Beating the House

Virtually every new patient has heard the old saw, “Once you go to a chiropractor, you have to go for the rest of your life.” And many chiropractors, especially those who see the highest and best use of chiropractic as a life-long adjunct to optimum health, overlook or ignore addressing this issue with a new patient.

Big mistake.

“Since the chiropractor hasn’t mentioned it, it must be true,” surmises the patient.

That’s when many unhealthy patient behaviors are actually created as patients go about the business of planning how they are going to “beat the house.” In other words, get the chiropractic that they want (symptomatic relief), without getting the lifelong care their chiropractor wants for them.

It takes two to tango, so let’s explore both sides of this communication dysfunction.
Turns out, patients don’t have to do anything.

Since you’re enlightened, you can appreciate the benefits of some type of ongoing chiropractic care for life. It helps that you can get your own chiropractic care without having to take money out of circulation to get it. My guess is that if chiropractors actually paid for their chiropractic care, they would more likely see why neglecting to neutralize this urban myth is so damaging to their patient relationships.

When chiropractors rely on this widespread belief about having to see a chiropractor for life as a way to get patients to follow through and embrace chiropractic as a lifestyle decision, they set a trap. For themselves. A trap that needlessly poisons their patient relationships and creates a never-ending need for still more new patients. Since this trap isn’t sprung until many weeks or months later, many chiropractors fail to see that neglecting this issue is one reason why their patient relationships end so badly.

If you make it difficult for patients to get the chiropractic care they want, the way they want it, you practically insure that you’ll never hear these words:

“Today is my last visit and I just want to thank you for the great care you’ve given me. Should I or anyone I know need a chiropractor, I’m going to send them your way.”

This is how a healthy chiropractor/patient relationship might end. Instead, most chiropractors are convinced that their persuasive report, compelling table-side manner, and the patient’s miraculous recovery have conspired to “seal-in” the patient for life. Why any chiropractor would think this as the growing numbers of inactive patient file folders create a storage problem is beyond me.

Instead, patients plan their escape. You (or more likely your CA) may recognize this common technique: almost perfect compliance with your care recommendations, until they feel better. Then it’s a few missed appointments and reschedules, followed by an inability to reach the patient by any other means other than leaving an awkward voice mail.

What makes the wasted energy exerted by the staff to track down wayward patients so tragic is that you created it. Your attempts to get patients to do something they don’t want to do, combined with not neutralizing the lifetime myth, plus failing to acknowledge your powerlessness, produce this predictable patient response.

Why are patients reluctant to announce their last visit? Because of the two possible responses they imagine that their thank you and goodbye will produce:

1. The chiropractor melts into a weepy puddle of despair and loss, or

2. The chiropractor attempts to talk the patient out of their decision

As patients contemplate which response they’ll get, both of which they assume will be accompanied by large doses of guilt and shame, followed by embarrassment, they decide it’s best to simply make and break appointments until somebody (usually your CA) gets the idea that they’ve not coming back. And breaks the news to you.

It gets worse.

Since they discontinued their care as soon as they felt better (the allopathic model they’ve known their whole life), they are predisposed to a relapse. When it occurs, they have quandary. On one hand, they’d prefer to return to the familiarity of your practice, but besides the “I-told-you-so” they imagine they’ll hear from you, they’re still smarting from how they disappointed you when they discontinued their care.

Do I return? Do I consult another chiropractor? Do I try massage or acupuncture instead?
All this because you forgot to talk about the 800 lb. gorilla in the consultation room. So, how about something like this towards the end of your consultation or report of findings:

“Oh, one last thing. Have you heard the one about, ‘Once-you-go-to-a-chiropractor-you-have-to-go-for-the-rest-of-your-life?’ I just want you to know that it’s not true. You don’t have to do anything. Now, there are some things you can do to speed your recovery and help avoid a relapse, but how long you decide to benefit from chiropractic care is always up to you. You’re the boss. After all, it’s your body and your health. So, when you’ve had enough chiropractic care, I hope you’ll let me know so we can celebrate your results, close your case file, and send you on your way.”

Lighten up. Think long term. Aim for more reactivations. Stop trying to control something (patient behavior) that you are powerless to control. It’s unattractive, it’s counterproductive, and it hinders reactivations and referrals.

Originally posted October 21, 2010