9 Fundamentals to Grow Your Practice

RYAN RIEDER 

9 

FUNDAMENTALS 

TO GROW YOUR 

PRACTICE

9 WAYS TO GROW YOUR PRACTICE 

There are only nine ways for any practice to grow. 

People like to confuse the whole thing or complicate the whole thing but this is it. 

Here they are: 

1. Get more new patients 

2. See more people 

3. Raise prices 

4. Average adjustment fee 

5. Price positioning 

6. Care plans 

7. Increase PVA 

8. Conversions 

9. You 

#1: GET MORE NEW PATIENTS 

Number one is get more new patients. I've got a whole book on this, a whole course on it. It's not 

that hard. 

Any time I jump on calls with people, they're like, “I need more new patients.” And I'm like, “Okay, 

how many patients do you have?” We can always do with more new patients. I get it. But if you 

have five to 10 a week, that’s not what you should be focusing on now. 

10 new patients a week can give you the practice of your dreams. 

You need to do the basics. I'm really going to hit hard on this. If you're not sending two emails a 

week to your list, you're leaving a lot on the table I promise you. Two good solid emails a week to 

your list. I know that makes many of you want to vomit in your mouth. But keep it conversational 

and send two emails a week to your list every single week. 

If you're not sending something in the post, you’re leaving something on the table. 

So, do the basics. 

Go for new patients. There's only four real ways to do that: 

• Screenings: I promise you it's the most fundamental best basis of marketing in the industry. 

I really truly believe that from the bottom of my heart. Screenings is a legitimate avenue 

for getting new patients. 

• Talks: 

• In-house Screenings: 

© 2018 - 2021 Rieder Wellness Ltd 1

• Facebook ads: You should be always doing that. When you open new practices, it's just 

about awareness. Just got there and just do those. There is definitely hyper-reactiveness in 

the marketplace these days for that type of stuff. 

Then holiday campaigns, back to school and then we're adding all the fillers, your print stuff and 

your welcome packs and follow up sequences and things like that. 

Do not economize on promotion and production. 

Again, I want to say that if you have between five and 10 new patients, or even anywhere close to 

10 new patients, this is not the thing that I want you to be focusing heavily on. If you’re an 

associate based practice it never stops for you. There's never enough. 

#2: SEE MORE PEOPLE 

Number two, you’ve got to see more people, that's it. You don't have a choice – there are only three 

ways. 

1. Work more hours. Who wants to work more hours? 

2. See more people across 

3. See people for less 

That's it. There is no other way. If you're going to take that lever off the table, that's fine but then 

you’ve got to pull other levers way more aggressively. 

Those of you that are already seeing three or four across, this is probably one of the biggest lessons 

I ever learned from a good friend of mine and a true mentor and one of the greats of our 

profession. He probably doesn't get enough credit because he’s South African and says what he 

thinks. I’m talking about Dr. Fred Schofield. 

He says the number one reason people don't see volume is that don't have enough benches. 

I often have conversations with chiropractors who say they want to see more people for less time. 

But the volume guys are going, “I want people in the practice for longer.” 

You might be with them for 30 seconds but if you've got eight benches, they're all lying down at 

once and you’re seeing eight to 10 across. Then they're in the practice for 10 to 15 minutes. But 

you can see a huge volume on two benches. 

For those of you who are open plan, I remember Wednesday mornings for me. I never had less than 

10 people waiting for an adjustment. If I ever looked up, I got intimidated. I started speaking fast 

and the patients could feel it. 

This is what we do wrong with open plan. When we're busy, we start speaking faster. The secret is 

you have to start speaking slow. The busier you are the slower you speak. You might be like a duck 

paddling away underneath, but you slow it right down. 

The way Fred saw thousands a week – on his busiest days, 500 in a day – they’d all walk in. They'd 

all block themselves and all are face down. 

If you are going across, you are not seeing one every five minutes. If you see 10 minute 

appointments, you're not seeing one every five minutes. You see two every 10, which is a different 

thing. 

It's slow and people are lying down, it's not rush, it's got panic. If Mary comes in and Mary's acute, 

Mary needs more time with you. Mary gets blocked. You say, “Mary, I need you to stay longer 


today.” I might adjust one segment, go on and do other things and Mary's in there for 30 minutes 

sometimes. 

Then I'm clearing and clearing, going back to Mary. John also needs a little bit more time, “John, 

you lie there. I need you to relax a little bit longer.” 

The hardest thing with open plan and multiple rooms is managing the energy. When someone's 

having a rough day, the whole room that he’s in has it too. And you've got to be able to manage that 

energy. 

