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The "TAO" of Referrals
John A. Amaro D.C., FIAMA, Dipl.Ac. (NCCAOM)

Recently I asked the office manager of my clinic to only accept three new patients a day as opposed to the usual five I have routinely seen for over 25 years. With my very busy lecture schedule taking me around the country on a weekly basis, I felt reducing my practice intensity would assist me in both my professional and personal life. But as Mark Twain pointed out in his famous classic "Tom Sawyer", just when someone can't have it, is when they want it the most. As a result of my accepting fewer new patients, it appears there is more demand than ever. Of course the acupuncture practitioners in my community are loving it as we refer an increasing number of patients their way.

It just so happens that I was fortunate enough to begin my practice of chiropractic in 1971 with acupuncture as a principle modality of treatment. As a result of my early intervention into American acupuncture, my practice grew at a steady rate as more and more people sought acupuncture as a result of seeing so often seemingly miraculous clinical response. Not only did people seek me out for acupuncture, but I also saw people for chiropractic care which would never had sought out a D.C. had it not been for the fact they came to me for acupuncture which has always had much better press than chiropractic has ever had.

By 1974 my clinic had become one of the largest and most successful acupuncture practices in North America at a time when voodoo was a word most often associated with its practice. The medical profession regarded acupuncture as quackery or hypnosis and acupuncture as a profession was more than 10 years in the future. Today, their is more potential than ever to achieve a full, busy referral based acupuncture practice for literally all practitioners, as acupuncture's acceptance has become matter of fact. through both the general public as well as the scientific community.

Today, in the U.S. alone, there are millions of patients who seek our service and their are less than 35,000 practitioners counting the Chiropractic and Medical doctors who employ acupuncture. Which means the current number of practitioners available for the number of people who wish to see us is staggeringly off balance. What is the difference between the practitioner who is seeing just a handful of patients compared to the one who is booked weeks in advance. I know of an acupuncturist who boasts he is booked three weeks out however, he only sees a maximum of four patients a day. The last I heard he was having major financial difficulties. Can you see more? Should you see more? it's a matter of technique and style. Interestingly enough, the percentage of patients who achieve remarkable clinical success is just as high in the practice that sees 60 patients a day as the one who sees six patients a day.

Did you ever have to wait an hour or more in a restaurant for a table? Obviously it was not the greasy spoon in the middle of the block or the restaurant with either poor food or poor service. It is usually an upscale spot with unique surroundings, or an old established restaurant with just great food. In essence the busiest restaurants are not the ones who generally advertise the most, they are the ones who achieve "fantastic results". When was the last time you referred a friend or family member to a less than adequate restaurant, on the other hand your enthusiasm for the unique one came with your highest accolades. The same is true of a clinical practice.

However, I learned early that a little help in getting your patients to refer is certainly legitimate, just as the restaurant owner might say on your leaving, "If you had a great experience, tell your friends". Just because you achieve good results in many of your patients is often times not enough motivating force to get them to refer. Just because your Clean, Neat, Brave, Trustworthy, Kind, Reverent and every other adjective for the perfect person as spelled out in the Boy Scout/Girl Scout handbook, is often times not enough to get patients to refer either. How many times have you achieved great healing response only to never hear from the patient and besides that you're a great person. You say there goes the theory of the restaurant with the one-hour wait. Not necessarily, often times people just aren't thinking of telling others about their experiences unless they're really motivated. How motivated are your patients to refer to you. In fact ask yourself this question! Why should someone refer their friend, co-worker or family member to you?

While you're asking questions, take this quiz!!!!!! What is the first name of the person who cuts your hair? How many if any kids does he/she have? What is the husband/wife name and what do they do for a living? Think about it, this is the person you see on a regular basis and if you're typical they have been cutting your hair for some time now . You discuss sports, politics, movies, current events in fact you probably have as much or more conversation and idle chit chat with this person than anyone else in your life. Besides that, they are a great person! Ask yourself this question, with all of this, how many people did you refer to the person who cuts your hair last year. Keep in mind, their success is predicated on referrals. In fact how do you think their clientele grows. What was your participation in their success? So, how many people did you refer to your car dealer, insurance agent, accountant, etc. etc. Why should someone refer to you???? What if you asked your patients to refer because you are currently building the biggest and best acupuncture facility in this part of the State. How could they refuse? They couldn't , just as you would refer to your hairstylist or barber if only they had asked. That's the point!

Did you ever stop to think the greatest compliment a person can pay us is not glowing comments about how wonderful we are, but it is the simple act of referring and entrusting their family and friends health into our hands, What an incredible compliment! Are you sending personalized handwritten thank you notes or some funky form letter with no personalization. Please, don't send one to me unless it is personalized with your message and signature.

The bottom line of the referral practice is actually very simple, strive to achieve outstanding clinical response in the least amount of time, motivate patients by impressing them with a nice clean well maintained office, as well as the professional appearance of the practitioner and office staff. Explain the procedures used in an easy clear cut manner so that they can go home and tell their husband/wife what transpired without all the razzle dazzle.

Should you have an assistant who is less than perfect, get one that is. This will destroy you faster than anything. Years ago, my clinic employed 12 assistants in my practice. Absolutely amazing how regardless of how competent I may have been, sometimes people would never come back only because the way they were treated by an assistant. Did you ever go to a restaurant only to be met by a waiter/waitress who turned you off so bad you stated you would never go back there again? Well guess what, it happens all the time in every endeavor.

Why do you suppose acupuncture has grown to the unprecedented level of public acceptance it has in such a short period of time. To me the answer is easy. Acupuncture delivers quick clinical results in a very short period of time and it is comparatively speaking, very inexpensive. I think B.J. Palmer the developer of chiropractic said it best, "The fundamental of this clinic is to see how little we can do at how few places, how rarely and how quickly it can be done to accomplish the greatest change in the shortest space of time at least cost to case and to know what to do and why we do it before doing it ".

I am totally convinced, striving for the quickest most dramatic clinical response and releasing the patient to maintenance care as early as possible is one of the major keys to a high referral practice. Remember that everyone has a dentist and they only see they're patients twice a year on average unless an emergency comes up. Because of seeing them twice a year routinely, people will see the same dentist for years and years.

The Asians have a philosophy to see their patients routinely whenever the polarity of the earth changes, that is, when fall turns to winter and winter turns to spring, when spring brings forth summer and summer gives way to fall at this four times of the year the universe is in a energy flux. What a great time to see patients, If we only saw our patients four times a year, whenever an emergency arose and as needed in between.

If you can go to your office tomorrow and tell Mrs. Jones, that you are trying to build the biggest and best acupuncture facility in this part of the State and you need their help to do so, I will assure you your success is assured. I personally conduct a straight cash, no insurance practice. I accept no personal injury cases, or insurance in any way shape or form. I do not participate in any HMO's and have no intention of ever doing so. My job is of a healer not an insurance pawn. My job is to help patients as quickly and as economical as possible. As a result, patients have always flocked to my office. Remember, regardless of insurance or anything else, people are going to go where they can get the most for their time and money.

Remember the number one rule of practice financial success and that is, to serve your patient not your bank account. As long as we have single mindedness of purpose in assisting the patient with their health needs the referrals and financial rewards will follow. As more and more practitioners of acupuncture set up practice across the nation, do not look upon them as competition. Only 3% of any profession, occupation, or endeavor make it to the very top. Strive by your continued study, spirit, compassion and dedication to become the best in acupuncture. Patients will always seek out the best! You may either thrive or survive I think I know which you prefer. The choice is ours.

John A. Amaro D.C., FIAMA, Dipl.Ac.(NCCAOM), (IAMA)