250 Keeping Patients Engaged

Welcome to the KC CHIROpulse Podcast.  

This week’s topic:  Are you keeping patients engaged? 

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

In this episode, we discuss:

• How left to their own accord, patients will decide when they need care  
• Why your recommendations are not being followed by patients
• How your staff is involved in patient engagement
• Why your treatment recommendations are non-negotiable
• …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 personalized 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, and represents the opinions of the speakers.  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

Keep Patients Engaged

Patient Engagement Problem

[00:00:00] 

Dr. Michael Perusich: Doctors, how well are you engaging your patients? Hi everybody. Welcome to the KC ChiroPulse Podcast, brought to you by Kats Consultants in Chiro Health, USA. We are your host. This is Dr. Troy Fox. I'm Dr. Michael Perusich, and we're here to lead the conversation Today. What do we talk about? We talk about some of the most innovative methods and current ideas for managing your practice for success.

And Troy, you brought up a, a great idea for today's topic and I, I think this is a really important one you were talking about. Engaging people in their treatment plans and keeping them engaged long term. So I think a lot of us, we do a, a pretty good report of findings and we think that's gonna engage the patient and then, zip three days later and they're, and they're gone.

Six days later, they're gone, they start feeling better and they're gone. And, you know, that's not keeping them engaged to turn them into long-term patients. So you had an experience, I'll let you roll. 

Case Study Shoulder Care

Dr. Troy Fox: I did, and you know, the worst words you can hear from a patient that [00:01:00] you're really trying to create wellness with is, I'll just come on an as needed basis.

So let me lay out what happened. Maybe this resonates with you guys. Maybe it doesn't. Maybe you guys are way better than I am because I make mistakes too. I had a patient that came in. She'd gotten Chiropractic Care, uh, from a different Chiropractor for a period of time, had gotten some results, but she was having a shoulder problem and she came to me for, said problem.

I'm not sure why. Probably 'cause a friend said, Hey, you need to go see Dr. Fox. But you know what? Whatever the reason was, she decided to come visit me and we put together a treatment plan. And she liked the treatment plan. It was. A little bit less care than she had seen from the prior Chiropractor where she'd signed a year agreement and done some real long-term care.

So she really liked one. I said, Hey, let's just look at, three or four weeks of care and let's see what happens with this. And if we are successful, great. If we're not, we'll change gears. Okay, [00:02:00] sounds great. Let's do it. So we start care. And what I was doing with her, I was actually doing shockwave.

Um. Usually with shoulder shockwave is just pretty phenomenal. So I was real confident that what I was gonna do was gonna work really well. 

Dr. Michael Perusich: Sure. 

Dr. Troy Fox: We get about two weeks in and guess what? She's not making improvement and we gave it adequate time. I feel like two weeks is plenty of time with shockwave.

I mean, we're gonna know the first couple visits if we're gonna see some, at least some minor improvement. So I said, okay, let's switch gears. Let's start doing some needling on you instead. So we switch gears and we started needling. Lo and behold, fantastic results. No. You know, I'm not patting myself on the back because it was just her body responded to needling better than it did shockwave.

Sure. The problem was when we switched gears, we didn't really talk about, okay, here's the treatment plan that we're gonna do. We just basically did a continuation of what we were already doing. We just switched treatment. Okay. And the misunderstanding [00:03:00] came when she started feeling a lot better. She's like, well, I don't think I need to get care anymore.

She was getting adjusted and getting the needling and. She basically says, okay I don't think I really need to get care anymore. And I made the mistake of really not going over those treatment recommendations again and saying, okay, here's where we're at at this point. Here's what I expect from the needling.

We hope that this is gonna be more effective than the shockwave. And at the end of this. Short course of treatment, I'll make further recommendations and we'll talk about moving you towards wellness that didn't enter the conversation. So as a result, she decided on her own, she was doing pretty darn good, which is a great observation.

Dr. Michael Perusich: Sure. 

Dr. Troy Fox: She was doing very well. The problem was, is I left her to make the decision on what to do with her care next and, 

Dr. Michael Perusich: and she probably based it on pain. 

Dr. Troy Fox: She based it on pain and she was doing really well. So she said, I'm ready to go play golf and do what, you know, what her treatment goals were. She wanted to travel and be [00:04:00] comfortable when she traveled because she's retired and her and her husband have done very well for themselves and she was making enough money.

