Using Topical Analgesics to Increase Practice Revenue

Topical Analgesics are a natural, mission-aligned fit with Chiropractic care and all its goals: clinical excellence, practice building, and financial performance. This is true from a purely clinical perspective for topical analgesics that are proven effective and are preferred by patients and doctors because of their ability to impact patient satisfaction, treatment, and outcomes. Additionally, topical analgesics are not systemic in their impact, such as NSAIDs (non-steroidal anti-inflammatory drugs) or COX-2 inhibitors and opioids. Some also feature natural ingredients.

From a practice building perspective strong topical analgesic brand awareness and its unique link to hands-on healthcare practitioners can help you find and retain patients. The key here is partnering with a product that has the power to bring people to you and then helps you market to them via free practice-building services such as customized product samples and online referral tools.

On the financial side, finding and retaining patients, as well as selling needed products like topical analgesics, obviously can contribute significantly to your practice revenue and your profits. Providing products as a professional service is a benefit to your patients and a way to ensure that they receive the right products. When you offer products you believe in and allow your patients to try the products for free, there is no pressure to buy. The right products are truly effective and, ultimately, sell themselves.

The powerful alignment of topical analgesics and Chiropractic explains why a Dynamic Chiropractic Topical Analgesic survey in December 2009 revealed that "of those surveyed, 91% use topical analgesics in their practice. This places the use of topical analgesics just under nutritional supplements (used by 94%) as one of the most used products in chiropractic practice in the United States."

This reported usage level is merely the tip of the topical analgesic iceberg. Though most Chiropractors use topical analgesics, many do not fully leverage this powerful, natural alignment to the full benefit of their patients and their practice.

Why Topicals?

From a clinical perspective, one of the primary symptoms Chiropractors deal with is pain. Chiropractic treatments, via varied modalities and techniques, can be incredibly effective at relieving pain. Topical analgesics play a critical supporting role in every aspect of the treatment process.

Applied prior to in office treatments, topical analgesics can promote temporary pain-free movement of muscles and joints to prepare for adjustments and other forms of manual therapy or in-clinic exercise. This approach can lessen muscle guarding and apprehension that might limit the effectiveness of treatment. Topical analgesics may also allow you to treat someone who would otherwise not tolerate your intervention due to their pain.

Applied after treatment, topical analgesics can lessen any soreness associated with manipulation or the use of tools, and can even add a positive sensation following an ultrasound treatment. Menthol based topical analgesics are particularly helpful here given the cooling sensation they achieve as part of the pain relief process. When used to enable exercise, topical analgesics promote faster long-term healing and recovery.

At their core, topical analgesics can provide a natural pain relief experience and eliminate the patient's need for oral drugs, NSAIDs, or opioids. In 2000, the American College of Rheumatology began promoting topical analgesics as a primary therapy for arthritic disorders before relying on NSAIDs because of the negative side effects of NSAIDs.

How To Choose

Even though topical analgesics can provide a more natural option for pain relief, there are a few things to look closely at when selecting a product.

Ingredients for topical analgesics can be measured by their quality level. Look for products that use United States Pharmacopeia (USP) grade active ingredients. USP sets standards for quality, purity, strength, and consistency in health products. Some manufacturers focus on both quality and natural ingredients and even provide colorless options.

Additionally, those who make claims that are consistent with the claims allowed by the FDA provide much needed patient and practitioner confidence and protection. The FDA allows topical analgesics to claim the following only: "Provides temporary relief of minor aches and pains of muscles and joints, which may be associated with simple backache, arthritis, strains, bruises, and/or sprains; providing penetrating or cooling pain relief."

This guidance from the FDA relates to all topical analgesics classified as OTC (over-the-counter) drugs. Beware of any topical analgesic product that claims more than this. Such claims are a violation of the law in the United States.

Check the Research

Some manufacturers have conducted clinical research on their products to understand and support efficacy and performance. For example, a number of studies have documented the impact of topical analgesics on pain and blood flow, while also capturing the very favorable comparison of the tested brand of topical analgesic to ice.

