Overview Market Share

Marketing

Competitive Threats

What do MD’s Want to Learn?

Call Preparation

What Can You Do Now?

Q & A

Marketing Chiropractic

To Medical Practices

Presented by Aligned Methods

Christina Acampora, DC

President & Founder

BACK PAIN MARKET SHARE

BACK PAIN MARKET SHARE

17% of Patients with back pain seek chiropractic care.

Chiropractic as spine care: a model for the profession Chiropractic & Osteopathy 2005, 13:9. Craig F Nelson, Dana J Lawrence, John J Triano, Gert Bronfort, Stephen M Perle, R Douglas Metz, Kurt Hegetschweiler and Thomas LaBrot

ARE MD’S OPEN TO MANIPULATION?

SNAPSHOT OF CURRENT MD/DC RELATIONSHIPS

WHAT MD’S SHOULD YOU TARGET?

Attitude toward chiropractic: A survey of North American Orthopedic Surgeons - Spine, December 2009

487 Surgeon’s 45% Negative Attitude 29% Favorable 26% Neutral

Nearly half of the physicians said they referred to DC’s primarily because of patient request.

73% unnecessary treatments 63% overly aggressive marketing 52% breed patient dependency in short term pain relief

The majority of physician’s felt that chiropractors were effective at treating musculoskeletal pain.

Attitude toward chiropractic: A survey of North American Orthopedic Surgeons - Spine, December 2009

Sources of Information Associated with Impression

Negative Impression: Older age Clinical interest in foot or ankle Media

Positive Impression: Relationship with a specific chiropractor Residency

Conclusion:Improved interprofessional relations may be important to ensure

optimal care of shared patients.

MARKETING

MARKETING

Traditional Marketing Tactics Yellow Pages Direct Mail Newspaper Health Screenings (Malls/Fairs/Health Fairs) Networking/Social Clubs Introductory Letters

WHAT MD’S THINK OF DC’S

$$$Treat outside scope of practiceFail to release patients from careSafetyFear of competitionNo scientific foundationMany know nothing about what we do

resulting in sustained misconceptions

IMPORTANCE OF MARKETING TO MD’S

Improved perception and understanding of the therapeutic value of manipulation

Improved understanding of the specialized training and education that chiropractors undergo both in manipulation and in differential diagnosis.

IMPORTANCE OF MARKETING TO MD’S

Establishing EBHC Chiropractors as specialists in treating neuromuscular conditions

Caregiver collaboration

Improved political and managed care platforms

Ward off competitive industry threat

IS THERE A COMPETITIVE THREAT?

IS THERE A COMPETITIVE THREAT TO THE CHIROPRACTIC INDUSTRY?

Manipulation has gained recognition in researchPhysical Therapy Industry has made research a

priority and is outpacing the chiropractic industry in supporting their foundation by 5 times as much as Chiropractors –Charles Herring FCER President

PT’s have long been established within the medical community with less research than that currently available for manipulation.

What reason are we giving the MD’s to refer their NMS patients to us over PT’s?

THE COMPETITION

The competition is any other therapy that could be considered in lieu of chiropractic manipulation.

Physical TherapistsMassage Therapists/AcupunctureMedicationDO’s

STRENGTHS OF PHYSICAL THERAPISTS

Readily accepted on Insurance Plans Readily accepted by Medical Doctors Trials of conservative care for back pain to prevent the need

for surgery are routinely referred to PT’s. Embraced EBHC

STRENGTHS OF MASSAGE

Open access. Public and medical acceptance of a therapeutic value for

back pain. Research Efficacy An article published in Forbes in June of 2007 (9) looked at

the trend of massage in healthcare, the following points illustrate their strong contention as a competitor: Massage therapists routinely receive referrals from orthopedic

surgeons, cardiologists and physicians. In 2006 30% of the population seeking massage do so for medical and

health reasons. 9 million more patients talked about massage with their medical

providers in 2006. Managed care coverage doubled from 5% in 2005 to 10% in 2006. In 2006 more hospitals offered massage for conditions such as post

partum lower back pain and stiffness from bedrest. This is a 1/3 increase in hospitals offering massage in just 2 years.

STRENGTHS OF ACUPUNCTURE

Of all the complementary alternative medicines Acupuncture has the most credibility with medical professionals

Substantial body of data showing that acupuncture in the laboratory has measurable and replicable physiologic effects that can begin to offer plausible mechanisms for the presumed actions.

Safety issues are more obsolete. While chiropractic care is extremely safe so is acupuncture. Unfortunately the public perception of “neck cracking” is over sensationalized whereas no derogatory press has occurred with acupuncture.

