For over three decades I’ve been an advocate of a two-visit new patient intake procedure. I’m sure it's familiar.
On the first visit the new patient completes the chiropractic intake form, watches an orientation video, has a consultation with the chiropractor, followed by an examination, instruction on some home care procedures and then dismissed.
The second visit consists of still another video to prepare patients for their report of findings, followed by the report and then their first adjustment. There are variations, but that’s the general idea. In fact, this two-visit protocol is taught by many of the management and chiropractic coaching organizations.
Is it time to rethink this procedure? Might it be no longer necessary? Or worse, could it be creating needless new patient friction?
But first, a confession.
Since I’m not a chiropractor with personal experience to test the outcome of either procedure, I’m only left with anecdotal data. Among other things, what I’ve discovered over the years is that chiropractors who use a two-visit procedure tend to have higher patient visit averages (PVAs) than those who use a one-visit procedure. In other words, chiropractors who adjusted patients on the second visit tended to see patients for a greater number of visits than those who adjusted on the first visit.
That was enough for me. Then, two-visits it is!
But it got me thinking recently. Was it the procedure that produced the greater PVA? Or was it the confidence and drop-dead certainty necessary to implement a two-visit procedure that produced the longer patient relationships? Perhaps the difference was just one more example of it being “the who, not the do.”
It seems that in many patient encounters, withholding the adjustment to a subsequent visit not only disappoints patients, but it’s, well, manipulative; almost a way of teasing patients and displaying a chiropractor’s power. (So much for creating a collaborative relationship.)
Getting adjusted shouldn’t require a waiting period like buying a gun!
I know. The two-visit procedure is often sold as a way to avoid overloading a new patient with too much information. But that doesn’t hold much water these days with the proliferation of the Internet and the public’s voracious appetite for consuming content demonstrated by the popularity of the iPad. Maybe you had to “protect” patients from information overload 10 years ago, but that seems unlikely today.
And it’s not as though chiropractors need a day or two to ponder the case or consult with colleagues to determine how they’re going to approach each new case!
Even more profound, how about accepting the fact that most patients drag their allopathic mindset with them as they begin chiropractic care. Withholding the adjustment in the hopes that they won’t think you’re treating their symptoms is absurd. Postponing the adjustment does NOT alter their worldview. If only it were that easy! Instead, it simply delays their recovery and annoys the patient.
Last time I checked, practices using a two-visit new patient procedure have about as many inactive patient file folders as those using a one-visit new patient procedure.
But before I officially abandon the two-visit model, maybe I’ve overlooked something. Is it time to rethink the two-visit procedure? Has it outlived whatever usefulness it originally had? Is it merely a vestige from another era? Please share your insights!