Request for clarification by Researcher davidsarokin on Wed 3 Feb 2010 - 2:50 am UTC:

timd,

I'm not aware of any marketing studies that address the questions you're
asking, but I just wanted to offer up a bit of my own thoughts on this.

I think people have three key considerations when they choose a
chiropractor:

1.  Convenience.  As probo's comment, above, notes, this is important,
though I would guess travelling more than a mile wouldn't discourage too
many potential clients.

2.  Philosophy.  People are looking for alternative sorts of doctors with a
healing philosophy that resonates with them.  Many chiropractors (and
acupuncturists, etc) advertise in natural living type of magazines, like
Pathways, in my area:  http://www.pathwaysmagazineonline.com/

3.  Recommendations.  Personal experience of family and friends carries a
lot of weight, and if they recommend a visit to a particular chiropractor,
then that can lead to new business as well.  


This isn't meant as an answer to your question, but I hope it's a bit
helpful, just the same.  

David

Request for clarification by Researcher clouseau on Thu 4 Feb 2010 - 3:04 am UTC:

Hi Tim,

I'm feeling a little badly after sending you here and it seems no one has
picked up your question to answer. Good comments that may be helpful for
sure, but I think you are looking for a bit more. So let me see what I can
do:

Quackwatch.org says the following:
http://www.quackwatch.org/01QuackeryRelatedTopics/chirochoose.html


"...Choosing a chiropractor can be difficult because the majority of
chiropractors are involved in unscientific practices [1,2]. If you do
decide to consult one, begin with a telephone interview during which you
explore the chiropractor's attitudes and practice patterns.

Positive Signs

Try to find a chiropractor whose practice is limited to conservative
treatment of back pain and other musculoskeletal problems. Ask your medical
doctor for the names of any who fit this description and appear to be
trustworthy.

Membership in the National Association for Chiropractic Medicine or the
Canadian Academy of Manipulative Therapists (CAMT) is a very good sign, but
the number of chiropractors who belong to these groups is small. CAMT's
"orthopractic guidelines" describe a science-based approach to manipulative
therapy.

In addition to manual manipulation or stretching of tight muscles or
joints, science-based chiropractors commonly use heat or ice packs,
ultrasound treatment, and other modalities similar to those of physical
therapists. They may also recommend a home exercise program. For most
conditions that chiropractic care can help, significant improvement should
occur within a few visits.

Negative Signs

Avoid chiropractors who advertise about "danger signals that indicate the
need for chiropractic care," make claims about curing diseases, try to get
patients to sign contracts for lengthy treatment, promote regular
"preventive" adjustments, use scare tactics, or disparage scientific
medical treatment or preventive measures such as immunization or
fluoridation.

Avoid chiropractors who purport to diagnose or treat "subluxations," who
have waiting room literature promoting "nerve interference" as an
underlying cause of disease, or who post charts or distribute literature
suggesting that chiropractic might help nearly every type of health
problem.

Avoid any chiropractor who routinely performs or orders x-ray examinations
of all patients. Most patients who consult a chiropractor do not need them.
Be especially wary of full-spine x-ray examinations. This practice has
doubtful diagnostic value and involves a large amount of radiation.

Avoid chiropractors who "prescribe" dietary supplements, homeopathic
products, or herbal products for the treatment of disease or who sell any
of these products in their offices. For dietary advice, the best sources
are physicians and registered dietitians..."

The author, Stephen Barrett, MD, continues on a bit. I think I agree that
many people view chiropractic as "not really a doctor". Personally, I have
had both good and bad chiropractic experiences so I shall agree with the
need to qualify.

There is a site that has an element of spam to it, but also a bit of good
information called, believe it or not, choosingachripractor.com:
http://www.choosingachiropractor.com/


"...10 Things Every Consumer Should Know Before Choosing a Chiropractor

Here are a list of pointers on how to find a good chiropractor (and what to
avoid)

1. Wellness or maintenance treatment. This is a good way for a chiropractor
to make extra money, and a common reason many medical doctors don't refer
to chiropractors. There is no scientific evidence that when you feel good
chiropractic treatment can prevent or maintain anything. If you feel good
and your chiropractor still wants to see you, get a second opinion before
continuing care.