So, slow it down, especially when you're busy. 

If you’re not willing to see more people, then you take that lever off the table. If you do that, you 

leave me no choice, but to push you for price. But if you want growth, you've got to trust. 

#3: RAISE PRICES 

Number three is raise your prices. 

Your prices should all be fives and tens. Don't be 47 and don't be 43. There's no point. And if you're 

43, you're not allowed to raise your prices less than five – it must be seven or eight. 

Once you've raised your prices a bit and you’re in abundance, your next step is an obnoxious price 

rise, which is more than 10. You’ve got to go there and rip that. 

The only reason you're worried about a price rise is because you're fearful that people are going to 

leave. That's a normal emotion. 

By the way, I'm part of some physiotherapy groups where they are charging $150 to $200 a session. 

Now, I'm going to ask you to charge that if you don’t want to try that, but you could be. 

So, the only reason you don't realize a price rise – and it’s the same for any human being, including 

me – is fear of loss. To take that off the table there's a couple of strategies. 

One is just do it for new patients and tell everyone who's currently under care that it doesn’t apply 

to them. They’ll appreciate that. 

Or you could raise your prices by 10 or 15 and tell everyone currently under care that you are 

raising their price by five. They'll appreciate that too. 

Or you tell them you’re going to lock them in at the current prices for the rest of the year. 

“Everyone else is 55 but don't worry, you are just 45.” Either way, they're going to feel like rock 

stars. 

One thing I highly recommend is whenever you raise prices, please do not say the following 

sentence anywhere, “We regret to inform you…” We don’t regret it. It’s just, “Notice to all 

members. Our prices will be changing to (price) on (date). 

Then you add in capitals, “PLEASE ASK THE FRONT DESK HOW YOU CAN LOCK IN THE OLD PRICES.” 

Then either sell them care plans or move them across to membership to lock in their prices. 

You could sell a ton of care plans. Trust me, you would definitely do a record. That's why I say to 

give it six weeks. 

It’s the only time you ever see your front desk sell, by the way. Because they save people money. 

They don't want to make you money but they wany to help patients save money! 


When it comes to pricing in your business, one of the problems is that you're asking people at the 

front desk who potentially would never spend that type of money on the thing to sell it. I'm not 

saying definitely I'm saying potentially. You're asking them to have that conversation when they 

maybe can’t afford it. 

Remember, sympathy and empathy are two different things. If you are sympathetic in your initial 

consultations or report of findings, you will never sell. 

So, the front desk is sitting there and they are sympathetic because maybe they couldn't afford it. 

Empathy in a sale is a different thing but if you share the emotion, you cannot sell the thing. 

What I mean by that is if someone walks into my business and they say, “Hey, Ryan, I can't afford it 

because my parents have been bankrupt, not once but twice. And, we lost all our cars and we lost 

our house,” I'm like, “Please don't pay the money.” Because I lived that emotion. 

I immediately go into sympathy. But if you're empathetic, it's different. 

I'm telling you right now, that's a trigger for me. I'm working on it, but there's still stuff there. 

I’m sure if you’ve tried to raise prices, you’ve had resistance from your staff or team. This is where 

you have to be a leader. The leader sells the team on a better future, even when they're not sure 

themselves. 

You can never be a hundred percent sure, but then you work backwards to make sure that it is 

better because you've got skills. 

That's the greatest definition I've ever heard of a leader. A leader goes first. A leader has to sell 

everyone else on the better future that this decision is going to make for the collective. And they've 

got to look and feel and do all the certainty. 

Many very successful people say some obnoxious things like, “I am great at this and I'm going to 

achieve this.” And most of the time, they're just trying to sell it to themselves, not everyone else. 

Then they can drag everyone along as a leader. 

So that's what’s needed. It’s, “Trust me on this. We're raising prices.” 

#4: AVERAGE ADJUSTMENT FEE 

Number four is average adjustment fee, which is different from raising prices. There are only two 

ways to clean that up. 

One, you have to know what it is. I've almost never met with any doc the first time where they are 

right about the average adjustment fee, where they spot on 100% know it for fact. Maybe there 

have been one or two, but almost everyone guesses and everyone rounds up. 

I’ll never forget one practice where they were £10 out in their estimate of the average adjustment 

fee. 

It took me 30 seconds. I was like, “Hang on, your turnover is this, your visits are this. It's impossible 

for your average adjustment fee to be that. How many weeks do you work? It's impossible. That's 

literally what I did. 

A lot of you need to look at that number squarely in the face and be frightened by it. 

So, the first way to clean that number up is to know it and the second is to know this stat. 

