In this episode of More Cheese Less Whiskers Podcast, I interview Joseph Tanti, a chiropractor in Edmonton, Alberta, who recently took over an established practice.
The discussion covers Dr. Tanti's current marketing and patient acquisition strategies, which are primarily focused on existing patients and some limited online advertising. He wants to do more to attract new patients and generate referrals.
We explore ways he can measure his ROR(Return on Relationship) with Dr. Tanti's active patient base, including tracking metrics like total "spines under management" and revenue per active patient. I also recommend creating educational content like e-books and videos to generate leads from people experiencing common issues like back pain, neck pain, and sciatica.
Key Takeaways:
I explored Joseph's transition from taking over a long-established chiropractic practice discussed Joseph's focus in Edmonton on patient retention through innovative marketing strategies, such as pay-per-click advertising, email newsletters, and community events tailored to attract new patients while maintaining the practice's 30-year history.
The conversation highlighted Joseph's concept of "return on relationship," emphasizing the importance of regular communication and engagement with patients, particularly those with sedentary lifestyles, to prevent recurring issues.
Joseph shared his evidence-based approach to chiropractic care, concentrating on musculoskeletal issues and the intersection with physiotherapy, moving from acute pain management to maintenance care for lasting wellness.
We examined the process of orchestrating referrals through meaningful conversations, emphasizing the importance of actively connecting people with solutions rather than merely mentioning names.
Joseph described the use of strategic engagement tools like text systems and embedded cues in communications to enhance patient relationships and increase referrals.
The episode delved into identifying visible and invisible prospects, using social media advertising to transform them into leads, and leveraging both digital and physical materials to maintain patient engagement., Alberta, to strategizing for its sustainable growth, including his journey to becoming an orthopedic specialist.
We discussed Joseph's focus on patient retention through innovative marketing strategies, such as pay-per-click advertising
Transcript - More Cheese Less Whiskers 260
Dean: Hello Joseph, there he is. How are you, dean? I'm good. How are you? I'm wonderful, thanks, well, welcome to More Cheese, less Whiskers.
Joseph: Yeah, it's great to be here. I've listened to your podcast throughout the years. I'm glad you kind of brought it back recently. Yeah, it's wonderful.
Dean: We're out of reruns, yes, out of syndication New season. You're one of the I think the first three or four. So it's exciting to be back. Yeah, having fun. So so you know how it all goes. We've got a whole hour here to kind of hatch evil schemes and talk about you, yeah let's do it. Yeah, excited. Maybe just a quick introduction who you are, where you are, what you do and what you're hoping our outcome will be today.
Joseph: Sure, absolutely so. I'm a chiropractor in Edmonton, alberta. I just recently this past year, august 2024, just purchased a practice from a doc who's been in this location for 30 years, so it's doing pretty good. We have massage chiro. It's a smaller office. I just recently added physiotherapy as well and, yeah, just trying to take over the world, or at least our section of the city here, in terms of helping people with their backs and their spines, joints, muscles, the nerve problems. I love that.
Dean: How long have you been?
Joseph: doing it? I've been a chiropractor since 2016. I became an orthopedic specialist in. I love it. How long have you been doing it? I've been a chiropractor since 2016. I was came a orthopedic specialist in, I think, 2023. So just a couple of years of the specialty.
Dean: Okay, oh cool. So, how does it work right now? Your business, how do you? What's your marketing landscape or how do you focus on? How do you get new clients?
Joseph: landscape, or how do you? Yeah, so on, how do you get new clients? Yeah, so right now I would say the large majority of patients are existing patients. Again, todd's been here for 30 years. He's still working here. He's a contractor here and he's possibly slowing down in the near future. Who knows? Kind of over the next. That's a hilarious cup, by the way, with the otters on the bottom. The milking cow yeah, that's good.
Sorry. So yeah, most patients are coming through there like existing clients, existing patients, and then we also do. You know people will find new patients. They'll find us typically online. They'll search chiropractor or massage or physio and then they. So I'm doing a little bit of pay-per-click on that. So on the Google end of things, and I just recently I've also been doing some email marketing to you know, pass patients, people that we have their contact information. So I'll send it like a weekly newsletter and I just done one of these so far, just like a in-person event. That was on back pain and sciatica. We had a handful of people show up and I thought that went pretty well. So I was planning on doing kind of like a monthly. I'd like to do more frequent than that Once we get kind of systems in place just on different conditions, if you will. So I was thinking, you know, spring's coming along, change of footwear, so foot pain, plantar fasciitis and those kinds of things.
Dean: You can help with that.
Joseph: Is that your physio thing? Is that? No, I can help with any spine joints, muscle or nerve problem in the body. So a lot of people typically think Cairo. You know they'll think back or neck. If they're having more of a what they think to be a muscle problem or a foot problem, they might go to a podiatrist or sometimes physio. But yeah, I treat those problems all the time. The scope of practice from my perspective of chiro and physio is it's pretty much overlapped. It's just kind of we do things slightly different and it's more what people think they need.
