Your total practice volume is determined by just two things: how many leads you get and your conversion of those leads. Leads are a result of your marketing – internal and external – but today, I want to talk about conversion. In many ways conversion is more powerful and certainly more important to get right first.

In your practice, every patient goes through a process. Maybe you have documented that process and maybe you haven’t but either way, you have one. At each step some patients will drop out. The rate of follow-through of your patients at each step is called your ‘conversion’. Because your patient process has many steps, the final result of how many people you can help is the direct product of each of these conversion steps.

Now here’s where it gets exciting. An improvement of any of these steps gives you (almost) the same improvement in your entire practice volume. So if you can improve just one step by 50%, you will get a 50% increase in your volume. If you can improve two steps by 50% you will get 1.5 x 1.5 = 2.25 or a 125% increase in your volume. That’s right; you can more than double your practice by using focused training in the right places.

On the other hand, if you train on a conversion point that already has 95% success, you will get at best a boring 5% improvement. So you want to be sure that your time and attention is going to where it really counts.

But just which places are the ones you need to focus on?

Today I’m going to tell you how to find out exactly where you need focus your training for maximum impact. I’m then going to tell you how to make sure you are tracking your changes and always know where you need to improve and where you are good already.

## Conversion

Here is a typical patient process:

Step 1: Lead – the patient goes into your system.

Step 2: Initial Consultation – the patient turns up for an IC

Step 3: ROF – the patient has a report (or two)

Step 4: Start of care – the patient starts some program of care

Step 5: End of care – the patient finishes the program of care they started

Step 6: Start of care – the patient starts on another program of care.

Between each of these steps is a conversion rate. For example, you have a Lead-to-IC conversion rate, an IC-to-ROF conversion rate, a ROF-to-Start Care conversion rate etc. It’s also possible of course that a patient may skip steps and go from, say, IC to Start Care without a ROF – and you want to know about that too because that may well show that your practice is making mistakes.

## What does ‘Conversion’ Mean?

Say in a given month that you have 100 ICs and that you do a report for 80 of them. Your IC-to-ROF conversion is 80%.

Let’s say that your conversions for each of the steps above is:

IC-to-ROF: 80%

ROF-to-Start: 40%

Start-to-End: 40%

End-to-Start: 40%

These would be fairly typical figures. So it works like this. Say you have 100 PPs (Potential Patients) have an IC in a given month. Then 80% or 80 will have a ROF. 40% will start care – that’s 32 of the initial 100. 40% of those will complete their cycle of care – that’s 13 left. 40% of those 13 will go on to a wellness program. That’s just 5 of your original 100.

What this means is that you can just multiply out these conversion percentages at each step and know how big your practice will be:

Overall conversion (OC): 80% x 40% x 40% x 40% = 5%

The maths actually gets a bit complex after this but the key thing to understand is that your practice volume is almost directly proportional to this overall conversion. (If you really want to see all the calculations, take a look at the spread sheet here: Checkpoint conversion to Practice Volume Calculations) Suffice to say for now, with an OC of 5%, this practice will do 80 adjustments per week.

## Now for the fun part…

You with me so far? We’ve done the maths now. This is where it gets exciting.

You see, since all of those conversions multiply, if you increase any one by, say, 50%, your Overall Conversion and so your practice volume increases by 50% too. Say you and your team train hard on the ROF. You increase your ROF-to-Start conversion from 40% to just 60%. That’s not too hard to do. Now your practice volume is 120 per week. You like that?

Next, you study your conversions and realize that you are weak in the middle of your programs of care; people drop out before they finish. You study your technique; you and your team develop your workshops and communicate increased importance on lifetime care. You increase your Start-to-End conversion again from 40% to 60%. A second separate 50% increase. Practice volume now? 152 per week. Almost double what you started with.

But check this out. If you trained on your IC-to-ROF conversion, even if you got it 100% perfect, your volume would only go up from 80 to 100. And no amount of further training or development of your IC methods or communication would ever make this any better.