She wanted to retire and play golf. Well, those are really good goals to get to. Well, she felt like she was there. She's like, I feel good. I'm ready to go. So a short conversation, luckily at the front. I didn't really have to convince her, but I just told her, I don't think we're quite ready yet. I'll see you next week.

So the conversation is gonna happen next week. Fortunately, that one was a save. Sometimes we don't have that opportunity to save, because what happens is the patient leaves the office and you guys have all had this happen, and they don't want to say anything to you. So what they do is they call in and cancel that next appointment and say, I'm feeling pretty good.

I'll just call. And 

Dr. Michael Perusich: yeah, 

Dr. Troy Fox: you're stuck at that point. At that point, you have no opportunity to convert that patient to wellness because they've already made a decision. So that's the story that happened today and I think it's an [00:05:00] important one. 

Dr. Michael Perusich: Yep, it is. And so we gotta take a quick break, but when we come back I wanna talk about ways that you can keep the patient engaged in their care plan so that they become lifetime patients.

Alright, we'll be right back.

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Break And Engagement Tactics

Dr. Michael Perusich: Okay, everybody, we are back. We're talking about patient engagement in their care plans and sometimes a patient falls through the crack and Andrey, right before the break, you [00:06:00] brought up a a great example of, you know, if we leave patients to make their own decisions about when they come back, sometimes they won't tell us, they'll just leave the office and then they'll call back a little bit later and want to cancel.

However, we know from being. Coaches in this profession and having seen almost every, um, I won't say every, but almost every scenario, there are ways that you can sidestep some of those kind of things, but more importantly, what we wanna do is we wanna stay ahead of the patient. And so I, I want all of you to think for just a minute out there.

What is your patient conversation like? Not on day one, not on day two, but let's pick visit number eight. What does it sound like? Is it about the weather? Is it about their golf game? Worse yet, is it about your golf game? What are you talking about with the patient? This is where engagement comes into play.

And Troy, you brought up a great point. When that patient walks out, sometimes they'll stop at the front [00:07:00] desk and want to cancel. Yeah. And is your staff ready to keep the patient engaged? Now some of you're thinking, oh my gosh, I think my head just exploded. 'cause how would my staff keep patients engaged?

There's a way, it's called coordinated communication. And this is something that we teach a lot in cat's consultants, but it's incredibly important that everybody in the office is on the same page to keep that patient engaged in care. So, we've gotta really think about these things when we're treating patients, when we're seeing patients, when we're communicating with patients, we've gotta make sure that engagement and patient retention is at the forefront of our thought process.

Dr. Troy Fox: Before I get in trouble, I've gotta give kudos to my staff because they were in process of engaging that patient in that coordinated communication. Perfect. And I just happened to pop around the corner and the patient goes, oh, there he is. Let's talk. And so luckily she was, she was one of those that was.

Inquisitive, at least wanted to know what [00:08:00] I thought about it as well, which is a good thing. Isn't that a breath of fresh air when the patient's like, Hey, I kind of wanna hear what you have to think about that. But if not, like you said, staff has to be ready to answer those questions. 

Staff Communication Playbook

Dr. Troy Fox: And the easiest way to do that is in your weekly staff meetings.

Oh my gosh. I just got another side there. Right? Oh my God. What's weekly staff meeting? A 

Dr. Michael Perusich: staff meeting. 

Dr. Troy Fox: In your weekly staff meetings, docs, it's great for you to step in with a scenario and to meet with your staff, and you guys run through that scenario because it's not gonna be the same verbiage for every your patient.

So we can't give you a script, oh, hey, here's a script. This is what you say to every patient. You have to have, you have to have a feel for where you're going with it. And then you have to have multiple different avenues based on the patient's response to that, because if you just get. A flat stone wall, and that patient is absolutely adamant about it.

I think in some cases we're better off not to engage the [00:09:00] patient too heavily at that point because all you're gonna do is, is irritate the patient. But that's a really nice time to maybe write a short note. I've got special little four by six. They look like note, maybe they're a little larger than four by six, but they're little note cards.

