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Dynamic Chiropractic – October 22, 2007, Vol. 25, Issue 22

Retention: 21 Ways to Keep Your Patients, Part 2

By Perry Nickelston, DC, FMS, SFMA
Editor's note: Part 1 of this article appeared in the Oct. 8 issue. Read it online at
  1. Set Specific Goals. How can patients be expected to hit a target they can't even see? Set a specific game plan with a clear-cut course of action. It is essential that a patient understand the direction and method of proceeding with treatment. Provide more than just a destination; give them a map for getting there. If you say they will get a re-evaluation on visit six, you better give them one on visit six. They will remember if you don't follow through. Follow the map.
  2. Paint a Picture. It has been proven that if you show how your service will prevent negative or unpleasant consequences, you will be infinitely more successful in your attempt to persuade. Avoidance of pain is a much more powerful motivator than seeking pleasure of good health. Sounds crazy, I know, but it's true nonetheless. Therefore, focus on what they will be saving themselves from (i.e., the pain, heartache), rather than what they have to gain.
  3. Enthusiastic "Know-It-All." Nobody wants to hear advice from a know-it-all. One of the very best ways of offering advice and having someone follow it is to let them know you don't have all the answers. You'll be perceived as infinitely more credible and sincere. People do business with people they trust! Example: At the end of a consult, say the following and wait for the reaction: "There are things I think I know, and there are things I know I know. And this is something I know I know. You must take of XYZ now."
  4. Stubborn Mistakes. Research in human nature shows that when we feel our freedom is being restricted or limited, we tend to move further toward what is being limited. It is called reactance. It can be so strong that people will actually do the opposite of what you are asking. So, refrain from the hard sells. Let the patient know up-front that they have the final say on what they ultimately do and thus bear responsibility for any decisions or outcomes.
  5. Name Power and Family. What's the sweetest sound in any language? Your own name. Become a master at remembering names and use them in conversation. It shows the patient you value and appreciate them. Use patient files as a biography. Take notes of career, hobbies, family, major dates and events important to the patient. Ask about past and future events. This sets you apart from the crowd.
  6. Say "Thank You" in Writing. Trust me, nobody does this, and it's the most powerful tool you have in practice. It is a significant opportunity to show personal appreciation. Send a handwritten (not preprinted) thank-you note to patients for choosing you as their doctor. Send a thank-you note to the person who referred the patient, too (call them to say thanks before you mail it). You will be remembered.
  7. Pick Up the Phone. After the first treatment, call the patient to check up on them personally. No matter what they say or how they feel, always reply the same way: "I expected that to happen, just keep resting, applying ice and I will see you tomorrow." Call existing patients after any exacerbations or change in protocol, symptoms or life-changing events.
  8. Selling Yourself. What do you do when a patient says they can't afford to get help? Can you say perceived value? Nothing is too expensive, because it all comes down to how valuable the service or product is perceived. Here is one of the great truths in life: If you don't place value on yourself, somebody else will. If you want to give yourself or anything, for that matter, instant worth, you need to create the right image. Make yourself more valuable by not making yourself so available. Don't give away services for free, or little value will be placed on you or your services. Keep a firm schedule to stay focused. Schedule very specific times in your appointment book for evaluations, health checks, consultations, etc. Only accept new patients at a certain time.
  9. The 80/20 Rule. Eighty percent of your success comes from knowing how to deal with people and 20 percent is clinical knowledge. As a doctor, you are not selling your expertise (the patient already assumes you are an expert); you are selling a relationship with the patient. That's why it's so hard to compete on price, because everybody assumes all chiropractors have the same skill. They do not know what makes you unique. Make their experience in your office like a visit to Starbucks. It's a home away from home, not just a place to see a doctor. You are selling an experience. Any office can provide basic medical services, but not every office can provide individual attention to a patient that makes them feel special. You can't see it, you can't touch it, but you can experience it!
  10. What's the Difference? Why can two doctors in the same town, with the same patient base, and the same practice protocol be so different in their level of success? One is barely surviving and the other is thriving. Why? It is probably their attitudes. Your attitude influences your behaviors, which influence your actions, which influence your results, which determine your destiny. Attitudes can make or break the doctor and are more important than facts. There are many things you cannot change in life, but you can always change your attitude.
  11. Underpromise and Over-deliver. Sure, you may think you are the best thing since sliced bread and the patient will miraculously heal with your care. Be careful. Don't promise what you can't always deliver. People become disillusioned over a preconceived period of time if their progress is not where they want it to be. They always have a set time in the back of their minds when they should be feeling better, irrespective of your treatment. Don't promise the moon in your report of findings; instead, give them the stars.

There are literally hundreds of ways to improve patient retention and practice success. The key to success is building a relationship. Unfortunately, it is human nature to look for the quick fix, trying one more trick or gimmick after the next hoping that will be the key to solving all of our problems. Remember, the cause of your problems or lack of success is usually not external; it is almost always because of something internal. Change yourself and you change your world. The person you are inside primarily determines what is happening to you on the outside.

Click here for more information about Perry Nickelston, DC, FMS, SFMA.

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