Girl Scout handbook is oftentimes not enough to get patients to refer either. How many times have you achieved a great healing response only to never hear from the patient, even though you're a great person? You say, there goes the theory of the restaurant with the one-hour wait. Not necessarily. People often don't think of telling others about their experiences unless they're really motivated. How motivated are your patients to refer to you? Ask yourself this question! Why should someone refer their friend, co-worker or family member to you?
While you're asking questions, take this quiz! What is the first name of the person who cuts your hair? How many kids does he/she have? What is the husband/wife's name, and what do they do for a living?
Think about it. You see this person on a regular basis. If you're typical, they have been cutting your hair for some time now. You discuss sports, politics, movies and current events. You probably have as much or more conversation and idle chit-chat with this person than anyone else in your life.
Ask yourself this question: with all of this familiarity, how many people have you referred to the person who cuts your hair? Their success is predicated on referrals. How do you think their clientele grows? What was your participation in their success? How many people did you refer to your car dealer, insurance agent, accountant, etc.? Why should someone refer to you? What if you asked your patients to refer because you are building the biggest and best acupuncture facility in this part of the state. How could they refuse? They couldn't, just as you would refer to your hairstylist or barber if only they asked. That's the point!
Did you ever stop to think that the greatest compliment a person can pay us is not a glowing comment about how wonderful we are, but the simple act of referring and entrusting their family and friends' health into our hands. What an incredible compliment! Are you sending handwritten thank-you notes, or some funky form letter without any personalization? Please, don't send one to me unless it is personalized with your own message and signature.
The basics of the referral practice are very simple. Strive to achieve outstanding clinical response in the least amount of time. Motivate patients by impressing them with a nice, clean, well-maintained office, and a professional appearance by the practitioner and office staff. Explain the procedures used in an easy, clear-cut manner so that your patients can tell their friends and family what transpired without all the razzle-dazzle.
If you have an assistant who is less than perfect, get one that is. Less than perfect assistants will destroy you faster than anything. Years ago, my clinic employed 12 assistants. It was absolutely amazing. Regardless of how competent I may have been, sometimes people would not return because of the way they were treated by an assistant. Did you ever go to a restaurant only to be met by a waiter/waitress who turned you off such that you decided to never go back there again? It happens all the time, in every endeavor.
Why do you suppose acupuncture has grown to such an unprecedented level of public acceptance in such a short period of time? The answer is easy. Acupuncture delivers quick clinical results in a very short period of time. Comparatively speaking, it is very inexpensive. I think B.J. Palmer, the developer of chiropractic, said it best: "The fundamental of this clinic is to see how little we can do at how few places, how rarely and how quickly it can be done to accomplish the greatest change in the shortest space of time at least cost to case, and to know what to do and why we do it before doing it."
I am convinced that striving for the quickest, most dramatic clinical response and releasing the patient to maintenance care as early as possible is one of the major keys to a high referral practice. Everyone has a dentist, for instance, but they only see their patients twice a year on average unless an emergency comes up. By seeing them twice a year routinely, people will see the same dentist for years and years.
Some Asian practitioners have a philosophy to see their patients routinely whenever the polarity of the earth changes: when fall turns to winter, when winter turns to spring, when spring brings forth summer, and when summer gives way to fall. At these four times of the year, the universe is in an energy flux. What a great time to see patients! If we only saw our patients four times a year, whenever an emergency arose and as needed in between.
If you can go to your office tomorrow and tell your patients that you are trying to build the biggest and best acupuncture facility in this part of the state and that you need their help, your success will be assured. I personally conduct a straight-cash, no insurance practice. I accept no personal injury cases or insurance. I do not participate in any HMOs and have no intention of ever doing so. My role is that of a healer, not an insurance pawn. My job is to help patients as quickly and economically as possible. As a result, patients have always flocked to my office. Remember: regardless of insurance or anything else, people will go where they can get the most for their time and money.
Remember the number one rule of a practice's financial success: serve your patient, not your bank account. As long as we have single-mindedness of purpose in assisting patients with their health needs, the referrals and financial rewards will follow. As more practitioners of acupuncture set up practice across the nation, do not look upon them as competition. Only three percent of any profession, occupation or endeavor ever make it to the very top. Strive by your continued study, spirit, compassion and dedication to become the best in acupuncture. Patients will always seek out the best! You may either thrive or survive. I think I know which you prefer. The choice is yours.
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