Dear Bill | Convincing Patients to Continue

Posted by Bill Esteb on Jan 19th 2021

Dear Bill,

I'd like to know what you've found to be the best way to motivate patients about the need for continued care. Is it sEMG, palpation findings, post X-rays, posture pictures, ROM studies, symptom surveys or functional questionnaires? What resonates best with practice members?




I don't think it works that way. I have a different explanation about what might persuade patients to continue their care beyond symptomatic improvement.

It's tempting to imagine that a properly worded message, along with the most helpful supporting objective evidence, is all it takes. But this assumes that patients are rationale creatures on a quest for optimal health.

Probably more important than the technology you use to justify continued care, is the way in which chiropractic is framed:

  • Not better than, but different from, medicine
  • It's based on nervous system integrity—not the presence of symptoms
  • It advances true health (function) rather than treating symptoms
  • Their problem is unlike an infection or other self-resolving health issue
  • A relapse is likely if they discontinue care upon cessation of symptoms
  • Patients use chiropractic care for relief, correction, prevention or wellness

That said, I think there are four circumstance in which a patient is most likely to opt for continued care:

Feel the need – Patients who are in touch with their body and who can detect subtle changes, are more likely to see the value of ongoing care. They know themselves well enough to choose some type of continuing supportive care. Objective proof from some type of assessment may be helpful, however the real motive is being able to sense when they need to be adjusted.

Series of relapses – In this scenario a patient learns of the value of ongoing care and that they have a problem that can't be fixed, but merely supported. The patient disengages from the practice without guilt or shame and feels comfortable returning. And does. This may be repeated over many years before the patient “gets it.” Or, quoting a patient in a focus group who observed, "It occurred to me that if I kept coming in, my headaches wouldn't keep coming back." This realization came after several episodes of care spanning seven years.

Health is a key value
– Those who place health and well-being in their top 10 values are often good candidates for ongoing chiropractic care. This is my story. In other words, it wasn't that a compelling case was made. (Although it was!) Rather, I was predisposed to using chiropractic to advance something I already thought valuable. Such individuals do many things to advance and support their health. (I also religiously floss my teeth.) Problem is, most people who are health conscious see chiropractors as back doctors. So, without a back problem, they rarely include them as part of their strategy.

Passionate leadership – From time to time I encounter chiropractors who have a special something about them that causes patients to “risk” breaking social convention and continue receiving care as a long-term lifestyle adjunct. These chiropractors have selected one or more of the assessments you listed that resonates with them, giving them high levels of confidence and certainty that in turn inspires patients.

In other words, it would be helpful to follow a formula or recipe that would create a wellness patient. Over the course of 40-years I haven't seen that. Instead, patients continue care for their reason(s), not the practitioner's. 

The short answer? Use the resource that gives you the greatest confidence.

Hope that helps.

Thanks for the question!

Email Bill with your question.

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