Stop Blaming Facebook And Text Back Faster

“My ads aren’t working” is usually the wrong diagnosis. When Meta ads or Facebook ads produce leads but your calendar stays empty, the problem is almost always the follow-up system, not the creative. We walk through the exact chiropractic marketing workflow that turns a name and number into a scheduled new patient without spending another dollar on ads.

We get specific about speed and sequencing: first contact within five minutes (two minutes is the standard), an instant SMS that confirms a real human is on the other side, then a call, then a second text that gives a clear next step like a booking link or a short video. We also talk about the emotional intelligence behind patient acquisition, because marketing is psychological. The words you use in that first call matter, and a simple question can interrupt the “sales pitch” pattern and start a real conversation.

From there we shift to metrics and accountability. Cost per lead is not the scoreboard. We explain how to track cost per scheduled patient, cost per show, and what “conversion” means in a real practice, including why every patient still needs a plan. We close with practical systems: better lead forms to reduce bots, a seven-attempt call process, and an email nurture sequence that keeps you top of mind.

Subscribe for more simple, field-tested practice growth strategies, share this with a chiropractor who’s blaming their ads, and leave a review with your biggest follow-up challenge so we can cover it next.

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Transcript

Intro And The Real Problem

SPEAKER_00 0:20

My ads aren't working. No, it's your follow-up is broken, not your ads. I'm a horrible singer. Welcome to another episode of Marketing 101 for chiropractors. Thanks for joining me each and every week. I'm here for you, really. Uh helping you grow and scale. And this has been going on for three years. Honestly, a lot of the feedback, people like, is Facebook still worth it? Is the meta ad still worth it? These cheap offers, the excuses are just now repeating themselves. And it's funny, but systems and procedures has to be the new focus for entrepreneurs, especially chiropractors, moving forward from this day forward. You have to go back to systems and procedures. And I remember being in my career where it was building systems and procedures. And as we go through our weekly team meetings at my current office, the office I've been running with my team, I'm like, man, we have all these systems. We've built these. I have them on spreadsheets, on Google Sheets, on actual paper, in binders. That's how old we are. And we we fall away from them because we don't recap them. And your associates and your team members, as time goes on, may get frustrated with your curriculum of your weekly meetings, but it's so important to stick to that curriculum. And I think us as the owners and the entrepreneurs, when we've been doing this for 20 years, we get bored of the curriculum and we start to slack. And then that whole team and the whole structure starts to slack. So when it comes to ads, let's dissect the nitty-gritty of how to make what you're already doing better. That way it doesn't cost more, it doesn't require more time. It doesn't do any. You just get to continue doing what you're doing and be more efficient and increase your conversion rates because you're already doing the work. Either you have a digital agency running your ads right now, or you're trying to do them yourself, or maybe you're just looking to get into them, whatever it is. It's the systems and procedures that are going to make you win or lose. Meta advertising and YouTube advertising are the most cost-effective ways to advertise right now. They have way past Google ads years ago. We're probably four years in now, where they have become more lucrative than Google Ads. Google Ads are now so expensive for our niche in most areas, they're not even worth running. You'll run into a few chiropractors in Midwest, rural areas that are still fans of Google, and you should still be dabbling in other ways. That's not what this podcast is all about. But the cost per acquisition is high. It's$200,$300 to acquire a new SEO is dominant across everything now. So every chiropractor in your area, every physical therapist, every passage therapist has their websites. So now the stream is full with information and you're competing to be uh in there. But for Meta, man, I've got some people still getting seven, nine,$11 leads. Like I'm getting$20,$30,$40 leads, depending on what type of ads I'm running in my area in big city. But for$20,$30,$40 to get a name and call them, and even if I have to call three names to get one in, that's$120 to get a new patient. Still the best cost return on anything you could possibly do, better than mailers, billboards, yada, yada, yada. That stuff all works really well. So it's your system that's broken. So we got to go back to systems. 