Dean: Yeah. What method of chiropractic or what school of chiropractic are you?
Joseph: So I guess the evidence-based side, if you want to call it that Certainly more of the you know. If you're, you know we try to help people get out of pain. Obviously that's the main reason people come in, and then a selection of those people like to come in for, you know, wellness or maintenance care, just to optimize how their body's doing. I would say most people come in due to some type of pain or problem, though I know you've had a couple of chiropractors on before and they do more like. I haven't got into the wellness coaching or the life coaching or anything like that. I know some people have, but I don't currently do that.
Dean: Or the applied kinesiology, or whatever.
Joseph: Yeah, I don't, yeah, no, I don't do AK more, more into like orthopedics and musculoskeletal injuries. Okay.
Dean: And so, when we look at this if I were to put your business on the examination table here and we're dividing it up into before, during and after your self diagnosis is that most of the business is after unit, meaning most of the people that you see are already existing patients that come back again.
Joseph: Yeah, yeah. So our during is good, our after is pretty good. You know, we can always be improved upon, but yeah, certainly more of the after unit for sure. And then people either had a good experience and they come back, or they're into the wellness kind of care, or they feel good and then they hurt themselves a few years later and then they come back and we help them through those injuries. Yeah, certainly the before unit is certainly, I'll say, lacking. I've been trying to improve upon those but I'm being pulled in other directions with the change in ownership of the practice, I'll say.
So I haven't been able to put as much time as I want into developing those. Yeah, I'm trying to run it rather than the marketing stuff, and I want to put more time into it, but it's very challenging.
Dean: So, if we look at it, one of the things that I like to do is, you know, think about your after unit and look at the metrics right for each of them, and I always like to create like a metric based on what you're talking about. So I was like this concept of you know well, let's call it spines under management that if somebody's in your world that they're, you know that you've got these spines under management. Your goal is to keep everything in alignment and keep everything functioning and pain-free and optimized, and it sounds like your ideal would be if people how often should people if you were, if they would get out of the way and just do what you think would be the best thing for them. Should they be coming once a month, once a week? Right?
Joseph: So this, yeah, so this is the impossible question to answer because it depends on the person, right? So let's take you know, the ideal person, so 45 year old mother who's you know fit or trying to get fit again, she's dealing with, you know, maybe reoccurring issues, probably for her, probably once a month, kind of thing. And then I get other people. They come every three months and then you know you have like a 11 year old or a baby even I like to see them maybe, like maybe every six months or so, if just to make sure, like a wellness checkup, if you will, in an ideal world you get someone who's you know riddled with arthritis in their 97. You know they're probably going to have to come in a little more frequently, but usually it's kind of once a month or every.
Dean: that's kind of a good mark there and so, when you look at it that, do you do anything to kind of orchestrate that and keep people on track with that, or do people pretty much dictate? Are they left up to their own devices? If I'm one of your spines under management, what's? The cadence of what I'm hearing from you. How often are you communicating with me and in what way?
Joseph: Right, you communicating with me, and in what way? Right, so if I, if Dean, we have your spine under management. You know I think I recall on a previous podcast you get massages pretty frequently.
Dean: Is that right?
Joseph: Yeah, like once a week, every two weeks.
Dean: Yeah, probably, on average three a month.
Joseph: Yeah, Okay, yeah. So in your case, I'd probably want to see you. You know, every three to four weeks and the way I'll usually communicate that with someone. Let's pretend you're a new patient and you had an acute crisis. Your back was bothering you and we've gotten into that.
Dean: I'll talk to you about that in a second but, I just had a situation.
Joseph: Okay. So you know I would, we'd probably be seeing you pretty frequently to get you out of pain and giving you some resources to help you out Once you're kind of feeling really good. I usually like to back that off slowly. So let's say you're pain free today, but last week you were dying. I'd say, okay, well, it's been a week since I saw you. Let's see you in two weeks, cause sometimes these things rebound.
But once we got you to that point where everything was pretty stable, I probably I usually say things something along this line you know, dean, this isn't like an acute episode. It wasn't because of something you did. You didn't just lift up a tire and things happened. It happened out of nowhere. So it's likely the life situation that is causing this, the stuff that you do day to day, and unless that's going to change, this is likely going to be a reoccurring thing. That's why you need to be doing those stretches and exercises that we talked about. So a couple options moving forward in terms of how we can help One.
Sometimes people just like to come in when they're dying.
I don't suggest that, but if you want to do that, I'm okay with that and we'll see you hopefully no time soon, because hopefully you're doing really well. What I would recommend is, you know, based on my past experience and all that dealing with people in similar situation, if we were to see you somewhat regularly now I don't know what that frequency is yet, but if we were to see you regularly, we can keep the things under control, keep you feeling well, keep things moving well. So this is less likely to be a reoccurring issue for you, especially since you've had this like 15 times in the past five years and you're very sedentary, you know, and go into it and then I and I'll tell people. You know it's up to you what you want to do. I'm, you know I'm here to help you reach your goals. So I would suggest the latter. So I'd suggest like a month, for example. Or if you want to just come in when things are really bad again, you can do that as well. It'd be something like that.
