Monday Morning Motivation | The Strongest Story Wins

Posted by Bill Esteb on May 11th 2024

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Let’s say you want to grow your practice. You determine that helping 15% to 20% more patients than you do currently, would permit you to reach your financial goals and have greater margin in your life.

So, you implement a couple of well-known strategies. And behold, the numbers start rising. Then peak. And eventually return to the previous set point.

It’s so common it’s practically a cliché.

Why? Often because the increased patient volume conflicts with one or more of the “stories” you (or your team) have created. When the numbers ticked up, somebody unconsciously tapped the brakes until the patient numbers were congruent with the governing story.

A common culprit? The story about patients waiting. As in patients waiting equals bad.

If you’re going to help more people, there’s bound to be waiting. Is your story about avoiding patients waiting stronger than about wanting to help more people?

Simply put, if your practice is up to something, there will be waiting. Count on it. Naturally, you’ll want to minimize it, but it’s virtually impossible to avoid.

Other than the patients for whom chatting in your reception room with other patients is the social highlight of their day, most patients would prefer not to wait.

Which is one reason for implementing appointment times.

Appointments turn your front desk into the likes of an air traffic controller, focusing on a perfectly spaced schedule with the objective of reducing waiting, avoiding downtime, and creating some illusory notion of being in control.

This places an inordinate emphasis on scheduling, taking energy away from other activities.

But consider this: we wait for things we want.

We wait at Disney World. We wait for the new iPhone. We wait for a table at a popular restaurant. We wait at the Dairy Queen on a sticky Sunday afternoon.

Is the aversion to patients waiting actually the fear that if patients experience any sort of inconvenience they might abandon their care? I hope your relationships aren't that fragile.

I’m certain some patients have used waiting as an excuse to end their care. But it was merely the most convenient. Especially, if you have the habit of promising specific appointment times which aren't consistently honored.

When you make an unkept promise, for any number of perfectly legitimate reasons, you’ve compromised one of your most valuable assets: trust.

A full reception room is a signal you offer something people want!

Granted, there will there be an occasional patient who does an about face upon entering a crowded reception room. Or counted the cars in your parking lot and just kept driving. I’ve done that. They may have budgeted a half hour, but by the looks of things it's likely to be considerably longer.

So, they return to their busy life. Are they angry with you? Not really. In fact, they’re more likely to congratulate themselves for having chosen such a popular, in-demand chiropractor.

If your practice aspirations are more modest, and you simply want a boutique with a modest schedule that avoids anyone waiting, no problem. Or if your technique is especially time-consuming, metering out patient arrivals makes perfect sense.

But if you’re up to something and seek to help more people, count on some waiting.

But could there a deeper issue?

Are setting appointments a sign of patient mistrust? An attempt to control? A convenient way to "take roll?" A way to enforce some accountability?

Find out. Become more present to the language you use when making care recommendations. Do you tend to say something like, “I need to see you three times a week for the next four weeks”?

Do you see the mistrust part?

It’s the “I need to see you...”

Just why do you need to see them? Boat payment? Statistical goal? Protect your reputation? Exercise some type of social authority?

When you trust patients to show up for their reasons and not simply complying with yours, it might sound something like, “You’ll want to get in here three times next week.” Or “To get the fastest results in the shortest amount of time, I recommend three visits a week for the first four weeks, and then a reevaluation.”

Rather than a parent, you're showing up as a partner, a guide; it’s an entirely different energy.

Naturally, you’ll still want to set appointments for the first visit or two, as well as progress exams, that sort of thing.

And you’ll still make your three-times-a-week recommendations, or whatever you do. The difference is you won’t be assigning specific appointment times, just days of the week.

“Now that you get the hang of how our practice works, we won’t be assigning specific appointment times—just the days of the week you’ll want to see us.

“We’ve found it works better when each patient sets the time of day that works best for them and their schedule.

“If you can come in during our off-peak hours, when we’re less busy, your wait times will be shorter than say, at five o’clock when everyone is getting off work and coming in. And if you can't make your visit, we would appreciate a call so we can reschedule as soon as possible."


Only for the first week or so.

Obviously, your front desk is still tracking no shows. Now, if you’re doing a lot of personal injury work, having a light touch in the appointment setting department may not be practical.

No matter. The point isn’t about eschewing appointments, but merely to provide a likely explanation why so many practice building strategies often don't last due to conflicting stories. The result is often an exhausting, dispiriting isometric practice accompanied by frustration and resignation.

Competing stories are so common, it’s something we explore throughout the 40-week HeadSpace Coaching program.

Patients waiting in the reception room is sooooo much better if it’s a choice rather than due to a broken promise. And by the way, most of us in the reception room are quite content catching up on our phones. The wait is actually a welcome respite!

Bill Esteb Headshot Photo

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.