The following is my accumulated wisdom about starting and building a practice in SI. One the one hand, I have built a number of successful practices – about 20 or so, both residential and visiting, during my 28 years of practice. On the other, I have known good practitioners who had a lot of trouble getting going, so this list is perhaps incomplete because of factors of which I am not aware.
All my practices have been solely Structural Integration, so some of this may not apply to those of you who combine modalities.
But I hope this is useful anyway.
Locating yourself: The first question is, where to practice? If you are already ‘home’ with no plans to move, then move to the next section.
There are three basic categories: a city, a town, or rural (City = 500k or more, Town = 50 – 200k, anything less than that is essentially rural).
If you locate in a large city, plan on concentrating on one group of clients for a while, like yoga students or some such, as it is simply not possible to have your fingers in all the pies at the beginning. Build a reputation in one group and the others will eventually filter in. It can take time (and a money reserve) to build a practice in a city, unless you have an ‘in’, a link (see below). In a city, it really doesn’t matter how many other practitioners are already there, there’s room for you regardless.
If you locate rurally, plan to take all comers, and perhaps to work on a sliding scale of fees. Be especially careful about dual relationships, as they are unavoidable here – your clients are also your friends, or your shopkeeper or mechanic at least, so different rules of interaction apply. If there are other SI practitioners in your rural area, make friends and stay friends – you share a lot more than you compete.
Perhaps the best place to locate for a beginning practice is a moderately sized town.
Here there are two categories: the way desirable and the average. The way desirable includes Asheville, Aspen, Boulder, Kihei, Santa Fe, Sedona, Taos, and the like. If you locate in one of these places, bring a bankroll, as starting a practice will take a year or so. There are usually more practitioners (SI and others) than the population will bear, so you are left with working with the rich visitors / residents (again, you need a link to start) or working with the rest of the supporting crew. Since these are often living hand-to-mouth, this often involves a period of trades or freebies before the money starts to roll in. Once established, of course, you have a very desirable practice, but be prepared to invest some time.
The non-flashy small city / large town is the easiest and to my mind the best place to get started. It gives you a wide variety of practice experience, a chance to gain confidence and skill while paying off your debts, in a place you are not necessarily committed to for the rest of your life or practice.
Obviously, the number of competing SI practitioners can be a factor here, but don’t be scared off by one or two others. Count the number of chiropractors in the phone book, and divide by four to see roughly how many SI practitioners a town will support. In a more educated or hip town, reduce the ratio to 1:3.
In a town of this size, you can have your finger in a lot of pies – the local sports scene, arts scene, therapeutic and medical community – a spread you simply cannot maintain in a large city. This gives you breadth of client experience, no bad thing for the beginner.
Landing cold in a town where you know no one is sobering. But you have a valuable and marketable skill, and you want to share it. People like this work, and they will pay you for it – you just have to let them know.
Ultimately, being where you love is important, and if you really want to be somewhere, go there and make it work. On the other hand, perching for a few years in some town that means less to you, but where you will get lots of work experience, is no bad thing either. You can then arrive at your chosen dream with more confidence.
Working overseas: While it is a wonderful thing for an American to live for a time outside our superficial consumption-driven, convenience-laden culture, it is not as easy as it once was for Americans to just land somewhere and start a practice. I did this 25 years ago, and it was easier then. In London, I built my practice from scratch; in most other cases, I had some form of captive audience or an ‘in’ – a local contact who delivered my a batch of clients or at least an audience to listen to my pitch.
Since that time, many things have happened – there is more regulation of alternative medicine, in the European countries at least, and much more native competition has been trained in. Working under the table is harder than it once was. Countries in Asia and South America are probably still easier practice in this way, but then you have their economy to think about.
Finding clients: Now that you are located, how do you find clients?
Here’s what not to do: Put your card up in the health food store and an ad in the local New Age or straight paper, and sit home waiting for the phone to ring. This goes nowhere. In fact, I advise against doing either of these things in the beginning.
A website might be a bit better these electronic days than these two strike outs, but:
Facebook is undeniably valuable – not around when I opened practices, but these days, essential – and worth the time you need to put in it. If you have a well-connected contact where you are arriving, maybe they will let you use their email list. Any and all these things are fine, but:
Practices are built on personal relationships. All the following suggestions simply lead to opportunities for building the relationships that make practices hum and thrive. Breaking the initial ice is the hardest part.