2. Questionable diagnostics. If your chiropractor tests your muscles, notes
they are weak, and diagnoses an internal problem, the DC should refer you
to an internist. On the other hand, if you have weak muscles because you
are out of shape, a good chiropractor will refer you to a therapist, a gym,
or design a strengthening program for you. If your muscles are weak due to
a serious disease, nerve problem or serious structural problem, your DC
should refer you for a second opinion with a neurologist or orthopedist.
Muscle testing alone should not be the reason your chiropractor wants to
continue to treat you if there is no pain.

3. Silly marketing gimmicks. Health fairs, swap meets, and shopping malls
often have chiropractors giving free spinal examinations. There are a
variety of gimmicks designed to procure you as a patient. The most common
one is a postural analysis. If you have poor posture and no pain, a
chiropractor should not want to manipulate you, but instead should design a
workout or exercise program for you, or refer you to a therapist or trainer
for such a program.

4. Treating areas that don't hurt. When you receive treatment, three things
happen: You get better, you get worse, or you stay the same. If you feel
good, only two things can occur: You stay the same or you get worse. If you
go to a chiropractor with lower back pain, the DC should not manipulate
your neck unless you also have a neck problem. There is no evidence that
performing neck manipulation can help your lower back or vice versa. If
your chiropractor insists on manipulating areas that don't hurt, get a
second opinion before continuing care.

5. Excessive supplementation. Chiropractors take many nutrition classes in
school. Beware of any chiropractor who says his vitamins are the only ones
that work. Beware of any chiropractor that wants to sell you large amounts
of supplements without referring you to a retailer or health-food store for
comparable products at a considerably lower cost.

6. Excessive x-rays. Beware of any chiropractor who uses x-rays for any
reason other than to rule out a fracture, dislocation, or bone disease.
X-rays should only be taken if you have sustained a recent traumatic injury
and are in considerable pain and discomfort; are undergoing a history and
examination indicate a possible bone disease such as arthritis; or have
long-standing pain in an area that has not responded or resolved with care.
No person is perfectly symmetrical; no one's spine is perfectly straight
and balanced. If you are pain-free and your chiropractor wants to continue
treatment because of what an x-ray shows, get a second opinion before you
continue care.

7. Excessive visits. When a chiropractor treats you, you should feel
better. It is not normal to be worse after treatment. Depending on the
nature and extent of your problem, after a few visits you should notice
considerable improvement. After one to four weeks, your pain should be
reduced by 40-50 percent, depending on how severe and how extensive your
original problem. Beware of any chiropractor who recommends a three, six or
12-month treatment plan based on your first or second visit.

8. Unwillingness to work with other professionals. If you are not getting
relief, you should not have to ask for a referral; your chiropractor should
have already recommended one for you.

9: Pre-payment for services that have yet to be performed. Beware of
chiropractors who ask you to pay "up-front" for treatment. Most
chiropractors will use the analogy of the dentist and braces. This is a
questionable procedure and should be avoided at all cost.

10: The "pinched nerve" theory: Beware of chiropractors who claim that your
problem is due to a pinched nerve. Although some conditions may indeed
result from a pinched (compressed) nerve, a competent chiropractor should
be able to determine if your health problem is due to other underlying
causes. The cause of a your problem may be due to nerve, muscle, ligament,
disc, nutritional, hormonal, environmental challenges.

Here is one more tip you should know:
 
11: Say NO to NOOPE (No Out of Pocket Expense): It is illegal for any
physician to not charge a patient a deductible. If a chiropractor offers to
waive the deductible that is a RED FLAG and I would advise you to either
stop going and/or to inform your insurance company. This is a serious
violation and although offering a savings for the patient, is likely to get
the doctor in hot water. This is sure sign of the integrity and honesty of
the chiropractor..."

More on this site.