Dean: So it's kind of like a strong suggestion, but you know people, they'll make their own choices, so I don't want to be like saying that in the wind up of that, somebody may come and see you a few times in a row to get something back into order, and then you have that conversation with them. Once I leave then, like outside of your office, how often am I hearing from you and in what way?
Joseph: So I'll usually send out those emails, like just a weekly, sometimes every two weeks, just to stay top of mind. So as long as you didn't unsubscribe, you'll get those. I've been sending out just a phone call or a text every like. If you haven't been in within three months, I'll reach out to you and be like hey, dean, just checking in. It's been a minute. I just want to make sure everything's still doing. You know that you're still doing well, and then that's all I've done so far. I know I need to do it more, more frequently, but that's what I've been doing so far.
Dean: So one of the things like how you know one of the diagnostics that you look at is, you know, measuring the what we call return on relationship in your after unit. So if you take how many spines under management would you have Look?
Joseph: here last year there was 5,631 patients that were on the books. Sorry, I'm having a hard time understanding this. Total patients, unique patients, about just under a thousand unique patients I guess that we've seen last year. Now it's been here, this product's been here for 30 years, so there's, you know, several thousand. Some of those people move on, they pass away several thousand.
Dean: Some of those people move on, they pass away, they yeah, exactly, and that's a number. Is that what we look at? Is the total number, like you're still the incumbent or we're a, you know, as soon as somebody comes in and you touch their spine I want you to adopt that position that spine is under management, now that it's up to you. You are, as far as you know, the incumbent provider of chiropractic services for them, and so what we want to measure, kind of on an annual basis, a rolling 12 months, is your return on relationship, and so we would measure that by counting the total number of spines under management, like historically, you know, divided by the number of people that came in to see you at some point in the last 12 months. That's what would be the minimum requirement to be an active patient. I would say it'd be one annual visit, at least one time, right?
Joseph: Okay, yeah, sorry, I don't have that number, sorry, no, and most people don't.
Dean: I'm just sharing it as a way that what would be to establish your baseline and to say this is what it is. It's a knowable number. You're just not tracking it. So it's a number, that those things. And from return on relationship, you can measure some key things. You can measure that as a percentage. So if you have the total number of patients that you have patient records I see all those files behind you there- yeah, there's a lot.
Oh yeah, you have there's way more, there's way more yeah, but I see all of those are, though I'm assuming those are all digitized by now, or these ones aren't.
Joseph: There's a ton that are, and there's we're in process of that there. There's a ton that are, and there's we're in process of that. There is a yeah we're in process.
Dean: I got it, yeah, okay, so let's say that it is. Let's say that it's 5,000 total spines under management in the last three to five years, say that's a fair guess.
Joseph: That's probably under, but yeah, that's fair.
Dean: Okay, so that would mean that right now, your current return on relationship, as far as just the top level, would be 20 percent. Yeah, right, in that, a thousand of them were, came, have come at least once in the last rolling 12 months. Yes, so the goal would be, of course, then to raise that number, right? So that's the metric that you're kind of looking directionally. We want to get that up, that, if every percentage that you raise that is going to have a increase in revenue right, that's a number that we look at Then one of the other things that you might, another aspect that you might look at from that return on relationship is the total value, the monetary, you know, the revenue that generated from those from your after unit, excluding new patients that come for the first time. These are only people that are returning returning patients, right, because we're going to separate we're going to separate the before unit from that, okay.
So if you look at that then you can determine sort of what the, the annual you know revenue per relationship is that if you look at the, the things that you had, you had a thousand unique patients who came in the last 12 months and they generated, you know, a hundred thousand dollars. That would be you know a hundred,000, that would be you know, $100 per patient. That's what you kind of want to look at. That number, right, and we're going to use a similar number in the before unit, you know, to look at your unconverted prospects. But this idea of you know, right now your after unit is yielding at some number that we'll call it 20% of your total spines under management are active in the last 12 months and they generated X dollars, which means that the revenue per active patient is Y dollars. Right that you can know that. So that's that way, knowing what you can actually you know what you can afford to invest in nurturing that relationship with your, with your after unit.
Joseph: Right, no, that makes a lot of sense.
Dean: Do you? Is there any physical mailing that I would get as a patient, or is it all digital by email text?
Joseph: Right now it's all digital. I was I've done it before where I would mail them stuff. I usually like, if you're a new patient, I'd send you a you know, a welcome kind of letter like hey, you know you're dealing with Dean, you're dealing with a disc bulge, you know, looking forward to taking care of you. It should take this long. You know, you made the right, you made the right choice, kind of thing, that kind of thing. And then I haven't been doing that lately, just I just haven't.
