Patient On-Boarding System Is Marketing

This week's blog is a guest blog by Dr. Bryce E Christianson, DC, CHWC

As I begin this article the survey in the Modern Chiropractic Marketing FB Group says that 17 members aren’t aware of onboarding, 3 have some knowledge of onboarding and there are 0 that say they know how to onboard patients.

The interesting thing is we’re all onboarding patients, whether you know it or not. And more times than not, onboarding begins well before the doctor every even meets or greets the patient.

My definition of onboarding is the entire process that happens when a person first starts shopping for a chiropractor and takes them through their first few visits plus through re-examinations. The goal is for them become a solid patient who refers all their friends and family members.

More specifically, onboarding is often thought of as to what happens after their first visit but really it starts at when they first hear about you, see your website or business card. No one needs a reminder on how important first impressions are, but I firmly believe we cannot strategize, sample, refine and perfect our clinic’s onboarding process enough.

I’ll never forget receiving the first and only direct complement about my onboarding process as a marketing process. This patient remarked, “this is quite the marketing strategy you have”. I never looked at what I was doing as marketing before, but after learning more about marketing it was the whole time.

This specific patient is really well educated and involved in the community. They’re excessively frugal and a well informed consumer who scrutinizes everything. It came on the patient's third appointment and much to my relief the patient was doing a lot better. When I took on their case, I was a bit intimidated and I was happy how much relief they received. But it was shocking that this person complimented me on a business practice that I never looked at as a marketing strategy.

As I tell you about some of the things us chiropractors do in practice and point out common onboarding strategies utilized by chiropractors I can see many of you say, “Oh, I do that but I didn’t call it that name”. That’s fine, but my hope is that now that you give the process a label you take action on improving it. I hope you look at your values, your mission or purpose and use your differentiators to ‘wow’ your patients through a strategic onboarding process.

Before I go into some of the aspects to my process I’ll share with you some examples I’ve seen in our profession:

  • ROFs - reports of findings. Going over the person’s problem(s), their test findings and recommending a care plan.

  • Mandatory health talks - the doctor covers over specific topics about their practice. The event aids the patient into becoming full engaged in their care and committing their time, energy and their $ to getting well.

  • Dinners - some doctors buy new patients dinners I hear. I am not too sure about this process. It’s so far from what I do I am a bit mystified by this one.

  • R1/R2/R3/R4 - these are usually a sequence of mini ROFs that ‘drip’ patient education on the patient.

  • Re-exams - some doctors use their re-exams as a way of getting the patient on board.

  • Mugs - I hope this makes some of you smile because I think some here may know what I am referring to. After so many visits, sometimes up to 900 visits, the patient ‘earns’ a free mug +++++ PLUS a photo with the doctor.


I hope you have a clearer version of how chiropractors onboard now. And now that you’re learning what onboarding is, the next time you’re a consumer of a service like ours I hope you look at and analyze that business’s onboarding process. A well intentioned, thought out and refined onboarding process makes the consumer a buyer for life. But more than anything what I want you to take home from this is your onboarding process should be so solid and smooth it makes your patient want to refer everyone to you.

There is no more affordable or quality way of landing a great patient than through a word of mouth referral. After you dedicate time to plan out, script and practice your onboarding process with you and your staff you will start landing more and more word of mouth referrals.

Furthermore your quality onboarding process helps ensure your newly committed patient has zero buyers remorse. Your process must consistently add value to your patient after they’ve already committed their care to you.

That last paragraph was my ‘take home’ message. If you care to learn a few specifics of my practices onboarding process I will bullet point a few significant processes we have. On a side note, there are all outlined in our policies and procedures manual and hope you’re doing the same.

A Simplified Version of the COOR Wellness Onboarding Process

  • Website → suggests we’re wanting to help people by simplifying the scheduling process. It has a victorious hiker who implies people will reach their physical goals through our system. It also conveys we’re a team; not 1 doctor who will solve all their problems.

  • Phone call → our phone script is based off the cliche, “no one cares how much you know until they how who much you care”. The staff is trained to show interest in hearing what’s going on. The external motivator is to show empathy and concern. The internal motivation is to know if this is a good patient case to take on or if we should refer them to another chiropractor where they’ll be happier.

