8 Ways to Avoid Losing Patients

Dr. Danielle was a great chiropractor with a strong chiropractic philosophy. She had met her first chiropractor at age 8 and been helped greatly with her food allergies. She was also hard working, personable and loved meeting people. So, why couldn't she get her struggling practice off the ground? She seemed to lose patients as fast as she got them. She was stumped.

She had a great little office, a faithful CA and a few patients who were crazy about her. But week after week, month after month – the same low numbers. Occasionally, she would think that the practice was taking off, but it always stalled out and crashed again, leaving her discouraged and needing to crawl back slowly. It was exhausting.

After she covered expenses and student loans, she was barely scraping by. I didn't spend $200K on chiropractic school for this.

Dr. Danielle and Dr. Amanda were chatting at a homecoming reception, and Danielle could hardly believe what she heard. Even though she'd graduated a year later than Danielle, Amanda was now seeing three times the patients, making three times the money and by the sound of things, had a fraction of the stress. She was so busy she was considering hiring an associate.

"Uh, my experience is a little different than yours." Danielle said, grimacing as she thought to herself, Amanda's in a smaller town, not the outgoing people person I am and she's killing it. What's she doing differently? OK, swallow the pride and just ask.

"Amanda, you see three times the people I do and it sounds like a it's easy for you. How do you do it?" Dr. Amanda wasn't the least bit condescending; in fact, just the opposite.

"Oh, Danielle, I was really blessed to associate in a great clinic that had so many things figured out. Things I had to actually see work to understand how powerful they were. Why don't you come to my office for a half-day and see for yourself? Then we'll have lunch, OK?"

Not wanting to be late, Danielle ended up in the parking lot of Amanda's office too early, but was surprised to see the lights on and movement inside 45 minutes before patients arrived. She went inside.

"Morning! Am I late?"

"Come in, Danielle! You're right on time. Let me introduce you to the team." Two smiling, well-groomed, uniformed CAs greeted Dr. Danielle courteously.

"We're here 45 minutes early getting ready for the day and our morning huddle. Kristi's going to lead that now."

Kristi reviewed the schedule, told Dr. Amanda where the tight spots were and exactly what everyone needed to do to stay on time. Amanda complimented each CA on a specific win from the day before and Jenny, the other CA, read a short patient testimony just posted online.

Dr. Danielle thought to herself, Wow, this is so organized and very exciting. She asked, "Do you do this every morning, Amanda?"

"Every!" Dr. Amanda, replied, smiling.

"Your report of findings is here, Doctor."

"Jason, do you mind if Dr. Danielle joins us this morning?"

"Not at all, doc."

What Danielle saw was impressive. Amanda's ROF took just 10 minutes to frame the working relationship, care goals, problem, care schedule, appointments and financial solution. It was so smooth, so effortless. Amanda called Jenny into the room.

"Jason, this is Jenny. She'll help you with the finances and your appointments. Then she'll bring you to me for your first adjustment. Jenny smiled as she shook Jason's hand.

Danielle's head was swimming. So professional!

Both Dr. Amanda and Dr. Danielle moved to the adjustment area, where patients had been placed on three tables. Dr. Amanda said, "Hi guys!" to the three men lying face down and then went to work.

Dr. Danielle watched how relaxed Dr. Amanda was moving from patient to patient, expertly adjusting, instructing and handling questions in courteous, short answers, but leaving no question about who was in charge and what would happen next.

EHRs were expertly done as patients made their way to unattended therapy. Dr. Danielle was impressed with how easy it felt. It was almost as if patient care were choreographed.

"James, tell my friend Dr. Danielle how long its been since your last migraine," said Dr. Amanda. The patient smiled as he recounted a dramatic transformation.

"I love hearing your story, James, and I know you tell everyone," said Dr. Amanda. "Do you need another free consultation certificate? Here, take two."

"Today, Jenny's going to help you do a Google review for us – did you bring your iPhone? Cool. Jenny, James is ready for you. See you next week, James."

Dr. Danielle had her iPhone out jotting notes about what she saw all morning.

Kristi appeared in the adjusting room with morning stats on a Post-It note. "Great morning, doctor. Wait times virtually non-existent with 31 regular, two new and your early ROF. If your charts are done, you can head out to lunch."

(Danielle was a little surprised by that comment and wondered who was actually in charge here.)

"Up to date as promised and I'm hungry. How about you, Danielle?"

The deli was a 2-minute walk away and after ordering, Dr. Danielle said, "It's all so smooth; so low stress. Such a contrast from what I'm doing."

"What did you notice?" asked Amanda.

"Tons," Danielle replied. "In fact, I made a list. I'd love for you to tell me what's actually going on in each item."

1. You Arrive Early

Danielle: "You're serious about your staff coming in 45 minutes early and strategizing before you're busy. Because of that, the morning went just like Kristi said it would."

Amanda: "Yes, we are and you're right!" Amanda laughed. "My practice is a real business and I've trained Kristi to run the business just the way I want her to."

2. You Take Control of Each Case

Danielle: "In your ROF, you take complete control and the patient loved it."

Amanda: "Control starts on day one and if they're a chiropractic case, taking control and leading is my job. Patients want me to be decisive."

3. You Handle Finances and Appointments Up Front

Danielle: "I love how you handle money and appointments right up front. It looked easy."

Amanda: "It usually is. Remember, patients give you their best decisions in the first three days. Since they want to get well, that means they need the care and need to pay. We provide easy solutions for both."

4. You Run on Time

Danielle: "Even with my low numbers, I run late and usually feel stressed." Danielle frowned as she spoke.

Amanda: "We train on everything we do including a very precise office call. My patients have learned to expect me to be focused and respect their time."

5. You Stimulate Referrals

Danielle: "I love the way you use certificates for referrals. Do they actually work?"

Amanda: "Half of my new patients come from those certificates delivered by my current patients. As soon as they start feeling better, we train them to refer."

6. You Get Internet Reviews

Danielle: "Tell me about how you do Google reviews."

Amanda: "People used to promise they'd review us, but rarely did. Now we ask for permission to use their smartphone's Internet browser and they dictate the review to Jenny. It's so easy for everyone."

7. You Work as a Team

Danielle: "I may know, but tell me why Kristi tells you when you can go to lunch. What's up with that?"

Amanda: "We're a team. If my charts aren't done, I let the team down and send the message that I don't care about our goals. I give Kristi the authority to enforce the standard. I get better buy-in from her and accountability for me."

8. You Aren't Afraid to Ask for Help

"This morning's been amazing," exclaimed Dr. Danielle. "You said you learned all this as an associate. How?"

"I worked with a great office where the doctor took his goals seriously and made sure we did, too," Dr. Danielle replied. "When I saw all the systems, I soaked them up like a sponge."

"But there's one thing you don't see. My boss in associateship was in a great practice management group. When I went out on my own, I found a practice coach. My coach gives me great ideas, holds me accountable, and the group inspires me to do my best."

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.