Dear Bill | Patient Retention

Posted by Bill Esteb on Dec 1st 2019

If the priority a patient places on his or her health is beyond the control chiropractors (including successful ones), what is the difference between doctors who have a low retention (low PVA) and those who have a high PVA? Somehow the high retention docs are being or doing something different. What have you observed that quality to be, and doesn't this suggest that we DO in fact have an influence over patient’s priorities?


Great observation. But there’s a critical distinction between changing the priority a patient places on his or her health and chiropractors who enjoy a high patient visit average. There isn’t a direct correlation.

First, the difference between chiropractors with high PVA and low PVA. Chiropractors who enjoy high patient visit averages share many of the following characteristics. They...

  • Show up as a servant and respect the free-will agency of the patient
  • Avoid the temptation to shame patients into care they don’t want.
  • Project certainty about the value of a chiropractic lifestyle.
  • Make chiropractic about nervous system integrity, not bones.
  • Communicate the whole body effects of nerve interference.
  • Enjoy high levels of reactivations and referrals.

What appears to be the ability to change a patient’s priority about their health is actually the difference between power and force.

Power: having a long-term vision while inspiring patients. Helping them get what they want and being healthy enough to avoid emotional attachment to what they do or don’t do.

Force: using manipulative techniques, scare tactics or financial inducements to get patients to do the “right thing,” while justifying them as being in the patient’s best interests.

In other words, chiropractors with high PVA have a light touch, tempered with certainty. They think long term and are not invested in the choices patients make.

As for the influence that a chiropractor has to affect the way a patient values his or her health, it can be significant. But not the way many think.

It requires an authentic curiosity about a patient’s beliefs, experiences and opinions about health issues. By demonstrating interest in the patient’s worldview it’s possible to provoke paradigm-shifting conversations. But it must be done respectfully. You must be invited in. Force-feeding (non-consensual table talk) your philosophy onto patients is egotistic, parental and rarely effective. Ask questions rather than make declarations. Try being a bit coy.

Thanks for the question!

Bill

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