Hello! Welcome back. Today I have a brand-new interview for you, with Dr. Juan Lugo, acupuncturist and chiropractor in Puerto Rico.

Dr. Lugo has some fantastic perspectives on marketing and practice building and I can’t wait to share them with you!

In this interview, we talk about:

• The free marketing avenues Dr. Lugo’s used to build his practice
• Starting small and expanding as necessary
• Marketing successfully even without a website
• What marketing hasn’t worked well for Dr. Lugo
• And more!

Let’s dive in:

How long have you been in practice?

In my own practice, about three months now. I worked as an associate and a locum chiropractor for a while whilst finishing my acupuncture and Oriental medicine studies in New York.

When my wife and I moved to Puerto Rico at the end of last year, I started working as an associate chiropractor at a local clinic. This summer, I started my own practice part-time. I currently work two days a week at my own place and 4 days a week as an associate. In my own practice, I do a combination of chiropractic, acupuncture, and functional neurology.

Where is your clinic located?

My clinic is located inside Bella Vista Med Aesthetic in Ponce, Puerto Rico. The clinic contains a spa, aesthetics treatments, an MD who specializes in internal medicine, and myself.

Where did you go to school and when did you graduate?

I went to New York Chiropractic College which, at the time, allowed students to do their Doctorate program at the same time that they did their Masters program from the Finger Lakes School of Acupuncture. I graduated from the chiropractic program in 2017, the acupuncture program in 2018, and the Chinese herbal program in 2019.

What brought you to chiropractic, and then acupuncture?

I’ve always been drawn towards the medical field. In undergrad, I thought I wanted to go to a medical school up until my dad and I both had pretty serious injuries that required surgery, rehab, and all that jazz. While this was going on, I gravitated away from the “traditional” view of medicine and was drawn towards other views of medicine and health. I stumbled upon chiropractic because my father started to see a chiropractor after his failed back surgery and, after a couple of months, he was as good as new.

I love that. So many DCs and acus find this medicine because of how much it helped them and their family members.

Do you have a specialty/specialties? I noticed you’re currently studying at the Carrick Institute of Clinical Neurosciences.

I feel like everything we do is a specialty. I don’t mean that just to sound annoying. I think you could be a chiropractor or an acupuncturist or both without a “specialty” and still do really special things.

Yes! Absolutely.

I’m a really young practitioner, and I know that I know nothing – lol. Having said that, I’m passionate about the nervous system and how it relates to manual therapies such as chiropractic and acupuncture. I love learning about neurology.

It’s a very heavy topic and the Carrick Institute is one of the best places worldwide to learn about all topics neurology based. I decided I needed more structure around the subject… also, I’ve been studying for a really large part of my life, so I might just have a really tough time letting go of the classroom, not studying just seems weird.

Agreed! I’ve always loved school as well. It’s weird not to homework, right??

What’s your business setup?

Currently, I’m a solo practitioner – I do everything myself; treating, booking appointments, taking calls, marketing, cleanup between appointments, etc.

What is practicing/life like right now in PR with COVID?

It’s definitely different. I feel my practice is great because it has security outside which helps people park and follow sanitization protocols before coming into the clinic, and front desk people (which don’t work for me) that point people towards their seat in the waiting room if I’m not ready for them yet. Since I’m just opening, I still try to cluster-book my appointments, but I give myself about a 10-minute window anyways to be able to clean up the room before the next patient comes in.

That’s such a great setup to have. It’s a relief to have the systems in place so we can be back in practice.

It looks like you primarily market in Spanish on Instagram and in English on Facebook. Why is that? In your clinic is it mostly Spanish, I would assume?

I usually market in Spanish on Instagram. I have it so anything I post on Instagram automatically gets posted on Facebook. I began marketing myself in January because I knew I wanted to go into private practice this year – this was pre-earthquakes in Ponce, COVID and expecting a child. Life comes at you QUICK – best be ready.

Facebook usually has an algorithm that will automatically translate my Spanish posts to English depending on the preferred language of the user. Because my ideal client is middle-aged, I know that person usually prefers Spanish advertisements in Puerto Rico – although the average person in Puerto Rico probably knows enough English to make out what I would be advertising.

I never knew that! So it’s showing me your Facebook posts in English because it knows I speak English. Amazing, and creepy, hah.

What marketing approaches have worked in building your practice? Is there one marketing method you would say worked best for you?

Social media definitely helped me begin to shed light on what it is I do. I set a specific time and day out of the week to create social media posts that I’ll post throughout the week. I’ll usually try to post whenever I know there will be more online traffic – a quick Google search will let you know which times are usually more trafficked so you can increase your exposure without having to spend money on ads (keeping that budget super duper extra tight).