First, though, preparation: Aim high, then take what you get. Invest in high quality business cards or printing for your practice materials (like the ‘Getting the Most From Your KMI Sessions’ piece), and/or for your practice space itself. It is false economy to take a grotty practice space because it’s cheap, or to have flimsy or badly printed materials to describe your work. If one of these economies is unavoidable, make sure the rest of your presentation counterbalances that aspect. This shows basic respect for yourself and your work.
Having prepped in this way, take anyone who comes. Think long and hard before you turn down a client. A raging paranoid, yes. Almost anyone else is a good candidate for learning and expanding your skill. I was 12 years in practice before I started deflecting potential clients. Just be honest and humble about the promises you make, especially to the very ill or the desperate (see the sociology lesson below).
Go to parties. Don’t stalk partygoers, but do have a few cards in your pocket. Such gatherings are prime places to establish relationships where you can share your enthusiasm for your work. No need to push – “What do you do?” is a standard question for an American to ask a new acquaintance.
Take classes, or join a club: Taking a class in something you like – yoga, martial arts, Pilates, whatever – or join a club like biking or chess or another of your genuine interests. Same procedure as above.
Speak at groups or classes: Your community is full of groups who need a speaker for meetings. Divorce Perspectives, health clubs, New Age groups or stores, even Rotary, God bless ‘em – these groups are great places to hone your skills at presenting SI. Also, yoga or martial arts or dance group classes may let you come and speak briefly to them before or after a class. (See lecture / demos below.)
Be prepared for a flat reception, but make sure you put your number up somewhere or leave cards around. It’s a big step for most folks to commit to something new in full view of their peers, but a few will call you privately after the event.
Get you and your practice editorial copy: The most effective and least expensive advertising is a story in the body of the paper. You’re new in town; the publishers are looking for new stories. Contact all the papers or local mags and rags, and see if you can get an article printed. Sometimes they take a while, but it is a surprisingly worthwhile investment of time.
Do presentations or lecture/demos: This is like speaking to a group, but you organize it yourself for the public. If you have no ‘in’ – someone who likes you who is bringing loads of people – then prepping for this is hard work. How often do you go out for an evening to hear a lecture from someone trying to sell you his or her service? But if other ice-breakers are not working, this can get you the few folks you need to get started. These lecture/demos are good to do when you first get settled. Especially do this if you get some copy in the local rag (as above). Take an ad for your lecture demo in the same issue that your article appears (this will make the editor happy also).
This is the time to pepper the town with posters – the health food store, the coffee shop, the theater, library, drugstore, any place where people gather. Repeat your postering, as they are often covered over shortly. Unblushingly twist any arms you can to get people there – the more the better, even if they are already friends, and especially if they are already clients. Clients are your best mouthpieces. And talking about this work to a group of three people can be deadly – but do it if you have to.
The rules for lecture/demos are few but strong:
1) Have some materials out, as some people will be shy and simply take some stuff along to read.
2) Have some food or drink there – a bowl of fruit and water is fine if you can’t afford more, but it gets people talking.
3) Be brief in your talk – 20 minutes max, then open it up for questions. People want to hear about the benefits, what it will and will not do, they want to know you are not crazy or sadistic, and they want to hear your enthusiasm. Long explanations about fascia and the recipe are likely to fall on deaf ears. Talk from your experience, as a client or as a practitioner. This works, and nothing else does.
4) Before questions begin to dwindle, offer to show the work on someone. I’m sorry, but if given the choice between a geeky guy and the pretty girl, take the pretty one. I don’t know why, but I have often been presented with variants of this choice. Believe me: to get more clients, take the more ‘normal’ one.
5) Do about 10 minutes worth of work, 20 max. They want to see you are not going to rip their flesh off the bone. Usually I do first session work around the sternum and ribs, as this often produces visible changes in the breathing, but iliac crest and trochanter, foot work, or bench work can be fine too, depending on your model’s pattern. If there’s big change, your day is made. If not – well, it’s only been a few minutes work, the effects are cumulative, and so on. Either way, bring the event to a close soon after your work is done.