They've got my logo and my name. At the top of it, I write a personal note. On the bottom and every note is different when I write that. So that's one way. The other way is when staff engages and the staff says. Hey, I understand what you're talking about right now. I know that the doctor talked with you about the care plan and your goals for the care plan, and I know that you haven't quite reached those yet.

Would it be okay if I have the doctor come up front and talk to you for a minute? That's one way to do it. Now, you may not be available. You may be with patients at that time. Maybe the doctor can call you later or. The other option, which I love the best, which my staff is really good at. Why don't we go ahead and get you scheduled and let's have you come in and we're gonna, we're gonna put aside a little extra time.

I'd like you to [00:10:00] speak to the doctor the next time you come in. So those, those seem to be the, the three avenues that tend to be the most frequent. It's not very often that you just get a patient that goes, oh, okay, he wants me to continue the treatment plan. No, because they've already come up with a plan in their own head or an intellectual thought in their own head of where they're at.

So we have to have a plan, and there has to be multiple avenues to it. 

Dr. Michael Perusich: And everybody out there. Do you hear what Troy is saying? He's saying, don't let your staff just accept the patient saying, I want to cancel. I don't want to come back. I'll call you when I need to. They shouldn't just be accepting that because doctors are gonna ask you this question, can your staff change a treatment plan?

Are they the doctor? Do they have the ability or the right to do so? Do they have the permission to change a treatment plan? No, probably not. But that's what they're doing. When they say, okay, well that's fine. Just call us when you need us. That shouldn't be acceptable in your practice. So right there, Troy's talking about you create that barricade, that [00:11:00] hurdle, if you will, that the patient has to jump over because now they have to talk to the doctor.

And I, I could almost invariably tell you that probably about 60% of the time the patient will cave because they have to talk to the doctor. They won't even want to talk to the doctor. They'll just cave and say, okay, well just schedule me. 

Dr. Troy Fox: Let's qualify why we're doing that. It's not because I'm trying to hold patients in my practice.

No, it's not trying because I'm trying to retain numbers. It's because I have a plan for the patient and we haven't reached the goals yet. 

Dr. Michael Perusich: Yeah, 

Dr. Troy Fox: we're not there. They may be out of pain, but they didn't hear the, the whole, the whole gist of what we were talking about. Because in a lot of cases, when patients are in pain, when they come into your practice.

What they wanna know is, can you get me better? How long is it gonna take? How much is it gonna talk cost? Those are the three things that are in their head at that point, and that's really, it's a very narrow window when you first talk to 'em. That's why table talk has to be not about the weather or your golf game.

I [00:12:00] love to talk about my golf game when I get patients. You know, we all do a little bit of that 'cause patients may ask you about that, but then you need to redirect the conversation. How are you doing today? Oh, you're 90% out of the pain. That's fantastic. We're right on track with where we're going. So there's that talk.

But when it comes down to that treatment schedule, the reason that we want to create that stop gap where the doctor talks to the patient again, or at least has the opportunity to, is because we have not completed the schedule that we created and agreed upon with the patient. And something happened in the communica communication cycle to disrupt that.

So it's a disruptor that causes that situation. So we just need to step in and clarify at that point if we haven't done a great job with the patient in the room. 

Dr. Michael Perusich: Yeah, and really what we're doing is we're creating a reset and an opportunity to reengage with the patient and tell them the importance of the treatment plan as recommended.

And hopefully you guys are making good, strong treatment plans and, and setting good [00:13:00] goals that aren't pain based. So we need to take another, another quick break. We're talking about keeping patients engaged in their care plans based on the recommendations that you've made. Remember, always make sure you're making great recommendations.

We'll be right back.

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That's where the real strain begins. Most clinics face the same set of hurdles, inconsistent new patient flow, operational bottlenecks, and the constant challenge of staying visible in an overcrowded digital space. National reports show that over 60% of clinics struggle with [00:14:00] scheduling efficiency alone and even more lack of clear marketing strategy that reliably converts.

But the good news, these challenges aren't roadblocks. They're signals with the right procedures, smarter outreach and guidance built specifically for ChiroPulse practices, clinics can turn daily stress into sustainable growth. Stronger clinics start with smarter strategies. Grow your practice with confidence.

Book your strategy session with Katz Consultants.