Dean: I used to do a during unit function, right that, and so I'll talk about that in a second. But the after unit there. If it's outside of that, I'm not really getting anything in the mail from you.
Joseph: No, I used to Otherwise nothing. No, none of those. I used to do a newsletter. I stopped doing those. I just wasn't seeing. I did it for about like 18 months at a previous place. I just wasn't seeing the return there and I think our rates are like a buck buck 10 now per stamp. So, yeah, so yeah.
Dean: So you'd have to look at that right and see is it worth the? Is the juice, the squeeze, right? The other thing, that's the multiplier of it, is the referrals, right? Like, if we look at our profit activators, the after unit is the last two, the profit activator seven, which is nurture lifetime relationships with the people, and then profit activator eight is orchestrate referrals. So do you get referrals from patients?
Joseph: Yeah, we certainly get referrals. Yeah, I would say about 20 to 30% of our new patients are referrals and they usually want like a specific person, which is great. One of the things I've been trying to help orchestrate that a little bit is again those workshops you know send anyone that you know dealing with X problem. Yes, I also like to give people this book I wrote, called Ouch Ouch, so kind of goes head to toe things we can help out with and how that looks like. And then usually so usually let's say you come in and we diagnose you with a disc problem I'll go through here and be like oh yeah, this is this problem. Kind of describes it in some detail if you're interested. And yeah, and then I tell people to. Obviously, you know, if you're having anyone complain of something or just give them the book. Be like here, here's the guy who you know we trust with our health, hopefully find this, you know, hopeful and then they can take that to the next stage if they find it's useful and want some help.
Dean: Yeah.
Joseph: Yeah, that's about it.
Dean: Yeah.
Joseph: That's about it.
Dean: The thing about orchestrating referrals is to recognize, like, what are the high probability conversations that are going to happen, that are going to lead to a conversation that could turn into a referral for you.
Right, you know, and we talk about the idea that all referrals happen as a result of conversation, and in those conversations, what has to happen is that they have to notice that the conversation is about something that you could help them with.
It could be about chiropractic, or we'll go through and list some of those, the high probability conversations. They have to notice that it's about that. They have to think about you and then they have to introduce you to the person that they had the conversation with. All three of those things have to happen for a referral to take place. Now, most of the time, many times, it'll happen that they'll hear a conversation about oh, my back's killing me, or I twisted my back or whatever. You know, anything that could be sort of like overtly clear that this is something acute onset that you could help them with, or it's a chronic complaint that they're that if they knew that this is something that you could help them with, maybe even in the periphery right, like headaches or, like you said, plantar fasciitis or all any of that ouch factor, things that you can help people with so they may hear the conversation and notice.
That's what it's about, but that may not immediately bring a thought about you Like if somebody came to see you because they twisted their back, they were in spasm and you helped them get out of it and then they haven't been back in six months or whatever. That then somebody's talking about plantar fasciitis. They're probably not going to think about you.
Joseph: I guarantee you they're not. Yeah, that's exactly right, right.
Dean: Yeah, that's exactly right, right. And then, even if they do think about you, the third step is the most important is that you get connected with that person. But often what will happen is that they'll tell people about you oh you should call Dr Tanti, that's the. You know. But that would be maybe the extent of it, maybe the extent of it. And they think that they've done a good job. They think they've done the thing. And then you run into them at the grocery store 90 days later and they say oh, did my friend Jason ever come in to see you?
Joseph: I get that all the time.
Dean: Yeah and they, oh, I tell people about you all the time yeah.
Yeah. So what we need to do is retrain them to not tell people about you, but to tell you about the herd that we want to be the bearer or bringer of good things to the people in our world. Right, we want to. There's some element of higher status. If you have a problem and I solve that for you, I, in that moment, I'm higher status than you because you came to me with this problem and I helped you because I yeah, you know the stuff.
Joseph: You're the guy to go to. You want to be that person for it, right.
Dean: So when you realize that's why people refer, it's not as a favor to you, it's not that they're doing you a favor by telling people about you that opens up the freedom to then put people in positions where they get to be the hero, where they can be the star, right. So I'll tell you, I always use this as an example because I have and this is what happened to me two weeks ago is I occasionally have had it happen, maybe four or five times over the last 20 years I've had a situation where I've grabbed something and my back went into spasm, you know, and it was, and it's terrible. I mean, it's like every nerve in your body's attached to it.
Joseph: Well, back pain is terrible. It's extremely debilitating. You know shoulder problem. I broke my arm last year and that sucked, but like I could still move. If you have back pain like it can take an hour to get out of bed.
Dean: Yeah, that's exactly right. So I and there's that. So I went to the chiropractor who hadn't been in in years, but it was something, you know, because this was a situation that now I needed to, you know, to get some relief from. But anyway, I was at and I get massages all the time. So I was having lunch with a friend, josh, who was.
