165 Chiropractic Patient Retention Strategies

Welcome to the KC CHIROpulse Podcast.  

This week’s topic: Chiropractic Patient Retention Strategies. 

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights and is hosted by Kats Consultants coaches Dr Michael Perusich and Dr. Troy Fox, both seasoned experts in Chiropractic care and business development.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• Understanding how to communicate to today’s new patient
• How to develop highly effective patient retention strategies
• Why involving your staff in the retention process is so important
• How to create lifetime patients
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.

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Transcript

Dr. Troy Fox: 0:00

Chiropractors,

Dr. Michael Perusich: 0:00

what are your patient retention strategies look like? Hi everybody. Welcome to the KC ChiroPulse podcast brought to you by Kats Consultants and ChiroHealth USA. I'm Dr. Michael Perusich and I'm joined by my co host, Dr. Troy Fox. Troy patient retention, kind of important, right? Oh,

Dr. Troy Fox: 0:18

it, uh, I think there's probably nothing more important than patient retention strategies. If you want to be happy in your practice, if you don't want to grow it longterm. Yeah. If you don't want to be the dog chasing your tail all the time, you have to have patient retention and it's very easy to do. That's the crazy thing about it is it's a, it's something that once you build into your practice, it is so helpful. All it does is breeds more communication with your patients. So it's just a, it's a wonderful concept from start to finish. It really

Dr. Michael Perusich: 0:51

is. Just to kind of lay out what do we mean by patient retention strategies in case you don't know out there, we're just talking about retaining patients in care. So, and that takes on a couple of different phases. One is retaining patients in the acute phase of care so that you get the outcomes that you hoped you would get for them, but also retaining them in the practice long term for long term chiropractic care, maintenance care, wellness care, whatever you call it in your practice. You know what I'm talking about? And because it's at that point when you retain patients, it's at that point that they become very important people to your practice. They become your soldiers, your advocates out in the community talking up great things about you and patient retention strategies not only help you grow your practice, help you have a happier practice, but it, it, it helps you get more referrals. And Tori, I don't know about you, but would you rather have more referrals or do you want to go out there and do spinal screenings all day long?

Dr. Troy Fox: 1:51

I want more referrals all day long and you really look at it. And this is something I say to a lot of my patients are our goal in this office for you is that we get patients well, and that we keep you well, and I put more focus on keeping you well. Then I do getting you well, and I think as chiropractors, we know that is really the end game in the longterm when we start talking about Wolf's law and we start talking about plastic deformation and DJD and knowing that it is not a disease of old age. Otherwise, why did your fifth lumbar age 30 years faster than your L4 L5 disc space, so we know as well that degenerative changes happen dramatically in certain areas of the spine and they happen as a result of loss of range of motion there as happened as a result of hypoxia in the joint. They happen as a result of, then the degenerative changes that happen, the loss of basically the annular fibers. I mean, we get into all the details, but we know this already. We learned this in school. So why are we not. Imploring to our patients that they change their paradigm from a 9 1 1 or a, what I want to call it an, acute care clinic.

Dr. Michael Perusich: 3:08

What is it? You always call it

Dr. Troy Fox: 3:09

the owie practice practice. Yeah. So the only time you go is when you have an alley and it's bad enough. That you can't, it's always the, I have a wedding tomorrow. I need you to get me better. That's that's the owie practic approach rather than, Hey, how you doing today? Oh, I'm doing great. So what are we working on today? Anything in particular that's given you any problems or we just tuning you up? I mean, literally that's a conversation that you have with people that are long term wellness patients because they want to be well.

Dr. Michael Perusich: 3:38

Okay. So let's talk a little bit about why sometimes we don't get to that point with a patient. Why? Why does, why do patients sometimes leave the practice too early? I mean, we could probably spend two hours on this part, but I think it's an important topic to bring up. What do we see with practices that we work with and in our practices? Why do patients leave

Dr. Troy Fox: 3:58

early? Number one, poor communication.

Dr. Michael Perusich: 4:02

We can, we get a drum roll, please. Absolutely. That's communication.

