Selling drinks in Africa and clinic marketing – valuable lessons for growing your clinic.

In the first ten years after leaving university I worked primarily in Africa, based out of the UK. 

A complete career U-turn led me into healthcare but now, as I look back, I can see how certain strategies used by multinationals can be applied to clinics of any size.

Whisky and the legionI had several jobs which included two working at large drinks companies.  I dug out this old photo out which sees me, bottom right, with members of the French Foreign Legion in a bar in Gabon, Central Africa.

So what does selling Grants whisky have to do with clinics??

It’s about the approach to marketing.

In the drinks industry the last three months of the year, and in particular Christmas, are when you generate most of the sales volume.

But, in order to get people to choose your brand, you have to have your brand in the purchasers mind when they are at the supermarket shelf, in a bar/restaurant or thinking about a gift for someone.

In that moment of decision a synopsis of all the brand messages they have ever been exposed to goes through the purchaser’s mind.  A lifetime of brand messages creates an attraction to a brand, but also the position of the bottle on the shop shelf/bar makes a big difference: “Eye-level is buy level” and then you have the influential promotions, special offers etc to sway the decision at the crucial moment.

Most clinicians will say with pride that “word of mouth” is their main source of new patients.

That is generally true, but I believe that this can partly be explained by the fact that very few clinicians have a consistent marketing strategy throughout the year to bring them patients from other sources.

If we relied on word of mouth in the drinks business, we would never grow the brand.  Likewise I visit clinics who invest a lot (time and/or money) in marketing and they are much busier than their competitors.

You see, like the person who buys one or two bottles of whisky a year, a potential patient may not be in pain right at the moment.  You have no idea when a person’s pain will be bad enough that they go looking for a clinic (brand).

Not all marketing works, but so often, clinicians expect an immediate response to a piece of marketing.  Then, when it doesn’t come (and they ‘lose money’), they retreat to thinking that “word of mouth is the only marketing that works”.  Perhaps the ad/message/activity wasn’t quite right anyway, but consistency also plays a big part.

It takes time to build trust in a brand, being there (visible) consistently with your brand plays a big part in building trust.

It is much harder to get people to switch a brand of whisky they have been drinking for ten years, than it is to introduce new consumers to your brand.

Whisky PromotionIn this photo you can see me centre (slightly worse for wear!) in a nightclub in Cameroun.

Drinks promotions in bars highlight your brand.  Any new consumer you engage, like any new patient is likely to stay loyal to you provided you look after them.

Plus, the non-whisky drinkers pick up a powerful brand message and one day they may have cause to choose a brand for themselves or someone else.

So, back to the person with a back ache:  most people live with their pain and take painkillers.  How many times do you hear people say “it was finally time to get my back looked at”.

Like the decision to purchase a bottle of Glenfidich whisky, the brand influences have been built up over time.  Drinks companies invest heavily in that.  As pain develops, so does awareness of pain remedy messages.  It’s been well documented that when you think of a new car you want, you suddenly see that make and model everywhere.  It’s the same thing.

For a clinic, even a few hundred pounds a month to get your BRAND visible to people in your community, gives you much more of a fighting chance to be selected over the competition- in that moment in the year when someone’s pain is sufficiently bad that they want to take action.

IMPORTANT – The other reason consistency is important is because it keeps your brand visible to your existing customers.  Of course, the relationship between a patient and their clinician is much more profound than the relationship between a consumer and a brand of whisky!

However, I am yet to meet a clinician who hasn’t told me that they acquire patients from their competition.  Now, when everyone says that, I’m afraid that means that some of those patients who left your clinic and never returned … didn’t all feel that they had a satisfactory experience with you or they aren’t that fussed where they go so are ready to respond to new messages from other clinics (like the eye level purchase decision at the supermarket shelf).

NOTE we Brits are very polite.  I once sat through a consultation with an osteopath, I answered the right questions but I didn’t get a connection with the guy so I never went back.  Now, he may have thought that he restores patients in one visit but that is not the case every time.

If you provide a good service, you have an opportunity to draw in disgruntled patients and those who don’t have particular loyalty – and there again is a reason to stay visible.

Remember 90% of clinics are passive and don’t market themselves consistently to grow their practice.  Therefore, you don’t need to invest too much to make yourself visible and stand out from the crowd.

I hope this helps.  It remains for me to say Sláinte (SLAHN-chə) which means “health” and is a Gaelic toast to use whenever you drink Scottish water.

For marketing strategy ideas for your clinic, you might like to visit our website to get a free report. CLICK HERE

Good luck.

