The Parable of the Goldfish

I once heard a story about a man who went to a pet store. While looking at the fish tanks, he noticed one small bowl up on the counter with a single goldfish in it. He looked at all the other tanks and many other fish – but kept coming back to look at this one fish in the bowl. Why was it up front all by itself? It was priced more than all the other goldfish over in the big tank. What was different? What made this one so special?

Finally, he decided to buy this special goldfish – even though there were dozens more in the big tank next to the counter priced much lower; this was the one he had to have. He made his purchase and as he turned to leave, asked the sales clerk if he'd thought he would ever sell this fish for so much more money. The clerk smiled and said: "Sure. I sell that fish about six times a day," and then turned and dipped another goldfish out of the big tank and into the small bowl on the counter.

The Perception of Value

So, what made that one goldfish different? The perception of value; the idea that it was different – unique – special. In this story, it took nothing more than setting the one fish apart from all the others to create the mystique. A crude analogy? Maybe, but the story is a parable for business practice. There needs to be value for the services provided – that is what makes people seek you out, pay for what you do, and come back for more.

What about our profession? What about chiropractic? What do we do to create value and need for what we do? Is each of us just a fish in a giant tank of many fish, all appearing the same, or are we standing out from the crowd?

I am no marketing guru. I have certainly had many struggles in business. I have been fortunate to have colleagues help guide me along the way. But probably the most important information I was given was to create value for the services I provide. Sure, there are other chiropractors and therapists in my region – but I am different. Other doctors refer specifically to me. Why? Because they see the value in what I do. What do you do to create value for your office?

Creating Value: 4 Strategies

1. Care about your patients. Dale Carnegie noted that the most meaningful thing to a person is to hear someone else call them by name. Are they just a file number or do they have a name? Call patients by name, ask about their family; remember to say (or sing) happy birthday. Showing others you care means a lot, and in today's world many folks just need to know someone out there cares.

Treat people like you would like to be treated. Explain what you do and why. One of my professors commented that he could teach any monkey to push on a back and make crunchy noises – but that was not chiropractic. Taking the time to evaluate and understand what is going on with a patient, explaining your findings, and then providing the right therapies and the right adjustment requires the skill and art of a chiropractor.

2. Be up-front about money. Asking fair payment for your services is no crime, and it should be no insult. No one goes to the grocery store, the mechanic or the beauty salon, gets what they want, and then tries to negotiate price. Your fees are your fees. (If you are participating with a third party, then your fees are decided for you, of course.) Be up-front about what you charge. Be fair, but be firm. If you waiver on your price, then it quickly becomes obvious that you don't trust in the value of your services.

3. Keep good records. I have talked about this many times already. The rules of the health care world have evolved drastically since I graduated. I used to jot a few notes on a travel card; now I spend at least 30 percent of my day doing paperwork – chart notes, narratives, etc.

My group recently made the jump to electronic documentation – I was surprised when the sales rep told us that "this will not save you time – in fact, it will probably mean you spend more time doing record-keeping – but the records will be accurate and complete." In many ways we are legally obligated to keep thorough records, but think about the value good records adds to your practice. You are able to send documentation to support your billing. You are able to look back and review a case history.

Good chart notes are also a great marketing tool – they allow you to communicate your findings and care to other providers. When they see quality notes, it carries an image of the quality of care you provide.

4. Be engaged. There is a lot to juggle through the course of a day, but stay focused and organized. If you don't know what is going on, no one else will. Every job in the office needs to be addressed and managed. Make sure each of your staff knows what they are responsible for, and ensure that they are willing and able to follow through.

Every phase of everything that happens in your office on any given day needs to be coordinated. When you encounter a patient – what are they in for? What phase of care are they in? How are they doing with rehab? What are their current work restrictions? What supplements do they need? (This is where good record-keeping helps!) When your care is organized, a patient will feel like everything in the office is lined up for them. That makes them feel special and creates value for the services you provide.

Stand Up for Your Value

I really don't like TV; there are very few shows I find engaging, most aren't even realistic – but I know I am in a minority. Tons of people watch TV, and that means they see tons of commercials. Recently, I witnessed a few that really caught me off guard:

• There is the guy who gets new shoe inserts and can play football with his son and go dancing with his wife. All it took was a good insert to "stabilize the foundation and balance his posture." That sounds an awful lot like what I do as a chiropractor.
• Then there is the celebrity who shows up on your porch after you've done too much bad holiday eating. She tells the lady with the upset stomach that if you eat the right yogurt it will stabilize your digestion and improve your health.
• The local pharmacy has a new computer kiosk. If you enter your symptoms, it will tell you what products you need to take to get good nutrition and be healthy and vibrant.

I could keep going, but I am sure you see where I am coming from. Chiropractic has long promoted good postural support, a healthy lifestyle, nutrition, etc. But now others are jumping on the bandwagon. How is what you do any more valuable than what the commercials promote? How is what you provide (which may include orthotics, supplements, etc.) different from what the commercials say they provide?

Chiropractic has value, but only as much as we give it. You need to be engaged in your practice every day to promote the services you provide – you are not just a monkey making crunchy noises. Know the value and promote it. Provide the highest quality services you are able.

If we do not promote the value of our profession, someone else will step up to take our place. Be the goldfish in the bowl – set apart, unique, valuable. Don't settle for anything less.