94.7% Referrals, Zero Marketing, and Where AI Fits in Your Practice

Featuring Dr. Laurence Tham

Ask a room full of chiropractors what would change their practice this year, and most of them give you the same answer. More new patients.

It's an honest answer. It's also, in a lot of cases, the wrong problem.

Dr. Laurence Tham built one of the largest chiropractic practices in Western Australia between 2004 and 2014. He ran no new patient campaigns. Ninety-four point seven percent of the people who walked through his door came from a referral. Five or six out of every hundred came in off the street.

He didn't get there by being better at marketing. He got there by working on the two parts of a practice almost nobody works on.

Three pillars, and the one everybody skips

Laurence breaks a practice into three:

Attraction — getting people to find you.

Conversion — turning a prospect into a patient.

Retention — turning a patient into someone who stays.

All three have to function. But they don't all deserve the same attention, and they almost never get proportional attention. Attraction gets the budget, the ad spend, the Instagram strategy and the Wednesday night worry. Conversion and retention get whatever's left.

Here's why that's backwards. If a hundred people find you and five become patients, you're converting at five percent. Move that to ten percent and you have doubled the practice without adding a single new person to the top of the funnel. Same spend. Same week. Twice the result.

Now do the same exercise on attraction. To double the practice through attraction alone, you need a hundred more people to find you — and each one costs money, time, or both.

Conversion is the cheapest lever in the building. It's also the one that never gets pulled, because most of us quietly believe we're already good at it.

And here's the part that compounds: a practice that converts well and retains well needs less attraction. Not none — less. Which is exactly how a practice ends up at 94.7 percent referrals. It isn't a marketing outcome. It's what happens downstream when the other two pillars are working.

The bucket

Laurence made an analogy on the show that we use constantly on the money side, so it was strange and a little satisfying to hear it come back at us from a practice-building conversation.

You can pour as much water into a bucket as you like. If the bucket has holes in it, the level never rises.

Nobody would run their money that way. If you were putting ten thousand dollars a month into something that lost value every single month, you'd stop. You'd move it. You would not sit there for three years topping it up and calling it an investment.

Plenty of practice owners do exactly that with their marketing budget. Not because they're careless — because the leak is invisible. A patient who doesn't convert doesn't send you an email explaining why. A patient who quietly stops booking doesn't file a complaint. The holes in the bucket don't announce themselves. The empty bucket does, about eighteen months later.

Why it's a communication problem, not a marketing one

Conversion and retention are both communication. Not marketing copy — actual conversation, with the actual person in front of you.

Laurence's frame is three questions he's running in his head during every initial visit: Why here? Why now? Why me?

The one that does the work is why now. Someone tells you they've had this for five years. Fine — but they booked on a Tuesday in September. Something changed. Maybe there's a three-year-old they can't pick up anymore. That's not a footnote. That's the actual reason they're sitting in your room, and it's the thing they need to hear you understand.

A script cannot find that. A script says the same sentence to a sixty-year-old man and a thirty-year-old woman and hopes one of them lands. It won't, because the two of them didn't come in for the same reason.

Which makes communication a skill — something you get better at deliberately, over years, the way you got better at palpation. Laurence still remembers his first technique class at CMCC, hands on a classmate's spine, unable to find the spinous process, wondering how he was ever going to do this for a living. He figured it out the only way anyone does. He did it several thousand more times.

Almost nobody gives conversion that same runway. We assume that because we can talk, we can communicate. Those are different things, and only one of them shows up in the numbers.

What this has to do with your money

We run a financial show, so let's be direct about the connection.

For most chiropractors we work with, the practice is the largest financial asset they own, and the one they think about least like an asset. It's the job. It's the thing you do on Tuesdays. Meanwhile the RRSP gets a review every year, the mortgage gets shopped every five, and the practice — which produces the income that funds both — never gets looked at the way an investment gets looked at.

A five percent improvement in conversion is worth more to most practice owners than a five percent improvement in portfolio return. It shows up faster, it's inside your control, and it compounds into everything downstream: what you can pay yourself, what you can save, what the practice is worth if you ever sell it, and how much of your fifties you get to spend doing something other than adjusting.

Before you spend another dollar attracting a new patient, go and find out what's actually happening to the ones already walking through your door.

The one thing: Fix the bucket before you turn up the tap.

Part 2 of our conversation with Dr. Laurence Tham, on what a chiropractor can learn from the ultra wealthy, is out now. Laurence’s tool for chiropractors, Align OS, is at getalignos.co.

Listen to episode 048 of The Chiro Money Show →

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