He arrived at the restaurant he's kind of walking gingerly and it was, you know. He sat down. I'm like what's going on? He said, oh man, I twisted my back in the shower just reaching for the shampoo. My back went into spasm and I had just left Sandy, my massage therapist, and I said, oh man, I had that same thing happen. Oh, let me see if Sandy can see you. And so I called her up and I said, hey, do you have time to see my friend Josh this afternoon? He did that same thing. I did His back's in spasm and she's like, yeah, of course I couldn't fit him in. So I handed her, handed him the phone and he got connected and he went to see her. And then, you know, I'm I in that moment my status is high with both of them because I introduced him, I got him an inside track to go see Sandy today and I and Sandy's because I gave her introduced her to a nice recurring. I don't know if you call them patients, but whatever a client massage client yes, Massage client.
Yeah, yeah, and so that's kind of a, you know, a double win that I'm getting those things, but I didn't do it because there was any reward for me from Sandy. It wasn't. You know, like I often say, like, imagine I did it, it actually feels best because I wasn't getting anything from Sandy. That was, it was a pure. I wanted Josh to get the help and I was able to facilitate that for him, Right. But imagine if Josh had walked into Sandy's office and there's a big poster, you know leaderboard on the thing and it's the referral contest and there's Dean at the top of the thing. You know, it would feel like he was a bounty in a way.
Joseph: You know yeah, a hundred percent.
Dean: And it changes the purity of the, of the intention, of why I was referring her to him. So, but that kind of scenario, that's exactly how those referrals happen, right, like? I noticed that the conversation was about his twisted back, I immediately thought of Sandy and I connected the two of them. That's how a referral actually takes place, right, right. So we want to, every single time that happens, let's say, you know, you've got a thousand spines under active, spines under management that are happening, that are there right now. And let's say that, on average, people are having three conversations a day right With their inner circle, with other people, super conservative, so they're having a hundred conversations a month. Basically, that is, there are 100,000 conversations happening among your spines under management. When you think about it like that, yeah, and odds are some number much greater than zero of those conversations are going to be about something that you could help somebody with, either or on a peripheral basis, right?
Joseph: Yeah, I mean 20% of people have back pain at any point in time, so it's at least 20%.
Dean: Yeah.
Joseph: And that's just the back, so not the other things.
Dean: So if there's a way to kind of get those things. If we were to say like what would be the top? You know three to five presenting situations that that people to you for.
Joseph: So back pain Number one neck pain. Number two, sciatica, or what they think is sciatica. I don't even know what that is. What is sciatica? It just means leg pain. So it could be due to a nerve, could be referred pain. It could be due to, like, a muscle issue in your actual leg. So I've had people Hip pain and stuff, or no, it means like. It means like pain. That's why people say sciatica. I've had people point to their shoulder and say sciatica so you know okay right.
So so that was three, and then it kind of varies between either headaches, shoulders, hips and knees, shoulders, knees and toes, exactly all. So any yeah, and we treat, like you know, any spine joint or muscle problem so, or nerve problem, so literally the whole body. But those are kind of the main ones people come in with yeah, so I love that.
Dean: So they're. Any one of those is very specific. Someone with shoulder pain is not the same as someone with back pain, or you know, yeah.
So if you think about the idea of programming these patients for referrals, I would say, if we start out that if we could plant a chip in the ears of your 1,000 active spines under management and active spines under management and we could listen in on all those 100,000 conversations that are going on in the next 30 days and we could get alerted every time one of these trigger words happens, that somebody's talking about back pain or neck pain or sciatica headaches, shoulders, hips and knees. If any of those conversations get triggered, we're able to kind of silently whisper in the ears of the people to plant a subconscious thought of how to turn that into a referral for you.
Joseph: Do you have a thing to do that? Because that would be magical, like we'd be so busy If a fraction of those were actually talked about and referred and a fraction of those came over. We'd be so busy, it'd be great and people would be feeling better.
Dean: And what we do with that is we kind of plant these referral seeds for people. You know that they're. This is one of like something like this, where on one side is the you know just very interesting trivia kind of facts and stuff, and then on the back we have a like a post-it note type of thing where we program these. Here's the kind of referral programming that we use. We would say, you know, hey, joseph, just a quick note in case you hear someone talking about hip pain this month or that their hips are bothering them. It's really common that here's, you know, some of the reasons somebody might have hip pain. But if you do hear someone, give me a call or text me and I'll get you our hip pain relief program or report or whatever. If you have a specific thing, report or whatever. If you have a specific thing, our hip, you know, instant hip pain relief report to give them, and that's kind of so.
Now they're looking and that's always the thing where we use that same pattern language of just a quick note in case you hear someone talking about insert high probability conversation. Here could be hip pain, could be sciatica, could be neck pain, headaches, whatever. It is. Then some amplifying of why that might be happening. Or text me and I'll get you. Insert high value information that you can give to somebody. Okay, to give to them. So now they're not, they're not selling you. They're not saying oh, you're not just telling people, oh, you need to call Dr Tom, they're saying they are getting something for you.