50 to 70% of leads never get contacted properly. So across all chiropractic offices running ads, at least 50% of them, all the leads coming through, are not being contacted properly. Most offices wait hours to get back to them. Now you're gonna say, wait, hours or even days to get back to a lead, which is crazy. We gotta, we gotta get to them quickly. The first contact has to happen within five minutes. My rule is two minutes. Within two minutes, they get some type of text, email, even a call, something that happens within the first 90 seconds of submitting a form. Boom, text is the easiest because 78%, I think, or is it 88% of all forms that are filled out are on mobile, meaning that they use the mobile device that you can directly text them on that they're gonna see before they can even exit Facebook or Instagram. The text message is gonna pop up saying, thanks for claiming your offer at ABC Chiropractic. That has to happen. The instant SMS plus a call is the chef's kiss. When we do that, conversion rates go way up. A voicemail drop if no answer on that call combo. This is a little extra thing you can add in automations now that you can record as the doctor. A voicemail drop that happens if no one answers that call and you create this on the robocall, that happens. Now you're gonna say that, hey man, I don't want AI calling my patients or doing any of this stuff. Hang on a second. If you have the call going through during office hours and someone picks up, it automatically says, Thanks. Uh hi, this is ABC Chiropractic. Hang on one second, we're gonna connect you with our front desk. And they're like, What the heck is going on? And hopefully before they even hang up, your front desk has picked up, say hi for life, you know, ABC chiropractic. And then they're like, Yeah, you guys are calling me. I'm like, Yeah, you just filled out a form, didn't you? And they're like, Yeah, I I did. Because when your CA picks up the phone, it's gonna say meta lead, it's gonna whisper it, meta lead call, and then it connects you. So there's ways to do these little things. That that's been a good one. Do you have to do that? No, but the text has to happen, and then the call follow-up has to happen. And then we need a follow-up text within 60 seconds. So boom, once the form is set up, and then a minute or two later, another one that says, here's what you signed up for. Click the link here to book your appointment. Click the link here to learn more. Click the link here to watch this video, what a YouTube video. You got to do something to keep them engaged. This is the emotional intelligence behind marketing. Marketing is psychological. This entire game we're playing is psychological. It has been absolutely fascinating for me to take marketing into my own hands over the last seven years and learn the psychology behind it. This is, and it makes you better inside the office because now it's barely talking about the history of DD Palmer. I don't think I've said BJ Palmer in seven years. I don't think I've that those words have come out of my mouth in the last seven years. Before that, BJ Palmer was pretty much the the standard uh, if you met me, I'm giving you BJ Palmer's uh family history. Like, and people are like, oh, that's fascinating. And I was missing the whole point. They're coming in with a problem, and I'm telling them about BJ Palmer. I look back at it, I'm like, who were my mentors? Like, what is happening? Um, but it's not about that, it's not about that at all. It's about the psychology. And now, once you immerse yourself in how people are and in yourself and how you buy, I catch myself on stuff that I buy, the emotional component to it. Just bought new shoes the other day and new shorts. My shorts are falling off because they're too big on me. And I've been wearing them for probably two years over overdue. And I'm like, I'm gonna buy new shorts. There was, and I'm like, why am I buying new shorts? Why? It's Tuesday, I gotta be at the clinic in three hours. What I could be doing something better than stopping at the outlet mall and buying new shorts. Why am I doing it? And I, you know, being more self-conscious, why am I doing this? I think I have my girls with me, two of them. No, it was a Saturday. And they came, I'm like, hey, let's go get some shorts. And uh, and I did it. It was it was a personal, it was an emotional buy for me in the moment. Like, no, I deserve, I deserve new shorts. I've been working hard, my body's changing in a good way. It's time to get some shorts that are a little bit smaller, fit me better, so I don't, they're not falling down. That's the reason why it was. It wasn't because my shorts were old and greasy, which should be the main reason why you buy new clothes. It was because there was an emotional component behind it. Your your patients are are looking for the emotion, emotional solution to it. They've been everywhere, not getting answers, and they are looking for answers. All you have to do to look hook them is show that you have you may have a solution to their problem. Great story right now, really quick. I know you want to listen to this podcast. Uh, a current patient that was coming in with what seemed like trigeminal neuralgia. Been everywhere. I did the whole BJ Palmer upper cervical thing with them after I did my marketing and closed them. Then I told them, hey, listen, the whole theory here is the upper cervical spine, it could be influencing this. She noticed a little bit of improvement, like all patients do at the beginning, but here we are seven months later. She's still coming in on bi-monthly wellness. I'll I'll link that bridge for you later. No, no solution to the problem. And I think about this. I'm like, dang, I I marketed, I got this patient in. She came in, and I almost promised a solution to this that we had this, and we don't. There's something else going on. Now, because I'm on her team and we're getting to the root of this, I think she's got a an old um root canal infection somewhere up high in her