Dr. Troy Fox: 4:06

And sometimes that is trying to drive a nail until you drive it all the way through the board. In other words, some of you are not realizing that your patients have already consulted dr. Google before they came in today. Truly they know, they know their condition inside and out. Some are the ones that just say, lay down on the table. Oh, yep. Right there. Yep. You've got, you know, is that hurt right there? Okay, I'm going to adjust that. And you have really haven't explained to the patient what's going on. So I think communication from the get go is very important. And I think it's important for the patient to understand your practice philosophy and what your goal is for them and doesn't align with their goal. And I think it's important that you find out if you align with their goal. Once you do that, your communication job becomes much easier because now you're working together as a team. Okay.

Dr. Michael Perusich: 4:57

And communication goes really deep here. So when patients come in, they have a feeling, right? They feel pain, but they can't always verbalize that pain. And so we've got to help them bring it from a feeling To a verbalization and then take it to a realization of how chiropractic can fit into that for them and how there is a need for ongoing care because what happens far too many people come in. They've got an alley. You get them out of the alley. And they think that's why they were there unless we've communicated with them to help them with that realization that it's more than just the owie and I'm not talking about, I'm not talking about a two hour spinal care class on day one here, not at all. It's really a different approach and we don't have time today to get into the approach of, of how you break this down. But when you bring that realization to the patient's mind, then all of a sudden they realize they're there for a different reason. They're not just there for the owie and to give you a great example, the orthodontist, what does the orthodontist do? You go to the orthodontist. Why? Because you don't like how your teeth look. They probably don't even hurt. I mean, I don't know, maybe they do. I didn't have braces. But, um, and they talk about going through this treatment plan for 18 to 24 months. Sounds familiar, right? Yeah, go through this treatment plan that is going to do what? It's going to straighten your teeth up, and it's not just going to be how straight your teeth are. It's going to be how great your smile is. So did they, did people come in because they don't like their smile? That may have been part of it, but they don't like their teeth. They don't like how their teeth look. So it wasn't necessarily their smile. It's just how their teeth looked, maybe they would bite into an apple and they'd get half of it stuck between their front teeth because of the gap or something, so we've got to take it to that. extra step because here's what the orthodontist did. It's not just I'm going to straighten your teeth out, but I'm going to put you on a plan of probably lifetime care that may include retainers, partial retainers. It may include Invisaligns to help keep your teeth straight. It may include permanent retainers that you need to come in periodically and we check up on. So. It's a process of care and they've explained it to us so well that even those of us that didn't have orthodontic care understand it and most of the patients coming into a chiropractic clinic. Especially if they haven't been referred by anybody don't understand all that if they have been referred by somebody What do they typically understand? Well Bob referred me and Bob had low back pain. I have a low back pain So that must be what you treat as low back pain. They have the blinders on they don't know you do other stuff and Or they're referred by Bob, who comes in once every six weeks on a maintenance plan, and that's what they're expecting. Well, you're going to get me out of my nine out of 10 pain, and I don't have to come back for six weeks. So you got to think about all these kind of things and bring it into your patient communication as quickly into the conversation as you can.

Dr. Troy Fox: 8:07

Yeah, and I think that brings into play what we're really trying to get at. If you drill down on this, what are we really trying to do? I'm trying to find out why you're really here. Yeah, because you've had back pain over time. How long have you had back pain? Oh, last couple of years off and on, it was worse six months ago. This time, actually it's almost gone today by the time I got here, but yeah, yesterday it was really bad, and so I'm here and all this pain, but what I want to know is what. Are you really here for, in other words, what is it keeping you from doing at this point? Because if I get into lifestyle changes and how it's impacted the fact that you can't get down on the floor with your grandkids, you can't play golf, you can't go ride bike, bowl, whatever it may be. Now we're talking a strategy at that point to get you back to life. And that's really what we offer people, not only that, but we offer longevity because once you get out of that functional care phase or that acute and functional care phase, and you get into more of a wellness strategy, now, what are we trying to achieve? I'm trying to achieve the least amount of damage to your joints over a long period of time to give you function later in life. So you can continue to do what the things that you just told me that you want to do. And you can't do right

