I hate it when great clinicians unwittingly lose patients in Private Practice.
Don’t let this happen to you.
You may have heard that in the world of business it takes far more time, effort, and money to get a sale from a new customer than it does to get a sale from a previous customer.
Now before you think I'm some money grabbing kind of treacherous doctor, what I'm about to say to you is that this is exactly what we should be doing for our patients, because it's about good clinical Practice.
When I’m working with Ninja clients, I ask them about their patient numbers.
“Do you know how many patients you saw in clinic last week?”
“Do you know how many of them were initial, first-time patients?”
“How many of them were follow-up patients?”
“What is the ratio of initial patients you typically see each week, versus the number of follow up patients?”
In my own practice, I’ll typically see a patient for an initial consultation, and then I'd expect to see them again three or four times. Your figures may be different in your Private Practice. Nevertheless, I’d expect you to have a trend.
The trouble is, if we don't have a feel for what those numbers are like (and there always will be some outliers) we don't really know whether or not we are losing patients. That's a problem when we are trying to grow a Private Practice.
By the way, this is a very good reason for having practice management software; you can't pull these numbers from paper easily.
When patients aren't returning to see a clinician, there is always a reason.
It might be a ‘real reason’. For example, they died (eek), they were made redundant and lost their insurance, they moved abroad, or maybe they’ve not yet had the surgery that they initially came to see you about.
But often there is another reason…
The other reason is our fault. It comes down to the simply ensuring that patients to book in again.
Let's unpack that a bit…
Have you ever found yourself saying to a patient…
“Do you know what? Let's see how it goes.”
“Come back and see me if there are any problems.”
“You're doing okay. Come back if you're worried.”
Is it really the patient who should be deciding when they come back?
Now, I'm all about a patient centred approach, but patients, on the whole, are not the best people to decide whether or not they are progressing well or if they are progressing fast enough. That's our job. That's why they come to see us. We’re the experts.
If you've got a patient that is likely to need a few follow-ups, (and let's face it I can't think of a single patient who was ‘mended' with one physiotherapy appointment), we need to plan that out with the patient. Even if the patient knows they need to be coming back, we need to ‘safety net' that process.
Sometimes the patient might say…
“Well, I don't have my diary with me.”
These days, most of us have smartphones or smartwatches, but occasionally the patient genuinely doesn't know what's in their work diary. They have to go back to work to check when they can be free. Here’s where it breaks down.
Don't leave it to the patient to remember to ring in and book another appointment.
Coax them back, even if it takes a little effort. Yes, it might take a phone call from your secretary or an email from you, but don't let patients slip through the net just because you can’t be bothered with the admin.
Patients who aren't being followed up sometimes become unhappy patients. You might bump into them six months later, and they say…
“I went to see another consultant because I wasn't any better!”
You might find yourself saying…
“But you didn't come back and see me.” “If you'd come back and seen me, we would have done X, Y, or Z after that.”
These are lost words. Don’t be dumped by the patient because you didn’t ensure they were looked after.
Map out in advance ‘the journey'.
Let’s imagine you’re helping somebody postoperatively with their rehab.
Make it very clear to them that you’ll be taking them on a journey whereby you are going to need to see them once a week, for a month. Then maybe once a fortnight after that. You would expect that they are going to hit certain progression milestones, and if they’re not making that progress at such and such a point, you will suggest switching to plan B.
Patients feel cared for when they know you know what’s expected for their recovery, and you could perhaps tell the patient, “Please book in for your next four clinic appointments because we're in the first phase of your ACL reconstruction rehab journey”.
Remember: It's very important to have the journey written down.
This is why I always advocate sending patients a very detailed letter after your first consultation with them, to get their commitment buy-in. If you’re not already doing this, learn to dictate and get this transcribed – it’s by far the best use of your time.
Feeling unsure about how predictable things might be?
Remember you’re an experienced clinician. You can make a pretty good guess of how things are going to unfold for a patient and the kind of milestones you expect them to achieve.
It’s all about better medicine. You get buy-in from the patient and everyone's really clear about their commitment to the process.
What kind of mechanism can you use for knowing if a patient hasn't booked back in again?
Hopefully, you have practice management software system that allows you to flag a patient, but I also look back in the diary a fortnight earlier and think to myself…
Who should have been coming back to clinic?
Who should have had an MRI?
Who should I now have seen post-MRI?
Yep, it it’s up to me to sometimes ping my secretary a little message saying, “Oh, has Joe Boggs booked back again? If not, what's happened?”
Don't leave it to the patients to get booked back in again, or some will simply wander off. Gather them back in. It’s best clinical practice.
How are your other practice systems? Do you think your practice could benefit from an update? We are here to help…
Now it's time for you to grow your Private Practice.
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