sinus. That's what I think. She's been to dentists, she's had the CT scans, she's done all that stuff, but she agrees with me because certain things drinking some wine or alcohol immediately within seconds sends her pain, just alcohol, not water, not fizzy soda, not anything else, not tea, not coffee, nothing else does it. The alcohol I'm like, huh, interesting. Bacteria, alcohol, yada, yada, yada. So I'm linking it to that. I'm no expert in that field, but the point of this came in on the ad, became a new patient, did the intensive 12 visit plan uh at the beginning, upper cervical checking her every three days, then every six days, depending on how she held with the titron. And then over the course of you know, three months, we did those 12 adjustments or so. And uh we were done with the program. And she's like, uh like 10% better. I'm like, I don't think we need to go much further with this. Uh, she's like, but my back's my low back's feeling great. I was in so much back pain. I didn't even tell you about that. Uh, I want to continue with chiropractic care. I forgot how good it is to just do this. Like, oh, great, here, join our wellness plan and we'll go from there. So that's what ended up happening with her based off my meta-ad. Okay. That's the point of this and the emotional ride that we're running with people. And if you remember this and reverse engineer this, it changes your entire systems and procedures on your marketing. And you focus, the systems and procedures become more important than the video, the text, the meta-ad, the retargeting on there, the email sequences. It becomes even more important because as you're funneling in leads and you're capturing them, the emotional intelligence is way higher in that, and your team is answering things differently, and your text that you're sending them, the first text in 10 seconds, and that second text, completely different than hey, claim this offer. Hey, claim the solution to your problem is right here. Watch this video. It changes the whole thing. So instead of ring, ring ring, hey, I'm just following up. What you do is, hey, I'm Sarah from ABC Chiropractic. I saw that you requested our$49 new patient special. Just a quick question before we hold your spot. Was this for pain relief or was this for general wellness? Why this works on that first five seconds of the call, once you connect with someone, they're like, it interrupts the pattern. It's an easy to respond to and it starts a conversation, not a pitch. And I love that one. So we change is this for you or the whole family? What? What are you talking about? This is just for me. What do you mean the whole family? I got a baby. Hey, great. We do babies too. They're like, what? Timeout. Right. And now you're spinning this whole thing. It's not a sales pitch anymore. So these little things. The real money metric, you know, is not the cost per lead. And I know I mentioned that, and I'm always like with these, some of my clients, 200, 300 leads per month. I'm like, guys, you're you're getting money buckets dumped over your head, and you're saying the conversions suck. Something's going on. Yes, is there robo uh forms? Yes, is there non-real for? Yeah, there's some of that for sure. There's some of that there. But what we should, what we really need to be tracking, what you need to be tracking is the cost per scheduled patient. That's what I was trying to tell you there. Even if we have$40 leads and it takes three three different leads to call to get one of those three in, it's$120 per scheduled patient to come in. Then you want to show the cost per show. If eight out of those 10 come in for$120, now we're at$150 to get the eight out of$10 in. So it's actually costing us$150 to get a new patient in. And then a conversion. That's up to you and how you base a conversion. Some offices convert if they come back on day two, that's a conversion. For me, it's signing a plan. We have a plan for everyone. Some people knock me for the plans. I'm like, what? I don't understand. What how are you running a business without everyone has a plan? People are like, no, no, you got to monitor and see. I'm like, that's a plan. Even if you run a sports ART acute clinic, I know what you're talking about. I almost got went down that road in chiropractic. I understand what you're doing. You come on in, it's a half an hour session. I get it. You're doing all the soft tissue, the functional movement, you're doing all that stuff, and you're like, you're waiting on response. That's your plan. What are you telling the patient? You'd be like, okay, listen, once the swelling reduces from all the grassing we just did and the bruising, you got to give that three days. You got to give that 72 hours. I want to see you on the fourth day or fifth day. Can you come back on Friday or Monday? But yeah, I know your volume's less. You're seeing them less, you're seeing them longer. So that visit was probably 175 bucks, right? I know what you're doing, and I understand. And those are the ones that argue with this. I get that's a plan, though. You're telling them ice at home, rest, heal, come back, and let's see how much more uh functional movement you have in the elbow joint after the after we worked on that tendinitis on that golfer's elbow. I know what you're doing. And and then you do that and you do another one. And you're like, in my experience at your age, people usually heal within three weeks, and it takes about four visits. You had a plan. That's the plan, the