Dr. Michael Perusich: 9:25

now. Yeah. So we're about to fall into, I think some good communication strategies. So before we hit that, let's take a quick message from our sponsors, Chiro health USA and cats consultants. We're talking about patient retention strategies here. We'll be right back

9:41

So we all feel it. Rent, or dining out, gasoline, or movies. As a matter of fact, the dollar is not going as far for a whole host of reasons. And it's impacting everybody, regardless of your financial situation. Did you know that 38 percent of the overall population is having to reconsider how they're spending their money just to afford the healthcare they need? And if you break it down further, 26 percent have actually delayed the healthcare that they need. Including going to see you, the chiropractor. So here's what we need to know about the breakdown in demographics. You would think that someone who's making 120, 000 or more would be continuing their care right now. But the actual number is 18%. 18 percent of that group is actually putting off health care. And that's a group of people making six figures. When you take that same information all the way down to a group making 40, 000. That number is much higher. It's closer to 40%. So it's never been more important than now to make sure you've made it easy for your patients to come see you, that you have choices for them, and you understand what they're going through at home. We want to make sure your practice thrives during this time, and we encourage you to learn about what ChiroHealth USA can do for you and your practice, and making it easy for patients to see you and continue care.

Dr. Michael Perusich: 11:07

all right, everybody. Welcome back to the KC ChiroPulse. Wow. I can't even talk the KC chiro pulse podcast, helping doctors keep their pulse on success. So we're talking about patient retention strategies, and we're really starting to dive into this whole idea of what is effective Communication try. I think you kind of started down that road when we took our break and I'm going to throw one word out. Empathy, empathy. We have to walk into the patient exam. So the first time we ever see the patient, we have to walk in, not with our doctor code on, not with our knowledge code on, but we need to walk into that room with our empathy coat on. So we listen to the patient. And I

Dr. Troy Fox: 11:54

would add to that, put your psychologist hat on over the top of your empathy coat, because you also need to read the patient and figure out where they're at right now, because some people are going to walk in very closed off. We had a discussion about this the other day, let's think about our geriatric patients and a lot of cases they have been to multiple doctors and some. Are very open to what those doctors say. But what I've seen is we have a, we have a segment of patients that really don't want to spend money, don't want to get care unless they got a leg falling off. And so they're going to come in with a very defensive posture to begin with. So you have to identify, is this person open to what I'm saying up front? You're the doctor. I'm here because I want to hear what you have to say. Or is it somebody with a wall up in front of you in the initial that you really need to work on softening that wall so you can find out what's going on. That person takes a little more time, but you can't just bulldoze through that because they're not going to allow it.

Dr. Michael Perusich: 12:54

Yeah, no, that's exactly right. And I can tell you a great story about that. I had a PI patient one time, kind of a young guy, and he comes in we did the evaluation and everything. And, and. Before the end of the first day, he asked me, aren't you going to get me out of pain today? And this kid was literally in like seven or eight out of 10 pain, neck, med back, shoulders, low back, he was a mess. And I said, we're going to do our best, but it's going to take time. He, I know sooner said that he jumped up out of the chair. He was going to punch me out. I mean, this is sometimes the kind of patient you get walking in the door. Well, by the time I finally got him out of pain and back to maximum improvement, he and I kind of become buddies. So we've got to remember that, yeah, some people come in closed off. Some people are going to come in mad and frustrated with their condition. Some people are going to come in loaded for bear. Some people are going to come in bringing you cookies. You're going to see all those and everything in between. We've got to learn how to develop great communication skills for almost every type of patient that could walk in your door. Now, I'm not going to say there's nothing. The patient that walks in that just isn't going to do anything and you probably should fire them. You need to learn how to do that too. We need to learn how to personalize our communication directly to the patient. So we start building those relationships right up front because that's part of what retains patients in care. Is building that relationship.

