Publicize your publicity. Whenever you do get publicity, get permission from the publisher to reprint the article containing the publicity. Make photocopies and mail the copies out with newsletters or any other literature you use to market your practice. The publicity clips lend credibility to the products and services you provide.

Keys to success: In one word, leverage. Though it does happen, don't expect one story placement to generate dozens of new patients. Your success depends on leveraging each press release, each article and each published mention. Put it all on your Web site: Create a news page and add a "What's New" area on your home page. Add it to your marketing kit and send the piece to patients, referral sources and professional organizations. Include a note in your newsletter that says "Recently Seen In..." And remember: PR is more cost-effective and more credible than advertising.

4. Leverage existing relationships.

Most people know at least 200 people. Do the math: If you know 200 people and they each know 200 people, that's 40,000 potential contacts! Spend time developing relationships with the people you already know — patients, people you meet through professional networking organizations, friends and even family.

Start by making a list of all the people you know. Next, prioritize your list into As, Bs and Cs. A's are your advocates. These are the people who feel strongly about you. They're the "cheerleaders" who would refer business to you right now. Bs could become advocates if they knew more about you, so you need to spend time with these people to educate them. Cs are those people you don't communicate with often enough. You may keep them in the loop, but they need more time and nurturing before they'd refer any business your way. If there are any names that remain, delete them. Learn to ask for referrals. Ask existing patients, prospects and casual acquaintances. When you get them, follow up on the leads.

Get your business cards into the hands of anyone who can help you in your search for new patients. Visit your cheerleaders and leave a small stack of business cards to hand out to their friends and colleagues. Talk to all the vendors from whom you buy products or services. Give them your business card, and ask if they can use your services or if they know anyone who can. If they have bulletin boards where business cards are displayed (printers often do, and so do some supermarkets, hairdressers, etc.), ask if yours can be added to the board.

Keys to success: Educate, don't sell. The key here is to build relationships. These develop over time as you create credibility and trust. To be truly effective, you must always be on the lookout for ways you can help your network. Start from the perspective of giving more than you ask and your network will become your most valuable marketing tool.

5. Commit to electronic marketing.

Marketing through e-mail is flexible, cost-effective, easy to measure (assuming you put the right tracking in place) and high impact. It allows you to easily drive traffic to your Web site, reach a broad geographic audience and stay in frequent contact with your customers and prospects. E-mail marketing allows you to market your services and establish your expertise with your audience.

Use it for newsletters, new product announcements or to share your publicity success. The ideas are endless. But know that this flexibility and ease-of-use can cause problems. Remember, this is a marketing campaign. So be sure to think it through, develop an appropriate message, create a piece that reflects your brand, know your objectives and make sure the information is valuable for your market, or people will quickly unsubscribe.

Most practices have harnessed the power of e-newsletters — and you definitely should be sending out one, too. It's very cost-effective. But exactly because e-mail marketing is now nearly ubiquitous, you can quickly stand out by occasionally sending personal, surface mail letters to existing and prospective patients. Just make sure the letter delivers something patients want to read, whether a personal analysis of recently published research or news item.

Become an online expert. This is the "free sample" approach to bringing in new patients. Research active e-mail discussion lists and online bulletin boards that are relevant to your practice. Join several and start posting expert advice to solve problems or answer questions. Online video is another great way to promote your practice in a digital format. Put videos of your expert advice on YouTube and other video-sharing sites. Set up a free listing for your business in search engine local directories. You can do this at Google.com/local/; Bing.com/local/; and listings.local.yahoo.com/ Be sure to include your website link and business description. Set your business profile or page up on LinkedIn, Facebook and Twitter. Be sure your business profile includes a good description, keywords and a link to your website. Look for groups or conversations that talk about health and wellness and participate in the conversations. You will need to keep this up for a bit. But the rewards come back in new patients and referrals.

Keys to success: Don't be seen as a "spammer"! Send e-mail only to those people who have given permission. When someone asks to be removed, respond immediately.

A Continuous and Targeted Process

Too many practice owners think marketing is like a trip to the dentist — something you just have to do every six months or so. But when marketing is continuous and targeted rather than occasional and shotgun, it gets easier. If prospective patients have a positive view of your practice and reputation before you call or before they start looking for a chiropractor, you're that much closer to the result you seek to achieve. The news flash is that ongoing marketing isn't tied to a price tag. It's defined only by putting the right message in front of the right person at the right time.

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Dr. Mark Sanna, a 1987 graduate of New York Chiropractic College, is a member of the ACA Governor's Advisory Board and a member of the President's Circle of NYCC and Parker College of Chiropractic. He is the president and CEO of Breakthrough Coaching (www.mybreakthrough.com).