Joseph: Right, right Most of the time.
Dean: Do you have a text system in your phone system Like?
Joseph: at the office.
Dean: Yeah, so if you give somebody that text number, if one of the things in your during unit that you get people to do is to put your hotline in their phone, dr Tanti, and that the the you're telling them, then they've are now they've got it in their phone, so they're not having to look up the phone number, they've got it there.
Joseph: Yeah, it's in their contacts.
Dean: Yes, and that way when you do this, you know if you get them to text you now, then you've got their phone in your system so that when they text you you'll know it's them Now. It all sets it up so that if somebody is like with me with Josh is you know when he came with the back pain, if I hadn't just come from Sandy, but I got a postcard from you that in the back of my mind it's planted there. Just a quick note, in case you hear someone talking about their back being in spasm. Here's, you know, there's some things, there's six things you can do that relieves 80% of the pain in 20 minutes or whatever you know.
Or whatever it is, yes 80% of the pain in 20 minutes or whatever, you know, whatever it is, yes, yeah, whatever the thing is something that's going to imply a rapid, you know, relief for this. Right Now I'm going to remember, cause he said that the way our brains work is we're constantly sorting the information that we have on file to bring it forward. In case we're going to bring it up in the conversation, like if we're you know so, if we're talking about movies, or we're talking about books or we're talking about anything, your brain is scanning. It's almost like the other. The prep team is going okay, we're talking about books, so he's got something, and then you're bringing it up. I just read this book, I just read this one. Oh, I saw this series, and that's all happening in background. And then, when it's your turn to talk, you guys oh, I just read this, and now you're like contributing to the conversation.
So we're kind of priming that, so that when they hear those conversations we're planting the seed that they're going to hear it Right. And then all of a sudden they do hear it and they have something to reply with, you know. So now, they're able to say oh, I just saw my chiropractor sent this. I can get you this, this protocol, or these stretches, or this thing to do.
Joseph: That'll help your problem. Yeah, yeah.
Dean: Let me text him as a matter of fact. So you're texting them right there in the moment, right, and that's coming into your office or coming into wherever whoever's manning the phone system there that it was, you know, jason, or whoever the patient is and they're able to reply back and say, perfect, I you know, or call or whatever you know, to be able to connect and say, hey, yeah, I can send that over. Who is this for? Do you want me to send it right to them? Do you want to introduce us by text? Do you want me to give it, send it to you, to give to them, right, all of that. But now you, you know that there's a person who has a person and you're greatly improving the number of people that have that, you know that are doing that.
Joseph: So that's a great idea.
Dean: Those things that, if you look at the, do you track the lifetime value of patients or annual value?
Joseph: What was so for a new patient it's I don't have the specifics, but for a new patient they're generally coming in about five times or so in that year for most cases. So it's usually around like four, 50, $500. Now if they turn into more of like a lifetime patient, which is what we always want, it's, you know, much higher than that Of like a lifetime patient, which is what we always want, it's, you know, much higher than that. Of course, some people Todd's been seeing some people for 30 years. So I mean, you know that person's the lifetime value is, you know, thousands and thousands of dollars, and it's great to create those relationships with people. That's really where it's all about.
Dean: So that's kind of where you know what the annual value of someone is, because that's kind of where you know what the annual value of someone is because that's what that return on relationship number is going to tell you You're going to look at. Of all the active patients, they brought in this much revenue. So our active patient value is this much our revenue per active patient.
Joseph: Yeah, I'm going to figure that out and that sounds like a good number to track for sure.
Dean: So that becomes then you that that's how you measure the, you measure the return on that, right, and that's why I created this postcard rather than a newsletter. Like I try and look for what's the way of getting somebody you know, getting the impact there, like you could. Probably it's much less expensive to send a postcard than to send a newsletter, but you get all the check box that you would get with a newsletter, except you're also orchestrating referrals, right.
Right referrals, right right on a, you know, deep track. Meta psychology of what we're doing with those interesting facts is we're priming up that they're going to have some interesting thing to contribute to conversations and that's going to anchor them to. This is where I got that. So, if they're like, one of the one of the things that we did on one of the postcards was thing about water rings, water marks on wood furniture that if you have a water, if you have a water ring on it, if you put mayonnaise on the water ring, it'll bring out the natural, the oils in the wood and the ring will disappear, right? So, julie Matthews, this'll bring out the natural, the oils in the wood and the ring will disappear, right? So, julie Matthews, this was one of the first postcards that we mailed out.
So our realtor, julie, was sending this to her clients and one of her clients owns the nail salon where Julie goes to get her nails done. But she walks in and the nail salon lady comes up and gives her a big hug and said you saved me $650. And she said well, how did I do that? And she said, well, I got your yellow postcard and it said if I have a water ring, to put mayonnaise on it. I did it and it took it away. I was going to have to spend $650 to get it resurfaced, refinished, and it was, like you know, such a great example of that people we have a great appetite for interesting things, right Like we'd like to little things to contribute, but the same way, if she ever heard anybody else talking about having a water ring, she, oh, I got this, I found out about this. I had one and I put mayonnaise on it and it went away. Now she's passing it on and she's getting that status.
