A rash of patients mentioning they can’t continue because they can’t afford it may prompt you to think that lowering your fees or making one-off financial arrangements is needed.

Careful.

Their “I can’t afford it” may have little to do with their checking account balance. Instead, it might mean:

I value other things – Their nails, Caribbean cruise, country club membership or luxury car payments may be more valuable to them than their health.

My self-esteem isn’t worth the investment – Perhaps spending their limited resources on themselves, especially after obtaining relief, is a selfish or extravagant indulgence.

I need a reason to quit – Using a financial excuse is the perfect get out of jail free card that can be played without fear of an imagined guilt trip or awkward negotiation.

Those who wish to avoid confrontation or letting you down simply make appointments they have no intention of keeping.

Problem solved.

Bill Esteb has been a chiropractic patient and advocate since 1981. He is the creative director of Patient Media and the co-founder of Perfect Patients. He’s been a regular speaker at chiropractic gatherings since 1985. His 12 books explore the doctor/patient relationship from a patient's point of view. His chiropractic blog, coaching program, patient focus groups and consulting calls have helped hundreds of chiropractors around the world. Since 1999 Monday Morning Motivation has been emailed to over 10,000 subscribers each week.