Stephen Small
Director Steadfast Clinics Ltd
www.steadfastclinics.co.uk  www.iddtherapy.co.uk  www.thermedic.co.uk

Case Study Template For Back Pain Treatment – Comments Invited

As we expand availability of IDD Therapy treatment for discs and nerve pain, we encourage all IDD Therapy provider clinics to write up case studies.

Ultimately we want to refine the patient cohort so that we get better predictability of outcomes and use the strength of the network for multi-centre data analysis.

We use subjective and outcome measures and I wanted to share the outline and structure of a case study template so that if someone had some suggestions for improvement, they could contribute.

The template has some details specifically for IDD Therapy treatment, but they can be deleted for use with other conditions, if someone wanted to.  The IDD CASE STUDY TEMPLATE is a word document you can click to open.

IDD Case Study Template doc

There are many different treatments for back pain and as the somewhat cruel saying goes, there is more than one way to skin a cat.  IDD Therapy spinal decompression is a tool used by clinicians when they want to decompress, distract and mobilise a targeted spinal segment in a manner they can’t achieve with their hands, or traditional traction.

Author: Stephen Small
Director Steadfast Clinics Ltd  www.steadfastclinics.co.uk  www.iddtherapy.co.uk 
email: stephen.small (@)steadfastclinics.co.uk

Low Back Pain Treatment – Inflammation, IL-6 and the new FAR infrared treatment connection.

I recently posted an article regarding drug-based Rheumatoid Arthritis treatment targeting the IL-6 protein.

I was interested in the potential implications of a study by Wong et Al (1), showing that as well as pain relief, post knee surgery patients treated with FAR infrared exhibited reduced levels of the proinflammatory IL-6 protein.  I raised the question whether the new FAR infrared modalities be an effective treatment aid for Rheumatoid Arthritis.

FAR infrared and IL 6 protein

http://www.ncbi.nlm.nih.gov/pubmed/22339105

“This study demonstrated that the FIR can lower the NRS of pain and thus reduce the discomfort experienced by the patient. Findings indicated that effective application of FIR decreased the serum level of Interleukin-6 (IL-6) and Endothelin ET-1, which represent the subjective indicator of pain.”

Working so heavily with low back pain and IDD Therapy spinal decompression treatment, this got me thinking about inflammation, IL-6 and low back pain.  What are the potential applications of new infrared modalities as a cost-effective tool to ease inflammation and reduce low back pain … without the need for steroid injections and anti-inflammatory medication?

With regards to Low Back Pain, we observe on many occasions that patients using Thermedic infrared pads report pain relief beyond what might be expected from a standard conductive heating aid.  I have written at various times that the humble “heat pad” offers more profound benefits than we might think, see evidence.

Looking at some of the research into IL-6 and back pain, Heffner et al (2) show that higher levels of IL 6 are associated with chronic low back pain (CLBP) and sleep disturbance:

“Individuals with CLBP had more sleep disturbance than controls. Circulating IL-6 levels were similar for the 2 groups; however, in adults with CLBP, poorer sleep quality was associated with higher IL-6 levels, and both sleep and IL-6 related to pain reports.”

Burke et al show that there are high levels of proinflammatory IL-6 in the nucleus pulposus of painful intervertebral discs:

“We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay. There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively). The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.”

Kraychete et al (4) show that:

“…  patients with chronic low back pain due to disc herniation presented higher levels of TNF-alpha and IL-6, but not of IL-1 or sTNF-R.”

Thus whilst looking at the Wong et al study showing reduced levels of IL-6 for knee pain post surgery using infrared,  we can also see that elevated levels of IL-6 are associated with CLBP.

Could Wong et al help us to explain more fully the observed benefits of FAR infrared for relieving low back pain?

TherMedic is a new technology which uses a mains powered carbon-fabric element which emits FAR infrared.   It replaces lamps.  Worn against the body TherMedic provides a localised constant infrared heat/energy source.  Evidence shows both thermal and non-thermal effects from the resonant energy for pain reduction for a variety of conditions.

Most of the evidence comes from Asia where the technology is developed and being applied to many medical conditions.  We expect that European academic interest will develop as awareness of the new technology and its applications spreads.

PW140-Lower-Back-Thermography-heat-only   l220103-heat-pad_jpg   l220103-temp-control_jpg

Regular users of Thermedic for low back pain report “not being able to live without their TherMedic” infrared pad.  Patients with sciatica report that their pain has disappeared which is surprsing for something viewed as a simple heat pad and used on the lower back.

PW140-TherMedic-Lower-Back-PackShotRather than simple pain relief from heat and increased blood flow which “feels nice”, might Thermedic infrared have a deeper effect by helping to reduce levels of inflammation-causing IL-6 in LBP?

