Florida Policyholders: Notice to policyholders recently affected by severe weather. 

Chiropractor Nicole Ingrando

A Diagnosis-Based Chiropractic Sales Practice

Speakers Bureau member Nicole Ingrando shares her expertise on running a diagnosis-based chiropractic sales practice.

Speaker Feature

By Dr. Nicole Ingrando

Prior to becoming a chiropractor, I spent time working as a sales executive for Marriott International. I didn’t realize at the time how important that experience would be. Not only did Marriott’s sales training help me become a better diagnostician, but it prepared me for the inevitable challenges that I would face as a new doctor marketing my practice. Marriott had a lot of strict rules, but one stood out as it related to our focus in sales. Above all, we will only sell a client what they need. To maintain and execute this vision, the process we learned to follow was heavily based on qualifying needs and in a way, we abandoned any attention on results. It seems counterproductive to take your eyes off of the results, even for a moment, but I learned that to focus on the process is to focus on the results.

If we want to grow our practices to become powerful influencers in our communities, we have no other choice. We have to sell ourselves and our mission. This means directly communicating with everyone we meet outside of the office and aiming for nothing less than clinical excellence when we have patients in the office. In my office, we separate our marketing focus into two categories:

  • Internal Marketing, which is achieved when we deliver results as physicians and ultimately, only if our patients are happy.
  • External Marketing, including our community outreach as well as meetings with doctors who have new patient referral potential. 

On a daily basis, most of us are doing great work in our offices, delivering quality care. We don’t find ourselves avoiding our new patient exams. What I see more avoided than not, are the external marketing efforts. Keep in mind, avoidance isn’t a coping mechanism.  It only serves to distort our reality. The reality is, if we’re in a business that serves the needs of others, we’re already selling and the need for communication strategies that we can rely upon are critical.

I understand that this may feel overwhelming and especially when our time has to be spent on so much more in our practice. This is why we need a simple process.  I also respect how scary the idea of selling is to most and even to me. I will admit feeling anxious almost every time I pitch my practice or meet with new doctors.  So much so that I have tried to “will” meetings to cancel. This is where the power of a functional process impacts the complexity and emotion of sales, offering us a logical tool of exploration in our efforts to make the biggest impacts. A clear and dependable process will define a target, organize pertinent data and help us determine our next steps towards the result and goal.

Diagnosis-Based vs. Feature-Based

A Diagnosis-Based Sales Process is very different then the conventional model of selling that prevailed in the 1970s, called the Feature-Benefit approach. The Feature-Benefit approach placed emphasis on information about the product, mainly the benefits and features of the product being sold. What it failed to consider though were the customers desires. If you’re currently marketing your practice and following a Feature-Benefit approach and not getting results, I urge you to re-evaluate the process.  Like Nick Saban would say, “A good process produces good results.” 

In comparison to a Feature-Benefit model, the Diagnosis Based Sales Process is consultative with a focus on establishing a referral partners needs through a series of open-ended, relationship-driven questions. Clearly understanding the needs of a referral partner enable the chiropractor to offer specific solutions to those needs. This creates a roadmap for success in selling your practice and selling yourself.

The Diagnosis Based Sales Process

A 6-Step System

1. Developing A Funnel

Developing a funnel is the very first step in the sales process and for good reason. In order to market a practice, we need an audience. In the sales world, we might refer to this step as prospecting, lead chasing or research. Funnel development is the process of identifying potential referral parters and patients. A requirement of this step is to have a crystal clear vision of who our ideal prospect is. Creating an ideal referral partner profile will help you narrow down the target prospects in the community and create an action plan to follow as the next steps unfold. I have been involved in marketing many commercial products which have spanned various industries and I feel that the chiropractic profession has the largest potential prospering audience.  The market is abundant with potential patients. Everyone has pain. Everyone has a spine. To a seasoned sales professional, this type of potential for product exposure and development is just unheard of. With potential that huge, where to start? Start by making a list of people you wish to share your mission, and consider these things:

  • Who would be considered “low hanging fruit"? These are people who already know you in the community, patients who already rave about your care. 
  • Develop a target list for your funnel. 
  • Create a profile to better understand the dynamics and thesis behind why these targets make sense. 
  • List common interests, observed behavioral traits, personal background, how you plan to reach out and consider any potential obstacles. 
  • Most importantly, can they refer patients? If a prospect lacks the capacity to become a referral partner, they don’t belong in your funnel. 