How many people did you see in the last 60 days below your line in the sand (which you're now 

going to draw)? 


This is really in two parts. But the second part is probably going to be a bit complicated for most of 

you from a time perspective and you don't have to go to that depth. 

For associate practices, this is big for you. The associates need to see not only how many people 

they saw in the last 60 days or three months below the red line. They also need to know how much 

that costs them in three months. So, I show them that in monetary value. 

Our red line is 30% off, so I can show them they lost say $2000 in two months. 

For us, an acceptable discount is up to 30%. That's my red line in the sand, but you're going to have 

a red line in the sand. 

So, how many people did you see below your red line in the sand? 

Keep looking at it every week. You'll be horrified. 

Most of the open plan docs are the worst at this. That's going to be scary for them. 

It can be scary because you're seeing volume. So, “It's just one. Just another one. That's not a big 

deal. It's just another one, another one, another.” 

All of a sudden, it's 50 in the last 60 days and it all adds up. 

As I said to someone in one of my coaching calls, we're here for a good time, not for a long time. 

That means we can’t mess around for too long, we have to sort this stuff out. 

#5: PRICE POSITIONING 

Number five is price positioning. This dovetails with numbers three and four but it’s a different 

point and it's worth mentioning. 

This is the positioning of the a la carte adjustment fee. Sometimes this is the only lever and it can 

be the reason you sell 20, 30, 40% more care plans. 

One of my docs did this recently and he was like, “Everyone's taking care plans. It's insane!” 

He pumped up his a la carte adjustment fee by so much that the care plans became a no brainer. 

Maybe you are charging $45 per adjustment but you actually want to sell care plans at $45 per 

adjustment. So, it's all about anchoring. You’re a la carte needs to be at $55. 

Not many people are going to pay that a la carte fee but it's a price positioning strategy as opposed 

to a price increase. 

The key to selling more care plans is you’ve got to stop being so attached to it. I worked with a 

couple of docs that were close to retirement and they were just like, “Actually I don't want to see 

anyone. I’m hiking my prices.” They put their prices up by $50 and they saw more people. 

They wanted less but they ended up with more because they were not so attached to the outcome. 

So sometimes that is a lever that you can pull. I like having people on care plans and taking payper-visit 

off the table. That's essentially what you're doing. 

For single practice docs, that’s a nice strategy. For associate docs, it’s harder because almost no 

associate really sells care plans that well. They're okay at it, but they don't really like it because it 

doesn't immediately put cash in their bank. 

#6: CARE PLANS 


Number six is care plans, which is a different strategy also. For some of you, that's your only lever 

you need is to have care plans where you either didn’t do a care plan before or you just change 

your care plans up. 

Remember, a confused mind doesn't buy. So, some of you just need to simplify. Maybe you've 

practiced for a few years and you've added this care plan, you've added this one and then you add 

another one on top. 

Then, all of a sudden, you’ve got 15 care plans and you just need to simplify. 

You should follow the rule of three with any care plan. It's either three care plans to choose from or 

three different ways to pay. So, your plans might be 15, 35, 55 or 12, 24, 36. I normally say that 

your biggest one should not be double the middle one. 

If you want to sell more middle ones, then I want to take the big one off the table. So, I'm going to 

go 12, 24 and then I'm going to go 42 because I want them to go, “I don't want the 42 but I don't 

want to look cheap and take the 12 one so I’ll take the 24.” You'll sell more middle numbers by 

potentially taking that off. 

Cash will always be king and it's a game changer for the conversation. If I ever adjusted full time 

again, I just would struggle doing it any other way because I just don't want to have the financial 

conversation every time. I want to have in once. Take it and leave it. 

#7: INCREASE PVA 

Let’s go to number seven, which is on the same lines, but a different strategy, it’s a different lever. 

Often, we talk about raising prices, average adjustment fee and price positioning in the same 

conversation. They are not the same conversation they do fall from the same remit. And then we 

often talk about care plans, PVA and conversions in the same conversation. They are not. 

So, number seven is increase PVA. Yes, if you sell care plans, you're going to increase your PVA but 

I'm going to give you the nuggets. 

Increasing your PVA is all about two concepts: 

• Anchoring 

• Future pacing 

It's about anchoring and future pacing and you can't anchor or future pace enough. 

For example, I might say to a group, “Those of you who have been with me for many years…” or 

“My long-term clients that have been with me for 15 years,” that's an anchor. 

There are other ways you anchor, for example testimonials. You purposely choose testimonials 

where they say things like “I've been coming to see Dr. Ryan for the last 15 years.” 

