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Dynamic Chiropractic – April 15, 2014, Vol. 32, Issue 08
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dynamicchiropractic.com >> Practice Management

One and Done: Keeping Patients From Vanishing After Just One Appointment

By Noel Lloyd, DC

What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel.

I tried to get her to reschedule, but she refused." 2) "She no-showed. I called, left a message and haven't heard back."

With the #1 challenge for most chiropractors being not enough new patients, when someone comes in for day one and then disappears, it's discouraging. But it's worse than that; the patient loses, the doctor loses and chiropractic has another person who can say, "I had a bad experience with chiropractic." Instead of a chiropractic ally and advocate in spreading the work, we have a critic.

I heard a young pastor explain that he was grateful for his critics and what they taught him. Can we put aside the excuses, irritation or even hurt feelings and be smart enough to learn from those who don't return? Lost after the first visit is a retention problem, and I've been working on patient retention for more than 42 years. Experience tells me to check three areas for problems. Are you ready?

  1. What the patient sees: the office, staff and doctor.
  2. How the patient is treated: customer service.
  3. How the patient is cared for: patient care.

Step #1: The Visuals

First, the visuals: We want to inspire confidence in our patients with what patients see. But there's no need to be grand or palatial – just show people you care about your look. Neat, clean and fresh goes a long way. Here's a short list for keeping up appearances:

  • Is there trash in the parking lot? An emptied-out ashtray is not a good look. Even though you may not own the parking lot, it's "your parking lot." Outside trash detail is an item on a CA's checklist and I inspect it.
  • Have someone with a discerning eye visit your office and give it a thorough inspection. Take all suggestions seriously. Every Tuesday I inspect my offices, with the CAs tasked to keep things ship-shape. I leave a to-do list and inspect later.
  • Dress the part: I won't preach here, but there are studies showing patients prefer and respond better to uniformed staff and a clean-shaven doctor wearing a shirt and tie (men) or a blouse and jacket (women).

Hot Tip: Ask a business-owner friend to trade office critiques.

Step #2: Customer Service

Second is customer service. Chiropractic offices grew up with the bad example of the ordinary doctor's practice. Their customer-service requirements seemed to be a rude receptionist, a 45-minute wait in reception, followed by another 30 minutes of freezing in your underwear in the exam room before seeing the doctor. Bad manners.

By contrast, great hotels and fine restaurants have customer care down to an art. Example: I made reservations at one of the country's best restaurants. When I arrived, I was treated like a king. "Dr. Lloyd, welcome to the Herbfarm. This must be your son, Chris. Chris, are you excited to head off to Wheaton?"

When I made the reservation, I was asked if we were celebrating a special occasion. I said yes, my son had been accepted to Wheaton College. No fewer than four staff congratulated Chris on his acceptance to his college of choice. We felt very special. Magic? No, just great training.

Now imagine you're the new patient on day one and not feeling well. Plus, a co-worker tried to scare you out of seeing a chiropractor and you're walking into a strange chiropractic office where you know no one.

You push open the sparkling glass door, enter a neat reception area and hear pleasant music. The young woman behind the desk makes eye contact with a smile, stands and walks around the counter to shake your hand. "You must be [your name here]. My name is Mandy. Welcome to Sound Chiropractic." It's an impressive way to begin the explanation of your intake forms.

How did she know who you were? If there's a new-patient appointment for 2:15 and a stranger matching the right gender walks in, you can bet that's your new patient. It's not rocket science, just thoughtful customer service. What's more, the effort tells the patient they're in the right place.

Hot Tip: Script and practice a CA greeting that shows your patients they're in an office that truly cares. Bonus your CA each time you hear the script done right.

Now it's the doctor's turn: Hands down, the best way to ensure your patient returns is do an excellent job connecting with the patient as the caring expert. It's even more important than the care itself.

For decades, I've started my consultation with the following script. By the time I finish this short introduction, we're all on the same page:

"Before we get started, Gina, I want to tell you how we do things here. I only have two concerns: what's wrong and can chiropractic help you. I'm a stickler for detail and I'll ask a lot of questions. What I'm looking for are good, concise answers.

"When we're done talking, if I think I can help you, I'll tell you. If not, I'll try to find someone who can.

"I'm also concerned about cost-containment and won't recommend any tests, X-rays or treatment that isn't absolutely necessary.

"Finally, I believe in teamwork between doctor and patient. I think it's the reason I get the good results that I do. I ask my patients to work with me – like a team. And If I accept your case, I'm going to ask you to work as hard as I do. Can I count on you for that? Great; now tell me all about…"

I've just told the patient I care first and foremost about them, framed our roles and how we'll work together, and asked for a commitment. Most patients are thrilled when you take this type of control.

Hot Tip: My clients have told me this is the most powerful script they've ever used, and it cut their "one and done" problem by half. Memorize and use it.

Step #3: Patient Care

Third is patient care. This may sound counterintuitive, but I promise it's true: Doctors who feel compelled to do everything on the first day have a much higher "one and done" rate than those who take the time to properly analyze their exam and X-ray findings, and then bring the patient back the following day for their first adjustment.

Before release, tell them that you'll analyze everything that night and review everything with them tomorrow. Be strict about home-care instructions such as rest, ice or heat. Patients like you taking control.

Walk them up to the front desk and explain to the CA what you both agreed on, and that you'll see them tomorrow for their ROF and first adjustment.

Hot Tip: Care enough to take control and give your new patient strict instructions on what to do between now and their next appointment.

Can we save them all? Of course not, but when you care to invest the time and effort on your look, service and patient care, most will return. That's important for their health – and vital for your practice.


Dr. Noel Lloyd graduated from Palmer College of Chiropractic in 1971 and became the youngest practicing chiropractor in Washington. He is the founder and head coach of Five Star Management, a professional training, coaching and consulting service based in Seattle, Wash.

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