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One of the business lessons I learned very early on in my life came from Jay Abraham.  He said there were only three ways to grow a business.  The first was to increase the number of new customers or new patients. The second had to do with all things pricing and raising a business’s average order value. And the third way was to, in his words, increase the number of transactions a customer has with you.

It is absolutely true that the chiropractors that see the highest volume, and are the busiest or make the most income and serve the most patients are the chiropractors that have the highest PVA. 

So How do I improve it?

If I had a penny for every single time I jumped on a coaching call and the client asked,  “How do I retain my customers for longer” i.e. improve PVA”,  I would be a very wealthy man. I’m gonna break this down into three categories and mostly focus on how you would improve customer retention across a team, for example, associates, but in truth, the process is the same whether you’re a single doc or run a team of associates.  

If you’re in a multi-doc office and have the unenviable task of trying to improve PVA across your associates, start with understanding that it is a slow, hard, long, and patient process. 

There’s absolutely no magic bullet that’s going to fix this alone, but here are three focus points I recommend;

  1. Certainty. 

It’s a bit of a cliché but boy doesn’t make a difference when it exists. All successful salespeople have certainty. 

Boy, does certainty change the game. Prospects, patients, and customers can just feel if someone is certain about the thing they are “selling”. Certainty and “passion” for me are quite interchangeable. I believe one becomes more passionate about the thing they are selling the more certain they are in benefit or end result that the thing they are selling gets/gives the prospect. This is why so many chiropractors who have had a life-changing experience themselves under chiropractic care get to a point of certainty a lot faster.

Let’s first start by saying that within the chiropractic context, when certainty is mentioned it’s often made with reference to philosophically-based chiropractors.

I’m here to tell you that it’s not just those who can recite the green books or the 33 principles that are successful. Having said that, you would have to be an idiot to not see the correlation with the fact that those that do have a thorough conviction or pursuit in deeply understanding chiropractic and its workings simply seem to be more successful. I mean heck, wouldn’t you want to see a professional that is passionately studying, in pursuit of better serving his clients? 

The dictionary definition of the word “certainty” is “A firm conviction that something is the case”.

But the keyword in that sentence is “conviction” which is often synonymous with “determination”.

An important point that many who teach others to simply become more

“certain” often miss, is that NOBODY was born certain of ANYTHING.

That means that certainty is a learned process. In my opinion, certainty comes off the back of a deep conviction or determination to understand the “thing”.

I’m absolutely convinced that just the pursuit or passionate desire to be better at one’s craft, fully understand or witness the benefits, results or workings of the thing they are “selling” or “doing” makes that person more “certain”.

I have almost never hired an associate ever who came from a sound philosophical background and even if you take philosophy out of the picture I can go further and say that I’ve never hired an associate that was particularly confident in the product they sell. 

That’s your job!

You put them in environments, be it around philosophy, science, or art/technique that improves their confidence and therefore certainty. Last point, spoiler alert, there is no “certainty destination”, you must simply never stop being the person that exposes your team to information, environments, and people that aid this process. 

  1. Training.

The second part to increasing PVA or what other industries simply call sales and retention, is persistent and determined effort to train on it. Scripting, role-playing monitoring, and in some cases extreme and constant feedback is the ONLY real way to drive a “sales team” in the right direction. THE ONLY WAY!

I recently read an article by one of my early mentors that was talking about just how much they train their team. What really stood out to me was that he pointed out that the culture of training was so deeply rooted in their culture that their sales team not only give feedback when a sale doesn’t go well or convert but rather that every single sale is analysed and feedback is given on how it could have been better, even when the sale was successful. 

Let that sink in for a second. Even when the business achieved the desired outcome they still trained and analysed the process, to get even better. It reminds me of watching any documentary about a professional sports team.  When they win, they still analyse the footage and train the next week don’t they? It would be ridiculous to say that if a team wins on the weekend they cancel training the following week. They continue to analyse, train, monitor, or hold accountable certain personnel and team members. Whereas when we look at our own businesses, if we are honest, we do a couple weeks of training with a new doc and then we simply move on and think our job is done.  

So in short, Certainty, Training, and enforced procedures and processes, followed by repeat, repeat, and you guessed it repeat.

Just so you fully understand how elusive sales conversions and retention are in any business it’s worth noting that by far and away most of the business books ever written have been around this subject. Next time you’re in a book store go to the business section and see just how many books specifically focus on sales. The reason I broach the point is to banish the notion that there is a quick fix, magic script, or magic speaker that is ever going to solve this problem. It simply doesn’t exist.

I remember many years ago jumping on a call with one of my coaches at the time as we were building a telemarketing team for my eight offices to phone leads. I asked him if he had any advice on how to improve the conversions of the telephone girl we hired. I’ll never forget his response. It was both obvious and heartbreaking at the same time. He simply said, sit in the same office as the girl making the telephone calls every single day for a month. He went on, sit with her and listen to every single conversation she has for the next month, then train on the conversations, give feedback, and work through the objections she gets. My heart sank as I realised that there was no easy script or salesperson I could hire that was going to save me. No magic procedure or sequence or CRM I could implement. There was only Certainty through training in accountability and procedures.

Where to next?

I’ll leave you with a few questions that may show just how absent this is in our businesses. let me ask you…

When was the last time you listened to your front desk make telephone calls or book leads?  When was the last time you yourself made secret shopper calls to your front desk and posed as a new patient? When was the last time you analysed recordings and trained on them as a team? When was the last time your team was required to do that for each other? When was the last time you spent time with the associate listening to their Day One, physically in the room? When was the last time you asked an associate to record themselves during an initial consultation or report of findings and analysed the recordings and gave them feedback on them? When was the last time you did any role-playing, or scripting in training? When it comes to procedures, are there processes and procedures that you simply need to mandate that you know for 100% certainty increases the likelihood of a customer converting or staying longer, why are they not made mandatory? Have you spent the time with your team to explain this until the objections they may have around forcing certain processes within the business? Have you made sure you are constantly exposing your team to the right research and philosophical input that increases their certainty?


Keep on keeping on. Slow and steady wins the race. 

Love and light 

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