STRENGTHS OF D.O.’S

DO’s: Friend or Foe?

Source: Osteopathic Medicine and Primary Care 2009Time for the Osteopathic Profession to take the lead in musculoskeletal research

Strengths of MedicationStrengths of Medication Advantage of DC care over MedicationAdvantage of DC care over Medication

Readily available

Covered under insurance

Effective at controlling pain and inflammation

Side Effects/Safety NSAID’s: GI and Heart

are of primary concern Flexeril

Studies which showed manipulation to be more effective

CostConsumer desire for

less invasive care

STRENGTHS OF MEDICATION

WHAT DO MD’S WANT TO LEARN?

WHAT & HOW DO MD’S WANT TO LEARN?

What is the difference between manipulation and manual therapy?

What is manipulation indicated for?What are the contraindications for

manipulation?

Avoid confusing terms such as subluxation and spinous listings.

NEEDS BASED SALES

NBS is a conversational sales model designed to illicit and uncover a need.

Do you need to be a salesman?

Can be used not only for MD’s but for political and managed care advancement and even job interviews.

COMPONENTS OF THE NEEDS BASED SELL

Probes: Asking questions to determine need and uncover treatment protocols.

Paint a patient picture that captures the “need”

Seed of doubtPresent applicable researchCompetitionTrial close: Gauge buy-inClose

EBHC

Research is the foundation that supports all MD conversations.

Not all services that chiropractors offer have research to support it – that’s ok!

CREATING NEED

Use of Nonsteroidal antiinflammatory Drugs. An Update for Clinicians. A Scientific Statement From the American Heart Association

DOI: 10.1161/CIRCULATIONAHA.106.181424 Circulation published online Feb 26, 2007

Musculoskeletal symptoms should be categorized as those that result from tendonitis/bursitis, those that result from degenerative joint problems (eg, osteoarthritis), or those that result from inflammatory joint problems (eg, rheumatoid arthritis). Initial treatment should focus on nonpharmacological approaches (eg, physical therapy, heat/cold, orthotics).

PRESENTING RESEARCH: EXAMPLE

Adapted from Haas, Mitchell et al. A Practice-Based Study of Patients with Acute and Chronic Low Back Bain Attending Primary Care and Chiropractic Physicians: 2-Week to 48-Month Follow-Up. (J. Manipulative Physiol Ther 2004; 27:160-9)

•Adapted from Haas, Mitchell et al. A Practice-Based Study of Patients with Acute and Chronic Low Back Bain Attending Primary Care and Chiropractic Physicians: 2-Week to 48-Month Follow-Up. (J. Manipulative Physiol Ther 2004; 27:160-9)

PREPARING FOR MEETINGS

ACCESS

Patients!GatekeepersHallway /Lunches / Meeting / DinnerHospital Grand RoundsNetworking with established relationships

Ethics Note:It is important to be cognizant of patient privacy andoffice operations while visiting the physician’s

office.

CALL PREPARATION

Insurance ProfileWhere does MD refer PT/Ortho/NeuroWhere does MD refer for DC/AcupunctureWho does the office preauthorizationsDo they see a lot of back pain patientsDo they treat workers compensation patientsGoogle

Affiliations/Medical School/Special Certifications/Affiliations

CLOSING

You aren’t selling used cars!

Close on what you gained buy-in

ETHICAL CONSIDERATIONS

Promote modest frequency and duration of treatment.

Promote conditions that are supported empirically by the research.

Avoid the opportunity for misinterpretation when approaching a medical practice.

There is no need to “spin” research when presenting the data.

Promotions should be done with integrity, authority, honesty.

WHAT CAN YOU DO NOW?

What can you do now to market yourself to the medical profession?

Your hands may feel tied as a student. Now is the time to get your feet wet. Marketing is easier as a student.

Where do you start?

Research the demographics of your home town.

Tap into your network. Contact your Chamber of Commerce.

Contact your local Economic Development Commission.

Your growth = The growth of the community Inquire on committee involvement for the future.

Where do you start? Continued….

Phone Book/Yellow PagesHospital DirectoriesImaging CentersMedical Supply StoresWeb Resources Ask for referrals!

What do I say?

Pre-call plan with every intended call/visitDevelop your elevator speech – practice,

practice, practice. Log objections and learn how to overcome

them.Never stop studying!

BENEFITS OF PROMOTING TO MD’S

83% More Market Share = $$$ Support Research Financial and Practice Stability Substantially decreased Advertising Costs