Reset Mindset And Wrap Up

Dr. Michael Perusich: Okay, everybody, we are back. Have a little calamity with the, uh, with the microphone there for just a second. A 

Dr. Troy Fox: mic. It's like a mic drop moment there. Yeah, I wanna add, mic dropped. I wanna add something real quick. In a lot of cases, docs, when a patient does say, I want a quick care because I want to go on as as needed basis, there's two things that go through your head.

Number one in, in the small voice in your head is, well, they haven't finished the treatment schedule, but in a big voice, a lot of times we feel like failures and sometimes we don't wanna face that failure. It's [00:15:00] a psychological thing that you have to jump over that barrier and go, you know what?

This isn't about me. This is about the patient. So when you psychologically want to kind of run and hide behind the door and let your staff take care of this. Step out, it's probably not gonna turn out well. You have to engage, but you have to remember a lot of this is that psychological battle in yourself.

You are great doctors, you do great work, but sometimes there's miscommunication. So like you said, I love the term reset. Let's go for a reset at this point. Yeah, let's talk about what we're doing. So I want to throw that out there because docs, I feel the same way sometimes. I felt that way this morning. I felt like I failed my patient, but I was ready to step in.

Dr. Michael Perusich: But you did yourself and your, and your patient both a favor. 'cause first you, you stepped back and said, what did I do wrong? 

Dr. Troy Fox: Yes. 

Dr. Michael Perusich: And, and didn't immediately think, well, the patient doesn't have any money. The patient lives too far away. They can't get in and start making excuses for the patient.

Right. We should never do that. And patients will throw up excuses. Sometimes that seemingly sound [00:16:00] logical like money, but that's never the excuse. They just are trying to throw something out there that you can't argue with and, and you can't argue. About the money necessarily. But what we can't argue about is the goals.

And so this is where goals become very, very important to set. We need to make sure we're setting the right goals. And I'm not gonna go into that 'cause that's a, that's a cat's consultant secret sauce moment. Um, but e. If you're having good patient communication and keeping the patient engaged and the reason why the treatment plan is constructed the way it is, then you have a better chance at hanging on to that patient.

Now, you will once in a while have the patient who just gets beller in about, I'm feeling better. I don't have time, I can't come in, whatever, and you can't get 'em past that, and that's fine, but make sure you explain to them what the repercussions. R, your pain may come back sooner than you expect. It may be harder to get over once it does come back.

If it comes back for any length of time, whatever it is, make sure you're explaining [00:17:00] that so they're preempted to not just think Chiropractic didn't really work. I was still in pain. I just wasn't noticing it because of the magic of Chiropractic. I've heard that one before. And making sure the patient has some relativity to why that pain may come back.

'cause likely it will. 

Dr. Troy Fox: And you and I both had instances where we've had patients that have put the hand out, right? Yep. It's the old block hand. They put the hand out. And you know what I I, I do exactly what you're talking about as well. I talk about the ramifications of not getting care, but then I also tell 'em, Hey, I still love you.

My job is twofold. Number one, I work for you. Number two, we work together as a team to create this health and wellness model that you and I are looking at. And so just remember, I may disagree with you, but I'm never gonna be irritated with you. I'll, I'll see, and I'll sometimes say, I'll see you when I see you.

And the interesting thing is you, if you are genuine and [00:18:00] honest about where you're at with that. And it's not about holding onto a patient number. It's about me genuinely caring about that patient and taking care of them. What will happen, and you've had this happen as well, a lot of times those patients will end up coming back more often than you ever recommended them.

And I'm talking about a patient's maybe on a, on a maintenance or a wellness program, and you may be wanting 'em to come back every three weeks for care. 

Dr. Michael Perusich: Mm-hmm. 

Dr. Troy Fox: And next thing you know, every two weeks they're in your office. And they called and made the appointment. You can't, for the life of you get them to make an appointment.

Hey, how about we see you again in two weeks? How about I just call you? Okay, you're in charge. I'm not in charge, and I'll smile. Hey, I love you and we'll talk to, we'll talk to you. See you in, I see you, and two weeks later, I'll see 'em again. There are patients like that, that, that are going to self-direct no matter what you do, and guess what?

They're in charge. You're not in charge. We're there to make recommendations. Our job, when a patient comes through the door is to use our wisdom, [00:19:00] and you guys are all really smart doctors, you guys and gals. I say you, you guys know, I say guys all the time, and I mean guys and gals, but when they come in, they're looking for your wisdom.

