Article featured in the February 2020 issue of the American Chiropractor.

When it comes to the topic of growing a practice, most doctors I speak with assume the priority is on getting new patients, not creating patient loyalty. After all, isn’t growth simply a matter of seeing more people? It seems pretty straight forward. Right?

And certainly getting new patients is important, however where I see even more potential for growth is in the area of retention. I mean, what’s the point of getting more new patients if your patient loyalty is not great.

Not only is improving loyalty going to result in increased patient retention and practice growth, but it’s also been reported to increase profits.

In fact, studies by Bain & Company, along with Earl Sasser of the Harvard Business School, have shown that even a 5 percent increase in retention can lead to an increase in profits of between 25 and 95 percent. Now, this study had to do with online retailers, but the lessons learned can certainly be applied to your practice.

Think about that for just a minute. If your patients stay with you an average of 40 visits, a 5% increase is only 2 more visits. That increase from 40 to 42 could result in your practice profits going up at least 25%.

How does that happen?

First, the cost to acquire new patients is much higher than the cost to keep patients. So your expenses will be lower. It’s been reported its seven times more expensive to get a new patient than to keep an existing one.

Second, patients are more likely to spend more money with companies they’ve already done business with, thus increasing the revenue per patient.

In addition, they’re more likely to refer others. Bain & Company’s research showed that after just one purchase from an online store, an average shopper was likely to refer three other people to the site. However, a higher retention customer (one that made 10 purchases) was likely to refer seven different people to the site.

Between the lower cost to keep patients versus getting new ones, the increased revenue from more services being provided to those patients and their referrals, your profits will skyrocket. I know this to be the case from personal experience.

In my practice, my Patient Visits Average was just over 300 visits. And that’s not using the funky chiropractic PVA formula of Total Visits divided by New Patients (which tells you nothing). But using an accurate formula of taking a true average number of visits among a group of patients (that’s a topic for another time). With the retention of over 300 visits, I was not only able to get better clinical results, but I was very profitable.

So I think by now, you may be on board with the idea of putting some energy into increasing your patient visit average. I like to think of it as building a practice full of loyal patients.

I have to warn you though, a practice full of loyal patients will not only result in higher profits, but you’re likely to have more fun, help more people and get this….. Have time to take vacations. That’s right… All kidding aside, let’s get into what you can do to increase your patient loyalty.

There are four pillars or areas of focus that require your attention in order to build a high retention practice. It’s best to think of them like a pyramid where a strong foundation is required. And the others build on top of the foundation.

Now what I’m about to share with you has been seen among the most successful, high patient loyalty practices. Before I go into them, I will also state that none of this matters unless the doctor has the right attitude and a strong understanding as what they deliver of value to their patients.

In essence, the doctor must be laser-focused and crystal clear on their mission, purpose and what patients get from them in exchange for their time and money. A topic I can delve deeper into another time.

So let’s get into the four pillars.

Patient Loyalty Pillar #1 – Care Plans

Absolutely, without question, the foundation for building a high retention practice is ‘care plans’. Enrolling patients into care plans is by far the most important step in increasing loyalty.

When a patient enrolls in a care plan, they’re committed to the program a much higher level compared to a patient buying one visit at a time.

A ‘care plan’ is an agreement between you and your patients that defines all the services and products a patient is going to get during the course of care. It’s important to understand that, like any type of contract, care plans are a legal document.

So you want to be careful about just making one up or just using one without either having it reviewed by an attorney. For example, in California, the Board of Chiropractic Examiners requires all care plans to be submitted to the California Department of Managed Care for their review.

In my experience, one of the major benefits of care plans is no longer having patients drop out of care when their insurance ends or questioning the need to continue care once their pain is gone.

When it comes to apps, you can attempt to calculate the cost of these plans using spreadsheets. In fact, that’s what I did back in the 1990s. However, with all the rules and regulations governing how discounts can be applied to care plans, I recommend using an app that abides by the rules.

The Care Plan Calculator is a program that takes into account these rules and regulations ensuring you not only create care plans that are profitable but compliant as well.

Patient Loyalty Pillar #2 – Automate Payments

Patient’s spending money in your practice is not a problem. But the repeated asking them to pay is a problem. The ‘repeated’ thought of money is a patient retention killer.

More formerly it can be stated, The frequency of the conscious purchasing decision influences your retention. The more frequent a patient thinks about paying for care, the lower the retention.

Back in the early 2000s when I was in practice, automating payments meant asking patients for predated checks. Later we migrated to having our CA’s manually punch credit card numbers into terminals.

Nowadays, automating payments is a breeze. There are literally endless options on the market when it comes to processing one time and recurring payments.

When it comes to selecting a technology for payment processing, I recommend you look at the following:

Does the processor require you to sign a 3-year contract and hit you with penalties if you cancel early?
Can they really get you low competitive fees or is their advertised rate really just for certain types of cards?
Will they support you if a payment is ever disputed? Who goes to bat for you if you have a dispute with a patient?
Is the payment processing fully integrated with the technology you use for care plans?

Check out our own auto-debit payment processor!

Patient Loyalty Pillar #3 – Automate Patient Education

If you’ve read this far (and I’m running out of space for this article), I will assume you already know how important patient education is, so I will just give you the technology I suggest for automating some of your education efforts.

You absolutely should have TV’s all over your office playing patient education content. In my practice, I had a TV in the reception area, one in each room and one even in the bathroom. Five TVs in all. Patients couldn’t get away from my patient education messages. There are several great companies offering this type of program. One of my favorites is ChiroTVNetwork.

Another type of technology you should consider is an email-based patient education program with premade patient educational content. This is really a no-brainer when it comes to patient retention. Simply assign premade email content to your patients and for the next year, they’ll be getting automatically getting educated.

Patient Loyalty Pillar #4 – Give Progress Reports

Pearson’s Law states – “When performance is measured, performance improves. When performance is measured and reported back, the rate of improvement accelerates.”

I’m guessing you’re already doing re-exams to “measure improvements” in your patients. However, are you “reporting it back” to them so they know they’re making improvements?

In my opinion, it’s the “reporting it back” that builds the patient loyalty. It seems that when patients know they’re making progress towards a measurable objective goal (not just the reduction of pain), they stay motivated and are more likely to “perform your care plan better”.

I recommend you look into some of the great technology available for showing your patients they’re making progress. I like both the Insight Scanning and PostureScreen mobile app as well as digital x-ray. A great way to summarize all those findings (and more) in an understandable progress report is to use The Wellness Score.

So there you have it. The four pillars of patient loyalty. I encourage you to take action and apply these to your practice for higher patient retention and collections.

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