The horse shelter at Raza's Clinic

Our friend Raza Shah, ND has a large Mennonite patient base–so large, in fact, that he actually has a place to shelter horses while patients have their appointments. So cool.

In The Practitioner’s Journey, we wrote about how my dentist used to amaze me by thanking me in person for each referral over the past year as I sat in his chair. It made me feel great, of course, and I was sooo impressed he remembered.

The truth is, he wasn’t really remembering–he or his staff simply wrote the names of people I referred in my file. As he sat with me, he could look over and say, “Thanks for referring Lisa.” A free, simple tool to get a simple, but important task done. And like good magic, even when the trick is revealed, I’m still impressed.

Raza’s like my dentist. His gift is connecting with people, and it’s important to Raza to remember the little, personal things. The problem, of course, is that you really can’t remember them–not all, anyway. To accomplish similar magic to my dentist, his office uses sticky notes in the file to remind them of the little things that are important in the lives of their patients.

“One patient had missed a previous appointment, which was very rare. When she called to reschedule, we found out she’d missed her appointment because her horse had fallen in a ditch the night before. Carol put a sticky note in the file that the horse’s name was Tony. When she came back in, I asked, ‘How’s Tony?’” – Raza Shah, ND

Needless to say, the patient was thrilled that he asked. I love this. It’s an elegant, painless and basically free way to remember important things, and communicate them between practitioners and staff.

The sticky note, though, isn’t really what this is about. The sticky note is just the manifestation of actually caring. It’s no different than putting a note in your calendar to remind you of a friend’s surgery, or your mom’s birthday. It’s just a way to make your clients feel like their lives are important. Because…they are, aren’t they? (And, no, writing it down doesn’t mean you care less, or that it’s a gimmick. The fact that you write it down at all means you care more than most.)

Your patients might not arrive by horse. But for the price of a few sticky notes, you can still perform magic of your own and show you care.

Note: I love that patients arrive by horse. Anyone else know of out-of-the ordinary practice set ups or patients? Do share…   -Dan

Back in 2006 (wow) we listed five things we wished we would have done in practice right from day one. Since the New Year is almost upon us, it seems like the right time to pass on a few more. Even if you started your practice long ago, you can still pretend like the new year is a fresh start, right?

1. Think Illness Not Wellness…

…at least when it comes to marketing. We all want to feel like we’re in the wellness business – and we are. But for many practices, people who are already well don’t make great clients. Time and time again, we find that people seeking “wellness” don’t really need that much help. They pop in for a visit and the reassurance that they’re on the right track, then they vanish.

People with problems you can solve – sick people – make great clients. And they refer others. And the people who you help out of illness are far more likely to buy into wellness programs – they know first hand what being sick is like. Advertising “wellness” isn’t nearly as effective as marketing a solution to a health problem.

Get people in the door because of illness. Then keep them by getting them well.

2. Restrict Your Hours

Work less, earn the same. Have a life. Why? Here’s why.

3. Book Effectively

When the schedule looks like a wide open slate, it’s easy to think that booking efficiently isn’t critical. It is. I wish we’d spent more time early on focused on how effectively the hours were booked, and less time on how many of them there actually were. Get a waiting list going. Book wisely. Enjoy the results.

4. Use Social Media – Especially Facebook

This one’s a  bit of a cheat, because Facebook wasn’t around when we started. But if it were day one for us right now, I’d be all over it.

Facebook is quickly becoming the largest source of traffic to our website other than Google searches, and there are vast amounts of people in the right demographic. More than half of users are women, and the older age groups – those with both health concerns and the money to spend on them – are the fastest growing by far.

If you’re already doing this, great. If not, start with the easy part: get a Facebook account and just start exploring. Don’t be scared – you can lurk and learn at first. When you’re ready, here’s a good resource for starting your practice page.

5. Create Marketing Partnerships

Sometimes you can’t reach everyone you’d like to. It takes time, money and energy to market directly to people who might user your services. Wouldn’t it be nice if someone could reach some of them on your behalf?

