Do patients say goodbye?
Saying goodbye is a social signal sent when one party leaves another. You do it all the time with friends and relatives. But if patients don't say goodbye on their last visit it could mean several things:
1) They're afraid you'll collapse into a weepy puddle.
2) They're fearful you'll try to talk them out of their nonnegotiable decision.
You create these imagined patient reactions by how you reveal your attachment to what they do. Maybe you seem more interested in their health than they are. Maybe you make them ashamed because they lack the discipline or interest in prioritizing their health as you do.
By making a patient feel small or having such a pedestrian goal as merely feeling better, you make it emotionally unsafe for them to announce their last visit. The result? It obstructs reactivations by imagining your "I-told-you-so" scolding should they return.