Dr. Troy Fox: 14:23

And once you start to build that relationship, you can't rush that red at the beginning. I know as we walk in, we're all on a time schedule. I had that happen to me this morning, actually, where I had a patient that was 92 years old that came in. I already knew we were going to be fighting the clock. That when you've got somebody that's 92, because they move a little bit slower, they've probably got a little bit more history to tell you about. And so I knew going in that I had to do one of two things, either cut that patient off, which wasn't going to happen, or I had to make sure that I was very efficient with the things that I said and did. In other words, I need to hear the patient story. I don't need to extrapolate. I don't need to talk more about what's going on. Let's find out what's going on with you. Really listen, really put it together. Go ahead and give them affirmation that I'm hearing. So what you're telling me is blah, blah, blah, and then get to a point where I'm ready to do an exam and I have to do it in a way that I'm not looking at the clock, even though I I'm in my head, I probably am still thinking about it, but I already know that I might be a couple of minutes off. As a result of that, but I'm not going to cut short that conversation with my patient, because at that point, once that patient has regurgitated everything that they want to tell me, and they feel like I've gotten it, and I've heard this a lot of times from patients, I came to you and I'm still here with you because you listened to me. That's so important, and it doesn't mean that you have to have a 15 minute conversation every time you adjust them. But if you give them that up front and you don't rush that portion of it, a lot of us want to rush right to exam. I want to, I want to get the, I want to get you in a position for straight leg raise right now, because I want to know what's causing your low back pain. They're not ready for that. They want to talk to you a little bit. And so some of our younger patients, you get them there a lot quicker. They tell you what they need to tell you. And it lasts about 30 seconds, right? And then sometimes it lasts longer. So that is one of the big keys when you're being empathetic. And when you're using your psychology to understand where the patient's coming from, you need to understand as well, when it's time to actually physically do the exam.

Dr. Michael Perusich: 16:35

That's really true. That's very true. Sometimes we get in such a rush. We want to cut the patient off. Letting patients talk oftentimes does a couple of things. It gives you a ton of information if you sift through it correctly. But number two, it also helps them get to that point where they can verbalize the feeling of what they're having into something that's real, a realization that they can actually go, Oh, now I understand why I'm here. And when you get the patient to that point, so what patients 20 years ago, Troy were information based patients. They didn't know a lot about chiropractic. The internet was kind of new and so forth. And so their ability to research was limited. It was just I don't want to say just word of mouth about chiropractic, but kind of was in some ways. Today's patients are different. They have all the information at their fingertips, their needs based. Today, they want you to fulfill a need there. I know as much about chiropractic care as they want to know. Otherwise they wouldn't have called your office there and they want to be your patient. That's why they called your office. We just need to help them understand what their need is.

Dr. Troy Fox: 17:52

Right. Which sometimes does lead into a little more education. I don't want you to think that you can't ever tell them anything, but. You may have a starting point that's a lot farther along than you thought it was, which actually, to me, seems like a win because they come in armed with information and all I have to do is put the finishing touches on it to get them to understand what care looks like, what different phases of care look like, and why it's important that they follow through with care. It becomes easy at that

Dr. Michael Perusich: 18:24

point. It, in my opinion, the report of findings today is so simple that the chiropractic education component happens at your table on each visit, you give them a little bit each time. Here's what we're doing. Here's why we're doing it. Here's wolf's law. Isn't that cool? that's when you bring that stuff to them, right? What they need to know up front is, can you help me fulfill my need? That's how people accept care. And so once you get them to accept care and then they understand care along the way, and you've set your goals correctly. Now, by the time you get to the maintenance point, they're excited and ready to go. Yeah. It's you're taking the braces off and giving me the retainer. This is cool. I made progress.