I wish we’d spent more time creating partnerships early on. Not just Please-Can-You-Send-Me-Some-Clients referral relationships, but partnerships based on cross-promotion and offering value to each other’s clients. Added bonus: sometimes health care is a lonely job. A few more colleagues is a nice thing to have.

It’s never to late to start any of these. And if you’re inclined toward Fresh-Starts-In-The-New-Year, maybe there’s something here that’s a fit. -Dan

One of the ideas in The Practitioner’s Journey is that complexity is what gets us bogged down. We often know what to do in practice. We just don’t know what to do next.

You’ve probably been there. You take a look at the pile on your desk, or the to-do list, or you scroll through your mental file of marketing tasks you should be tackling, and suddenly all the initiative just drains right out of you. For any one single task, you probably know what to do. The problem seems to be deciding where to begin. Things are just too complex in their present form.

Sometimes, the best place to begin is with the low-hanging fruit – things that don’t take a lot of time or money, but deliver great results. This is particularly true when you need to get results quickly.

Perhaps you’re in a dip in practice, for example – maybe client visits have slowed and you want to take action, but you aren’t sure what’s going to get faces in the door the fastest, and you can’t afford to waste time and money on things that won’t deliver for a few months. You’ve got a lot of marketing ideas floating around in your mind. You may even have a bunch written down somewhere. But every time you look at the list, your brain kind of fogs up, and you just end up pushing paper around or checking your email.

Here’s the system we use to find the low-hanging fruit. Don’t be deceived by how easy it is – this is a great way to build momentum and confidence, and get results.

What You’ll Need

I’ve made the simple template we use available here (PDF). Just download it, and print it out.

The steps are pretty simple. You can probably get through a trial run of a full single page in about 10 minutes.

Step 1.  The Brain Dump

Our first job is to get as much of your “to-do’s” on paper as quickly as possible. In this case, you want to simply write down, as quickly as possible, all the marketing & practice growth  ideas already you have in your mind or on paper, and any more you can generate in 2-3 minutes of brainstorming. Write them all down, one per row in the first column.

Here are some we wrote down the last time we did this:

1. Contact new clients who never showed up for their first appointment
2. Send out an email newsletter
3. Create a video for our website showcasing the clinic and our services
4. Arrange a lunch date with another practitioner
5. Start a Twitter feed
6. Contact existing clients who’ve fallen off the radar
7. Send a letter to other practitioners who refer to us

Try to come up with at least 20. They can be big ideas, or small tasks. Your sheet will start to look like this:

Step 2. Prioritize

If you look across the worksheet, you’ll see two columns near the right: Impact and Ease. For each item you’ve listed, you’re going to allocate a score between 1 and 5 in the Impact column, and the Ease column.

Impact: This is your guess as to how effective this item will be. Something that will generate a lot of business in your practice, for example, would score a 5. Something that might do very little would be closer to 1. In our case, contacting the new clients who for whatever reason had to cancel their appointment, was likely a 4 (or even a 5). They’re already interested – we just have to get in touch and rebook.

Ease: This is your guess as to how much this is going to cost you, in time and money, to do. In our case, making a video was going to take a lot of time and money, so it got a 1. Reaching out to those new clients who had to cancel was just a few phone calls – it was an easy 5.

The trick here is to estimate. Sometimes you don’t really know – don’t worry about it. Use your judgment and guess. You may have something that will have big long-term impact, but nothing for a while. Because we’re looking for quick results, that’s going to get a lower impact score.

Now the important part: for each item, multiply the ease x the impact. You should get a number between 1 and 25 for each item, and a sheet that looks something like this:

Step 3: Final Details

Next circle the top five scores in the Total column. You’ve now got five things that are easy to do, and deliver results!

