Overcoming the historic challenge of keeping people under care
When working with a new chiropractic client, I immediately ask about the most important number; the retention number. This is defined by the number of patients that are going from an initial care plan to an on-going wellness plan (Or a patient whose wellness plan is rolling over into the next wellness plan). AKA a “re-sign” number.
Very few doctors know or track this number as the focus is generally on new patients and the initial conversion. Yet, in terms of long-term value to the patient, health impact, and the economic stability of any business, not just a chiropractic clinic, this retention number is paramount to success.
The Three Ultimate Retention Number Questions:
1. Are the people in your waiting room patients or ex-patients?
2. Are they walking out of the clinic or walking the green mile?
3. Are the new patients really new patients or re-patients (just replacing the existing people at the speed they’re leaving in a “revolving door” type practice)?
The most elusive species in Chiropractic is the lifetime patient. It’s often talked about, true to our purpose, but rarely ever truly established. The vast majority of Chiropractors are in incredible denial when it comes to the issues of retention.
Most clinics are new patient dependent. They remain flat for years and require many new patients to sustain the practice. While new patients are the life-blood of a brand new clinic, if you find yourself five to twenty-five years later still requiring new patients to survive or thrive; you have a revolving door practice. Plus – nobody wants to still be killing themselves to bring in new patients when they’re 50.
If you’ve been starting 20 new patients a month for 5 years, that’s 1200 people under care. If just half those people were still around, coming in once or twice a week, you’d have a great practice even if you never got another new patient. After 10 years, everyone should be adjusting 1000 people a week even if over half their patients quit care, never came back, and gave you a one-star Yelp review. Yet, the average chiropractor sees only 10-15% of that.
We want the whole world to live by the 33 principles of chiropractic and for families to be under care for life. The trouble is now that over half of the population has been to the chiropractor, only 1-2% still regularly see a chiropractor. We’ve lost over half the country, about 150 million people, who have dropped out of care. I’ve studied these numbers carefully over 27 years. While some of these are very approximate numbers, they’re close and the facts remain – we need to get a whole lot better at retention if we’re going to really save lives and change the world.
5 Areas of Patient Retention to Master—Is the Machine in Place?
1. Do you have re-exams, re-x-rays, re-calls, and review programs in place if the patient misses a visit?
2. Is the proper recall system in place? Do we keep people on the list until they have either come back or reached a point of a specific de-activation process or do they get called once or twice (if at all) and then disappear?
3. Do you utilize positive reinforcement when patients do make their visits and call to reschedule or only complain when they miss?
4. Is there massive education going on through every visit literature, white boards, audios/videos playing, posters, literature racks, email, and text? Are you doing events like Patient Dinners, Advanced talks, and Shopping or Fitness Field Trips?
5. Are you ex-patient sensitive? If people are missing appointments, rescheduling consistently, not referring, not participating, etc. etc. then they aren’t patients, they’re soon to be ex-patients. When they leave your door, it may be the last time you see them … they’re literally walking the Green Mile.
We’re as much coaches and accountability leaders as doctors and CAs. As Uncle Ben said to Peter Parker (Spiderman), “With great power comes great responsibility.” It’s hard to be a coach and keep people on track, but we have lives to save and a world to make a better place.
Have fun saving the world,
Dr. Ben Lerner
