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Dear Bill | Making Up Missed Appointments

Posted by Bill Esteb on Jan 6th 2023

Dear Bill

I was taught that when patients miss a visit, they need to make it up to stay on track. Will you share your perspective on this?




This is a relic left over from the practice management advice ladled out so generously during the Mercedes 80s. I thought it had passed into oblivion. Where it belongs.

You can no more "make up a visit" than you can make up forgetting to brush your teeth yesterday. The opportunity has come and gone.

Even if the visit includes the adjustment and specifically targeted traction, precisely chosen unilateral maneuvers, or special stretches aimed at strengthening atrophied supporting muscles, I can't see how you can "make it up."

For this threat to work, and that's what it is, you need a patient allergic to critical thinking and happy to mindlessly turn responsibility for their health over to you.

It would be far more intellectually honest to say…

"Since each visit builds on the ones before, if you miss a visit, you may lose some of the momentum necessary to make spinal changes."

Or

"If you miss a visit, it's likely to interfere with the process of establishing new, healthier spinal patterns."

Or

"Like skipping a workout at the gym, if you miss a visit, it can delay the strengthening of the muscles supporting your spine, prolonging your recovery."

All three approaches are truthful, rational and respectful.

If your daughter missed the math test because of an absence, well yes, she can "make it up" by taking it upon her return. But you can't "make up" the sunset you missed yesterday. Or the adjustment you missed last week.

Granted, if patients miss their appointments because they're out of town, they may very well need to temporarily increase the frequency of their visits upon their return to get back to their pre-vacation status. But they're not making anything up.

Thanks for the question!

Email Bill with your question.

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