Other forms of clinical feedback can be valuable as well. Visit the Facebook page of topical analgesic products to gain an unbiased view of the patient response to these products. Post after post of unsolicited user experiences document meaningful pain relief that has significantly improved that user's quality of life. This can increase your confidence in the efficacy of that particular brand of topical analgesic. My company's research in 2010 showed that 70% of Chiropractors felt their use of topical analgesics would increase in the future because they were "finding topical analgesics to be effective for [their] patients." (Data on File, Performance Health, August 2010)

[pb]When a user receives a recommendation from you, and possibly even experiences a topical analgesic for the first time in your clinic, they will connect the pain relief they receive between treatments with your care. In order to increase practice revenue in a way that supports clinical excellence, make sure to use an effective topical analgesic and provide free samples of it. This will allow your patients to experience the product and develop their own belief in its efficacy.

Retention and Self-Efficacy

The in-clinic and at-home application of a topical analgesic has value for satisfying temporary pain relief needs. But it can also serve two higher purposes. One is self-efficacy—the patient's belief that he or she, as a result of your treatment, will actually be able to achieve a life free of pain. The other is the development of trust in a long term, non-systemic product that complements your care and provides meaningful benefits to your patients as they transition from recovery to wellness.

A fellow practitioner, Timothy Tyler, PT, MS, ATC started to believe that some of his patients self-discharged (were not returning after their first or second visits) due to pain. He wondered if applying a pain relieving topical analgesic during a patient's initial evaluation and sending them home with the same product would decrease his self discharge rate. He was aware of a previous study showing that a topical analgesic application on patients with non-complicated neck pain gave greater pain reduction, lasted longer, and was preferred in 9 out of 10 patients as compared to ice.

Tyler examined the rate of self-discharge (or patient discontinuation) in his clinic over a three-year period and discovered that he lost 6.5% of his patients. More than one out of every twenty patients was not coming back after the first or second visit.

As a documented experiment, all patients presenting for an initial evaluation received a spray topical analgesic application on their area of chief complaint at the end of their first in-clinic visit. The patients also performed therapeutic exercises, received appropriate manual therapy and appropriate modalities. For their personal care at home, they received a bottle of the topical analgesic spray with the instructions to use it three times a day at regularly spaced intervals and not to use it in conjunction with any other form of cryotherapy or heat therapy.

What happened? The rate of patients self discharging during the spray-application program period dropped to 1.6% (from 6.5%)—a 75% reduction! Applying the reduction in discontinuing patients illustrated in Tyler's pilot study to an average physical therapy clinic yields an annual revenue increase of over $28,000 and an increase in profit of more than $8,900.

Tyler measured one more interesting phenomenon. While he was giving the spray away to almost all his patients on their initial visit, his topical analgesic sales increased 22%. The product literally sold itself without any overt selling strategy or tactic. This provided additional unanticipated revenue beyond the increase due to more patient visits.

But most importantly, Tyler noted, "It is very gratifying to see patients return for more of my care. Obviously, when patients stay on track with their rehab program, we can help them recover quicker and maintain a pain-free and healthy lifestyle." Tyler not only discovered but also quantified the power of using and sampling topical analgesics as an adjunct to the recovery and treatment process.

Revenue Formula

The formula for increasing revenue is very simple: 1) use topical analgesics in your practice, 2) send each patient home with a free sample, and 3) display that product for sale. Following this formula with the right product literally allows you to sell without selling because patients become believers in the power of pain relief provided by topical analgesics and they appreciate the convenience you provide by offering it.

To make things even easier, well-known brands can also literally draw future patients to you. As you work with manufacturers that can provide free product samples customized with your practice name and contact details, a sample is transformed into a marketing tool for you. One topical analgesic with strong brand awareness enables online consumer searches for practitioners in their community via their "Where to Buy" Service. Free patient education material should help patients understand and embrace the science behind topical analgesics. Free countertop displays and reseller window signs further increase visibility.

In my company's research, Chiropractors who resell topical analgesics report sales of between five and 200 patient-sized units per month at a clinic gross margin of between 35% and 50%. As an example, selling 150 tubes of topical analgesic for $12 each provides $1,800 in annual revenue. When you add to that revenue from the high leverage benefit of increasing the number of patients who return to you, and the referrals they generate, it's easy to see why so many Chiropractors believe in the power of topical analgesics.

Given the natural alignment of Chiropractic care and topical analgesics, supporting clinical excellence, practice building, and financial performance, there has never been a better time for you to increase practice revenue by fully leveraging topical analgesics. Take full advantage of every benefit available to you . . . for the benefit of your patients and your practice!