Yes! You can also check your account analytics for both Facebook and Instagram to see when your followers are most likely to be online. I love this strategy.

Besides highly trafficked social media times, there are also highly searched hashtags (if you’re into that type of action). Instagram will allow a maximum of 30 hashtags per post. I keep a couple of things into the “notes” app in my phone – one is an “end announcement” and the other is 30 hashtags that I believe are relevant to my page and are also highly searched for.

I copy and paste these two into every one of my posts with the intention of increasing my online traffic. (After this pandemic started, I’m not so sure “online traffic” times are as relevant anymore because everyone is online all the time now.)

I also try to follow other practitioners and pages that will allow me to share their posts in order to have continuous activity in my pages.

Besides this, I’ve also done some community outreach projects to help out after earthquakes affected the southside of the island. Those weren’t done in order to market, but they helped.

But, honestly, I feel like word-of-mouth has worked out best for me. Usually, if a patient feels you’re good at what you do, they eventually tell people about how and why they’ve been feeling better. The majority of my referrals have been from word-of-mouth. Besides that, other people have sought me out from social media posts that were relevant to something they were experiencing.

Perfect. I’m also a fan of keeping the budget super duper tight. Love that both of your main marketing avenues (referrals and social media) are totally free.

Any marketing ideas that fell flat?

I tried promoting a post on social media… not the best spent $15 of my life.

But, in all seriousness, I feel like I would promote something and use my hard-earned money on social media if it’d be a well-done 30 second promotional video of the practice – not just a “knee pain post” type of thing. Lesson learned. Keep those extra bucks and use them on something of substance.

It’s so tempting to boost a post on social! Especially because FB bugs you about it all the time, ha. I agree though – if you’re going to pay for advertising on social media, you want it to be for more than just “brand awareness.” You want to get people to take a specific action. I also learned this the hard way.

You don’t have a website but you still have a strong online presence through your social media – what made you decide not to set up a website?

Since I’m a solo practitioner, I feel like I can give people a real glimpse of what I do at my practice through social media. These platforms are practically universal in our culture, everyone or their family member has a Facebook or Instagram – so, I just decided to start with that and have a landing page (“Linktree”) that can point people towards either my social media, or my online booking page through “Jane”. With “Jane” I also get the opportunity to communicate the treatments offered, prices, location, email, phone numbers and additional information about myself.

I feel like those are the main things I look for in a website, and they’re all available through social media, so, why bother with an actual website right now? Maybe later.

Jane does a great job of highlighting the essential information. And you’re right, you can share such a huge variety of info on social media as well.

Any marketing suggestions for getting patients right now, during this strange time (2020)?

Support other small businesses around you. Everyone is struggling to keep their traffic up. Helping others near you might bring you new patients. You can tag them on social media… maybe you buy a coffee or lunch frequently at the café across the road, take a picture of your lunch, post it on your story and tag the business. Their followers will see it and they will also see you – that helps them, it also helps you.

Yes! I love this and recommend that people do this all the time. The other business is also likely to share your post, which gets you in front of a new audience. I wish more people would do this!

Use this free time to either create more content for your pages or dive deeper into things you’re passionate about.

Finding out things about yourself, likes and dislikes, will help you be true to who you are as a practitioner – it’ll help you realize who your target market actually is, not just who you’d like it to be. A strong relationship with yourself with help you build stronger relationships with other entrepreneurs and potential patients.

I could cry, you’re so spot on. Seriously. I think entrepreneurship forces you to get to your know yourself like almost nothing else. You’re responsible for everything and it brings out your strengths and weaknesses… but as a result you get to build something meaningful both to you and your community 🙏

Do you have a business mentor or accountability partner?

I do. My father has been an entrepreneur for a large portion of his life, so his advice is always heard and solicited. Besides that, I have a small group of people that either have their own practice, or have a practice that runs similarly to what I envision for myself. I usually talk to the majority of them for a larger amount of time about once a month to talk about different ways of doing things, either as clinicians or businesspeople.

I also think I’ve been blessed to have worked as a locum chiropractor for a while. That experience allowed me to see a lot of ways to run an office, different scheduling patterns, treatments, setups, layouts, etc.

It’s very important to look at places that run the way you’d like your place to run, but also look at places that don’t. You might be surprised and find yourself changing your mind about what you previously thought.

Yes, absolutely. I find that most people who work for someone else always come away with a really clear picture of what they want – and what they really don’t want.

What kind of business does your father run, by the way? Advice on having a parent or family member as a business mentor?

My dad currently has his own small business. It’s a company that is in charge of disposing medical records. Before that he also had a business that focused on selling used pharmaceutical and office equipment.