You’ll notice, however, that there are three other columns. You only need to use these for your five circled items. Here’s how to use them:

Next Action: Sometimes the items on your list are just a single to-do, like, write an article for the local paper. In that case, the next action is really just that. Sometimes, though, it’s got a few more steps. To create an email newsletter, for example, you might need to pick a system to use, sign up, add your email addresses, etc. before you can start writing. It’s not hard, but there are a few steps – to avoid being overwhelmed, you’ll want to decide, what’s the very next action for this item?

Person: If you’ve got help, then it’s not always you that needs to actually do the thing on the list. If you have some admin support, or a web guru, or a willing partner, this is where you offload to them.

Date: When will this item be done by?

Step 4: Accountability

This step is optional, but it truly makes a difference. Find someone who can hold you accountable to those top five. Their job is to check in with you on those five easy, high impact choices, and make sure you’re on track. Just forward this to a colleague and ask them to partner with you – it’s that easy.

The Beauty of the System

You’re now staring at five things that are easy to do, and deliver results. It’s like having someone say to you, “Just do these five things in order. It’ll be great for your practice.” All you have to do now is just follow orders.

The beauty of this system is that it quickly finds the low-hanging fruit – things that are easy to do, that will almost certainly work. Because of that combination, you get great results quickly, and build some success and momentum. It makes it easier to keep going. It’s inspiring, effective, and takes that tough dilemma of what to do next off the table.

The Rest of the List

And as for the rest of your items? Don’t throw them away. Those things still have value, they’re just not fruit that’s as juicy and easy to pick.

There are likely things on that list that are critical in the long term. You’ll still want to tackle them. But when you’re feeling overwhelmed and need quick results, this system really works well.

Contrary to popular belief, you don’t need to be booked solid to have a waiting list. It’s a tool that works wonders at any point in practice.

The challenge is that waiting lists are harder to use than they seem. Here’s how you can make one work for you and your clients with no cost and minimal effort.

The Challenge

We were doing well with our scheduling strategy, but we still had a lot of holes coming from last minute scheduling changes. We don’t double-book, over-book, charge for missed appointments or use any other fixes that I feel reduce our level of service, but we really needed to do something to get the schedule filled more effectively, while still serving clients even better.

The waiting list was the answer. We just needed to use it the right way!

The Benefits

We were already using a waiting list, but it wasn’t working the way we thought it should. This time, we fixed our process for good and noticed the following in just a few days:

• Less waiting for new and existing clients
• More client visits in fewer clinic hours
• More convenient scheduling for patients
• Better daily flow for practitioners
• Greater revenue with the same or lower costs

To make that happened required five key shifts. Not difficult ones, but each is important.

Shift 1: Work Less

In the past, we’d tend to scale up available hours as things started to get busy. Once the schedule approached the 70-80% mark, it was harder for patients to get in at certain times, so we’d add a few hours here and there. It seemed sensible – after all, if there’s not much room in the schedule, you add more, right?

Wrong. This year, we took a new approach. Faced with a busy appointment book, we actually reduced our consult hours. This was the real turning point.

Reducing available time is really a way to push the adoption of a waiting list. It forces you to find a way to truly use the time that’s available in the schedule.  Why book only 75% of 30 hours when you could book 95% of 25? The deliver similar “billable time” but the latter involves a lot less time in clinic.

The result for us? We’re seeing more patients in the new reduced schedule than we did before, and providing much better service.

Shift 2: Change the Intention

In hindsight, “waiting list” isn’t the greatest phrase. I mean, who wants to be put on a list for waiting?

In the past, we might ask someone, “Can we put you on our waiting list in case there’s a cancellation?” Many would say, “No thanks.” A waiting list wasn’t really a patient-centered offering, and people weren’t interested. And for our staff, who take our clinic values very seriously, the waiting list wasn’t much fun either. For them it felt like a frustrating exercise that was all about making the clinic more financially efficient.

