165: Patient Retention Strategies

165 - Chiropractic Patient Retention Strategies

Hosts

Dr Michael Perusich, Dr Troy Fox

 

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.

 

Dr Michael Perusich: Chiropractors, what do your patient retention strategies look like?

Hi everybody. Welcome to the KC CHIROpuse Podcast brought to you by Kats Consultants and ChiroHealth USA. I'm Dr. Michael perusich. And I'm joined by my host Dr. Troy Fox 

Troy patient retention - kind of important, right?

Troy Fox: 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 Yeah,…

Dr Michael Perusich: Yeah, and if you want to grow it long term.

Troy Fox: 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 something that once you build into your practice. it is so helpful and all it does is breeds more communication with your patients. So it's a wonderful concept from start to finish.

Dr Michael Perusich: It really is and 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. and that takes on a couple of different phases one is retaining patients in the acute phase of Hair so that you get the outcomes that you hoped you would get for them. But also retaining them in the practice for long-term Chiropractic Care maintenance care Wellness care, whatever you call it in your practice, what I'm talking about because when you retain patients, it's at that point that they become very important people to your practice.

Dr Michael Perusich: 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 helps you get more referrals and Troy out about you, but would you rather have more referrals or do you want to go out there and do spinal screenings all day long? Absolutely.

Troy Fox: 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 And that we keep you well and…

Dr Michael Perusich: exactly Yep.

Troy Fox: I put more focus on keeping you well than I do getting you well and I think as chiropractors. We know that that is really the end game in the long term 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.

Troy Fox: Otherwise, why did your fifth lumbar age 30 years faster than your L4 L5 disk space, so we know as well that degenerative changes happen dramatically in certain areas of the spine and…

Dr Michael Perusich: right

Troy Fox: they happen as a result of loss a 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 we learned this in school.

Dr Michael Perusich: Sure.

Troy Fox: So why are we not Imploring to our patients that they change their Paradigm from a 911 or what I want to call it an acute care clinic program.

Dr Michael Perusich: What is it? You always call it the alley Proctor.

Troy Fox: Our practice.

Troy Fox: So the only time you go is when you have an owie and it's bad enough that I have a wedding tomorrow. I need you to get me better. that's the hourly practic approach rather than How you doing today? I'm doing great. So what are we working on today? Anything in particular? That's given you any problems or we just tune in 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: Yeah, yeah.

Dr Michael Perusich: Okay, so let's talk a little bit about why sometimes we don't get to that point with the patient. why does…

Troy Fox: Mm-hmm

Dr Michael Perusich: 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.

Troy Fox: right

Dr Michael Perusich: What do we see with practices that we work with and our practices…

Troy Fox: mmm

Dr Michael Perusich: why do patients leave early?

Troy Fox: number one poor communication I mean that's And sometimes that is trying to drive a nail…

Dr Michael Perusich: we get a drum roll, Absolutely. It's a poor communication.

Troy Fox: 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. they know their condition inside not some are the ones that just say lay down on the table.

Dr Michael Perusich: It's really have.

Troy Fox: Yeah right there. Yeah, is that hurt right there? Okay, I'm gonna adjust that and you really have an 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 understand your practice philosophy and what your goal is for them and does it 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.

00:05:00

Dr Michael Perusich: And communication goes really 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…

Troy Fox: 

Dr Michael Perusich: how there is a need for ongoing care because what happens fart too many people come in. They've got an alley you get them out of the owie 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 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 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 give you a great example What is 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 don't know. Maybe they do I didn't have braces, and they talk about going through this.

Dr Michael Perusich: Treatment plan for 18 to 24 months sounds familiar, right and…

Troy Fox: Yeah.

Dr Michael Perusich: go through this treatment plan. That is going to do what it's going to straighten your teeth up and it's not just gonna be how straight your teeth are. It's gonna be how great your smile is. So did people come in because they don't like their smile. They may have been part of it, but they don't like their teeth. They don't have how their teeth look so wasn't necessarily their smile. It's just how their teeth looked, maybe they would bite into an apple and they get half of it stuck between the 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 gonna put you on a plan of probably lifetime care that may include 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

Dr Michael Perusich: So it's a process of care and they've explained it to us. So 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? Bob referred me and Bob had I have 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.

Troy Fox: Yeah.

Dr Michael Perusich: The referred by Bob who comes in once every six weeks on a maintenance plan, and that's what they're expecting. you're gonna 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.

Troy Fox: Yeah, and I think that brings into play what we're really trying to get out if you drilled out on this, what are we really trying to do? I'm trying to find out why you're really here. Because you've had back pain over time.

Dr Michael Perusich: Yeah. exactly

Troy Fox: How long have you had back pain? last couple years off and on, it was worth six months ago this time, it's almost gone today, but the time I got here but yesterday it was really bad, and so I'm here and all this pain pain, but what I want to know is what are you really here for? Another words? What does it keeping you from doing at this point because if I get into Style 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 bull, whatever. It may be.

