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February, 2011

Bridging the Gap: Making Inactive Patients Active Again

By Lawton W. Howell

How many bridges have you burned today... this week... this month... this year... this decade? Many more than you probably are aware of. Allowing a patient to become inactive is like burning a bridge and effectively placing your patient at a point of no return. How you react to those patients who drop out of your care or become inactive will determine your ultimate success in helping people enjoy a healthier and more active lifestyle.

It's important to remember that you are not in the chiropractic business, you are in the relationship-building business. Whenever you burn a bridge, you impact your ability to bridge the relationship and increase the level of difficulty to reactive the relationship. You may argue that it is the patient who decides to cease care - and you would be right. But, it was your contribution to the relationship that ultimately caused the burned bridge.

Don't be offended by these comments.

Continue reading, and you will learn some vital tactics that will not only help you reduce the burning bridge syndrome by building better relationships with your patients but also build a stronger practice.

Your Brand

The process of developing and building relationships with the objective of retaining lifetime patients begins with your brand of chiropractic. How the people in your marketplace and your patients perceive your brand of chiropractic will have a profound impact on their commitment to care and their level of trust and respect for you and your staff when it comes time to vote with their feet.

Your brand is more than a name or logo; it is the "experience" that begins with the first contact with your office via: your marketing, a phone call, the parking lot, the condition of your building, the entrance to your office, the reception area/receptionist, your interior decor, dress, appearance of forms, etc.

It is all the little and big stuff combined that will be seen and heard, stored and recalled by the patient to "grade" their feelings about the quality of care expected and ultimately, their decision regarding lifetime care. Branding is important, but the focus of this article is on specific techniques that you can use to bridge the gap between active and inactive patient status.


The process of building lifetime patient relationships begins with your marketing. Your marketing message creates initial perceptions. Those perceptions can be positive, neutral or negative. The design, copy, illustration and the offer will have an impact on how your brand of chiropractic is perceived. Plan your marketing communications carefully to have an opportunity to serve more patients.

Retention Process

From the moment your office receives an inquiry, the retention process begins. That means it begins before the first adjustment! Most patients will have their first physical experience with your office when they call for information or to make an appointment. In fact, each time they call your office, the "experience" contributes to their level of trust, confidence and respect; which are all critical components to building a lifetime relationship.

How the telephone is answered is a factor; whether it is by a live person, an answering machine or the doctor, all send specific "unstated" messages about your brand of chiropractic.

Next comes the physical visit to the office. Beyond your physical facility, the receptionist often sets the tone for the patient's first visit. Their dress, appearance and communication skills will contribute to the all-important first impression. Even the condition and appearance of your "paperwork" can influence the patient's perception of the quality of care they can expect.

When the patient moves to the exam room, the process continues with the doctor. Your appearance and level of confidence communicated will have a significant impact on the patient's perception of your expertise; this is a critical component for building long-term retention.

The new patient's first visit is the most vital component for building lifetime patients. You and the office are essentially being viewed under a microscope, and being "evaluated" in live, continuous time.

At the end of the first office visit, the patient will leave with a "perception" about your brand of chiropractic.

Unfair? Shouldn't they wait until they begin care? From your perspective, yes. But, remember, your patient care protocol must be developed from a patient-centric viewpoint. Patients will make decisions instantly, and if you did not exceed their expectations, it becomes more difficult to create a lifetime patient.

Repetitive and Continuous

As important as the first visit is, the process of creating lifetime patients continues on the second visit, the third, fourth, fifth and hundreth visit! In other words, you are building a relationship on each and every visit and you are always being "graded" by the patient to determine whether or not to continue care or become inactive.

You and your staff are on stage every time you have contact with your patients for the rest of their life with your practice. Your protocols, procedures, and systems will impact your patient's perception about your brand of chiropractic. You must be delivering the ultimate experience on each visit. This can be tiring. But, think of your practice as a hugely successful Broadway play where all the actors must deliver their lines perfectly for each performance. And, you can change the "play" to generate new interest in your brand of chiropractic.

Outside Influence

Obviously, patients spend more time away from the office, than in the office. Maximize your patient retention through continuous connections with the patient at home, work and in the community.

Be visible. It is bad enough if you adopt an out-of-sight, out-of-mind marketing perspective, but it is even worse if your patient embraces an out-of-sight, out-of-mind attitude toward your brand of chiropractic.

Here's a basic patient loyalty marketing campaign:

  1. Weekly e-mails.
  2. Monthly newsletters.
  3. Monthly promotion.
  4. Quarterly patient-only events.
  5. Weekly column in local newspaper.
  6. 2-4 external lecture engagements per month.
  7. Monthly screening events at strategic locations.
  8. Patient recognition program.
  9. Patient focus group sessions.
  10. Surprise gift to support their "aliveness" (what they love to do).

The biggest mistake you can make is to give up. When a patient becomes inactive, that's when you should ramp up your efforts, not discontinue your communications. Just because a patient has not returned to the office for some time does not indicate that they are no longer a viable source of revenue. In addition to their own care, they can be a source of referrals.

The most cost-effective marketing is the investment you make with your entire patient list: active and inactive. The lifetime patient process begins on the first contact, but never ends until you shut your doors.

Lawton W. Howell is the founder and chief executive officer of WellnessOne Corporation, a chiropractic alliance marketing group based in Las Vegas. Direct questions and comments regarding this article to 877 WELNES1 (toll free), send an e-mail to , or visit

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