The solution? We changed our waiting list to a rapid care service. I know – it sounds like fluff, but it’s not. It was a fundamental shift in the purpose of the tool. Now the staff can reassure patients who can’t get in as soon as they’d like by explaining our rapid care service that will get them in sooner. Then they delight them a day later when they say, “Guess what? We’ve got a space for you.” Patients love it. It’s helpful for the staff. The practitioners love it. And the clinic is busier than ever, with fewer wasted clinic hours.

This shift is simply about service. A waiting list that is built around the intention of, “not wasting time we could be billing for,” will never work as well as one that’s built to serve.

Shift 3: Just Start

Don’t make this a big deal.  You can start your own rapid care service with a scrap of paper taped to the front desk. That’s what we did, and it worked great. Just get started, and figure it out as you go.

And don’t wait until you’re busy. The waiting list isn’t a tool for booked-solid practitioners. It’s a way to increase the speed and convenience of services in your office for everyone from the clients to the staff to you. That means no matter where you are in your practice, day one or day one thousand, you can use this tool to make life in the office easier for everyone. Even if it’s just you and a small roster of patients, get this habit in place now.

One of our early problems was making this bigger than it needed to be – that kind of thinking puts up too many roadblocks and “buts.” Just get started.

Shift 4: Get Involved

A real turning point was when I manned the front desk for a few days over the school break when we had some staff shortages because of vacation. It’s a job I used to do more in the clinic’s early days, but haven’t done much recently. It’s a great way to appreciate a) the challenges of filling a book effectively, and b)just how often a waiting list can be put to work.

You may be doing your own scheduling, and know exactly what those challenges are, but if you haven’t done the job in a while, it’s worth making a few hours to live in your staff’s shoes by answering the phone and booking appointments.

If you’re not doing your own booking, you’ll still need to be on top of gaps in the schedule. Make a point of checking the schedule regularly through the day. Help your team think of ways to fill any holes. “What about Mrs. So-and-So? She could come in.” Getting your waiting list to work is about changing habits, and that’s going to require you to be leading the charge.

Shift 5: Collect Better Information

To make this work, you’ll likely need to start learning more about your patients than you currently do – or you’ll at least have to start writing it down somewhere. Focus on these three areas:

• Best contact: To make your system work, you need more than just a way to get in touch with people. You need the fastest and most certain way to reach them. If you have a sudden opening in the schedule, you won’t be able to fill it quickly if you’re calling someone at home, but they’re at work for the next six hours. That means you need to know the best way to reach them now. Is it their cell phone? Email? Text? Work number?

• Patient preference: You waiting list needs to have some details – like what service patients are waiting for, and their preferences for times and days

• Patient flexibility: You’d be surprised how many clients have flexibility in their lives. The trick is to know who those people are. They’re the ones that are going to be a) great candidates for your waiting list, or b) the people whose appointment you can shift to accommodate someone else on the list who’s less flexible, and waiting for a specific time slot.

How you collect that info is up to you. Whoever does your bookings will develop a good sense of patient flexibility and preferences, but only if they ask in the first place. You need to be asking patients this information during the booking process. If you can’t reach flexible people in the fastest way possible, your list is going stumble before it gets out of the gate.

Small Effort, Big Benefits

Once you get this in place, you’ll find the benefits tend to spread into the schedule. When you have a great intention, and you can reach flexible clients easily, it become easy to shift the schedule to make it more efficient even when there aren’t people waiting. That frees up more blocks of scheduled time that help you get people in right away without ever having to be on the rapid care list at all.

Don’t be scared to work less to make this work. Test-drive it for a couple of weeks – you’ll be surprised not only at how efficient you can be, but how well your clients will respond.

A couple of years ago we noticed that although we’d had a great year as far as new patients were concerned, our return visits seemed to have flattened out. Patients seemed pleased with the service, success rates were high, but it still felt like we were gaining new patients but not growing.

The problem, of course, was in the scheduling.

If your office is reasonably busy, a great booking strategy can increase your profitability almost overnight. If you’re not-so-busy, there’s good news here as well: Effective booking drives return visits like nothing else.

