Seven Steps to Reboot Patient Retention: Post Pandemic Practice Recovery

Mar 1, 2023 | Consultants

by Mark Sanna, DC, ACRB Level II, FICC • 

President & CEO Breakthrough Coaching • 

One of the challenges that chiropractors and their practice team members confronted as the result of the pandemic was an increase in the inconsistency with which patients attended their scheduled appointments. Working and schooling from home, exposure to COVID, and the subsequent quarantine requirements made if challenging for patients to stick to their schedule of care. As these issues are becoming less prevalent, many practices are having to reorient their patients to the importance of the regularly-spaced intervals at which chiropractic care is best delivered. Inconsistency in scheduled care results in an increase in patient dropout. It’s time to reboot patient retention in your practice.

Rebooting Patient Retention Begins with You

Rebooting requires action and commitment by your entire practice team. It requires re-engaging with patients in a way that inspires them to follow through with your recommendations for their care. Touchpoints are those moments of interaction between your practice and your patients. Every touchpoint must reflect, reinforce, and reiterate the value of your care. How effective you are at orchestrating these touchpoints determines how likely a patient will be to continue with your practice, leave for a competing practice, or drop out of care entirely.

Numbers Don’t Lie

If you are unclear about how well your practice is doing at retaining patients, a good tool to measure patient retention is your Patient Visit Average (PVA). PVA is a measure of the average number of visits a patient is seen at your practice. It is calculated by dividing the total number of new patients into the total number of visits seen during a period of time, typically one month. Practices with a PVA of less than 12 tend to be pain-relief focused. A PVA of 12-24 indicates that a practice is moving beyond pain relief and into functional improvement. A PVA of greater than 30 means the practice retains patients into the wellness phase of care.

Actively Create Positive Touchpoints

Touchpoints don’t just happen. You must proactively create them. If you are not purposely creating a great experience for your patients, you are, by default, staging a mediocre or poor one. Create a solid foundation of positive interactions that is strong enough to keep your patients loyal to your practice. Remember, the patient’s perception is your reality. The new normal requires going the extra mile. Patients are stressed, worried, and anxious. Consciously fostering a calm, organized environment creates a sanctuary for the patient in their harried world—every little detail counts. Let’s review seven steps to help your practice reboot patient retention.

Step 1: Start off Right

You never get a second chance to make a great first impression. If it takes several hours or even days for a phone call to be returned, chances are the patient will start looking elsewhere for care, especially if their situation is urgent. It begins with the first phone call. This interaction sets the stage for all of the experiences to come. Answer as quickly as possible before the third ring. Use a friendly, professional tone and put a smile on your face. Patients can hear your smile over the phone. Avoid long hold times and return calls promptly.

On a patient’s first visit to your practice, know that they are coming, and be ready to receive them. Greet the patient by name and provide a smooth check-in process. When possible, securely deliver intake forms electronically for completion by the patient before arrival. This significantly decreases waiting time. Have a welcoming reception area with a dedicated new patient chair in clear line of sight of the receptionist. Limit the wait to see the doctor and complete the consultation, history, and examination procedures as efficiently as possible. Check-out should be as smooth as check-in. Follow up with a text or phone call.

Step 2: Make Finding You Easy

Have an easy web presence. Provide clear contact information with an easy-to-remember web address. Keep your site updated in the search listings by actively posting on your “Google My Business”, Bing, and Yelp pages. Have an easy physical location. Your building, or office within the building, should be easy to find and marked with clear signage. Text patients your address, with directions and landmarks, before their first visit to. Include parking instructions to make their experience even easier. No one likes to feel like they do not know where they are going!

Step 3: Advance Multiple Appointment Scheduling

Make scheduling appointments easy. If your patients have difficulty scheduling appointments, they will be more likely to drop out of care.  Offer convenient appointment times. Before and after work tends to be prime time in many practices. Schedule new patients outside of these busy hours. Make scheduling easy by offering each patient multiple appointments at the same time of the day. This helps the patient prioritize their care and schedule more flexible items around their chiropractic visits. Patients appreciate online scheduling on your website or through an app. Provide two-way texting or chat to make communication easy when you or the patient are running late. Be sure to have a reminder and recall system should patients fall out of their regular schedule of care.

Step 4: Financial Consultation

Make it easy for patients to understand their financial responsibility for care, including their insurance benefits. Have a space where you can review finances out of earshot of other patients. The individual performing the financial consultation should be comfortable discussing money. Most patients have limitations in insurance coverage. Don’t apologize for their coverage; provide them with options such as a payment plan to help care fit into their family budget. Most people can afford care when it is broken into manageable payments. Explore the benefits of a Discount Medical Plan Organization (DMPO) that allows you to legally discount your services when no insurance coverage is available. In cases of documented financial hardship, you can provide a Hardship Agreement for a set period of time.

Step 5: Practice Efficiency

People’s time is more valuable than their money. Be realistic with your appointment times and lengths. Be realistic with how many patients you schedule. Schedule appointments to maximize patient flow. Schedule staff for optimal patient flow. Be transparent if you are running late. If you find you are consistently behind, then something needs to change. Change your scheduling rules. Set aside special times for new patients—cluster book appointments to avoid gaps of downtime in the schedule. Limit walk-ins to emergencies. Learn to direct patients to select appointment times that will limit their wait time. For example, “You can come in at 4:00 pm; however, there will be less waiting time if you come at 3:30 pm.” Systems lead to efficiency. Continually train your entire practice team on efficient, repeatable systems for scheduling, patient care procedures, and patient financial procedures.

Step 6: Engaging Wellness Visits

Pre-schedule wellness visits as part of the patient’s original treatment plan. Make wellness visits special by showing value on each visit. Teach the patient a new stretch or share a current bit of health-oriented information. Perform an annual wellness check-up examination to monitor the patient’s health status. This procedure enables you to increase the frequency of a patient’s schedule of care if coming in more frequently for a short period of time would help them gain any lost ground. This is the time to frame their view of lifetime care. Teach your patients to “feel” when they need an adjustment and make it easy for them to come in for wellness care. Offer a schedule of recurring appointments, for example, every second Tuesday at 10:00 am. Keep payment information on file and schedule auto-payments to make finances a snap.

Step 7: Welcome Them Back

When a patient drops out of care, let them know your door is always open. While we would like all our patients to continue through wellness care, it might not be a realistic expectation. Many of these patients will cycle through episodes of care and return year after year when they feel that they are in need. Make it easy for them to return. Welcome them back and give them a fresh report of findings and a plan for care. Who knows, this may be the time they get the big picture! Every contact you have with a patient influences their decision whether they’ll come back or not. As a rule of thumb, happy patients stay and pay—retention results from keeping happy patients.

Dr. Mark Sanna is the CEO of Breakthrough Coaching. He is a Board member of the Foundation for Chiropractic Progress and a member of the Chiropractic Summit. To learn more, visit