Troy Fox: Now we're talking a strategy at that point to get you back to life. And that's really…

Dr Michael Perusich: Yep.

Troy Fox: 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 face and you get into more of a wellness strategy now, 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. Yeah.

00:10:00

Dr Michael Perusich: And you can't do right now. 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 ChiroHealth USA and Kats Consultants. We're talking about patient retention strategies - we’ll will be right back.

SPONSOR MESSAGE

Dr Michael Perusich: All right everybody. Welcome back to the KC CHIROpulse 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 Troy I think you kind of started down that road when we took our break.

Troy Fox: Mm-hmm

Dr Michael Perusich: And I'm gonna throw one word out. 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 coat on not with our knowledge codon, but we need to walk into that room with our empathy coat on so we listen to the patient.

Troy Fox: And I would add to that put your psychologist hat on over the top of your empathy coat…

Dr Michael Perusich: true

Troy Fox: because you also need to read the patient and figure out where they're at right now. Because some people are gonna 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

Troy Fox: Are very open to what those doctors say, but what I've seen is 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…

Dr Michael Perusich: right

Troy Fox: 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: Yeah, yeah. No, that's exactly right and I can tell you great story about that. I had a pi patient one time. Kind of a young guy and he comes in and we did the evaluation everything and before the end of the first day. He asked me aren't you gonna get me out of pain today? and…

Troy Fox: mmm

Dr Michael Perusich: this kid was literally in seven or eight out of 10 pain neck Med back shoulders low back, he was a mess. And I said, we're gonna do our best but it's gonna take time. I know sooner said that he jumped up out of the chair. He was gonna punch me out. I mean, this is sometimes gonna patient you get walking in the door.

Troy Fox: All right.

Dr Michael Perusich: 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.

Troy Fox: Mm-hmm

Dr Michael Perusich: Yeah, some people closed Some people are gonna come in Mad frustrated with their condition. Some people are going to come in load it for Bear. Some people are gonna come in bringing you cookies. You're gonna 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 not that 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. But 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.

Troy Fox: Yeah, 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 where I had I had a patient that was 92 years old that came in. I already knew we were gonna 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 gonna 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 store. 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 and then get to a porter where I'm ready to do an exam and I have to do it in a way that

Troy Fox: Not looking at the clock, even though 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'd not gonna 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 listen to me.

00:15:00

Troy Fox: That's important and…

Dr Michael Perusich: It's huge.

Troy Fox: 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 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 and…

Dr Michael Perusich: right

Troy Fox: 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 patients coming from you need to understand as well when it's time to actually physically do the exam.

Dr Michael Perusich: That's really true. That's very true. sometimes we get in such a rush we want to cut the tient Letting patients talk oftentimes. Does a couple of things it gives you a ton of information? Is 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 a realization that they can actually go. I understand why I'm here. And when you get the patient to that point, so what patience 20 years ago Troy were information based patients.

Troy Fox: Yeah.

Dr Michael Perusich: 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 kind of 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.

Troy Fox: 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.

Dr Michael Perusich: Yeah, you don't cut off the education. Yeah.

Troy Fox: 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 different phases of care look like and why it's important that they follow through with care. It becomes easy at that point.

Dr Michael Perusich: 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.

Troy Fox: Mm-hmm

Dr Michael Perusich: 's why we're doing it. Here's Wolf's Law in that cool. that's when you bring that stuff to them. what they need to know up front is Can you help me fulfill my need that's…

Troy Fox: right

Dr Michael Perusich: 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. you're taking the braces off and…

Troy Fox: Yeah.

Dr Michael Perusich: giving me the retainer. This is cool. I made progress.

Troy Fox: 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 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.

Dr Michael Perusich: right Sure.

Troy Fox: 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 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 gonna 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 giving him care.

Troy Fox: Are and he chose to do a month time frame 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 conversation was when he told me that I got goosebumps on my arms. I was excited about it.

00:20:00

Dr Michael Perusich: Yeah. …

Troy Fox: So excited…

Dr Michael Perusich: yeah, that's awesome.

Troy Fox: because I made a change in this guy that he thought would never happen. Do you think that guy trust me as a doctor? Absolutely now…

Dr Michael Perusich: Sure.

Troy Fox: if I had a 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 a doctor number one when I haven't really made a big change.

Dr Michael Perusich: It starts to wane after a while.

Troy Fox: 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 a really rock solid way to create retention and…

Dr Michael Perusich: Yeah.

Troy Fox: that's not going to happen with every patient that walks through your door.

Dr Michael Perusich: No, it's not but that should absolutely be a goal. And along with that when you get that patient…

Troy Fox: Mm-hmm

Dr Michael Perusich: who has that miraculous turnaround and gets their life back gets their function back.

