This original article is featured in the February issue of Chiropractic Economics

As chiropractors, we are guided by our principles.  For example, “the body is self-healing” Or “the nervous system is the master system”.  These principles guide what we do, and without them, who knows what we would do with our patients.  In essence, the principles tell us what to do to accomplish the goal of restoring health.

Just as chiropractic has principles that shape and guide our practice, building retention also has principles.   What do I mean?  Building retention is not an accident.  It happens when the principles I’m about to reveal are applied.    

 And before you say, “retention is easy.  All I have to do is educate my patients better.”, let me be straight up with you.  Have you ever had a well-educated patient drop out of care?  Better yet, have you ever had a patient not well-educated on chiropractic stick with you through thick and thin?

Ok, I can hear you saying, “But education is the key.  I need to do more of it”. 

Do you have patients or people you know who know they should not smoke but still do?  Do you know anyone who knows they should eat better but still eats like crap?  How about anyone who knows they need to exercise but never does?  Ring any bells?

People have more information at their fingertips than ever before in today’s world.  And yet, one could argue that people are sicker than ever.

Why am I harping on patient education so much?  Because I want you to realize that patient retention requires MUCH MORE than just patient education.  In fact, of the four principles I’m about to reveal to you, it’s the least important when it comes to retention.

And why should you care about retention? Here’s why… Your patients’ lives depend on it.  Would you agree that one of the most common reasons for patients not getting the full benefits of your care is their failure to follow through with your recommendations?  In other words, due to them dropping out of care prematurely?

The opposite of this is retention.  Retention leads to better clinical outcomes.  Will that translate to personal success and financial rewards?  Experience says yes.

These principles must be practiced and put to use day in and day out to cultivate a high retention practice. They are the foundation for long-term success. 

To illustrate the foundation for success, let’s use a pyramid as an example, with the goal of success at the top of it. Imagine for a moment what would that success look like for you? For me, it was being able to help my community and provide for my family while spending my evenings and weekends with them. 

How I achieved success in practice and currently help teach others to achieve that is to have a high retention practice. Imagine the pyramid again. High retention is the second layer and the method to create the success we crave.

To create that high retention practice, our patients’ journey in our practice must be set up with that in mind. Every touchpoint and interaction needs to be centered around a journey that cultivates patient loyalty. Our patients’ journey is the third layer on the pyramid. 

This brings us to the principles that I mentioned earlier that are the foundation for success. A loyal patient journey is built upon four principles of retention that lead to this success! 

In chiropractic, constantly getting new patients is a hot topic. However, what’s the point of continually marketing for new patients if you’re losing them? Now I know saying you had 15 new patients in one week sounds a lot cooler than saying you had five existing patients sign on to wellness care or had zero patients drop out of care. But, it would be best if you looked at the impact on your practice. Retaining patients makes a much more significant difference! Did you know, getting a new patient costs more to the practice than retaining an existing one?

Let’s take a deep dive into the retention principles. There are four retention principles that I built my practice on, and thousands of successful offices are utilizing them as we speak. To easily remember these, remember them as the 4 F’s. 

The 4 F’s of Patient Retention are: 

• Feedback that’s intuitive demonstrates the need for care and tracks progress throughout care. 
• Forecasting Care ensures a clear path to wellness and doesn’t leave the patient confused about the game plan for treatment. 
• Frictionless Payments take the financial discussions out of the equation and removes the thought of money.
• Frequent Contact that allows for automated education and marketing.

Let’s talk about the first F: Feedback.  Just how intuitive is your Feedback?  Do your patients understand the need for care and the progress that they’re making?  Do they realize that even if they’re out of pain, there still are improvements to be made?  These questions are fundamental to think about.  If a patient doesn’t understand how they’re doing or why they’re still seeing you, they’ll drop from care.  This is detrimental to your retention.  

Think about this: Have you had a patient come to you that’s been to another chiropractor before? Did you ever ask the patient, “Why are you coming to me now? Why aren’t you currently seeing your previous chiropractor?” If you’ve asked this, you’ve probably heard the patient say something like, “I didn’t know how I was doing over there” or, “I felt like they just wanted me to keep going back, but I didn’t know why.”

The underlying cause of why that patient chose not to return was because the previous doctor failed to communicate the patient’s progress effectively.  You can stop this from happening by providing Feedback that your patient understands.

Moving on to the next F, Forecasting Care.  Do you forecast care for your patients, outlining their treatment plans with all of the recommendations that you know they’ll need rather than verbally telling them?  Now think about your financial options for your patients.  Do you have any?  These go hand-in-hand and are so important for retention!

It would be best if you made it convenient for your patients to not only pay, but understand their financial obligation to the office with a professional care plan with your recommendations included. This simple step can reduce those awkward financial conversations that no one wants to have, and it will drastically improve your conversion to wellness care. 

By recommending a plan initially and automating payments versus having them pay every time, patients will say yes, stay under care even when their insurance is exhausted, and they’ll transition to wellness care.  

For the third F, we’re going to talk about Frictionless Payments.  Payments must be a frictionless experience for your patient and your team as well!  Ask yourself, “How often are patients stopping to pay at the front desk?  Could I make this more efficient and automated for everyone involved?”  

Related Article: The Art Of Front Desking

The #1 reason patients drop out from care is the repeated thought of money which directly affects retention.  If you can take the focus off the patient’s payments and onto their care instead, you will increase your PVA, retention, and profits.

Automating all payments in practice will save time, headaches, and frustration from manually entering billing information for all parties involved.  If you could save upwards of 40+ hours a month by simply having billing automated, wouldn’t you do that?  

However, not all payment systems are equal. It’s vital to ensure that you’re compliant with your financial policies in practice.

The last step to increase retention is Frequent Contact.  How are you currency educating your patients? Are you flooding them with information on the first couple of visits? Or have you embraced a more practical approach to small bits of information shared over an extended period? It’s essential to have a constant connection with your patients to educate them frequently about the benefits of chiropractic.  

Emailing your patients, prospects, and leads occasional educational and marketing campaigns is the perfect way to accomplish this.  Now, if you can automate these emails, even better!  Creating these relationships will help you attract more new patients into your practice and give your retention the boost it needs.

The best way to apply these principles is to utilize systems that implement the 4 F’s. You can thoroughly understand each retention principle, but they are useless without using them in your practice procedures and business model. 

Imagine a practice full of lifetime wellness members that pay, stay, and refer. Imagine having the practice of your dreams, bringing more joy, freedom, and profitability to your life! To accomplish this, remember the pyramid! 

Think about success and what that looks like for you. To have success, I highly recommend you focus on retention. Retention can be accomplished when you have a successful patient journey that cultivates patient loyalty. 

To execute a patient journey that creates loyal patients, the focus needs to be on the 4 F’s. Applying the principles are Feedback that’s intuitive, Forecasting Care, Frictionless Payments, and Frequent Contact throughout the entire patient journey. 

To consistently implement the 4 F’s throughout the patient journey, you use systems designed to accomplish each. 

Once you master these systems, you will have a practice run on automation. You’ll make it so convenient for new patients to say yes to care while eliminating any roadblocks to continued care. You will increase your conversions to wellness care, which increases your retention and revenue for the practice.

Check out our other articles!