Yes, they want a good technique practitioner or somebody that fits their style, blah, blah, blah, but they're looking for your wisdom as well. So when you share that wisdom. You can't share it out of anger because they didn't follow your recommendations. Medical doctors did that for years and we're even seeing a, a much softer side of medical doctors.

Very much so. In most cases nowadays, they are not like they were back in the seventies and eighties when they said. You know, as Steve Martin said in the Famous Skid on Saturday Night Live, who's the barber? If you haven't seen that, look it up on YouTube. It's freaking hilarious. He says, who's the barber here?

Anyway, and that's really not the approach we want to take. So use love. Sometimes patients are gonna do their own thing whether you want to or not, and sometimes they will end up exceeding your expectations. But our job is to [00:20:00] educate, and that's really where the plan comes into play. So. I think when we're dealing with patients, if we approach it with love, and I think a lot of us do, you're gonna get results, but sometimes you need to have those conversations.

And preemptive, we've said that millions of times, maybe not millions, thousands, hundreds of times we've said preemptive convert, uh, conversation wins every time. 

Dr. Michael Perusich: Yep. You know, and I've, I've had patients, and I know you have too, Troy, that only wanted to treat the pain, and I would tell 'em, you know what?

It's not typically what I do, but that that's fine. We'll do it your way. But I'm gonna tell you right now about the third or fourth time you come in here with the same pain, I'm gonna tell you I don't like treating the same thing over and over and I'm gonna do one of two things. I'm either gonna discharge you from care and you can go somewhere else because I don't want to keep treating the same thing.

Or you can try it my way and see what happens. And I had several of those patients in practice over the years in. Almost [00:21:00] all of them would convert to regular care and started coming in two or three times a month after that when I would look at 'em and say, you know, it's number four. Number four episode, you got the same thing going on.

I met one of them at the front door of the clinic one time. I just walked out with my arms fold and smiled at me and said, all right, doc, let's do it Your. 

Dr. Troy Fox: That brings in one of our podcasts. I think we just did, uh, one or two ago, talking about Doctor Authority, and that's a whole different podcast. So if you haven't listened to that, go back and listen to the podcast on Doctor Authority because some of you're going, I couldn't do that in my practice.

Sure, you can. You have to, you have to have the authority to do that. But that is a created scenario where you become the doctor where all of you wanna be. So go back and watch that podcast if you haven't as well, because that's, you know, when you said that, I'm just smiling because I'm like, not everybody can pull that off, but you have to have the authority to pull it off.

Yeah, you can try to pull it off and you'll run the patient right out the door if you [00:22:00] don't have any authority with that patient. If you're just a Chiropractic technician. I say that in the nicest way, but if you don't, if you're not their doctor and you're just a, you're just a technician that pops their back and you don't ever clarify that, you're more than that and you don't create that doctor authority.

You're never gonna get to the point of where Dr. Perus said like, Hey, after about three or four times, you gonna do it my way, or are we gonna keep doing this? Yep. Because I'm getting tired of this. 

Dr. Michael Perusich: Yep. 

Dr. Troy Fox: I love 

Dr. Michael Perusich: it. Absolutely. All right, everybody. Yeah. That's funny. Go back and listen to that other podcast.

You know what, just tune in every week we do these, uh, out of the love for the profession. So tune in every week, like, and subscribe and tell all your, your comrades in the profession about it. Our podcast is growing like crazy and it's because of doctors out there like you. So if you wanna learn more about what we do at Katz Consultants, go to katz consultants.com.

Pretty simple. We've got some free downloads on there and things, and you can check out all the great [00:23:00] things that we're doing, maybe even. Join one of our online seminars. We'd love to see you there. Troy, anything to add? 

Dr. Troy Fox: I think we're fantastic. I think you guys learned enough today that you can just put this in place in your practice and it's gonna make you focus this week on those treatment schedules and on table talk with your patients about where we're at in your treatment plan.

That alone is gonna help your practice this week. 

Dr. Michael Perusich: I don't have anything else to say, so stay engaged docs. We will see you next time. Thank you, uh, to Chiro Health USA, for being one of our great sponsors. And we'll see y'all on the next podcast. 

Dr. Troy Fox: See y'all later.