When my high school sweetheart broke up with me way back when, I thought the world was ending. I’m embarrassed to say there were tears and gnashing of teeth.

I’m over it now, but it’s what many patients imagine when they contemplate breaking up with you.

Not necessarily the theatrics, but since you seem to care about their health so much, they can easily imagine your desperate attempts to talk them out of discontinuing care.

Awkward, to say the least.

Some patients solve this dilemma by making future appointments they don’t intend to keep. Prompting your staff to leave unreturned voice messages. Eventually the breakup is officially acknowledged.

Tragic, because at the very moment everyone should be in a celebratory mood, the relationship ends with deception and evasion.

All this, because you lack a consistent “goodbye procedure.”

You have your “hello” procedure down cold. But have overlooked the disengagement process?

Without a goodbye procedure, you force patients to invent their own.

Their clumsy version produces enough shame to avoid you in the grocery store and other public places. Not surprisingly, when their health issue returns, as it so often does when care is discontinued immediately upon cessation of symptoms, they feel uncomfortable returning to your practice due to their imagined “I told you so.”

It’s enough to cause many patients to restart care elsewhere. Or give up on chiropractic claiming, “I tried chiropractic but it didn’t work.”

An effective goodbye procedure is designed to avoid the patient’s care from ending—without being complete. An important distinction. Plus, it sets the stage for a subsequent reactivation while unleashing another delighted chiropractic ambassador into your community.

“So, Bill, what’s involved in such a procedure? And how do I know when to administer it?”

That’s the challenge, isn’t it?

Unlike what you might expect, a goodbye procedure isn’t implemented at the end of a patient’s care. It’s done at the beginning!

You can append it to your report of findings or devote an early visit (maybe the fourth or fifth?) to your goodbye procedure.

Our popular Road to Recovery wall chart and take-home handout is designed for this purpose and incorporates the essential scripting. However, if you’re going to implement a goodbye procedure without this visual aid, you might say something like this:

“We have many patients who enjoy nonsymptomatic wellness and preventative care, seeing us anywhere from once a week to once the month. They do so to help them stay well after they get well. If that’s not you, no problem. Let me explain the best way to conclude your care with us. It’s a very simple procedure. Are you ready?

“Okay.”

“When you’ve had enough chiropractic, just tell me. I promise I won’t try to talk you out of your decision. Instead, you and I will celebrate your success, close your case file properly, archive your records should you ever need us in the future, and send you on your way with our blessings.

“How does that sound?”

By the way, you’re not “allowing” them to discontinue their care. They already have that right.

And you’re not “approving” of their decision to end their care. You’re simply acknowledging that they control follow through.

And you’re not creating a “self-fulfilling prophecy.” Count the number of inactives with whom you never explained how to say goodbye and you’ll notice that many, if not most of them, discontinued care without a mention from you. Clearly, patients leave without a goodbye procedure.

Instead, what you’re doing is eliminating the unease and, well, patient lying, that often accompanies the conclusion of their care. Not to mention the waste of staff resources used in an attempt to track down wayward patients who decided not to share their intention.

The handful of visits you may miss because patients don’t feel pressured or obligated, will be more than made up in the increased number of reactivations and referrals—not to mention the goodwill you create in the process.

(We lean into this topic big time during Week 21 of the 40-week HeadSpace Coaching program.)

Bill Esteb, a passionate chiropractic advocate since 1981, brings a fresh perspective to the profession as Patient Media’s creative director and co-founder of Perfect Patients. With 12 insightful books examining the doctor-patient relationship, he inspires chiropractors worldwide as a chiropractic speaker, through HeadSpace Coaching, and consulting. His weekly Monday Morning Motivation, emailed to over 10,000 subscribers since 1999, continues to spark breakthroughs across the chiropractic community.

Email Bill