Dr. Troy Fox: 19:08

And then to add into that, now you have got a built in group of folks that are willing at that point to either give you a review on Google, or they're willing to do a testimonial that you can put up online. And what's important about that is, and I'll give you an example, I had a guide. Today, come in and talk to me. And he had been on maintenance care for, I don't know, eight or nine months now. And since I had taken over this practice, he had been basically coming in whenever he hurt bad enough that he felt like he needed to get adjusted. So he was self directing care. I talked to him about the benefits of wellness. He followed through with what I said. And today was amazing because he looked at me today and he said, doc. I just want to let you know, you putting on mate, putting me on maintenance was a life changer for me. He said, when I get up in the morning, I don't have any pain now and I've got my life back. He said, I cannot believe how easy it was for me to get my life back when I thought I was going to have to live with this pain for the rest of my life. And he said, you convinced me. That it would be important for me to get periodic care and what the benefits would be. and I did a little education with that about why it would be beneficial and how we would make forward progress by, by giving him care. And he chose to do a month timeframe. And, I told him it'll happen a little slower if we're doing it a monthly rather than every two weeks or every week or whatever, but the eventual. Point of the, of the conversation was when he told me that I got goosebumps on my arms. I was excited about it. I was so excited because I made a change in this guy that he thought would never happen. Do you think that guy trusts me as a doctor? Absolutely. Sure. Now, if I had continued the status quo and said, I know you've been coming in just when you hurt, why don't you just call me? We would have been in the same boat. He would have come in every month, told me what hurt this time. And it's probably still going to be the same area over and over again. And we would gain nothing at that point. How much trust does he have it for me as as a doctor, number one, when I haven't really made a big change, it starts to wane after a while. Yeah, all I did was made you feel better for a few days and then you're right back where you were. So when you make a long term change with the patient, that is, that is a really rock solid way to create retention. And that's not going to happen with every patient that walks through your door. No, it's not. But

Dr. Michael Perusich: 21:38

you know, that, that should, that should absolutely be a goal. And, you know, along with that, when you get that patient who has that miraculous turnaround and, and gets their life back, gets their function back, if you don't put them on a regular care plan and they, they relapse and that's when they come back and, you know, that's, that's all that ever happens is they, they go away for a while, six or eight weeks, they relapse, they come back, you get them out of pain, they go away for six or eight weeks, they relapse, they come back. When you get into that cycle, you degrade that patient's experience with you. And so it's imperative that you help the patient understand that, Hey, six or eight weeks isn't going to work two or three weeks is probably where you need to be.

Dr. Troy Fox: 22:24

And sometimes your patients will even tell you that, which is great. Once you get into that cycle, they'll go I don't think four weeks is working for me. Can we drop back to three? So think of it this way you buy. A new cell phone and the new cell phone goes haywire on you. You take it back down to Verizon. That's my provider. So I take it down to Verizon and they fixed my cell phone and it works again for two weeks, then all of a sudden I get locked out of everything. And I take it back and they fix it again. And then two weeks later, now all of a sudden I can't send or receive calls. That could be because the whole world got hacked, but I don't, maybe not, but if it's just my phone and then I take it back again, now the back cover's falling off and the battery's not doing very well. Am I eventually going to lose faith in that product? Yeah, real quick. Yeah. So as you think about that, you have to realize that status quo for your patients. It's not good enough if they're not getting the results that they want. So for you to have an effective retention strategy, you have to have an effective strategy for your patient to retain. And hold function over time, it can't just be cookie cutter. Everybody goes to a month or six weeks or eight weeks or whatever you have to work with the patient. Now, if the patient just flat refuses and says, you know, I'm not into all that stuff, if you can only get them to come in once a quarter. It's better than nothing, but then at that point you explain, you're not going to get the same results as somebody that's coming in every two to four weeks is going to get, and that's just bottom line, but I'm not afraid to tell people that because then once they get tired of still not feeling good, they eventually will go, you know, doc, I think I'm ready to try that monthly thing. You know, I'm right, you know, and then we can wean it down from there. If, if four weeks is good, great. If we need three or two, now the conversation is open. Hey, why don't we do this?

