This article was originally featured in Chiropractic Economics Issue 8: May 19, 2024

This article explores five key elements for building a successful chiropractic wellness clinic, including starting with clear expectations, communicating wellness principles, leveraging behavioral psychology insights, implementing intuitive feedback systems and aligning clinical and financial expectations.
As DCs, we understand our patients’ journey when they seek our care. It often begins with addressing specific concerns or ailments, progressing through a corrective care program and ideally culminating in a wellness care regimen that promotes long-term health and vitality.

Why would someone want to focus on having a wellness-based practice? The benefits are many! It’s no secret wellness practices often see high retention rates and don’t have to worry about constantly bringing in new patients.

Offices that consistently add patients without losing any existing ones grow year after year. When patients complete their initial treatment plan and transition to wellness care, they get better clinical results and experience the lifetime benefits of chiropractic. Practices that continually add new patients and, more importantly, don’t lose them, grow their cash collections year after year.

So, how do you build a high-retention, low-stress wellness practice? The transition from corrective care to wellness care is a critical juncture, one that can significantly impact patient retention and practice revenue. In fact, we often see it’s at this point of transition that many patients test the waters by dropping out of care, often leading to the recurrence of their initial complaints.

This article will illustrate how you can smoothly guide your patients through transitions in their wellness journey, helping them stay motivated and involved and ultimately achieve their best health.

Drawing from industry expertise and proven strategies, we present the five essential elements that underpin a successful chiropractic wellness clinic.

1. Start with the end in mind
   The foundation of any successful transition lies in setting clear expectations from the outset. My recommended approach exemplifies this principle by beginning the patient journey by articulating the goal of achieving optimal health. By framing the treatment plan in terms of progress toward this objective, patients are motivated and reassured that their care is finite, instilling a sense of purpose and direction.

So how do we do that? To ensure the patient is on board with the frequency of care, it is important to start with the end goal and then work backward. Instead of immediately suggesting multiple visits per week, begin by discussing the overall length of treatment and gradually introduce the frequency of appointments. This approach can help avoid overwhelming the patient and increase their acceptance of the recommended care plan.

Here’s how it might sound when reviewing your treatment plan in a report of findings: “So, John, in a year when you’re well, when we’ve got these great results, the good news is I won’t need to see you very much. I’ll see you once a month, maybe twice, but the good news is, I won’t need to see you as often.” I refer to this as “easing them into” the conversation.

I did two important things there: I informed the patient their care would end and assured them they wouldn’t need frequent visits. When telling patients they need to come in more frequently, I focus on the positive aspect of regular reevaluations rather than overwhelming them with the frequency of visits.

In this next section, we establish trust with the patient by communicating our experience and willingness to refer the patient to another provider if their care goals are not being attained.

“John, to get you well, there’s a period where I will need to see you more — twice a week. But here’s what I want you to focus on, John. Every month, I’m going to reevaluate you. I’m going to check your progress regularly. We will repeat the tests we did on you to ensure you’re making progress. I’ve been doing this for more than 20 years, and I’ve cared for thousands of patients. With all that experience and all that knowledge, I know exactly how well you should be doing at the first re-exam and the progress you should be making on the re-exams that follow. And John, here’s what I can promise you: As long as you’re reaching the goals that I know you should be achieving along the way, then the plan I’m telling you today is exactly the plan we’ll stick with. If for some reason you’re not reaching the goals as I anticipate you will, we’ll figure out why and make appropriate changes — even if that means referring you somewhere else.”

Lastly, for the start of care, I want to let the patient tell me they “want” to come in more frequently. Here’s how that might go: “John, when you came in yesterday, and I was getting your history and learning about your XYZ, I got the impression you would like to feel better as quickly as possible. Am I right in that assumption? (Patient agrees.) Then here is what I recommend. We go above and beyond what’s required to get you great results and have you come in three to four times per week these first few weeks. Again, you can start twice a week and get great results. I’m only suggesting you come in more at the beginning so you can feel better faster. Either way is fine with me.”

I take this approach because my job is to get results (i.e., not pain relief but a spinal correction). However, I empathize with the patient’s desire to feel better faster. Thus, framing it this way allows the patient to “want” to come more at the start versus me telling them they have to come more at the start.