four-visit plan. Now, are you writing a care plan for four visits and presenting it to them for the next two weeks of care? I understand you're skipping that, but you still have a plan. You have to have a plan. S-O-A-P, you have to have a plan. If you're not, it's malpractice. You're you're malpractice. That's that's you're not doing practice correctly. And I'm going to report you. So people that don't do plans, I don't understand what you're doing. You're, of course, you're doing a plan. You're writing a plan section in your note. So we all treat our patients with a plan. You all do. You can't argue with me on this. You all do. So for me, a conversion is the 12-visit plan, a six-visit laser plan for my acute sprained ankle, whatever it is. The reason we give it to them is so that they can sign up for six visits and get 10% off. Everyone gets the same plan. Like if it's 12 visits, you get 10% off. You get 24 visits, 10% off. You get 36 visits, you get 10% off. It's 10% off. That's just the way it all works. If you have 20 leads sitting in your CRM right now that haven't booked, you don't need better ads, you need a better system. How many of you have leads sitting there in contact, waiting to be contacted, left a voicemail? We need better systems and automations to follow up the framework. So here is a big win for you. Five short clips is what you're gonna do. Your hooks like you're losing 70% of you know, you're um trying to find a solution to a problem, and you're going to post that video to those problems. We talked about this to capture the leads. Then you're gonna focus on your systems. That's what I want you to walk away with this week is systems and procedures for your office. Revisit them. Some of you are gonna realize once you look at that and you pull your CA aside or you pull whoever helps you with capturing the leads and calling them that they're they're kind of craving for some type of guidance on this. They're like, well, are we doing this right? What should we change? How can we maximize this? Because they're just gonna keep repeating the same process. Lead comes in, try and contact them as quickly as possible. I call them, I email them. Maybe I get a response. I don't. They left in the in-contact uh file for a long time, then we miss them, or they just don't answer. Remember, your CA is making calls for all your active patients. They care about helping the people coming in. So do you. So the secondary ones on your leads and all the things you're trying to do with all the marketing is secondary to them. And they know that just passively, subconsciously, they know that that's not priority number one when it really needs to be to keep new patient flow coming in. I hope that makes sense. Revisit it. I could sit here for another half an hour on the podcast going through specific systems and procedures, but yours are going to be unique to your practice. Instant text has to happen. Another text within a minute or two confirming the offer. The first text is saying, hi, we've received your form intake for ABC Chiropractic. Da-da-da. That's the first text. Confirming that it's real, that there's a connection on the other side. Did they just fill up a form? That fixes it. Your forms are going to be designed with questions and fill in the blank answers to minimize bots so that the chances of all of these being real are real. That's how we do that. So we don't just jump to a one-page form that says phone number, email, because the bots can fill that. So we say, How eager are you to get started? Options. So I want to be in there in the next few days. I want to be in there in the next week. I want to be in there in the next one to two weeks in your office. I'm not sure. I'm just searching. Those are your four options. So then now that they have to pick a multiple choice question. The next one is tell tell us about your chief complaint. Or uh what uh what area are you looking for? Uh, what's the issue? Or what uh service in our office are you most interested in? Spinal decompression, chiropractic care, upper cervical care. You could put that in there. Um, but a fill in a fill-in-the-blank question really limits the bots. So there you go. So now you have a better filtration rate. Then your systems and procedures, what does your team do? Do you have our team knows they have to make seven calls? I want to see seven notes on there. And yes, sometimes it's left VM voicemail, left VM, left VM, left VM, left, and you see it. One, two, three, four, five days in a row. Then three days were missed, left VM, left, and then once they hit seven, I find them. I'm like, okay, listen, you can you can kind of give up there. They are now seven days into our lead nurture sequence via email. Hopefully, they're getting our emails or opening them up, or or in the future they may come back because now they're in an email loop for eternity. The loop just keeps going. I think it's 24 emails. They just they just loop every couple weeks. So that's the procedures and systems that we should be following. And you need to create and fine-tune. If you're missing a few of those, you got to add those. These are the basics to it. Don't work harder, work smarter. Throwing the money out the window on marketing is not the best way to see what sticks. It's about the systems. So if we're gonna do this, let's do it right and maximize the conversions. Go get them. If you have any questions, reach out to me. Info at enrico d.com. I'm here for you each and every week.