6) Have your appointment book handy. Do not be shy to make appointments on the spot.
Giving freebies: This is a dubious strategy which I seldom used, but others have used to great advantage. The danger is disrespecting yourself and giving so much away that it gets hard to draw the line and start to charge. Never give away more than one session per customer. In the rare times when I did offer a free session, I often take a careful history and talk about what the person wants, and then give a demos worth – 15-20 minutes or so – of work, and leave them to think it over. Other practitioners give the initial interview and assessment for free as a matter of standard policy. Having the prospective client in front of a mirror where you can point out their structural pattern, compensations, and imbalances is quite effective in enrolling them in the idea of structural change.
Approaching the busy practitioner: One place where freebies are very effective and worthwhile is with the busy practitioner. Find out who the busy folks are in your town. This can take some digging on your part, as they are so busy they don’t need to advertise. This could include a doctor friendly to alternatives, a chiropractor, a PT, a psychotherapist, a yoga or dance teacher – anyone in the healing or movement education trade. It is perhaps more difficult with someone who could conceive of themselves as competitive – another SI practitioner or massage therapist – but hey, nothing ventured, nothing gained.
Get hold of this person – in person if possible, rather than just the phone – and offer them a session so that they can understand what it is you are doing. Be prepared to offer it on their terms – on their time, maybe at their place – they’re busy! If they like what you do, they will be the most likely people to refer clients on to you – their most difficult, chronic and intractable people, probably – isn’t that who you would refer on? If you have success with any of these people, then more referrals are likely to come your way. Stay in communication – not bothersome, but reporting back in on this client or that. In this way you build a network. If you can and it’s appropriate, refer other people back to them,
Forging links: The above way of linking with successful practitioners is one way of forging links. Forging links, getting connected, making friends, getting an ‘in’ – however you want to put it, this is the most important sine qua non of building and maintaining a practice.
Some of you have heard my story of arriving in London, deciding to start a practice there, and going out to a seminar where the leader had invited me to come and ‘share’ about my work. The seminar (est, if anyone remembers) was run with a lot of ‘enrollment’ rigamarole, and I got to feeling stroppy and rebellious. I never did stand up to share about my work to the 100 or so people attending the seminar, but my stroppiness attracted the attention of the guy sitting next to me. He and his wife gave me a ride home, and they were among my first clients. They must have sent me 30 people in the next few months.
The point being that one good contact is worth 50 lesser ones. This one happened by accident, essentially, but I have learned to look for these ‘opinion leaders’. So now, for my last bit of wisdom, to the sociology lesson:
A sociology lesson: Those who study the spread of innovative ideas among groups tell us that there are three sub-groups within any given group you care to identify: the innovators, the opinion leaders, and the followers. (Understand that any one person might be an innovator in one group, and simultaneously an opinion leader in another group – the roles are fluid.) If you define the group as your potential clients, everyone wants to get the opinion leaders in the community onto their table, as the followers all watch the opinion leaders, and do what they do or what they suggest.
The trick here, the essential understanding, is that the opinion leaders never do anything first; they watch the innovators, and if the innovators have a good experience, the opinion leaders will give it a try. So in any given group, you have to convince the innovators first. Most people go for the opinion leaders first, and wonder why they can’t convince them. Go for the innovators first.
So who are the innovators? The crazy, the desperate, and the artists. The people who are a little nuts are often less comfortable in the social life, and therefore risk-takers. The folks who have intractable pain, or are ill with something that no one can figure out are also prepared to try something new in hopes that it will break the logjam. Artists are by definition out there and prepared to think differently. Go for these folks first; the opinion leaders will come if the innovators have a successful experience, and the rest will follow as the night the day.
Maintaining contact: Finally, in order to maintain your practice, it pays to maintain contact with your former clients. A six-month follow up call or letter, the occasional ‘press release’ when you do some new training or have a new practice address or something (anything) to announce – any of these will help remind folks that you are there, and spur them to come in for some follow-up / advanced sessions, or send someone else in need of your services.
Employment situations: All of the foregoing was aimed for those with private, self-owned practices. Some of you may find yourself as an employee, as in a chiropractic office or a spa or a multi-disciplinary clinic. Since I have not been in those situations myself, I cannot be very helpful, but I imagine that much of what’s here still applies.
