Do you have a problem with keeping patients, and would you benefit from knowing how to increase patient retention? I’m guessing yes, and many of the clinicians we work with face a similar problem.
How to you keep patients coming back to clinic, and very importantly, if you run a physio or osteo clinic, how do you get your physios and osteos to keep patients coming back to clinic?
(I’m using physio and osteo clinics as an example, but the same principles will apply whatever your flavour of medicine, surgery or psychiatry.)
What are your current patient numbers?
How do you know you have a problem with patient retention if you don’t know your figures? You might have a feelingthat not enough patients are coming back, but how can you know for sure?
Whether you’re a solo practitioner, or whether you run a clinic of many clinicians, I recommend that you take an hour a month to check on these basic stats. See If you can pull up your numbers using your practice management system.
How many brand new patients did you have this month?
How many initial patient consultations did you have this month?
How many follow up consultations did you have this month?
What is the average initial consultation to follow up consultation ratio (is 1:7 or just 1:2?)
How many patients DNA’d or cancelled?
If you’re running a clinic of several clinicians, how do they individually compare?
When you look at the numbers, it can often be quite revealing.
What can be even more revealing is when you compare insured patients with self-funding patients.
Do you and your team tend to treat insured patients and self-funders differently? If so, does this frustrate you?
Let’s face it; we’re Clinicians first and, we don’t like to talk about money. If you have physios or osteos working for you, might they be hiding from having financial conversations with patients, that they perceive as difficult?
Have you or your Clinicians ever found yourself saying ‘let’s see how you get on your own, and come back if you’re not getting better’?
Leaving patients to their own devices can be wrong on several levels (!)
Stop and think about it. When a patient comes to see you, they are coming with a problem that they want solved.
They don’t typically think ‘Ooohh, I fancy a spot of physio or osteo today’; they think ‘this shoulder pain is really getting out of hand now – I can barely sleep and there’s absolutely no way I can get involved in that tennis tournament now’.
Your role is to help them get better. To get rid of that shoulder pain, and to help them get back to doing things they love. Obviously.
But what if you only half do that, because you were too nervous to talk about the financial investment and you felt like you were ‘spending their money for them’?
You’d only have made them half better. Which is a bit pointless.
In fact, you could make the argument that only half mending them was wasting their hard-earned cash. It’s a bit like paying for a half-built kitchen. Or having half an operation.
The bizarre part is that you could be the best therapist in the land, with the most experience, but the patient could still leave feeling dissatisfied because you’ve not be able to demonstrate that you can confidently and skilfully ‘steer them all the way into port’.
They’ve been left feeling that you’ve not given them the solution to the problem they wanted you to solve.
In other words, patients want to help guide them to the finish line, and not expect them to finish the journey rudderless.
Additionally, it’s a little unfair to place the onus on the patient to know how best to steer their care. How are they to know when they ready to return to running? Do you really want their best friend /personal trainer / five-aside team mate to decide for them?
So how do we keep those patients coming back to clinic (until the job is done)
I know you know this (because you’re a great Clinician), but I think it’s helpful to very purposefully map out what great care would look like for your patient and their goals.
Imagine the financial barriers were removed.
For example, let’s imagine you’re a physio taking someone through hip arthroscopy rehab.
You might be expecting to see them on a weekly basis until they’ve met certain landmarks when you could then set them biweekly goals. You could probably describe this process and how you’d like progression to go, relatively easily to the patient. That makes buy-in simpler.
You can have an up-front conversation about approximate session numbers in order to achieve that all-important goal (e.g. getting back to tennis), and what you’d expect them to achieve in terms of landmarks (that meant they were bang on track).
But what if the patient is coming to see you with a more ‘nebulous’ problem that’s not a run-of-the-mill, post-surgical case?
What if you think you can get them better, but it’s a bit more, well, woolly?
How do you keep the patient returning and avoid defaulting to the stepping-stone approach of week-by-week ‘we’ll see how it goes after this week’s treatment’?
I think it’s crucial to demonstrate your clinical prowess by mapping this out in advance with a defined road map, with lots examples.
E.g. ‘I’d be expecting you to be able to do this by our third meeting, and if you can, we’ll move to doing such and such, and if you can’t it’s an indication that we’d need to switch to x or y, or get an MRI scan to prove z, by which time we’d be deciding to……’
When patients see as clearly as you do, how you’re going to tackle it, with the plans a’s, b’s and c’s in place, they know they’re in good hands and they will see the value in what you’re doing for them. At every step try to reinforce the educational message.
Demonstrate the value (in advance), and you’ve got a happy, motivated patient who will gladly pay for your expertise.
When you see this moment happening, don’t let it sail by. Use it to gain their commitment for the process, by using language such as:
‘Great – we’re agreed your goal is to be able to return to ‘x’, and we’ve talked about the steps we’ll be taking to take you through to achieving that goal and how we’ll know we’re on track. Shall we get cracking? Let’s get our dates mapped out in the diary, so we ensure you get the times you’d prefer because the diary gets booked up quickly- we can always change them if we need to.’
Other ways to show patients value include:
Swiftly sending them a summary after your initial consultation, with the road map planned out (why not outsource the typing to a transcription service).
Following up with an email a couple of days later with ‘any questions about your exercises’ or an email that anticipates how they might be feeling ‘you may have a bit of soreness after increasing your achilles loading – if so, don’t worry, it’s all part of the process of tendon adaptation’.
Chasing them up if they go AWOL. ‘How’ve you been? I’m guessing it may have been mad busy at work and perhaps you’ve not had time to breathe, let along time do your exercises. No worries, let’s get you back into clinic, and we’ll get things rolling again’.
Remember patients sometimes hide from us when they’re concerned they’ve not fulfilled their side of the bargain. It can make them feel like a nine year old who hasn’t done their piano practice. Help them save face and remind them it’s ok, and you can help them get their goal back on track.
Finally, celebrate their (small) successes
When a patient is in the thick of it, it can be difficult to see that they’re making progress, especially if rehab is lengthy. Remind of where they started, the landmarks you’ve been looking for, and show them the before and afters. Bring it back to the value you promised:
‘Fantastic – look what you’ve achieved! You’ve nailed that squat. We’re past the difficult part and beyond half-way now that you can ‘x’. We’re bang on target for that spring marathon, and by next month we’ll be into the pylometric work we talked about’.
Need help in getting your team to skill-up in their patient retention?