I was an associate in a practice where we had a Hall of Fame board. It was a bit messy but it 

definitely did the trick. We had a 50 club, a 100 club, a 200 club, a 300 club and those were all 

people with a number of adjustments. We had photos up on the boards. 

When you’re sitting there on your seventh visits and in front of you is a wall that that has a 50 club, 

a 100 club and a 200 club, that’s huge. That’s future pacing. 

Another way to future pace is have a 1 Year Club, a 2 Year Club, a 3 Year Club, whatever. 

It matters and the best place in the world to put that stuff is in a newsletter. 


This is all about demonstration of the behavior you want to see. 

If you want to see lots more referrals, you better be demonstrating referrals. 

One of our members has this great board in their practice demonstrating referrals. It shows this 

person referred this person and it's just awesome. So, when people walk in, there's this amazing 

board full of referrals saying, “Thank you.” And you can do this easily. 

Again, a newsletter is a great place to do this. “Thank you to the following people that referred 

new patients to us.” 

The point is that's future pacing. 

The single biggest mistake that I see with PVA is the choice between hard or easy. If you do easy 

first, it becomes hard. It’s as simple as that. 

Easy is saying, “We’ll just do six sessions and see how it goes.” 

Then guess what? Next appointment you have to have that conversation again. And the next 

appointment, you have to do it again. Now you have to do that for the rest of your life. 

Alternatively, you make the first step harder. This is where sometimes your conversion percentage 

might drop, but your PVA may go up. 

I often say this but I’m going to say it again. Your PVA is what you say. You have to stop minimizing 

yourself. 

It's equivalent to me saying to a client that wants to coach one-on-one with me, “If you don't give 

me a one year commitment, I'm not doing it.” 

I just want to make sure straight away that they are on the same page with me. I've been up front, 

they've been upfront. We made a commitment. I set that expectation, that context from the start. 

Here's the biggest mistake people make with regards to this is they try to reduce the tension by 

saying a lower number or healing time so they don't have to sit in the silence. 

They would rather say, “I can help you very quickly,” to gain the approval of the person than 

actually tell the truth. 

The truth is just look at any textbooks, whatever it takes. Find your truth, but it is the truth. 

That's why I love the “soft tissue close” by Dane Donohue. If you look at the textbooks, they say 

that soft tissue takes 18 months to heal. It a statistic. I don't make this stuff up. Go look at the 

textbook. Nerve healing takes much longer. 

That right there is probably the biggest mistake. People are not having that conversation. 

I can't stress this enough. Stop selling the thing. If you want someone to see you 24 times, stop 

selling 24, you've got to be selling 56 or time. 

So, you have to have an anchor. 

It’s like if you try to sell something for $10,000, to most people that seems like a lot of money. The 

one way I can do it is stack the value so that it is ridiculous and it automatically sells. There has to 

be something in the thing that I'm selling that has an anchor point, a preconceived value in the 

marketplace. 

Like I saw someone giving away gold plated flash sticks as their bonus. Because there's a 

preconceived idea of how much gold costs. 


But if I say the thing is $18,000 but because you are reading this it’s only $9,995, you cannot say 

anything other than it’s better. But selling that requires some tension building. 

Now let's bring it back to your recommendations, not the money. Most people are not prepared to 

do the equivalent of that. 

For example, if it takes 18 months to heal the soft tissues, it’s the same conversation. And the sale 

requires a level of tension. 

You can do the DJD model or you can do the soft tissue or you can do that road to recovery but 

ultimately the conversation's the same. 

You can draw a diagram showing two points and say, “This is healthy, this is not healthy. I want to 

get you from here to here.” 

Then insert a large obnoxious number. “It may take up to 18 months. So, we do it in three phases. 

It doesn't matter which approach I’m using, it's the same thing. 

• “In the first phase, we see you three times a week.” 

• The most important statement you can ever say when you're describing second phase is 

this: “This is the most important phase. We see the biggest changes in this phase.” You can 

then say, “We'll see you between two and three times a week.” 

• For phase three, we hand all the power across to them. “This will be whatever you decide 

when we get there.” You can add, “Most of my clients choose to see me… whatever you say. 

At this point, don’t say, “Once a month,” just because you want to be liked. You can say, “Most of 

my clients choose to see me once a week, for some it’s every two weeks. It's completely up to you 

when we get there.” That’s a little bit of tension release. 

Note that they haven't been told what they're doing yet. We’re just telling how we work here. 

What everyone does wrong is they talk about the progress exam as if they're going to drop down. 

