Chiro Connect
The average chiropractor has fourteen hundred patients on his mailing list. And the gap between that number and the one that actually matters is wider than you think.
Here’s the math you’re running in your head. More names means more reach. Cutting anybody means tossing patients you paid to get. The big number is the one to be proud of. So you keep everybody, even the addresses that haven’t opened in years.
None of that holds up, and it’s not your fault. Nobody ever showed you what that list is actually doing to you. The size of your mailing list was never the number that mattered. Who opens is. And the patients who don’t open are quietly dragging down every patient who does.
Is a bigger chiropractic mailing list better?
No. The size of your mailing list is a brag, not a result, and the addresses that never open are the reason your real reach keeps shrinking.
Every email provider watches one number to decide whether you belong in the inbox, and it’s the one you’ve been ignoring. Your opens. Every dead address on your list drags that number down, and it takes the patients who still want to hear from you down with it. A list of fourteen hundred that two hundred people open isn’t a list of fourteen hundred. It’s a list of two hundred wearing a costume.
Try this: Pull your last send and find the raw number of opens. Not the percent. The count. That’s how many patients actually saw you. Then sit with how far below fourteen hundred it is. That gap is the whole problem, and it’s fixable.
Why are your patient emails landing in spam instead of the inbox?
Because Gmail reads the health of your list from who opens, and a list full of addresses that never open tells Gmail you’re not worth delivering.
This is cause and effect, and it runs one direction. When most of your list never opens, Gmail stops believing anyone wants your email, so it quietly routes you to spam or the Promotions tab where nobody looks. The patients who do want you never see the email, because the patients who don’t poisoned the well. You didn’t write a bad email. You sent a good one to a list that was telling Gmail to bury you. This is also why a consistent weekly newsletter to a healthy list outperforms a big list you email twice a year.
Try this: Ask three patients on Gmail where your last email landed. The inbox, or did they have to go digging in Promotions or spam. That’s Gmail’s verdict on your list, and it’s the most honest read you’ll get for free.
Should you delete patients who never open your emails?
Yes. Cutting the addresses that never open is what makes your open rate jump, and that jump is the signal that gets Gmail to put you back in the inbox.
Here’s the part that feels backwards. You cut the non-openers, your open rate climbs, and Gmail reads that climb as a healthy list and starts delivering more of your email to the inbox instead of spam. The rate going up isn’t the prize. It’s the signal that makes Gmail move you. The percent is the message you send Gmail. The raw count is the real answer about how many patients saw you. We’ve worked with more than 1,000 chiropractic practices, and the doc who trims the dead weight reaches more patients than the one who hoards names every time.
Try this: After the list is cleaned up, pull the report and find one name that’s opening now and never opened before. Look them up. That’s a patient you’d quietly written off, raising a hand again.
What This Means for You
- ✓The size of your list is a brag, not a result
- ✓Cutting the dead addresses is what makes Gmail start delivering your email
- ✓Open rate is the signal that earns the inbox, and raw opens are the proof you got there
- ✓Every new name that opens is a patient who couldn't see you last month
Pro Tip: Don’t grow the list to fix this. Clean it. A chiropractor sitting on four thousand names Gmail won’t deliver loses to the one who’s built the discipline behind chiropractic email marketing that actually reaches patients.
See What’s in Your List → Book a quick call
Want to know how many of your patients are actually seeing your emails, and which ones quietly stopped opening? Book a quick call and we’ll show you what’s in your list. If you want this kind of thinking every week, the Chiro Courier is where it lives.
Inside CC with Nerissa: The Reckless One Built Everything I’ve Got
I’m in my blue thinking chair. Same chair, all week, cleaning up a mess I made a few days ago. I spend my days living in 2029. And the thing that took me out this week was some dusty old platform I assumed had caught up with the times.
It had not.
So I floored it into the old stuff at full speed, because full speed is the only speed I’ve got. No brakes. Never had them. My gut said slow down. My gut always says slow down. I’ve never listened, and I’ve never gotten anywhere being cautious.
Threw caution to the wind, like I do. And there we were, days later, mopping.
Lesson learned, Nerissa. (It wasn’t. We both know it wasn’t.)
Here’s what nobody tells you though. That reckless streak costs me and it pays me. Same streak. The same week I drove into a wall being impatient, I sat down with a leader in this profession and walked him through the Agentic OS we built. The wild part of me that won’t slow down is the exact part that built all of this.
And it all runs at one thing. Hundreds of thousands of patients getting more consistent care because we won’t sit still. We take that seriously, no matter who holds the mop.
Exciting news worth sharing. Greg bought us a cocktail smoker. The old fashioned, the torch, the smoke, the whole ritual. That first sip was perfect. I found some homemade maraschino cherries in the pantry and they were a hit.
And don’t picture some careful, cautious guy. He’s not the cautious type any more than I am. He just knows what’s worth slowing down for.
The gut that says slow down and the gut that says floor it are the same gut. I’ve spent years questioning whether I should listen to the careful one. Turns out the reckless one built everything I’ve got. She makes a mess now and then. I’ll take the mess.
What does a Chiro Connect newsletter actually include?
Every newsletter ends with a Week of Wellness, a simple daily calendar that gives patients something to check and use all week, and a reason to open the next email. Here’s the one that went out with this issue.
Frequently Asked Questions
What is a good email open rate for a chiropractor?
A healthy chiropractic list opens at a rate most practices never see. 50 to 70% of the patients on our client lists open an email from their chiropractor every month, and the number one reason a practice sits far below that is a mailing list clogged with addresses that never open.
Should chiropractors delete inactive email subscribers?
Yes. Removing the addresses that never open raises your open rate, and that higher rate tells Gmail your list is healthy, which lands more of your email in the inbox instead of spam. You lose names that were never reading you anyway and gain delivery to the patients who are.
Why are my chiropractic emails going to spam?
Because a mailing list full of addresses that never open signals to Gmail that your email isn’t wanted, so it routes you to spam or the Promotions tab. Cleaning out the non-openers is the fix, since a higher open rate is the strongest signal you can send that your list is worth delivering.
Does a bigger mailing list mean more patients see my emails?
No. List size is a vanity number. Reach is who actually opens. Dead addresses lower the open rate that Gmail uses to decide whether you reach the inbox at all, so a bloated mailing list can mean fewer patients see you, not more.