Joseph: Right, exactly, oh, would you hear that? Oh, for my realtor, she's great.
Dean: And yeah, exactly, you're right, you're reinforcing that when that postcard comes, you're going to look at where you know you budget. You know maybe you budget two or $3,000 to test it with a sample size of your of 250 of your active patients compared to the rest of them and see what the referral, what the return on relationship is with those 250 people compared to the group that's not getting the postcard, before you dive in to sending it to all thousand of the active patients you know, Okay, that's a great idea.
Joseph: That's pretty low cost and I think that could worth testing, definitely.
Dean: Yeah, now, and what are you doing in the before unit?
Joseph: then if you look at how, so yeah, so I'm doing the like I said. The pay-per-click that's pretty like that's just you know, someone looking up chiropractor or physio or some of the services we offer, so that's. Those are okay. It's definitely bringing some people in. I'm doing some of those workshops, so I'll throw up some, or I'm planning on putting up some social ads and social media to try to attract people to those workshops. The past one that I did, I just did through the email, through our past patient list, and got some people re-engaged. So that's kind of where I thought would be the best place to start there, just to re-engage people. Some people re-engage. So that's kind of where I thought would be the best place to start there, just to re-engage people lowest, lower hanging fruit there and that's pretty much it.
So not a ton how far if we were to plot on a map your existing?
Dean: spines under management. How far reaching like? How far do people travel?
Joseph: Yeah, so I recently moved before I purchased this office, so I still have some patients that travel from across the city, which is maybe 20 minutes, but I would say 70, last I looked, 70% of our clients and patients come within our postal code. So within, you know, within five, within 10 minutes, for sure, but within five, within 10 minutes, for sure, but within five minutes, that's both.
Dean: That's part of it is that you want to be five mile famous, that in a five mile radius, anybody who's got back pain, that you know that the top of mind chiropractor is you. That's our, that's your goal, right. So there's a no, you don't have to have like global reach. You need to be famous in that five mile radius, that anybody that has any kind of issue is the thing. So one of the things that we've been doing, you know, is definitely books or downloads, you know PDFs, anything digital downloads that have a title that is immediately calling out to that person.
So we work with a podiatrist in Milwaukee and we did a series of books with about the big five things that people come. Plantar fasciitis was one of them. That we did a book called the plantar fasciitis solution and we would get leads for people who respond because they have plantar fasciitis or they're sitting right beside someone who has plantar fasciitis, right and yeah. So that level of engagement, you know that's kind of what we're looking for is that anybody that raises their hand, you know, because you have what we call invisible prospects. I always use chiropractors as an example, like to explain the difference between visible prospects and invisible prospects and I say to people look, if your target audience is chiropractors, you have visible prospects because you're very findable, you're licensed, you have yes.
You have You're in the yellow pages or online, or you have an active practice.
Joseph: There's a list of us. Yeah, you could find all the chiropractors.
Dean: I can point right to you and say you're the one. Then there is for chiropractors. You have invisible prospects because you can't get a list of the people who twisted their back this morning in the shower or who woke up with plantar fasciitis pain or walking around with chronic neck pain or shoulder pain. You can't get a list of those people but you know that they're all within that five mile radius, that many of the people in that five mile radius are going to have back pain. You said 25% of people. So if you look at everything on Facebook, if you're not doing any Facebook Instagram advertising, that's all done on a CPM basis, right? So the success of the ad is going to depend on the prospect density per 1000 people. So if you show the your ad to 1000 prospects that's how the ads are sold it's going to cost you 30 to $50 per 1000 people to show that thing. So three to five cents to show an ad in somebody's newsfeed and it's all on the phone now. I mean it's 90% of it is mobile and you're one of the people who has plantar fasciitis or your spouse has it or your parent has it. Whatever it is somebody relative to you you recognize. That would be welcome information in your sphere. Right, 100%, so you download that.
Now you have turned an invisible prospect into a self-proclaimed, a self-identified, visible prospect for you. Because somebody who you know, if they're going to download a book on the planner flashlight solution, odds are that they have it right, yeah, they're not going to read that for fun. Yeah, right, exactly. And so same thing with neck. I would be on a constant rotation of those of neck pain, back pain, knee pain, hip pain. And because anybody is only interested or attracted to their own pain, they're not. If they don't have headaches, they're not going to download the headache solution. Yeah, they don't care. Yeah, right, exactly.
Joseph: So you look at those as individual lead generators you know, would you do you find the the downloadable ones more effective, or like a hard copy and then mail it to people?