Dr. Michael Perusich: 24:16

And so you preempted that patient by saying, okay, we'll do it your way, but you're not going to get the results you want. And when you don't get the results you want, This is what I used to tell him, I'll see you two or three times like that, but then about that third time I'm going to look at you and I'm just going to smile and cross my arms because at that point, if we're not going to do it my way, I'm done with you because if we're just going to keep degrading your experience with chiropractic care, I don't really want to play that game. I'm about helping people understand the true value of chiropractic care and the benefits of making it part of their lifestyle so that they can keep doing the things they want to do. And that is not repeating the pain cycles over and over again.

Dr. Troy Fox: 24:57

That is a hundred percent true. And that is the bottom line to retention. You have to be willing to put your doctor hat on. Yep. If you want retention, you can no longer allow the patient to self direct care or ask them what they want to do, because you know what they want to do? Not come back at all because they're busy. And I get it, you know, there are days, and I don't know about you guys, but there are days for me that I get out of the office and I I'm scheduled to go get adjusted that day. And I have to force myself to get in the car and go get adjusted because you know what, I got 18 of the things I need to go do, I could, I could pull out of my parking lot and make a right turn instead of a left really easily. Sure. But I have to know I want to take care of myself. I have to want it. Your patients have to want it as well. So for them to create a mindset where they want to be in your retention model or in the, in, in their retention model, they have to buy into the care. And that takes you

Dr. Michael Perusich: 25:56

directing them. And one more thing, you've got to get your staff involved in this process to, your staff can run patients off. You may not even realize this, but if they're telling the patients things different than what you're telling them, so maybe you tell him, Hey, I want to see you back in two to three weeks and they get up to the front desk and maybe the staff says, when does the doctor want to see you back? And the patient says, Oh, I don't remember what he said. Well, let's just put you down in a couple of months. How would that be? Okay. I mean, that's going to begin to degrade that patient experience because now the patient thinks, Oh, wait a minute. I think the doctor told me more frequently than that, but you're saying too much. You're the one scheduling. So that must be right. So everybody in your office has to be on the same page and your staff should be emulating the same communication in the same style that you do to patients, they should be emulating that, which is really

Dr. Troy Fox: 26:47

easy to do. All new staff that come in and work with you should either shadow you or be it within earshot when you're working with patients so they can hear the verbiage that you're using. So that way they start to mimic that verbiage because quite frankly, docs, you guys are the ones in charge in your practice. Yep. Don't absolutely don't duck your head in the sand and hope that the staff is able to schedule that patient for their next appointment in a timely manner, because that's not their job. Their job is to follow up on what you've said.

Dr. Michael Perusich: 27:15

It's exactly right. Be the leader of your practice. Be the leader of your staff. Be the leader of your patients.

Dr. Troy Fox: 27:19

We covered about 800 things already. I mean, literally, that's like a master class. There's so many ways we could go. That's the thing. If you guys listen to our podcasts all the time, you guys listen and you hear, Oh my gosh, there's 80 different directions are going, but you have to realize there's an interconnected web to everything that we do. One thing leads to another, which leads to two other things. And you, and you will never nail it all down. Even in my practice on a daily basis, we are constantly working to be better for our patients. And as a result, we're constantly revisiting what I would call these hallmarks or these points in this masterclass. It's like looking up into the sky and seeing the stars. There's a lot of points up there, right? It's the same thing in practice, but you will, you will come close to mastery on a bunch. It's like juggling balls, I guess. And every once in a while, you're going to drop a ball. You got to pick it back up and throw it back and play. So that's how retention is built is by a whole bunch of good processes in your office, just like we just talked about today. Absolutely.

Dr. Michael Perusich: 28:24

And don't be afraid to listen to this podcast again and work on these principles. And if you need help, give us a call. That's what we do at Kats consultants. We help doctors improve their practices, bring success into the practice, bring the fun back into practice. And above all. make the practice profitable and great for your patients as well. So check us out at KatsConsultants. com. We've got all kinds of free downloads on there. Subscribe to the podcast. Make sure you tell your friends about it. Our podcast is growing like crazy, so we appreciate everybody out there listening. And I want to thank our sponsors, ChiroHealth USA, as well as Kats Consultants. All right, everybody, thanks for tuning in to the KC ChiroPulse podcast. We will see you next time. See ya.