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Lean Startup for Chiropractors: Fundamental Principles to Follow

Jasper Sidhu, BSc, DC

What does a technology process born out of Silicon Valley have to do with your chiropractic practice? More than you can imagine. Whether you're a new practice looking to grow or an established practice, there's a lot you can learn from the lean startup.

The lean startup is a process that allows new startup companies to develop and implement processes to make their companies successful. A technology company, not unlike a chiropractic practice, needs to know how to best serve its customers; but more importantly, it needs to learn how to build a sustainable business. The principles upon which the lean startup is based can help you think outside the box on how you market and run your practice. Let's learn about some of these principles, with a focus on applying them in your day-to-day operations.

Validated Learning

The lean startup process relies on various principles that form the foundation of the system. In the technology world, there is a process called validated learning. A company first learns, then adapts, and eventually launches a product. A company needs to build, measure and learn. The quicker it can go through this cycle, the faster it can learn what the market values.

To put this into practice, I participated in a weekend session of the lean startup. As a group, we had a business idea we thought the customer wanted. The tendency is to begin focusing on the product or service. Instead, we went out to the streets to talk to actual customers before we decided to pursue our idea.

As chiropractors, it's easy to establish our practice, techniques and services based on our own training and views. If our interest is in sports, we set up a sports-specific rehabilitation practice. In the technology world, your assumptions are thrown out the window. If you go to the customer first, you'll begin to understand what they want.

Starting a new practice? Instead of focusing on setting up your practice, why not go into the community and see what type of services they want. Do the local sports teams have their own chiropractors on staff? Are companies looking for chiropractors to help them implement work safety programs? Are there influencers in the community you can approach before you start your practice?

If you are starting a sports practice, does your community actually have a need for this? What if you went into the community and talked to fitness clubs and sports organizations? You may find that the community lacks any chiropractic access to the youth market, while the adult weekend-warrior market is oversaturated. By going into the community and getting feedback about what they are looking for, you may find areas that are underserviced or have never even been addressed.

Minimum Viable Products

With technology companies, there is no room to spend a lot of money creating a product, making it perfect and then seeing if the customers are receptive to it. They build what is known as a minimum viable product. Then they go out to the customer and learn whether it's something the customer actually wants. They get feedback, learn, measure and either move forward or shift, which is referred to as a "pivot."

Let's see how this applies in a chiropractic practice. In your practice, you may want to set up a weight-loss program as a service. However, what program should you research and set up? Most of the time, we look at the programs out there and pick which we feel our patients may want. Rather than taking this route, why not create a minimum viable product? Why not create a screening process for patients who may require weight loss? Go into the community and offer that first.

You may have initially assumed that your focus should be on quick weight loss. However, by surveying your patients and potential patients through a screening program, you may realize your community is filled with people who have physical limitations that hold them back from beginning an exercise program. You may find that your community consists of people who are tired of quick weight-loss promises.

By starting off with one simple screening process, you can begin to identify who your ideal patient is, rather than generalizing to the entire population. That way, you can then go ahead and find the right weight-loss program – the program that will be the best at addressing their concern.

We often take courses or find products out there that we think will interest our patients. However, we never test them to see if they're what our patients really want. Want to get into laser therapy? Get a test unit and market to your community. See what the response is. See what your patients think about laser. What's limiting them from using it? By doing this, you will have validated the market prior to rushing into any program or technology.

Growth Models

One of the other aspects of the lean startup process when it comes to technology companies is growth. There are three ways to grow: sticky growth, viral growth and the paid model. Sticky growth is developing a product or service customers will continue to pay for over time. Viral growth is your current customers bringing in more customers. The paid model is based on taking profit from your older customers and putting it into advertising for new customers.

In chiropractic practice, it's important to know which growth strategy you are using. You could be using one or all three. With sticky growth, are you finding that your patients are receptive to wellness care? If so, looking at your retention rate is very important. For example, does your marketing program for orthotics involve regular follow-ups with your patients? Do they get annual reminders for check-ups?

With viral growth, do you have the systems in place to allow your customers to refer their friends and family? Do you have the right follow-up procedures to ensure your patients are educated and knowledgeable about sharing their health benefits with others? Are you able to identify which patients promote your practice the most? If so, are they provided with the right support to carry your message and make patient recruitment easier?

The paid model involves putting money back into advertising. Surprisingly, this is the model used most often. However, you need to pay attention to two variables: lifetime customer value and customer acquisition costs. For every $1 you spend on advertising and marketing, are you monitoring what your lifetime value is? Initially, you may not feel your marketing is working. However, tracked over time, you may begin to see that your patients are referring others, or a certain service is providing you with the most revenue. As you track this, you'll be in a better position to know which services need to see an increase in advertising costs.

The lean startup process has gained considerable traction in the past few years in helping technology companies grow fast toward profitability. However, the process applies to all types of businesses, including chiropractic. Understanding these principles and applying them in your practice should provide the constant feedback to ensure you're putting your money and efforts into the right services. By shifting focus to the customer and following these principles, technology companies won't be the only ones benefiting from lean startup.

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