Dean: I like both because I get the minimum viable is that it'd be more valuable right now. You've got that there's a fixed number of people that live in that five mile bubble, right, if you on Facebook, you put that in there, it'll tell you how many people. That is right, how many people are in that audience. And then it would be it's one level up if you can get them to identify themselves and say I've got plantar fasciitis and they give you their name and their email and maybe their phone number, right. Those three things. That's valuable enough. But now, out of those, some number of those are going to be what we call five-star prospects. Those are going to be the ones that they're willing to engage in the dialogue. They're friendly and cooperative, they know what they want, they know when they want it and they'd like you to help them.
The whole thing is to now put those people through a process that identifies the five-star prospects and makes it super easy for them to get started. So maybe they come in for a consultation, you know, or a free exam or whatever. Whatever, the right thing to do, I imagine all of it is to come on in and see Right, that yeah.
Joseph: Right, that is the ideal. Yeah, that's the end result. We want them in. Yeah, so we can work on them and help them out.
Dean: And if they're not able to come in right now or they want to, we want to at least give them. Well, until then, at least try this or do either. Here's some things that might help you or help you understand what's actually going on and why yeah.
Joseph: I actually had a call Actually I did this with a so-and-but, just kind of coincidentally I guess. They called and they wanted their father-in-law to possibly get help because they have a shoulder problem due to arthritis. So I was like so I had some material again the book and then also wrote another magazine on thriving with arthritis. So I was like so I had some material again the book and then also wrote another magazine on thriving with arthritis. So I was like hey, can I get your email or your, can I get your address and I'll send it to you in the mail. And she was like oh, okay, she's kind of blown away by that.
Dean: So we'll see what happens with that and that's part of the thing is, once they're willing to engage and they're friendly and cooperative, then by all means it's a great idea to send them something physical. Now you've got their mailing address and you've got those. You've got somebody who lives in the five mile bubble and has identified as plantar fasciitis interested and is willing to engage and gave you their physical address. Now that's a much higher prospect that over the next six months that you're going to be able to get somebody to come in. Maybe they might try something else, or they might try and just tough it out, or that it'll hoping it'll go away, or they might try something and get some temporary relief.
But you know within the first hundred days it's gonna come back or become enough of a problem that usually yeah, the other people that you talk about that have had relief because of working with you, that they're going to want to come in. You know, yeah, 100 okay cool and that gets you famous. You know, yeah, a hundred percent Okay cool and that gets you famous.
you know, in that five miles there were these guys from Milwaukee, I think they were maybe from Michigan, but they were a couple of guys they were. They build themselves as the most famous physiotherapists on the internet. They just did these little videos and talk about all these. They just shot videos that talk about all the different things and what's going on and how they, how they treat them and things you can do to get some relief right, yeah, like educational type videos, okay, great, yeah, I think that's a good idea.
Joseph: This is a lot to work with and a lot to work to for me to do, yeah, which would be great. I already have some things on some of these topics, but awesome I think that's good.
Dean: Well, what's your takeaway? How did it all land? What's yourself? What's your understanding of what your action steps are here?
Joseph: well, start tracking return on relationship for sure. That's again. We have the numbers. I just gotta put them together so that shouldn't be very challenging. I think I'm going to certainly test out the the. Would you call it the most incredible postcard?
Dean: the most interesting, the world's most interesting postcard world's most interesting.
Joseph: Yeah, test that out, you can get, I have a whole.
Dean: I have a free book that you can get about that call at getting referralscom.
Joseph: I write this down for calm and then then just like the lead magnets on specific topics, so like condition type reports. I find sometimes I just get too in the weeds with trying to make all these things in terms of like what do you call it? The curse of knowledge? So try to describe it like the itty gritty details and people are like I don't want to know, I just want to get better.
Dean: So it's very simple, right, like you just have. If you just were to create like little, you can have like PDF. It doesn't have to be a whole book about it, but if you had like your best, 10 minutes of advice for somebody with plantar fasciitis to maybe explain what's going on, maybe show that, if you just talked about it, answered the most you know the questions that they probably have about it, identified what's the thing and describe what the solution is, and then just got that transcribed and illustrated, create a cover for it. That would be all you need, version one, to get that done.
Joseph: V1 is better than none, right. That's exactly right. All right, cool, I think I'll do that and then, yeah, you're right, I think I know all the information. It's just putting it down into a digestible format for people I find challenging. So I like the video and then transcribe it and make that into a book and then video as a bonus possibly.
Dean: I like that. Exactly, that's exactly right. Perfect, awesome. Well, that went fast. Yeah, that's a good insight per minute here for you.
Joseph: I love it Awesome.
Dean: I'll send you and notice when it should be up pretty soon. So you'll be famous. And where do people go if they want to connect with you? What's your?
Joseph: river bend chiropractic and wellnesscom. It's a crazy long URL. I need to change it, but that's kind of what I inherited. Or you can look me up, dr Joe taunty, t a n t? Icom, and that should take you to our webpage as well.
Dean: Perfect I love it.
Joseph: All right, man, thanks a lot. Thanks. Have a great day, you too. Bye.