Dr Michael Perusich: If you don't put them on a regular care plan and they relapse and that's when they come back and that's all that ever happens is 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 patience experience with you? And so it's imperative that you help the patient understand that hey six or…

Troy Fox: Mm-hmm

Dr Michael Perusich: eight weeks isn't gonna work. Two or…

Troy Fox: Yeah.

Dr Michael Perusich: three weeks is probably where you need to be.

Troy Fox: And sometimes your patients will even tell you that which is great.

Dr Michael Perusich: yeah.

Troy Fox: Once you get into that cycle, 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…

Dr Michael Perusich: Mine, too.

Troy Fox: they fix my cell phone and it works again for two weeks. Then all the sudden I get locked out of everything and I take it back and they fix it again and then two weeks later now the 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 covers falling off in the battery's not doing very well. Am I eventually going to lose faith in that product?

Dr Michael Perusich: Yeah real quick.

Troy Fox: Yeah, so as you think about that, you have to realize that status quo for your patients is 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…

Dr Michael Perusich: Yep.

Troy Fox: 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.

Dr Michael Perusich: Great.

Troy Fox: You have to work with the patient. if the patient just flat refuses and says, 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 gonna get the same results as somebody that's coming in every two to four weeks is gonna get

Dr Michael Perusich: Yeah.

Troy Fox: 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, doc. I think I'm ready to try that monthly thing. You…

Dr Michael Perusich: Yeah.

Troy Fox: I'm right, and then we can wean it down from there. 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: And so you preempted that patient by saying, okay, we'll do it your way but you're not gonna get the results you want and…

Troy Fox: Mm-hmm

Dr Michael Perusich: when you don't get the results you want. This is what I used to tell them. I'll see you two or three times like that. But then about that third time I'm gonna look at and I'm just gonna smile and cross my arms because at that…

Troy Fox: right right

Dr Michael Perusich: if we're not going to do it my way I'm done with you because if we're just gonna 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…

Troy Fox: Yeah.

Dr Michael Perusich: the benefits of making it part of their lifestyle so they can keep doing the things they want to do and that is not repeating the pain Cycles over and over again. boom

Troy Fox: That is a hundred percent true. And that is the bottom line to retention. You have to be willing to put your doctor at on if you want retention.

Dr Michael Perusich: Yep.

Troy Fox: You can no longer allow the patient to self-direct care or ask them what they want to do because …

Dr Michael Perusich: exactly

Troy Fox: what they want to do not come back at all because they're busy and I get it.

Dr Michael Perusich: Yeah.

Troy Fox: 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'm scheduled to go get adjusted that day. And I have to force myself to get in the car and go good adjusted because you know what? I got 18 of the things I need to go do I could pull out of my parking lot and make a right turn instead of a left really easily. But I have to know I want to take care of myself.

00:25:00

Dr Michael Perusich: Sure.

Troy Fox: Your patients have to want it as well. So for them to create a mindset where they want to be in their retention model. They have to buy into the care.

Dr Michael Perusich: Absolutely. And one more thing you've got to get your staff involved in this process too,…

Troy Fox: and that takes you directing them.

Dr Michael Perusich: 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 them hey, I want to see 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? I don't remember what he said. let's just put you down in a couple of months. How would that's gonna begin to degrade that patient experience…

Troy Fox: 

Dr Michael Perusich: because now the patient thinks 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 The same communication in the same style that you do to patients. They should be emulating that. It's super easy.

Troy Fox: Which is really 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 verbs that you're using so that way they start to mimic that verb Bridge because quite frankly docs you guys are the ones in charge in your practice.

Dr Michael Perusich: Yep, absolutely.

Troy Fox: Don't duck your head in the sand and Hope. Staff is able to schedule that patient for their next appointment in a timely manner because that's not Their job is to follow up on…

Dr Michael Perusich: No. It's exactly right be the leader of your practice be the leader of your staff be the leader of your patients.

Troy Fox: what you said.

Troy Fox: We covered about 800 things already.

Dr Michael Perusich: We did.

Troy Fox: I mean literally this a master class and there's so many ways we could go that's a thing.

Dr Michael Perusich: remember

Troy Fox: If you guys listen to our podcast all the time you guys listen and you hear my gosh, there's 80 different directions. They're 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 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 reason as a result,…

Dr Michael Perusich: So we call it practice.

Troy Fox: we're constantly revisiting what I would call these Hallmarks or these points in this master class. It's like looking up into the sky and seeing the Stars. There's a lot of points up there, right?

Troy Fox: It's the same thing in practice, but you will come close to Mastery on a bunch. It's like juggling balls, I guess and every once in all you're gonna drop a ball. You got to pick it back up and throw it back and play. So that's how retention is by a whole bunch of good processes in your office. Just like we just talked about today.

Dr Michael Perusich: Absolutely, 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 a Kats Consultants. We help doctors improve the 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 Kats Consultants.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.

Troy Fox:  See ya!

Meeting ended after 00:28:43 👋