Here’s how we worked with our staff to create a more effective appointment strategy.

Strike While The Iron’s Hot
There will never be a better time to book the patient in question than right now. Whether they’re on the phone, or standing at your front desk, do it now. The patient who doesn’t book now is going to come back fewer times. Or never. It’s that simple.

Tell, Don’t Ask
You need to approach booking from a place of confidence. Adopt the attitude of assuming patients will book/rebook. Why? because your inner confidence is reflected in how you speak, in subtle ways that shift the likelihood of success.

• Wrong: “Did you want to schedule a follow up?”
• Right: “Let’s schedule your follow up.”

Small difference in words. Big difference in outcome.

Leverage Our Love of Routine
Humans tend to be creatures of habit. We like consistency. Giving your patients recurring appointments in the same time slot makes it easy for them, and gives them a sense of ownership in the process.

• Wrong: “When would you like to come back?”
• Right: “If this time slot is convenient, I can get you in at the same time on Wednesday at 10:30.”

If you can’t offer the same time, offer the same time of day: “We can get you in again on Wednesday morning next week.”

Narrow the Options
While you’re at it, consider offering just two options for any appointment. It’s easier for everyone. There’s some surprising research that shows that people buy more when their choices are not overwhelming.

• Wrong: “What day is good for you?”
• Right: “We have an opening on Wednesday at 10:30 again, or Thursday at 2:15.”

Don’t Create Islands
When you’re offering up those two time slots, pick them carefully. Cluster your appointments back to back. You’ll work more effectively than if you schedule appointments haphazardly over the day, and you won’t end up with tiny windows that people who might need longer appointments, like new patients, can’t fit into. There’s nothing more frustrating than having a day full of holes, but not being able to see a new patient.

Create Scarcity
Many people (like me) don’t want to book a follow up if it’s too far in the future. Others just don’t want to commit ever. What gets me every time is the idea that if I don’t book, I might not get an appointment.

• Wrong: “Okay. Call us in three months.”
• Right: “The schedule tends to fill up quickly. We should book it now so that we can be sure to get you in.”

Remind People
I also don’t like to book too far out because I’m afraid I’ll forget. Reassure your patients by giving them an appointment card, and by telling them you’ll call a few days before the appointment to remind them.

Step On a Crack
We also have a monthly protocol for catching those stray patients that might fall through the cracks. Every month, we print a list of every patient whose birthday is in that month. That report shows the patient’s status (active, inactive, etc.) and when their next appointment is. Every active patient who doesn’t have a next appointment is examined to make sure we haven’t lost someone along the way.

If you know the annual value of a patient, it’s not hard to see that the few minutes it takes to scan through a few pages of names is well worth the time.

Protect the Schedule
All your best scheduling efforts are in vain if your patients don’t respect their appointments. Read our master list of tips for reducing no-shows, cancellations, and reschedules so that your booking strategy pays off.

Implementing most of these strategies is as simple as educating your staff. This list is essentially the blueprint that we used to write up a short booking policy for our front-line people. Use it if you find it helpful. What works even better is to use this list as a starting point for discussion – have your staff read it over, and then discuss any additional ideas and adjustments they might have.

Then, of course, let us all know in the comments!

We’ve discussed scheduling problems in the past, pointing you to a few resources here and there, but we’ve never really provided a comprehensive approach for those scheduled appointments that go off the rails due to patients canceling, rescheduling, or simply not showing up at all.

Here are the exact strategies we’ve put in place over the last few years. If you’ve got something that works in your practice, leave a comment and share it with us.

Make Reminder Calls
We all forget things, and appointments (particularly those with a long lead time) are among the easiest things to lose track of. Appointment cards are helpful, but in the end, a phone call is your best bet. Email, text message and other automated solutions are starting to make some headway, but a good old-fashioned telephone call is still the most effective tool to combat schedule disintegration.

