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The Sure Fire Way To Cut Attrition In Half

By: Shawn Veltman

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Who's more likely to be in for an appointment within the next month - A patient who's last appointment was yesterday, or a patient who's last appointment was 6 years ago?
It's a stupid question, right?
The answer (and the point) is obvious - The patient who was in more recently, will be most likely to come back.

In fact, it's SUCH an obvious point, that almost all practice owners overlook the importance of it - which is extremely costly, both in monetary terms, as well as in terms of patients lost.
Okay ... So why is this obvious point so important?
Because it's a VITAL factor in one of the most impactful and important marketing activities your practice can engage in – Patient Re-Activation and Patient Retention.
They’re both incredibly powerful strategies. Most consultants and “experts” spend a LOT of time talking about patient re-activation, and for good reason. It’s one of the absolute best ways you can spend your marketing energies.
But they also spend a LOT of time in this area because in truth, it’s pretty easy to track. After all, it’s easy to show you how many patients I brought back – but it’s MUCH harder to show you how many patients I helped you keep from leaving in the first place.
When I talk to clients of mine, most of them show a very clear understanding of the importance of patient re-activation, but they understand that there’s a more powerful strategy.
In fact, when talking about patient re-activation, you may have a similar understanding…
"I don't want to have to RE-activate my patients! I don't want them to be leaving in the first place!"
Ah, that's a fantastic point!
So, let me ask you a vital question. What systems do you have in place to let you know when a patient is getting ready to stop seeing you altogether?
And what systems do you have in place to try to bring them back in?
When I ask these questions of new clients (to help them set up just such systems), I often get a blank look ... Then an explanation that it's impossible to set up a system that lets you know when a patient's not going to continue treatment.
"After all, they just never book another appointment - so how can you tell that's going to happen in advance? How can you tell when a patients’ LAST appointment is?"
“Okay, wise guy - so how DO you set it up?”
Once again, I'll answer with a question. How can you be sure that the patient you JUST treated is still active? In other words, how can you be sure they'll come back for their next appointment?
The answer, of course, is that you can't.
What you DO know, through years of experience, is that they’re LIKELY to come back.
We can continue asking this question - How do you know the patient you last saw yesterday is still active?
5 days ago?
30 days ago?
90 days ago?
Yes, I tried to trick you there. 90 days since the last visit almost certainly means inactive.
So now we get to the really hard question...
How many days can go by between appointments without a patient being considered inactive?
When I ask this question of new clients, they often look at me like I'm dumb. Then they very patiently explain to me "Well, you can't say. There are too many variables. Just because John Smith is inactive after 20 days, doesn't necessarily mean Jane Doe is."
Of course, like any good TV lawyer, I know the answer before I ask this question. And, in fairness, my clients have it half right.
Because the answer is...
"It depends."
But the half they get wrong is that in almost all cases (certainly enough for us to set up a reliable & very effective system), the ONLY thing that it depends on is how many visits the patient has had.
Our old friend modeling
As you may or may not know, I'm a big fan of using models of individual practices to figure out the best ways to create practice growth.
In the case of patient retention, one of the models we can create is a visit by visit analysis of just how long can go by between visits while patients remain active.
I'm sure you already have an intuitive understanding of this. After all, you know that all things being equal, a patient will come in for their 2nd visit much more quickly than a patient will come in for their 35th visit.
In other words, on average, your patients may have only 4 days pass between visit 1 & 2, while they may have 12 days pass between visit 34 and 35.
Now, I want to get this off my chest right here - I don't trust averages. They can hide a lot more than they show, in many cases (After all, if you have 500 patients who are 20 years old, and 500 patients who are 60, the average age is 40. But that tells you nothing about your REAL patients.)
So I recommend you don't work on a model of "average days between visits." Instead, it's much more useful to look at cumulative totals.
In other words - How many patients have their 4th visit within 1 day of the 3rd visit?
Within 2 days?
Within 10 days?
Within 100 days?
(Hint: That last one will be VERY close to 100%!!)
The 90% method
I have a lot of my clients adopt what I call the 90% method. Simply stated, when you find the point where 90% of your patients have already had their next visit, you set that as the point where you start actively pursuing patient retention.
For example - Let's say that we generate the model for your practice, and it shows that 90% of ALL of your patients let no more than 35 days pass between their 19th and 20th visit.

The 90% method says that when a patient has 19 visits, AND more than 35 days since their last visit, you should be actively getting in touch and trying to bring them back in - because if you don't, there's a 90% chance that they'll NEVER come back in.
Making it work
At the very start of the article, I asked an obvious question, with an obvious answer. Of COURSE the patient who was in most recently, is most likely to be an active patient, and not need you extend any "retention" efforts - In fact, any efforts extended to active patients will at best be useless, and at worst become annoying.
The 90% method lets you know WHEN you should start making active retention efforts.
Yes, it does differ based on how many visits your patients have had. Yes, you can make it extremely specific. In fact, the more specific, the better. That’s why I often set my clients up with a visit-by-visit breakdown, and create systems that automatically flag patients who are crossing the "90% threshold."
Obviously, the more finely detailed the model & your systems are, the better the results will be. However you decide to do it, though, I urge you - Ask yourself which patients you should be contacting, and when. Then start doing it!
It will be the absolute highest return on any time, effort, or energy you can spend on marketing and practice growth, and it will DRASTICALLY reduce the number of patients that “slip through the cracks.”
Want to learn more?
Cutting Attrition is one of the many strategies covered in Real World Growth Strategies for Your Practice – an exciting new marketing program for Chiropractors. To find out more, call Scott at: 905-963-3771, or e-mail info@svachiro.com
Did you find this useful?
Why not send it on to friends and colleagues and share the knowledge with others. Alternatively you can reprint these tips in your own website or newsletter, but please include the following information:
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Shawn Veltman is a marketing consultant and the creator
of the highly acclaimed ‘Real World Growth Strategies’ program
for Chiropractors. To find out more, e-mail info@svachiro.com
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