In other words, you get the greatest ROI by focussing your attention on the weakest conversion. It has the greatest amount it can increase. Heck, if you have a conversion point of only 20%, you can do just about anything and make it better!

Actually, with a little effort you can easily get your IC-to-ROF to 90%. Let’s say you do that and get all the other conversions to 80%. Practice volume now? 540 per week. But get this – this practice hasn’t done any extra marketing to bring in any more NPs than before. They haven’t changed any of their care programs. Their average visits per patients have remained the same. All they are doing is focussing attention on doing things right with the people who come in the door. Fix your weakest link first and you’ll get by far the greatest ROI.

(By the way, this still only results in an OC of 46% – plenty of room for further improvement.)

Improving your conversions is probably the most powerful way you can increase your practice success. It costs largely nothing and results in happier patients and better clinical standards. It has nothing to do with ‘patient management’ and everything to do with communication and standards.

## How long will it take to see a difference?

When your OC is low, like under 20%, you will get to your new level in about 2-3 months after you make changes. As your OC gets higher, it will take longer to get to your new level – like 7-10 months. It will change in the first 2-3 months but will not plateau to the final level until 7-10 months.

## How can you make the change?

Once you have worked out which is your weakest conversion, you know that to fix it you must focus on the step in front of that conversion point. For example, if IC-to-ROF is the weakness you want to fix, focus on your IC. If Start-to-End conversion is your failing, focus on Start… and middle. End is where you see the problem and it is common for teams to focus their attention on the point where the problems manifests rather than its source. This will simply lead to frustration and disappointment!

I would recommend that once you have worked out where you are weakest, you make fixing it your Current Initiative. Focus all your attention on it for 3 to 6 months. Ask your friends what they do in that step. Go to seminars that focus on that step. Read books, surf the web, contemplate. Break down what you are currently doing, see the problems, and build it up again better. Use the Experts in Spinalogic to ensure consistency with your new plan. Repeat. Since you have all your attention now focussed on the right spot, change will come fast.

## OK. I get it. But how do I measure my conversions??

Ah ha! I thought you’d never ask. I did actually gloss over this bit a little earlier. If you have 100 NPs in a month and 80 ROFs you may think that your conversion is just 80/100 = 80%. But what if you do a big promotion at the end of one month and all the ROFs from that promo come in the next month? In that next month, you may have 100 ROFs and only 80 NPs and get a meaningless conversion of 100/80 = 125% Huh? This problem gets bigger when the two checkpoints of the conversion get separated by more time such as the Start and End of a program of care.

In fact, this gets so hard to work out that after several attempts over a couple of years I sat down and spent an entire day to work out how to get this right. It turned out that the only way to do it properly is to make your conversion check patient-by-patient. The correct way to measure it is like this: Say you want Start-to-End conversion in the month of May. You first have to find all the patients who had an End in the month of May and then see how many of them came from a Start. You then need to find all of the patients who had a Start in the same date range and see which ones have an End in the future. Now you gotta do the same for all the other conversions that go from Start and calculate the relative percentages… and then… well, I think you get the idea. It’s actually quite complex. No wonder I’d never been able to get figures that actually meant anything!

So how can you get accurate measures of these so-important KPIs (Key Performance Indicators)? Well, in Spinalogic, you just put in the date range and click one button – out comes a super-easy-to-read report. After 30 seconds, you know where your weak spot is and then you know what you have to work on. This is included in both Spinalogic Full and Spinalogic Express. To the best of my knowledge, no other software has this powerful capability

## Summary

Measure your conversions. Determine the weakest. Set that as your Current Initiative and make everything you study and all your team training revolve around that. Then… reap the rewards in 3 months’ time. Select your next weakest conversion, repeat.

I’ll talk to you more soon about KPI’s and how to track them in your own Dashboard to give you that 50,000-foot view of your practice.

As always, I look forward to your feedback.

Warmest Regards,

Richard Sawyer.

What a great piece! Excellent perspective and thoughtfulness.