• Provide some lead time. Don’t make your calls the night before. Give patients at least 2-3 days notice.
• Don’t leave wiggle room. Saying, “Call us if you can’t make it,” is an invitation for people to reschedule.

I don’t think we started making these calls as early as we should have. When you’re not busy, it can feel like it doesn’t matter as much, but the truth is that it does matter. In fact, you could argue that it matters more – those cancellations are pretty painful in the early days.

Some practitioners argue that reminder calls encourage people to reschedule. I don’t buy it. Better to know, and take steps to deal with it, then have a sudden hole in your day.

Stay on Time
If you want patients to respect your time, then you need to start that process by respecting theirs. Make sure you stay on time. Don’t reschedule patients. Keep regular office hours.

Yes, emergencies crop up, but your clients will accept that if you explain it to them, apologize, and don’t let it happen regularly.

Book Tightly
What we’re really after here is teaching your patients to value their appointment. A large part of that is demonstrating that you’re busy and run a tight ship. Many practitioners tend to spread patients out over the course of a day, but for us the looser the schedule gets, the more reschedules we seem to encounter – patients figure they can get an appointment on just about any day, so what’s the big deal? It is a big deal, and it starts with effective scheduling.

Don’t Overbook
However, if you’re tempted to treat your appointment book like a discount charter flight and book it 120% full, you’re going to have problems. Overbooking to deal with last-minute scheduling changes is like treating symptoms instead of causes – it’s not getting to the root of the problem. In fact, just like running late, it’s probably creating more of them.

Book Acute Care Visits ASAP
Acute care visits are fertile ground for scheduling glitches. When patients call with an acute care issue, it’s because they want to be seen now. If you can’t see them soon, recognize the fact that they might get better or find someone else in the meantime. That increases the likelihood of a no-show or cancellation.

Follow the 1-2 Month Rule
When a patient wants to reschedule or cancel, remind them that they may not be able to get another visit for 1-2 months. Patients often reschedule simply for convenience, and this technique can often resurrect the appointment. You can read more on this approach here.

Deal With Repeat Offenders
You may discover that a large proportion of your problem appointments are with the same small group of patients.

We do have a no-show fee, but we use it with discretion. And while we don’t often charge people for missed appointments – unless they have some hard cost like custom formulated IV treatments – we do try to educate these people over time by explaining that someone else could have used their time slot.

Failing that, we follow a three-strike rule. After they bail a third time, we usually don’t hurry to call them back. If they call, we try to fit them in that day, or tell them to call back again another day when we might be able to provide same-day service.

Track Your Results
Although you may have a general sense of how well your appointment book holds together over the course of a month, nothing beats having some hard data. The easiest way is simply to have your staff track the numbers. This also lets you identify patterns that might crop up based on the time of day, week or year.

If your software doesn’t do this for you, it’s still easy to implement using pen and paper. Head to CalendarsThatWork.com, and print a lined version of their monthly calendar. Use the first line for reschedules, the second for cancellations (with no reschedule) and the third line for no-shows. Have your staff just put a tick on the appropriate line each time, then add them up at the end of the week/month. You can even enter your email address, and the site will send you the same calendar just before the start of each month.

Everyone has a role to play in keeping the schedule healthy -you, your staff, and your patients – and much of this is about teaching everyone involved about the value of a scheduled appointment. Consider yourself the Dean of the School of Appointment Value, and train your students accordingly.

We’ve noticed some dramatic improvements over time using these strategies – if you’ve got any other tips, we’d love to hear them!

Reader B. writes in to ask about dealing with patients in multi-practitioner settings:

You decide to take a 2 week vacation…now, the client doesn’t want to see you as their primary practitioner anymore and has requested to switch to the other [practitioner]. What is the etiquette? How should the client be accommodated? How can this be prevented?

There are really two possible scenarios here:

1. The patient has, for whatever reason, found a better fit for them.
2. Another practitioner is actively soliciting your patient.

Let’s deal with the first one first – your patient saw another practitioner in your absence, and now wants to continue seeing them. What do you do?

