"Over 90% of our patients are referrals.  Give us a fair opportunity to help you, and please share your positive experience with friends and fellow workers.  Use our website as a tool to share."

Dr. Katherine Crafton
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Studies have been underway to determine the demographics of the chiropractic patient.  The Rand study identified that middle aged, married people are in the majority.  Also women more than men see chiropractors.  This does not seem too enlightening, since I am sure that this is true of those who see medical doctors.  I have seen some of the older articles that tried to convey that somehow those who see chiropractors are more rural, thereby implying that they are less educated and more easily deceived and manipulated.  One old time chiropractor told us that it was best to locate away from cities to areas that were rural with some populaton base and less chiropractic competition.  We believe that today's patients are far better informed and, for the most part, they are more health conscious.  The internet and television seem to be promoting a health consciousness with certain talk programs and the abundance of information related to health.   I do not know if being located in more rural areas is still true, or that it fits some older idea , but it did not fit us.   We believe that we are better served being among many chiropractors.  Essentially, three things are true and universal:  patients go to the doctor when they hurt, when they have resources, and when they get results.

We were told one statistic about chiropractic patients.  60% of all people will not see a chiropractor under any circumstances.  This leaves 40% who might.  Only 9% see chiropractors, but most likely they are not consistent, or that they may never have completed a plan of care for their complaint.  The question of who sees a chiropractor is important, because when studying how chiropractic patients feel about their experience it is most often very positive.  Independent studies show that they are pleased with the results and they were pleased with the way they are treated.  So why are the overall numbers so low.  There are only about 50 active licenses in all of Mobile county, and there are thousands of medical  doctors with numeorus hospitals and clinics.  I believe there is an answer to the question and it has nothing to do with effectiveness or even that much to do with impression.  It has to do with money.  Frankly, if there were no insurance or Medicare, people would not see medical doctors as much or as often.

Nothing aggravates me more than the rural stereotype and that only the gullible see chiropractors.  It seems just the opposite.  When cities started to decline, it was the smarter ones that got out.  It is only in the media that they would have us think that  the  smart people live in "New York City" and anyone from Alabama or Mississippi is backwards.  Mobile is a very diverse smaller city with many plants, manufacturers, along with traditional education and government employees. Many of our patients are from all over the country and world, and choose to live in Mobile.  Ones patients are always a reflection of the people that represent your community.  Offshore, river and coastal shipping, energy, and recreation are part of the Mobile Bay and coastal economy.  And the largest consistent employer in any community are its educators and its support staff.

We do not seem to be successful at meeting people and encouraging them to become patients formally or informally.  Whenever one asks us what kind of doctor are we, they always say something like "I need to see you."  "I really need to get my back cracked."  They tell me either how good it felt to get their back or neck cracked, or how afraid they were, or that it hurt and they did not go back.  Sometimes when they know we are chiropractors they ask whether we have massage.  Many make these more shallow connections and see chiropractic primarily as  a "feel good thing" that one does only when they can find a few extra bucks.   I used to make the mistake of trying to educate them or at least to relate that we are different.  Very few people ever made an appointment.  I think that two things are going on:  they know that they do not have the resources or they pull back thinking that somehow I am trying to talk them into being a patient.  For the most part, it is clear that they have a stereotypical view of chiropractic that devalues it. They do, however, really believe that they know what it is that we do, but really all they know is what some other chiropractors seem to be doing.

We have stopped presenting at health fairs and educational events, because we just cannot overcome the impression that we are trying to sell them on something.  After all, if we are helping people and are busy being successful in our office, why is it that we are talking to them and why is it that we have the time to go to health fairs.   "Real doctors do not do these things."  Even our college training encouraged us to go out and meet the average person and solicit for patients.  What a lousy idea!  Also it is counterproductive for any physician to think that this is how people choose their doctors.

In understanding who becomes a chiropractic patient, it seems important to know that a chiropractic patient is different from the medical patient.   A
chiropractor has a more difficult task;  since if they are doing the right thing, they are always asking more from the patient.  Medicine is almost always asking less and expecting less from their patients other than making another appointment.  Chiropractors put the responsibility  into the patient's hands.  Also we need to education more and to communicate the value of what we do.   Natural healing is much more labor intensive.  It takes a different person to take the path of greater resistance.  Also when you get people better, it is more difficult to get them to come back when they do not hurt.  If you are really only managing disease, the patient never gets better and  it is ongoing lifetime care requiring little personality with mutual agreement that  little or no progress is expected.    In some cases, when there is concession that your condition is supposedly permanent, just ask your medical doctor when it is that you no longer need to take your medication.  Ask what you need to do so you no longer need to take medication.  There will be silence and perplexing look.  As said by our past pastor in California, "Any dead fish can float downstream."  Chiropractic patients swim upstream.  They ask the questions and want choices in life, and want to take control of their life.  They do not want to be managed by the select few because these chosen few have a greater good in mind for you.