  • Taking a deposit → we sell our time. Unless you sell a TON of products, we generally are time merchants. So we require new patients to put a deposit down. It was a bit extreme when we did this, but at that time we were scheduling new patients out 3 weeks, existing patients couldn’t get in and we were referring people we cared about to other chiropractors because there wasn’t space on the schedule. More importantly it tells the patient, we’re a respected business and that time is strictly reserved for them.

  • Scheduling their 2nd visits the same time as their first → this is another way of saying we value seeing them improve and internal studies have shown that they get better faster if visit 2 is 2-3 days after visit 1. Repetitive motion injuries and non-emergent cases we’ll book out a couple weeks when visit 1 and 2 aren’t scheduled properly.

  • First visits → we have loosely written scripts for the consultation and the exam. Our exam is thorough and we’re constantly educating what each test is looking at so they’re being educated on what needs help. **Staff training is vital** The handouts we give on visit one further educates the patient on how we’re different. By then, if they’ve been to another chiropractor, they’re a bit overwhelmed. The papers explain things and outline expectations. They emphasize high standards in health care, patient involvement and full resolution.

  • The referral source gets a thank you card sent to them that day. This helps make sure our referral sources are acknowledged and when the two parties speak about their experience often times the referring patient continues to ‘sell’ us as the person who will solve the patient’s problem.

  • 2nd visits → This is what we’re emphasizing right now. We’ve worked hard as a team to develop processes and tools to help on visit 2. By then, if we’re doing our job right, they should have confidence that they’re getting the care they need, they’re be restored to strength and they have autonomy in choosing the level of care they desire.

  • Visit 2 check out → instead of doing a ‘talk’ or dinner I designed an optional questionnaire. This way the patient can choose to do it and learn more about what we do or they can brush it off without judgment. But this was the tool that patient complimented me on. She chose to do the questionnaire and was impressed. On our questionnaire are questions about:

    • Chiropractic: it’s helpful to know someone’s current understanding of chiropractic. If they believe something different than I do, I want to respect their perspective and care for them appropriately. If they have no knowledge I can briefly share my understanding of chiropractic.

    • Our differentiators: when the patient sees that what we do is unique, respected and hard to come by they often want to talk about this with their spheres.

    • Our resources: our Facebook and YouTube pages are ways that we genuinely support their care outside of their appointments. Having them visit our YouTube and Facebook accounts helps them see that we support them outside of the office too. It also helps them become part of our ‘following’ or what many email marketers call your ‘tribe’.

    • Our ancillary services: this is super helpful for them knowing how we can help them beyond the adjustment.

    • Our wheelhouse conditions: my mentor and preceptor is a plantar fascia (PF) guru. Learning his approach is a true blessing but people don’t know my practices success rate on PF unless we tell them. Now usually I frown on self-promotion, but seeing so many dollars wasted on PF gadgets has concluded that I am obligated to inform people that we can help their PF. PF is just one of many conditions we notify them we can help.

    • The last question is: “Do you know someone who needs these services?”

  • Patients that return the questionnaire earn a reusable grocery bag, a quality water bottle, and pedometer all with our branding plus a healthy eating book written by a local author.

The onboarding process can be either low tech or high tech. We’ve put the questionnaire on Surveymonkey but most people choose paper handouts. A lot of your onboarding sequence can be done through automated email sequence, and I believe this is the future. Whether you do a low tech or high tech way of doing it is your choice. But your email marketing service is a great way to help automate it.

Before your next big marketing meeting or strategy session I encourage you to think about Frank R. Sovinsky, DC’s emphasis in the E-Myth Chiropractor - before you work on your marketing, work on your systems. Your onboarding process comes down to your purpose, your mission and your strategy. Consider all of these in every little detail of your process. Who says what, when, how and WHY needs to be lined up with overall goal in practice. My guess is if you really perfect this in your own unique way you’ll gain 2 patients for everyone you onboard correctly.

Bryce Christianson, Owner COOR Wellness