The short answer is “don’t worry about it”, but I know that’s not helpful when your patient has just flown the coop. This will happen from time to time, though – we dealt with it a lot after our sabbatical. Here are a few tips to make it easier and help your practice at the same time:

Think Patient Service First

It’s just not about you. If a patient wants to switch practitioners because they’ve found a better fit, then you need to honor that decision; they’re doing what’s best for them. The patient-practitioner relationship is critical in alternative medicine, and if every patient can find the best possible practitioner for them, then the whole clinic will benefit.

How should you accommodate your patient’s request? With grace, respect and encouragement. It’s good for your health and theirs.

Understand the Strengths and Passions of Every Practitioner

The most underutilized advantage of multi-practitioner settings is that every practitioner has their own unique strengths, expertise, and passions. While practitioners tend to clump together in clinics for financial reasons, it’s actually a perfect opportunity to align patient needs with practitioner focus, and maximize health outcomes. Try to think collaboration, not competition.

If someone else’s specialty or passion can better serve your patient, consider referring to them – yes, even within the same clinic and modality. It’ll come back to you.

It may seem crazy if you’re struggling to make ends meet, but I think Gandhi would have said it best if he was in CAM practice: “Be the change you want to see in your clinic.”

Don’t Take it Personally

To really get comfortable with this idea that your patients are occasionally going to change practitioners, you need to get your ego out of the game. Recognize that you can’t be all things to all patients. You can’t name a book, film, song or person that everyone likes, and it’s the same for CAM practitioners. You can’t please everyone, and trying to make a patient’s square peg fit your round hole isn’t helping anyone.

Don’t assume a patient crossing the lines is a comment on your talent. It’s likely not.

All of these approaches are going to improve your clinic relationships and the health of your patients. And that means more referrals. We’ve seen it time and time again – letting patients go gracefully earns their respect. Former patients who’ve found a better home with another doctor in our clinic or another, still refer back to us. Really. They remember doctors who’ve acted with their patient’s best interest in mind, and it means a lot to them.

And what about the other scenario? The one where another practitioner is actively “poaching” your clients?

The truth is that most “patient-poaching” complaints aren’t what they seem. They arise out of a perception of patient scarcity, and insecurity about your own skill. It’s a natural response, but don’t buy in. The fact that you’re concerned about your own level of performance is more often an indicator that you’re doing just fine.

There are times, though, where unprofessional patient solicitation happens. Here’s the best way to approach it:

Deal With it Immediately

Don’t wait and stew over the issue. You’ll need to address it face-to-face, and soon. This isn’t about email, letters, memos, or voice mail. This is about conversation, in person.

Arrange at least 30 minutes of uninterrupted time to talk to the practitioner.

Be Sure

Did another practitioner really solicit your patient, or did they just provide them with care that better suited them? The only way to know for sure is to hear it from your patient. The problem is this: most patients are extremely uncomfortable switching practitioners. It’s very awkward for them, and asking them outright is going to make them uncomfortable. The only time you can really be sure someone is poaching your patients is when a patient approaches you about the issue.

Most of the time, however, it’s difficult to know. So how do you approach your meeting with them?

Ask for Their Help

Yup. Explain that your patient has chosen to see them instead of you. Tell them you’re concerned that you might have failed to deliver (if you’re honest with yourself, you probably are a little concerned).

• Ask them if they think there are ways you could improve your care to help your other patients.
• Ask if they’ve lost patients in the past, and how they dealt with it.

Asking for help opens the door to discuss the patient in question without accusation. That way, even if you’re not sure, you can still approach the practitioner in question without fear of things becoming confrontational.

If you discover, before or during this conversation, that things aren’t on the level, make sure you…

…Come from a Place of Compassion

If someone in your clinic is actively soliciting your patients, you can be sure they have a reason, and it almost certainly isn’t pretty. Financial and personal problems can make people do crazy things. Be empathetic for whatever it is that has brought them to where they are.