There is clearly a lot to explore, but as you look into the new FAR infrared fabric application for low back pain relief, you will see that there is a lot more than meets the eye.

Convention has it that heat should not be applied when there is inflammation.

Having heard from people suffering with inflammation but reporting relief when using TherMedic Infrared, could the new infrared turn some of that conventional thinking about heat and inflammation on its head?

Author: Stephen Small
Director www.steadfastclinics.co.uk  www.thermedic.co.uk  www.iddtherapy.co.uk

1) Wong CHLin LCLee HHLiu CF. The analgesic effect of thermal therapy after total knee arthroplasty.  J Altern Complement Med. 2012 Feb;18(2):175-9. doi: 10.1089/acm.2010.0815.  http://www.ncbi.nlm.nih.gov/pubmed/22339105

2) Heffner KLFrance CRTrost ZNg HMPigeon WR Chronic low back pain, sleep disturbance, and interleukin-6. Clin J Pain. 2011 Jan;27(1):35-41. http://www.ncbi.nlm.nih.gov/pubmed/21188850

3) Burke JGWatson RWMcCormack DDowling FEWalsh MGFitzpatrick JMIntervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002 Mar;84(2):196-201. http://www.ncbi.nlm.nih.gov/pubmed/11924650
4)  Kraychete DCSakata RKIssy AMBacellar OSantos-Jesus RCarvalho EMSerum cytokine levels in patients with chronic low back pain due to herniated disc: analytical cross-sectional study. Sao Paulo Med J. 2010;128(5):259-   62. http://www.ncbi.nlm.nih.gov/pubmed/21181064

Rheumatoid Arthritis Treatment – A link between drug treatments, new FAR infrared and targeting the IL-6 protein.

Last month a news article in The Daily Express, a UK newspaper, appeared referencing a new drug treatment for Rheumatoid Arthritis (RA).  The drug targets the IL-6 protein which is responsible for inflammation.

This stimulated my memory banks for a different study for knee pain which I vaguely remembered made reference to an IL protein … hang on, it’s the IL-6 protein!

Have I just discovered a link to a potential treatment for RA?

Here is the extract from the article and a link, but read on.

Sarilumab

http://www.express.co.uk/news/health/444653/New-breakthrough-jab-to-ease-arthritis-agony-and-slow-disease

Whilst preparing a summary of evidence for new FAR infrared (FIR) elements, I came across a study showing the effects of the FIR treatment on patients who had undergone knee surgery (total knee arthroplasty).  As well as significant pain reduction, reference is also made to IL-6 reduction:

FAR infrared and IL 6 protein

http://www.ncbi.nlm.nih.gov/pubmed/22339105

“This study demonstrated that the FIR can lower the NRS of pain and thus reduce the discomfort experienced by the patient. Findings indicated that effective application of FIR decreased the serum level of Interleukin-6 (IL-6) and Endothelin ET-1, which represent the subjective indicator of pain.”

FAR Infrared TherapyNow, anecdotally we hear countless testimonials from people with arthritis (not specifically RA) reporting significant pain relief from using TherMedic infrared ProWraps, as well as other conditions including low back pain, Frozen Shoulder and more.

Some of these effects may be down to the thermal effects of sustained vasodilation but other studies detail non-thermal effects which may explain other significant properties and benefits of TherMedic FIR for pain relief, see evidence summary.

For some people living with Rheumatoid Arthritis, medication does not always work and can include side-effects.

l220100-heat-pad_jpgThe above paper looking at the application of FIR for knee arthroplasty and reduction of IL-6 protein is not a large double-blind randomised controlled trial.

HOWEVER, in the context of this and other scientific evidence surrounding the re-emergence of FAR infrared, as well as the growing anecdotal evidence, there is surely a case for more detailed investigation into the potential applications of the new localised carbon-fabric infrared modality, TherMedic for the relief of pain caused by Rheumatoid Arthritis.

This question may well be being addressed in Asia where the new carbon fabric infrared element was developed, but to the scientific community in the UK, the new technology is still unknown.  That is changing.

NOTES:

Endothelins are proteins that constrict blood vessels and raise blood pressure. They are normally kept in balance by other mechanisms, but when they are over-expressed, they contribute to high blood pressure (hypertension) and heart disease

Interleukin-6 (IL-6) is an interleukin that acts as both a pro-inflammatory and anti-inflammatory cytokine. Expression of IL-6 is enhanced at the site of inflammation, and blockade of IL-6 and IL-6 signalling is effective at prevention and treatment in models of inflammatory diseases (including arthritis and colitis).  Overall IL-6 is important – indeed, critical under certain conditions – to the development of persistent inflammation.