Chiropractors have created their own negative impression.  Too many chiropractors are willing to see anyone for anything.   There even existed a movement in chiropractic where Dr. Gold, a famous straight chiropractor, created a short lived movement that "everyman" can become a chiropractor.  He envisioned "spinalogists" across the nation and in your neighborhood with only a very limited education performing  the chiropractic adjustment with the "patient" putting some undisclosed contribution in a box on the wall.  People do not value what seems unrealistic and  cheap.   How can something cheap really help me? 
  Medicare people have been conditIoned in only a few short generations to expect "free stuff', and when they discover it costs them to see you, they become only occasional users.  People have come to believe that every senior citizen needs to be taking medications, so they line up just like the children at the desk of the school nurse.  They would not be taking these medications if they were not subsidized and essentially free. 
Medicare with a good Blue Cross secondary coverage often become far more consistent chiropractic patients.  The worse patients are patients who own their own businesses.  They are more risk takers and play the odds on health coverage.  They generally have poor health care coverage or select the option of having a high deductible.  Also they seem to have a notion that  seeing anyone where money is going out and not coming in is a battle where they are losing.  Also people who are more affluent are also not necessarily good patients for essentially the same reason.   Most all medical doctors accept insurance;  the medical community is entirely dominated by insurance, federal or private.  We have observed that the more affluent are too cheap and self important to spend time or money.   If there were no insurance, chiropractic could no longer operate as it has for the last two to three generations;  it would become a cash business as it is now currently for a certain segment of chiropractors.  Insurance in any form whether Medicare or Odamacare or Blue Cross is dependent upon people not using the system to pay for those who do, or it is dependent upon people with resources to pay for those without resources.

Our patients seem to be middle class people who still have fairly good insurance from their employment or spouse's.   Many have a small amount of discretionary resources that they can direct at immediate health challenges and copayments whenever insurance no longer reduces and contributes to the costs.  People know or should know that it costs to use your insurance, and I am sure that many people with employment that for now provides chiropractic and medical coverage do not use it  because it costs them in time away from work, copayments, and deductibles for each person in the family.  We seldom see patients pay for any consistent care for their children.

Since chiropractic is somewhat represented in the major medical health coverage, we see people who want to use this coverage toward their bill.  Most of our patients have Blue Cross and Blue Shield.  People with better coverage are those who work for employers who have larger and more influential bargaining units.   These jobs are generally secure jobs with good contracts that protect them.   People who choose to work there know the limitations of the income but value the security and regularity of these positions.   Most people in any one bargaining unit do not use their chiropractic coverage, and many we have found do not even know that they have coverage.

Many of our patients have seen most all medical doctors and specialists.  They seem to be
dissatisfied with injections, drugs, surgery, and physical therapy.  If people are pleased with these treatments, they just do not elect to come here.  Seldom does a person come to our office not having first seen a medical doctor.  Our mission is to attempt to turn around this trend of dumping on chiropractors after hope is challenged, discretary resources are exhausted, and conditions worsened by surgeries and medications.  For now, many of our patients have taken medications and some have had surgeries.   Some are even angry with the medical system.  They do not feel like anyone listens to them.  They feel used and devalued.   They certainly feel taken for granted.  Most are shocked when they get a bill in the mail, because they thought insurance covered it or that they are paying high retail fees that they never would have accepted if told.  In one way of another they have become a cause driven microcasm.  Also they seem to read more books, articles, and use the internet on health issues.  We do not even have popular media magazines and newspapers in our office which are common in the medical lobbies.  They seem to go to health food stores.  Occasionally, a health food fadist, self educated new ager will experiment with our practice, but they generally have two things that make it so that they do not develop any consistency:  they have no resources and they are only looking for recognition on what it is that they think they know.  They like the idea of being healthy and knowledgeable but do not invest in the process and want our information and knowledge base without sharing resources. 

In the last three years, we have discovered that 90% of our patients are referrals.  By referral, I mean that they heard good things about us from friends that they respect.   Also some have come from a family referral.  Chiropractors have no formal referral program like medical doctors which is the specialists' source for business.  We get our referrals somewhat as would a specialists from a generalist, since they think of us as targeting a specific chiropractic related problem.   Many patients even initially believe that our copayment is the same as for specialists, because they came for a targeted problem that others could not help them with.  We have a few professionals that refer patients to our office, but it is much like referrals from their friends whom we have helped.  Chiropractors, of course, are a separate and distinct profession not requiring a formal referral;  they are primary care physicians, but the general public has conformed to the formal medical referral system and chooses to "schedule their life in someone else appointment book."