Ask How You can Help Them

Instead of accusing, warning, or berating someone who’s been chasing your files, consider the scenario as a health crisis. How can you help the other practitioner build a vibrant practice in a healthy way? Ask them how you can help them grow their practice. Consider the following options:

• Offer specialized knowledge or skills you may have in marketing, PR or practice management
• Offer to collaborate on advertising or other promotional efforts
• As above, ask them to describe the type of patients and conditions they enjoy the most, and the skills they feel are their strongest. Do the same for yourself. Are there ways to refer to each other?
• Ask the to describe their goals for their practice. What are they trying to achieve? Where are they headed? Where do they see themselves in five years?

The trick is to take the high road through all of this. It’s non-confrontational, constructive, and will prevent most future patient poaching. The positive approach to the situation lets the other practitioner know you’re aware of what’s happening, and in most cases, that’s enough to straighten things out.

If you’ve dealt with this in the past, let us know in the comments!

SpectraSoft has a free white paper on reducing no-shows and cancellations. While their specialty is software for physiotherapists and other health care pros, some of the tips are quite good, and applicable to any CAM/holistic practice.

“No-Show” White Paper

(You’ll have to register, but it’s just a four-liner.)

There are a million conceivable things to do when you start your practice, but what’s really important in the big picture? What’s going to lead to increased referrals and practice growth? Here’s a few seemingly innocent but critical things to do from day one. And if you’re already well past day one, fear not – it’s never too late to start.

Track Your Referrals
Discovering where your referrals come from is the single best way to get more of them. You can use our five P’s or something of your own, but make sure you track them from day one. Before you know it, it’s going to be day one of year two and having referral source data is going to be incredibly helpful in figuring out how to spend your marketing dollars.

Accept Debit and Credit Cards
Just do it. I know it’s expensive. I know it’s a hassle. Just do it.

Still not convinced? Follow the link.

Make Sure the Phone Is Answered
You might not be able to afford a receptionist right away (although it may well be worth the risk). But if you miss those calls, you’re going to lose business. Consider an answering service at the least – one that can book appointments on your behalf.

Act Like You’re Busy
Whether you want to treat this as metaphysics or practical behaviour, acting as if you’re a busy CAM practitioner from day one is going to get you there faster. It’s particularly helpful in how you manage your appointments.

Pay Yourself
Get in the habit of paying yourself consistently. It’s far too easy for your practice to consume all the cash flow, and for you to find yourself five years down the road still breaking even. Just look at how easy it is to spend all the money in your personal bank account. Your expenses have a habit of rising to meet the available cash, and your practice is no different.

It doesn’t matter how much. Ten bucks a month is fine – what’s important is to start the habit. Just set up an automated system and forget about it (except for regular raises!). Everyone in practice can afford ten bucks, and believe me, it will make a difference.

And don’t forget those raises. Stretch yourself. Pay a tiny bit past what you can afford, and you’ll find your practice will grow to accommodate the increased expense.

First things first. Accepting credit cards in your holistic practice is a must – you can read more on that here.

That being said, there can be significant barriers to actually doing it. Assuming you can get a merchant account, setup fees can be several hundred dollars, then there’s a monthly fee to have the terminal in your office, plus the per-transaction cost.

All of this, unfortunately, tends to deter many CAM’ers from taking the credit card plunge.

Since many of you are already familiar with PayPal, PayPal’s virtual terminal might be just the thing. The premise is pretty simple: enter your client’s info online, and PayPal processes the card. The money goes in your PayPal account (accounts are free), and you tranfer that to your regular business account as desired. Not quite as slick as swiping a card, but it’ll do the trick for low volumes.

Virtual Terminal costs $20 a month, and fees are about 2.9% plus 30 cents per transaction. It’s currently available only to US account holders, but should be launching in the UK soon.

All in all, it’s well worth it if you’re not accepting credit cards now!

Virtual Terminal Overview