The chiropractic slow season plan, starting with your own patient file
Why January and midsummer empty the schedule, the reactivation sequence that fills it cheapest, and a month by month plan for a chiropractic practice.
Chiropractic has a seasonal shape and most owners feel it without ever charting it. Deductibles reset and January collections drop even though the schedule looks busy. Summer vacations pull patients off care plans for three weeks at a time and half of them never restart. December disappears into holidays. Then the practice panics in a slow month and buys ads at exactly the moment the ads cost the most and convert the worst.
The fix is a calendar, and the first move on it is not advertising at all. It is the list of patients you already have.
Reactivation is the cheapest new patient you will ever get
Open your practice management software and pull everyone with no visit in the last 6 to 18 months. A practice that has been open five years usually has 800 to 2,000 names on that list. Nobody looks at it because it is a list of people who stopped, and that feels like a list of failures.
It is not. Most of them stopped for logistics. They moved offices, had a busy quarter, went on vacation, meant to call. A properly run reactivation campaign against 1,200 inactive records typically books 20 to 60 visits, at a cost measured in text message fees rather than dollars per click.
Compare that to buying the same 30 new patients on Google at $80 to $300 each, as laid out in the Google Ads guide. Reactivation is not a little cheaper. It is a different order of magnitude, and it is available to every practice reading this, right now, for free.
The sequence that works
Segment the list into three groups before you send anything: 6 to 12 months inactive, 12 to 24 months, and over 24 months. The first group responds best and should get the most personal message.
Message one, text, to the 6 to 12 month group. "Hi [first name], this is [name] at [practice]. It has been a while since we have seen you and I wanted to check in. If you want to come get looked at, I can get you in this week. Just reply here."
Message two, four days later, to non-responders. A specific slot: "I have Thursday at 4:00 and Friday at 8:30 open this week if either works."
Message three, ten days later. A reason to act that matches the season. In November and December that is the deductible: "Your insurance deductible resets January 1. If you have already met it this year, now is the cheapest time to get looked at." In January it is the new plan year and the annual re-exam.
Email, in parallel, to everyone including the older segments. Longer, from the doctor, three paragraphs, no design template. What the practice has added since they were last in, an offer to be seen, and a phone number.
A phone call from the front desk to the 6 to 12 month segment only. One call, one voicemail. This is the single highest-converting touch and it takes about two hours of desk time for 300 names.
Two constraints. Every message must be clinically vague, because a text naming a condition sent to a reassigned phone number is a disclosure. And you must honor opt-outs immediately and permanently. Keep the record.
Season by season
January and February. Deductibles reset, patients get price-sensitive, and cash practices actually do well while insurance practices feel the squeeze. Run reactivation hard in the first two weeks of January when people are in a fix-my-health mood. Push the new year re-exam. Do not discount, because the traffic is already there.
March through May. Yard work, gardening and the first weekend of softball fill schedules with acute low back cases. This is the strongest window for condition-specific advertising on both Google and Meta. Spend here rather than in December.
June through August. Vacations gut care plan compliance. The move is retention, not acquisition: call anyone who has missed two consecutive visits, and build the plan around their travel dates before they leave rather than after they vanish. Youth sports physicals and back-to-school posture messaging start working in mid-August.
September and October. The best acquisition months of the year in most markets. Everyone is back to routine, budgets have not run out, and attention is high. Run your largest ad spend now.
November and December. Two distinct plays. Use-your-benefits messaging to inactive patients with insurance, which is the highest-response reactivation message of the year. And gift certificates or prepaid plan sales where your state rules permit, which pull January revenue into December.
What to do in a slow month that is not buying ads
When the schedule is thin, owners reach for ad spend because it feels like action. Four things work better and cost less.
Reactivation, as above. Always the first move.
Referral source visits. Two hours a week visiting the attorneys, urgent cares, physical therapists, massage therapists, gyms and running stores that could refer to you. Personal injury and auto accident referrals in particular come from relationships and documentation quality, never from ads.
Reviews. A slow week means the desk has time to work the review process. Practices at the median of 15 reviews are competing against map pack holders past 100, a level only 21.3% of the 71,195 listings in this dataset reach. The reviews guide has the scripts.
Fix the profile and the site. Weekend hours, condition pages, insurance page, booking link. Slow weeks are when these get done, and they compound into every future busy month. The benchmark report shows where the gaps usually are.
Build the calendar once
Sit down in December with twelve rows. For each month, write the one acquisition activity, the one retention activity and the ad budget. Reactivation in January, condition ads in April, retention calls in July, heavy spend in September, benefits messaging in November.
It takes an hour and it removes the panic decision, which is where most chiropractic marketing budgets actually die.
Frequently asked
How often can I run reactivation? Twice a year against the full list, plus a rolling monthly sweep of anyone who just crossed 90 days inactive. More than that and you train people to ignore you.
Should I offer a discount to come back? A free re-exam is the natural offer and it is exactly the kind of thing several state boards restrict, so check your board's advertising rule first. A specific open appointment slot converts nearly as well and carries no rules problem.
What if the list is old and the numbers are bad? Expect 15% to 25% of numbers on a five year old list to be dead. That is fine, since the cost of sending to a dead number is a fraction of a cent.
If you want the reactivation campaign built and run against your patient list, it is one of the services in the free 14-day trial. Text or call (385) 832-6175.