And you can find numerous place that profess to help you make a wise
decision:

The 11 Questions You MUST Ask BEFORE Choosing A Chiropractor!
http://www.endpainforever.com/south_bay_hermosa_redondo_manhattan_beach_chiropractor_11_questions.htm


How To Select The Best Chiropractor
http://www.spine-health.com/treatment/chiropractic/how-select-best-chiropractor

How to choose a chiropractor that's perfect for you
http://www.nbcactionnews.com/content/health/story/How-to-choose-a-chiropractor-thats-perfect-for-you/8adAu3B2hkq50uSNgwhTWw.cspx

This one is interesting as it refers to reviews on Angie's List. Hmmm.

I could find dozen's and dozens of sites like the above for you, so let's
switch gears a bit.


Well, Angie's List seemed like a great place to try so I looked for
similar. It seems people post on Yelp in their local areas looking for
local recommendations.

http://www.yelp.com/topic/san-jose-need-recommendation-for-a-good-chiropractor

Seems a little like cars and home audio - people recommend the one they
have. But, with more than one recommendation to one chiropractor, I might
look into that practitioner a little farther if it were me.

Here's a Homeowner's Association chat board looking for recommendations:
http://www.broadlandshoa.org/hoaforum/showthread.php?p=129868

Insider Pages:
http://www.insiderpages.com/b/3710501734

There are quite a few like this. Seems like a little viral, guerilla
marketing might pay off getting the name out by replying to some like these
in your chiropractor's local area and surrounds.

The why really seems to come down to proximity and recommendation. And
special techniques if the consumer is aware of something particular they
seek. Not much more I could find here.

How far do they travel? Another tough question but I was able to find:

http://www.centrachiropractic.com/faq.html

Why Do People Travel Large Distances to See You?
Although individuals have many choices for chiropractic health care
services and many are just down the street from their home, many choose to
travel 100+ miles to utilize the effectiveness of Applied Kinesiology and
the benefits it has to offer. Not all chiropractic techniques are equal.

Hmm, so a choice to travel could be made on the techniques offered. And
here they claim 100 miles!

Santiago Clinic claims even greater distances:
http://www.dailyrecord.com/print/article/20100120/PTW12/100118078/Scarano-joins-Santiago-Chiropractic-team

Describe your most unusual patient, job or work experience.
The most unusual and heartening experience that I have witnessed at
Santiago Chiropractic thus far is seeing patients coming into the office
that have traveled from as far as the Bronx, Pennsylvania and even
California just to receive a treatment at our office. When a patient has
that kind of loyalty, dedication and faith in what you do, to be willing to
travel such a great distance for care, it really makes you feel that you
are doing something special. 


Now, Chiropractic Location Specialists look at the effective coverage area
of a chiropractor this way:

http://www.locusmap.com/company/story.php

"...The distance from the practice site is the most prominent demographic
factor (Figure 1). We know that two thirds of all patients from a practice
reside in a fairly tight zone around your practice site. Density of the
population will determine the size of this practice zone.

Surprisingly enough, 25 percent of your patients give you 80 percent of
your practice revenue. The American Chiropractic Association indicate the
average chiropractic patient is 40.2 years old; 56 percent are female; and
50 percent are college graduates. Additionally, 83 percent are white, 11
percent are Hispanic and 4 percent are black.

How does one find this chiropractic ideal population profile? Data can be
sorted by county, zip and postal carrier routes. Using these sorting
methods can help you find a high potential practice site with the highest
"ideal chiropractic population profile."
Figure 2: The denser the population, the smaller the practice zone.

How large of a radius around your dream location should you study? In a
small town surrounded by low population, 25 miles is an acceptable radius,
but in a large cosmopolitan city with a high density population a radius of
1.5 miles is ideal. The more usual suburban practice radius is three miles.
Ideally your office should be located in an area in which you wish to live.
It should be in a growing, active trade area with other health
professionals. The people in your community should have a favorable
attitude toward chiropractic and there should be no serious geographical
obstacles to block patients from reaching your office..."


And here is an interesting article on how to find new patients using Google
Adwords:

Chiropractic Marketing Tip – Gets You New Patients For 1 Cent Each
http://googleblogsite.info/chiropractic-marketing-tip-gets-you-new-patients-for-1-cent-each/


So, Tim, there is a bit of information I hope you find helpful. If so, I'd
be happy to post as an answer. If not, let us all know what misses the mark
and perhaps I or another researcher here at Uclue can find more.

Best,

--clouseau=-