It's not a dropdown exam. It’s a progress exam. So, don't tell them they can drop down here. 

You don't know how their body heals, how it’s going to respond. 

Now, what is the person sitting there thinking right now? Whether they consciously think it or not, 

they’re thinking this. 

Please understand. Nobody ever came to your practice hoping to be there for three months. 

So, deep down somewhere, right now, they think right you're a nutcase. 

That's cool. A bit of tension. 

Now, you’re going to release the tension with the following line. 

“John, I said it might take 18 months. I spoke about the three phases. But, for today, what I want 

to do is just focus on phase one. Is that okay?” 

“Sure, that's okay. We can do that.” 

“Cool. We’re going to focus on this phase. As I said, we're going to see you three times a week for 

six weeks. Does three times a week work for you?” 


So, now it’s three times a week for six weeks compared to 18 months. Is that better for them? Oh, 

my goodness, yes. 

They’ve been thinking, “This guy's nuts. I’m not coming for 18 months.” 

That's what happening. But you've had the conversation. Now the context is completely different. 

By the way, I was never really a three-times-a-week guy. I was way more comfortable when I was 

twice a week. 

But I’ll say this, I've almost never seen anyone explode in a short space of time by not being at 

least three times a week. That doesn't mean you need that. But I’ve found the biggest volume docs 

were always three times a week for three months. 

I was never really three times a week. But I did understand that, at times in my career, where I 

wanted that quantum leap, I had to be stronger with myself. Remember that whatever you say is 

your PVA. 

Bear in mind that a problem when you start with twice a week is you can end up dropping quickly 

to once a week. Now, philosophically, I want to be clear. It is better that they get adjusted once a 

week then nothing. 

But if you go to a personal trainer and you say to them, “I want to lose 10 stone, but I only want to 

come once a week,” they’re going to say you're completely delusional. It's not like it's not going to 

happen. 

Generally, no one gets better at anything once a week. 

#8: CONVERSIONS 

Number eight is conversions. Again, conversions is a separate conversation, but it's closely aligned 

to what I've just done. 

Sometimes I look at stats where someone is pretty good at selling care plans but there's just not 

enough people getting to three adjustments. That might mean they either convert you to a plan or 

you're out. Perhaps the volumes are big enough to justify that. 

Sometimes small changes make a big difference. One of our members is in Malaysia where you can’t 

have x-ray equipment in the house. So, they have to go out for the x-ray. 

He was driving a lot of new patients into his business, he was getting 10 new patients a day at some 

points. 

But the complication of sending people out for x-rays was affecting certain conversion rates. 

When people were having to go offsite and have an x-ray somewhere else they often wouldn’t get 

the x-ray done and wouldn’t make the report of findings. He worked out he was losing about 40% of 

the people. 

So, we identified the need to introduce a new step. We had to get the front desk to pick up the 

phone right then and phone the x-ray place. 

Just by doing that, we estimated that we get about 50% of them coming back in, meaning 25 extra 

new patients. 

Just one little change made a huge difference to conversion. 

#9: YOU 


Number nine is you. I'm not going to go too big on this but there is an element of telepathy that 

happens between the salesperson and the audience. 

It happens big time with speakers on stage. That’s why presence exercises are so important and 

that's why needling is so important and practicing staying the heat is so important. 

One of the great exercises we do at our sales bootcamp is we purposely needle you and we 

purposely put you in a position where you get some objections. 

Many of us get a bit hot and flustered under the collar when we get an objection in sales. You need 

to go through it and sometimes you have to stick with that needling process a few times before it 

loses its charge. 

One way to get over the charge is to write down specific objection scripts. So, write down all the 

objections you get, especially for your team. 

It’s also about presence. Can you just be present? It’s just practice. If you can't be present, you're 

not going to be able to sell because you're going to be giving unconscious triggers all the board of 

the place. 

When you sell from stage, silence is deafening, it's something that you've never experienced in your 

lifetime. There are unconscious triggers. Maybe you grab your water bottle too many times and you 

look a bit too nervous. So, there is a huge process to go through for you to be better at this stuff. 

The Information provided by Rieder Wellness Ltd is for general informational and 

educational purposes only and should be used as a model or guideline to base your work on 

and tweak where necessary. 

You should not rely solely upon the material or information as a basis for making any 

business, legal or any other decisions, and should ensure that any information you use sits 

in line with your own /governmental current legislative guidelines and procedures. 

Rieder Wellness Ltd accepts no responsibility and any reliance you place on such material is 

therefore strictly at your own risk. All rights reserved, no part of this publication may be 

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9 Fundamentals to Grow Your Practice

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