We have never gotten any real business from coupons, promotions, and advertisements.  Earlier we did these things.  We spent money and wasted time and resources on the curious not the serious.   You will not see us in the yellow pages or the coupon packets.  The overhead costs are too great, and the outcomes are too long term to know whether or not they have any value at all.  It was only slow growth from referrals that determined who are our patients.

Lately, a few patients have been coming to our office because of the internet.  This is encouraging, because it is efficient and very good way to communicate how we are different.  People may not want to see us when they know more about who you are, but that is good thing.  It is an efficient way to make a good first impression.  They will  know that we do not adjust manually like the other chiropractors; they know that we want the committed patient; and they know that we care; and they will know that we invest in our business so we can improve.  They know that we take pride in the appearance of our office.  They may believe that we are a little rebellious and outspoken but most all of our patients are not "dead fish".

We differ in whom we attract as patients.  I believe that we are unique as a practice because of the use of technology and instruments.  We see many people who have never seen a chiropractor before.  We see many who have had a bad experience with chiropractors or are afraid of chiropractors, and they heard that we are different.   We see more patients who drive further, and this seems because we moved and yet they do not want change doctors, and many drive further because of our specialty.  They have found that no one else seems able to help them.   We spend more time with our patients.  Our office is attractive and has a very comfortable and relaxing feeling.  We also see nearly as many  patients for health problems that are not directly related to chiropractic.  They become chiropractic patients and remain nutrition patients.  What some people will not spend from their resources  for chiropractic, they will invest  to overcome the health challenges  that  they believe are critically important to them.  People who have not been helped by others and still have hope will exchange resources for results.

The most evident trend in our business over the years is that we see female patients who want to reclaim themselves in late middle age.  We can and have helped these people where it becomes clear to them that the
medical profession was taking them for granted.   Women seem to be more motivated and disciplined about following through with care, while at times men are less disciplined and do not like to follow direction from either a male or female doctor.  Of course, there are many exceptions.   Single women in a certain age group can become very motivated when they are on their own, while men at that age seem to be less driven.  Young single men and women are less likely to be committed, but it is more likely that a young women will be driven to help herself.

We have many highly educated patients.  Our patients consist of several attorneys, many teachers and support staff,  and college employees from professors, scientists, and support staff.  Many patients work for the larger plants in the area with some being executives and others skilled trades.  We see retired postal workers and teachers.  

We do not see as many Medicare,  Medicaid, or retired military, since chiropractic is excluded from these  programs.   We see more Medicare patients since dropping Medicare as a provider.  Some of these people come to recognize that they have been excluded and a few use their own resources to have consistent chiropractic care.  We did not exclude them from chiropractic; it would seem that a significant savings with improved health would be the overall result.  It takes a rare person to part with discretionary resources for either medical or chiropractic services, or any service for that matter that can be rationalized away as not being critical.

We do not seem to attract suspicious types or negative people.  Oftentimes our patients are very tolerant.  We can count on one hand those patients who were rude  to our staff but nice to the doctor,  roll their eyes at any paperwork, complain about waiting, or what's expected in a plan of care.  Knowing how long they must wait to see a medical doctor, I cannot imagine that anyone would find fault waiting in our lobby.  It is hard enough to see those patients fast enough and often enough who appreciate being helped.  Most all chiropractors are far better at getting to their patient in a timely way.  Medical doctors often have  two to three waiting rooms before you get to a room where you wait again.  We would say these few people are overly negative, looking to exclude, and looking to be angry, sometimes looking to find a reason to fit us into the limitations of their own pocketbook.  We never ever dread going to work or feel like someone is out to get us.

Our goal regarding identifying a patient for our practice is that we want whoever will give us a fair chance to help them.  

Who has the resources and time to schedule a reasonable amount of treatments?  Success leads to referral, and referrals have hope and the start of a belief that they are going to be helped.   Probably the most consistent characteristic shared by our patients is that they are mostly of strong faith.  Most believe that the body was a perfect gift from God and that the body is self-healing.  Although their convictions differ somewhat, I hope that all feel comfortable and welcome and that we share with them in most ways regarding the importance of faith, belief, and humility.  With humility comes the ability to learn and increase ones knowledge base.

                                 Characteristics of Our Patients

In-Network Health Insurance with Chiropractic coverage that they want to use , not lose

Referred by someone they respect

Most are middle aged to 65 (Pre-Medicare)

Well educated and may never have seen a chiropractor before

Have a secure job and family structure

Committed to making changes in their health

Looking for something different in both chiropractic or medical experiences

Value natural health and have developed some healthy living habits

Someone who may go to a health food store

Looking for answers on their own

People of strong faith and generally socially conservative

They are hurting and are frustrated with the help that they have sought

People willing to read and learn more

People who are generally positive and reasonably trusting.