2. Communicate wellness
   Effective communication throughout the treatment plan is essential to facilitating a smooth transition to wellness. We introduce them to the concept of being on a wellness care plan from the outset so when they complete their corrective phase of care, it’s not surprising we are discussing ways to maintain that.

We communicate a message of wellness in everything we do at our office. Patients see our Wall of Stars celebrating milestone visits, receive educational emails on chiropractic wellness care and view consistent messaging on office TV monitors. Our staff embodies chiropractic wellness principles. Patients understand the importance of regular adjustments for health and well-being. Plus, they get used to feeling amazing and want to keep that going, so deciding to continue care is a simple choice!

3. Use behavioral psychology insights
   Understanding patients’ underlying motivations and behavioral patterns is paramount in guiding them through the transition phase. By leveraging insights from behavioral psychology, DCs can tailor their approach to address patient concerns, mitigate resistance to change and reinforce positive behaviors. Managing patient expectations, providing intuitive feedback and aligning treatment plans with individual needs exemplify this holistic approach.

For example, when delivering good clinical news to patients that they are ready to transition to wellness care, you must also deliver good financial news. Good financial news?

Imagine your patient is done with their initial program of care that they prepaid for. They’re feeling great. You present them with a new program, and it is going to cost $X. Your patient now has to decide if they want to spend “new money” on the next program. This is not good news.

So, how do you present the finances as good news? The conversation would have been different if your patient had been on a recurring monthly auto-debit from the start. However, there is a much higher success rate of the patient continuing on to wellness care. “Hey, John, great news: You’re ready for wellness care, and your monthly payment is going down to $X.”

The subtle difference here is that instead of presenting the patient with a new program they need to pay for, you present to them the good news that their monthly payment, which they’ve gotten used to making, is going down.

This is the most effective way to transition a patient from the initial program of care to wellness care. By starting with the end in mind, I hope you can see why having your patients on monthly auto-debits is the best.

4. Implement intuitive feedback systems
   Feedback serves as a cornerstone of the transition process, providing patients with tangible markers of progress and reinforcing the efficacy of chiropractic care. The use of wellness grades with objective assessments offers patients a clear understanding of their journey toward optimal health, empowering them to participate actively in their care. By removing ambiguity about how a patient is progressing and quantifying this progress, DCs can enhance patient engagement and promote accountability.

If you’ve been asking patients who have been to previous DCs why they are coming to you and not returning to the prior doctors, you’ve probably heard them say, “I just don’t really know how I was doing over there,” or “I just felt like they wanted me to keep coming back.” Some kind of negative sentiment like that.

That negative sentiment comes from the previous doctor’s complete failure to give feedback to the patient on their progress. If patients don’t know where they stand, especially once they’re feeling better, that’s an exit door to the practice.

Feedback is required, but not just any feedback. It needs to be intuitive and easily understood by the patient; otherwise, it’s not effective. And this is where many DCs struggle. They get caught up in explaining all the “stuff” they measure, forgetting patients don’t have the same level of knowledge we do.

The best practice is to summarize all your findings and grade them. Yes. Give patients a letter grade, just like you received in school. “Hey, John, based on all the exam procedures we did yesterday, I’ve determined your health is a C-.”

Imagine your progress exams and saying, “Hey, John, great job! Your C- is now a B. Keep up the great work! We still have more progress to go.”

Or at the final progress exam, saying, “Hey, John, I’m happy to report that your C- is now an A. It’s time for wellness care! Congrats! And the great news is your monthly payment will be much less. Talk to Amber at the front desk, and she’ll take care of you.”

You’ll see how easy that is without getting caught up in all the minutia.

5. Align clinical and financial expectations
   A successful transition to wellness hinges on aligning clinical progress with financial considerations, ensuring patients perceive value in their continued investment in their care. In the initial presentation of corrective care, you addressed the expected number of visits and frequency of care and identified the cost of care as well.

When the patient is ready for a wellness plan, the frequency and number of treatments will decrease, allowing you to give the good financial news that the cost of care will also be less. By transparently communicating and recalibrating costs, DCs can reinforce the mutual benefits of ongoing care and foster long-term patient loyalty.

Final thoughts
Mastering the transition from corrective care to wellness care requires a multifaceted approach encompassing clear communication, behavioral insights and strategic alignment of clinical and financial expectations. By incorporating these five essential elements into your practice, you can optimize patient outcomes, enhance retention rates and build a thriving wellness-focused clinic.