He’s been around a lot of growing and innovative companies, he’s been around the rise and fall of the city that I’m working in, he had the time to grow strong roots in the area that I’m practicing  in, which makes his advice invaluable.

Also, he’s family. He’s my dad. He does not want to see me fail.

I don’t recommend that everyone have a family member, much less their dad as a business mentor, but as the law of exceptions states; there’s always an exception (even that one?). In my case, I felt that my father would be a great person to ask advice from and so far, it’s been some of the best advice I’ve had (not that I’ve always liked it, that we’ve always agreed or that I’ve always followed through with his advice – at the end of the day, it’s your business, no one else’s.)

As a business person, you’re in charge of having “it”. Business plans call it “mission statements”. I like to call it “the vision”; I feel like there’s a lot of little things within a vision that aren’t included in a mission statement.

With that being said, only you have “the vision”, and there will be times where not everyone will see what you see – AND THATS GREAT!

So, choose mentors and who you seek advice from wisely.

Best business advice you ever received?

“Financial wealth isn’t about how much you make, it’s about how much you get to keep.”

Maintain as low of an overhead as possible without sacrificing quality when starting up.

This advice is, by far, what has allowed me to be successful thus far, but it was not easily accepted.

I’m a perfectionist and very stubborn. I graduated from chiropractic in 2017. It’s 2020. I’ve had three years to think about what I want, what I want my clinic to look like, how I want it to run, what the lighting’s going to be like… heck, I know what I want it to smell like.

Hah! I totally get that. High five from another obsessively detail-oriented person.

Before I came to Puerto Rico, I had my business plan prepped up. I knew what I wanted to do and how I was going to do it. I’d apply for an SBA loan, hit the banks, and rock! Before I went to the SBA representatives that were going to evaluate my business plan, I had received this advice, but I really didn’t consider it. And, even before I had the opportunity to do that, I had the opportunity to rent a space from a Naturopathic Doctor for a couple of months with a really low overhead.

So, I went for it. I rented a small 10’x10′ room and started seeing people out of that space one day per week, while I worked at my other job. After a while, I had a fully packed day, so I looked for another space where I’d be able to see people an additional day out of the week.

I found the place I’m working out of now. My overhead is low. The only thing I have to pay is rent – THAT’S IT. Everything else is profit. There’s a lot of responsibilities, of course; but there’s also a lot of freedom. I don’t see myself changing the way I’m practicing anytime soon.    

I’m always telling third year acupuncture students and new grads to start small and expand as it becomes necessary. I couldn’t agree more. Keep your money for now with a low overhead and you’ll build up to dream practice.

Along those lines, what advice would you give to acupuncture students about starting their practices?

Don’t be afraid to start your own practice.

Keep your overhead as low as possible, but don’t sacrifice quality.

Figure out who your target audience is and focus on them.

DON’T BE AFRAID TO CHARGE WHAT YOU THINK YOU’RE WORTH.

Use the hills and valleys as learning experiences. We all mess up, but we mess up more when we don’t accept we’re messing up.

Find ways to be more efficient with your time – keep a calendar or a schedule with things to accomplish every week or month.

TAKE BREAKS. Remember to eat. Take naps. DRINK THE JUG OF WATER YOU BOUGHT BUT NEVER MAKE THE TIME TO DRINK.

Be fast, but don’t rush.

Find mentors, especially if you’re not business-savvy.

When in doubt, stay small and keep working hard until there is no doubt.

Drink the jug of water. 😂 Story of my life! Anything else you’d like to add?

One last thing. The vision I had for my practice when I graduated – and during the three years I’ve been thinking about it – is definitely NOT where I am now. My practice doesn’t look like what I wanted it to look like. I didn’t expect my practice to be a 10”x 14” office space inside an internal medicine clinic.

And I’m totally fine with it. I’m ecstatic about it. I didn’t have to take out a business loan, I didn’t have to make renovations to it, I don’t pay utilities, I don’t pay wi-fi, everything that is in that room is mine and will come with me after I leave. Everything I make is mine… and the governments >.<

Maybe one day it will look like what I had drawn up. But, I am totally content with what I’m doing.

You see, practice isn’t about the place… it’s about what you’re doing. Are you doing what you love? Are you helping people the way you want to , the way you know how to, the way you prepared to? … That’s what practice is.

Great visions take time to work up to. You just graduated. You’ve got nothing but time. Don’t rush it.

I wish I was still teaching Practice Management at FLSAOM, because I would have you speak to the students! They need this perspective. It’s both powerful and practical.

I’m so happy you’re doing well and building a business you love! All while continuing to learn and serving your community.

Thank you to Dr. Lugo for taking the time to thoughtfully answer my questions!

You can find him online here:

• Email: juanestebanlugo3@gmail.com
• Facebook
• Instagram