(C. Gabay Interleukin-6 and chronic inflammation  Arthritis Research & Therapy 2006, 8(Suppl 2):S3 http://arthritis-research.com/content/8/S2/S3

Author: Stephen Small
Director www.steadfastclinics.co.uk

I first came across infrared whilst using it with IDD Therapy spinal decompression.  Initially I saw it as a simple heat modality but it quickly became apparent that there was a lot more to TherMedic than meets the eye.  Steadfast Clinics distribute Thermedic in the UK.

Sciatica or Back Pain? – Google statistics show us what people are actually looking for.

Working with clinics treating herniated discs with IDD Therapy spinal decompression, I am interested to see back pain statistics and trends around the subject of back pain.

Whilst “Back Pain” is the number one musculoskeletal condition people visit their doctor for, is it really back pain they need help with or does Google search traffic data reveal something not factored into the statistics?

Here below you can see the UK monthly search volume for certain keywords.

Google adwords Back Pain Searches

As can be seen, for every “back pain” search in Google, there are over three times as many searches for ‘sciatica’.

What about globally?

Google sciatica search results global

Again we see the same trend.

This throws up some questions which someone probably has the answers to (appreciating that sciatica and back pain are closely related): 

Is back pain more prevalent than sciatica?
Is the pain of ‘sciatica’
less bearable than ‘back’ pain?
Is it the latter which prompts proportionally more people to search for info/help with sciatica than back pain?

What do you think?

Author: Stephen Small, Director Steadfast Clinics Ltd
LinkedIn Profile
www.steadfastfastclinics.co.uk   www.iddtherapy.co.uk
Steadfast Clinics Ltd – Expanding IDD Therapy spinal decompression treatment for intervertebral discs and Thermedic Infrared Therapy Systems for joint pain and soft tissue healing.

Exercise compliance – Insights from using Yoga DVDs at home to instill discipline and motivation in patients.

I leave the clinicians to work out what the best exercises are, my interest is improving compliance.  

Knowing exercises is one thing, doing them is another! 

YogaFor a few years I have had a growing feeling that I need to preserve joint mobility, particularly in my lower back!   So I have toyed with the idea of doing yoga (also for a few years!).

or

At the end of the summer I bought a box set of yoga DVDs and over the last couple of months I have started to use the Yoga videos in the morning, at least twice a week.

They really help and now, I would probably be happy to join a class because I understand that “Cobra” is not a beer brand we have with a curry!

The point is, I did know what a sun salutation was but I never bothered doing them on my own.

With the DVD there is a framework and time structure.  From 30 minutes to 45 minutes.  ie it’s doable and someone is there with you.

Many patients leave a clinic with a set of written or verbal exercises to do. That is not going to work for most.  It DOESN’T work for most people!

I have written about exercise diaries, wall planners etc, my strong recommendation is to find a DVD that you like and sell it to patients for them to do at home (and record when they do it in their exercise diary!)

Then tell them to do the exercises at least 3 times a week or daily or whatever is appropriate.

The APPI do a video for back pain which I believe you can buy at trade prices
http://www.ausphysio.com/product.aspx?productid=344

but there are many others.

IDEA – Why not put on a “back class” at your clinic or elsewhere, get a local videographer to record it and then give that to patients as your own-branded DVD, give complimentary copies to GPs etc etc, then who’s the local daddy?!

COBRA beerIf you do hear yourself saying to patients “do try to do your exercices” you know that most won’t bother. Try the DVD route, it can can only help and you will stand out from the masses.

Now time for some Cobras … I’ll do my yoga in the morning 😉

Author: Stephen Small, Director Steadfast Clinics

Steadfast Clinics is the international distributor of IDD Therapy spinal decompresion, SDS SPINA, Accu SPINA and Thermedic Infrared Therapy Systems. We’re on a pain relief mission !

Leominster Osteopaths, Four Years of IDD Therapy Spinal Decompression for Back Pain, Neck Pain and Sciatica

Leominster Osteopaths was the second clinic in the UK to provide IDD Therapy for their patients.

With some great results and an expanding practice, the clinic is attracting patients from far and wide to get relief from chronic disc-related problems.

Stephen Small and Mark Roughley

Stephen Small of Steadfast Clinics is pictured here with Leominster Osteopaths Clinic  Director Mark Roughley.

For more information about IDD Therapy treatment at Leominster Osteopaths, visit www.leominsterosteopaths.co.uk