2. Initial Introduction

In my experience, this is where most chiropractors quit and bail on the process. The idea of making a cold call is unnerving and I couldn’t agree more. Cold calling and making initial introductions is much like physical exercise. Most people don’t ever really want to do it but once you start, you feel better that you powered through those initial few minutes. The workout you didn’t want to do often becomes the best workout of your life and you feel incredible for doing something you didn’t want to do. A key component of this step is to be certain of your message and have a clear confidence when stating who you are. This takes practice, preparation and at times, trial and error. The more confident you are in an introduction, often referred to as an “Elevator Pitch," the calmer your nerves will be when you start making calls.

3. Subjective Qualifying (Needs Assessment)

Step three is synonymous with our experience in performing exams. We identify a target, meet with our prospect and build a professional relationship based on a shared vision for our patients. Now it’s time to explore what they need the most. Just as we have tools like orthopedic and neurological exams, having a list of qualifying questions for our potential referral partners allows us insight into their needs. This is the stage where it is appropriate to ask about them. Sales professionals mistake this step, negate any preparation and find themselves without a strategy. When this happens, the result is that we over-pitch our product and are left to rely on benefit and feature pitches. Blindly stating perks to a potential referral partner without understanding what they need may render your pitch meaningless. Qualifying questions should change from prospect to prospect. They should also be considered and developed prior to the meeting. This is called Pre-Call Planning. For instance, if you’re visiting a busy primary care office but you’re unsure of the number of employees, qualify this in the meeting. A great question to ask about referrals is: Would you walk me through the process of how your patients with spine pain are referred out? Whatever questions you come up with, practice ensuring that they are all open ended questions. That is, questions that can’t be answered with a simple yes or no. Just like in a patient exam, you will learn so much more.

4. Statement of Solution

It’s time to ask for the referral. This step is often another potential pitfall for sales professionals and chiropractors marketing their practice. It’s easy to get stuck in the “friendship” zone and quickly become too comfortable for progress to occur. I hear chiropractors tell me that they were successful in getting a meeting with a prospect and they have built great rapport around a shared love of soccer but now all they are doing is going to soccer games. They ask me, how did I get stuck? It’s easy—you never asked for the business.  It’s not inappropriate to say, "My goal is to earn a position as a trusted referral source for the patients you see with conditions I treat. Will you consider referring me the next time you see a patient with headaches?" It’s great that we both love soccer, but I came here to solve a bigger problem.

5. Overcoming Objections

Hopefully you skip step five all together but the chances are slim in the chiropractic profession. When I was working for Marriott, I rarely encountered objections.  It was unlikely that I would receive feedback such as, “I’m scared to stay at a Marriott," “I don’t really know what Marriotts do," “The last time I stayed at a Marriott, they tried to get me to stay forever.” No one objected to Marriott. Don’t get me wrong, I faced other objections, but amongst all my prospects, everyone assumed Marriott meant excellence. Facing objections successfully requires altering your perception of objections. Objections are your referral partners way of stating what’s important to them. Their most important needs will be disguised and communicated in the form of an objection. Understanding objections in this way is a step you must reach if you’re on the right track in your sales communications. If you reach a point where someone is telling you what they don’t want, then you have earned an inroad to better understand what they need the most. I was once told, and it’s a rule I follow; that if you’re not hearing any objections, then you’re not communicating with enough people. When I am faced with an objection, I rarely deviate in my response. If someone states to me that they won’t refer to a chiropractor because they don’t like them, it’s my open door to ask them to tell me why.     

6. Re-Evaluation

The sales process is cyclical in that the re-evaluation step allows us a means to re-visit the funnel we created while asking another set of qualifying questions. Have the prospects we identified in step one been referring patients? If they have not, which step are we stuck in and how do we move this prospect to the next step? Have we identified any other prospects for our funnel? Along the way, does our process need to be altered in any way to ensure a victory? The qualifying criteria, internally and externally, should never stop.

A Diagnosis Based Sales Process is a process that doesn’t have a start or finish if you’re consistently engaged. It’s an evolution that is incomplete and it requires your consistent participation. The good news? It gets easier and easier the more you repeat the process and allow yourself the opportunity to learn along the way.


About Nicole Ingrando, DC

Headshot photo of Dr. Nicole IngrandoKnown for energetic, candid and relatable lectures, Dr. Nicole Ingrando provides advice and real-life tools to help Doctors of Chiropractic overcome their biggest challenges in practice. In a market teemed with patients seeking relief from pain, she believes that every practicing Chiropractor has the opportunity to be successful, if they apply the right tools with consistency.

Learn more about Dr. Ingrando or book her as a speaker.

All opinions expressed by guest writers are their own and do not reflect the opinions of NCMIC.

This website uses first party and third party cookies to improve your experience and anonymously track site visits. By visiting this website, you opt-in to the use of cookies. OK