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Virgins, Reluctants and Prodigals

prodigal.jpgI’m preparing my presentation for the Masters Circle New Patient seminar in Santa Clara later in March. This is a new talk and it addresses the topic of new patients in a way that I haven’t seen others touch. Anyway, while putting my PowerPoint together, I became present to a rarely mentioned bias I’ve noticed among chiropractors. From what I can see, there is a “pecking order” to the desirability of certain new patients!

Now, if you’re suffering from what appears to be a new patient shortage, and you’re anxious to help anyone with a spine, warmer than room temperature, this may be difficult to accept. But there seems to be different “classes” of new patients. With some being more valuable or sought-after than others.

Set aside for the moment how these patients pay for their care or their willingness to follow your instructions. Instead, consider their experience with chiropractic:

The Chiropractic Virgin. Clearly, the most coveted patient is the one who has never had a previous chiropractic experience. Not only are there few habits to break (other than the one’s learned at the hands of medical doctors), Chiropractic Virgins are the most forgiving. They’ll more willingly put up with your 45-minute report of findings and, with no one else to compare you with, assume your explanation (and delivery) of chiropractic is chiropractic. These new chiropractic conquests, while the most coveted, rarely, if ever, embrace chiropractic as a lifestyle decision. Yet, most chiropractors overlook this little detail about “first-timers,” searching for the magic words or special procedures that will somehow override a lifetime of symptom treating and seeing chiropractic as a short-term “diet” of natural pain relief.

The Reluctant Convert. Almost as juicy as the Chiropractic Virgin, these patients are esteemed for a different reason. Not because they are returning for another episode of chiropractic care, but because they have given up on their previous chiropractor. How delicious! Usually, the patient has chosen not to return to their former chiropractor because of the tactics used when they wanted to discontinue their care. Reluctant Converts are valued not because of their allegiance to chiropractic principles, but that by rejecting their former chiropractor in favor of you, is interpreted as proof of your superiority over your colleague down the street. While Reluctant Converts are better prepared to withstand the “squeeze” to embrace lifetime care, it can still be off-putting; practically insuring the relationship will be something of a one-night stand, even though this time around, it may take several weeks or more of care to reduce their symptoms.

The Prodigal Patient. While ostensibly the least desirable within certain chiropractic circles, the reactivated patient is the most important of all. The Prodigal Patient is someone you have seen in the past, who, because you didn’t make them feel like they were “letting you down” when they previously tried to extricate themselves from care, feel safe in returning without fear of an “I-told-you-so” from you. Good job! Now you get another opportunity to explain that chiropractic care can be used as treatment for aches and pains, as well as a healthy habit and lifestyle decision. Great! Maybe after three or four starts and stops with the former intent, they will come to realize the wisdom of the latter. And maybe not. Who knows?

If you want a true practice rather than a stressful new patient “promotion,” referrals and reactivations are the key. This is often overlooked by the gleeful one-upsmanship that many chiropractors exhibit as they “trade” patients amongst the other practitioners in town.

It’s so counter-intuitive, but it turns out that the easier you make it for a patient to discontinue care, the easier you make it for them to resume their care—with you. Sure, you have a professional and moral obligation to outline the optimum care plan. But the free will choice to follow or ignore your recommendations is the privilege of every patient, regardless of whether they’re Chiropractic Virgins, Reluctant Converts or Prodigal Patients. Help enough Prodigal Patients return and you won’t have the room (or the need) for Virgins.

Comments (4)

So true Bill. I look forward to your posts every Monday.

Greg Kelley D.C.:

"...the easier you make it for a patient to discontinue care, the easier you make it for them to resume their care". I hadn't thought of a patient dropping out of care in this way, counter-intuitive and so right on. Easy come, easy go, easy come, easy go ... till they stay!

Mithra Green:

I LOVED!! this posting! In the past when patients dropped out of care I never saw them again for the very reasons you describe.(Guilt, shame, hard sell) Using your hallucination of a perfect practice I almost look foward to their first drop out, because when they come back (and come back they do) the relationship is on a different level. They know I can help and they seem to grasp more what chiropractic is. Since they're not keeping one eye on the exit door, they can focus more on what chiropractic can offer. Thank you again Bill for all you do.

Tony Russo:

Well Bill,
That describes my practice to a tee. Call me lazy, but I don't necessarily want Virgins"... possibly... per se. What a delight it is to have patients who haven't been in my office since I moved five years ago. My longest is a 9-year reactivation. It's so much less work. And all because I followed your advice: "Give them a safe place to fail." There is nary an ounce of guilt in them when they return. Good practices grow slowly enough as it is. At least with this advice they grow steadily and avoid this roller coaster we all fear so much.

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From February 28, 2008 9:03 AM

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