This original article was featured in the February 2023 issue of Chiropractic Economics.

What are your retention goals and how are you going to achieve them?

If patients knew what I knew, they would do what I do. 

No doubt that’s not your first time hearing that statement. I’m sure you have also had patients who really “get it” when it comes to chiropractic. They understand the “Why” and love the benefits they feel. 

But then, have you ever had that same “well-educated” patient still not follow through with the recommended treatment plan and leave your practice? You find yourself wondering, “What happened? I know they got the big idea!”  

Just because people understand something doesn’t mean it will change their behavior. 

Do people know they should exercise yet still don’t? 

Do people know that they should eat right yet still regularly eat fast food and drink sodas daily? 

Do people know that they shouldn’t smoke, but they still do? 

People know the right things they should do but still do the wrong things. 

Like you, I thought I was a smart chiropractor and believed patient education was the only thing I needed besides delivering stellar care and educating my patients. New patient workshops. Weekly handouts. Table talk. TV’s throughout the office show educational content. You name it; we did it. Yet, despite all that education, we still had patients who would drop out of care. 

Why? Why did some stick, even the ones who didn’t necessarily get the big idea, and some didn’t? And why were my patient education efforts not causing my patient to “do what I do.”

So, instead of banging my head against a wall, I went straight to the source – I asked my patients! 

“You’ve been coming here for over two years and have over 100 visits; why are you still coming?”

“You left your prior chiropractor to come to see me. Why?”

“When you first came in, you made it clear you did not want to be told you need to keep coming back, yet you still signed up for care and are still here. Why?”

I share my expertise on what drives our patients’ behavior to follow through because patient retention is the most important thing you need to master as a chiropractor. The motivation for increasing patient retention is not driven by a desire to make more money – although you do. It’s driven by a desire to help more patients get the full benefits of their care. 

Would you want to know if there was an adjustment I could teach you and you would always get better clinical results? Of course, you would. We’re in the business of helping people, and if there’s something you could learn that helps people, we learn it.

Would you agree that one of the biggest reasons you may not be getting the best clinical results for a particular patient is not that you don’t know that magical adjustment? It’s simply because your patient failed to follow through with your care recommendations. They prematurely dropped out.

And if you’re willing to learn that magical adjustment to get better clinical results, wouldn’t it make sense to master what it takes to help patients follow through with your care recommendations better?

Again, don’t make the mistake of thinking retention is all about making more money. Granted, high retention practices do make a lot of money. But that is not the reason to focus on retention. We focus on retention to help our patients do better. And yes, as a result, you generally make more money.

I know many doctors who focus on retention and whose practices grow year after year—in a decade, growing from a few $100k per year to well over $1M to $2M per year in cash collections. See the case study example below: 

Now, like all things, any past performance, projection, forecast or simulation of results is not necessarily indicative of the future or likely performance you may experience. Past performance is not a guarantee of future results. 

So how are offices like this able to achieve these numbers? While there are many contributing factors, one of the main ones driving these results is that not only do successful practices add new patients, but more importantly, they don’t lose patients. They have high retention and an office filled with loyal patients. 

So how do you create a loyal patient that stays in practice? 

While patient education, stellar customer service, and incredible adjusting skills do play a role, there’s a bit more to the equation. We want to focus on 4 fundamental retention principles. These are the 4 F’s, making it easy to remember. 

Forecast Care

Forecasting care is a crucial step! Patients need a game plan for their treatment from the beginning to the end. When you give your patients a complete treatment plan that outlines all of their visits that reach their goals rather than asking them to buy care a little bit at a time, they do not feel like they are constantly being sold to.  

This will not only help to reduce awkward financial conversations, but it will drastically improve conversions to wellness care. When your patients are on plans and their payments are processed automatically, they don’t have to think about whether they can afford the next visit or not. 

Frictionless Payments

The more friction there is for your patients to pay, the less likely they’re going to continue. Make sure to always have frictionless payments in your practice; this will not only save you a ton of time in practice but will also help your patients say yes to care. Even when their insurance is exhausted, they’ll transition to wellness care because they’re not wondering if they can afford the next visit or not– even in pandemic times. 

Remember what I was saying about one-time payments vs. recurring ones? This simple step can change EVERYTHING.  

Feedback

You know the story — patients get the “big idea” and know that chiropractic works! Once the symptoms that initially brought them into the office wear off and they’re out of pain, they drop out. 

However, you know they need more care to correct the cause of their issues, not just mask the symptoms. The solution is to give regular feedback on how they are progressing with care. This feedback needs to be in a format that is easy for patients to understand.

There are many ways you can achieve that, but I like to produce a report with a letter grade at the report of findings that shows the actual state of their health in an objective manner and in language that the patient can understand. During re-exams, we run another report and present the patient with the fantastic progress they have been making. They also see that even though the pain has stopped, improvements must be made.

These wellness reports will take the conversation away from “I just want to get out of pain” or “What does my insurance cover?” to “Wow, I really need to get my grade up. How do I do that?” This will drastically improve your retention rates also. 

Patients must always know how they’re progressing with care, or they will more than likely drop out. Avoid that issue with feedback!

Frequently Contacted

Routinely contacting the patient is important to remain at the top of mind awareness for the patient. If you can automate that, even better! Using automated email campaigns that slowly drip patient education on the benefits of chiropractic, as well as marketing content that spans from office announcements to Happy Birthday emails, are proven to be effective. Although there might be other creative ways of achieving similar results, automated emails are the most efficient for my team and me.

Having emails geared towards education and marketing efforts will not only give you a constant connection with your current patients but will also bring in new patients. The key here is to make sure that these are automated. Having campaigns sent out automatically can save you upwards of five hours a month, so you can then spend your time elsewhere instead of manually sending out content.

We want to look at the whole picture to make sure that the entire journey for the patient is complete and doesn’t have any points that the patient drops out. Do you know at what point your patients are dropping out? Taking the time to identify this will help you diagnose where to make improvements that can make HUGE changes to your retention rate.

About the Author:

For nearly two decades, Dr. Miles Bodzin ran a successful, high-retention wellness practice in San Diego, CA. He retired from practice in 2011 to focus solely on helping chiropractors increase their patient retention. As Founder and CEO of Cash Practice Systems, Chiropractic’s #1 Technology Platform for Creating Loyal Patients, his leadership resulted in serving over 6,000 chiropractors, being listed on the Inc 5000, and being named one of San Diego Business Journal’s Most Admired CEOs. Dr. Bodzin may be booked for interviews and speaking engagements at bookings@cashpractice.com or reached directly at drbodzin@cashpractice.com or at 877-343-8950 x200.