Are you Saying Goodbye to Your Patients?

Are you losing patients because you're not saying goodbye to them? Talking about how we discharge patients is something that isn't really done enough. I think when it comes to communication, we always want to know, how do we explain maintenance care, supportive care, ongoing care, wellbeing care, whatever you call it, that level of care that goes beyond just solving the problem to trying to prevent it. And I get asked this all the time. And there's a whole section on my course of how to talk about maintenance care. Most of seminars I do, it's a really key topic as well. So we talk about this a lot. What we don't really address is what to do if the patient isn't going to come back, if they haven't chosen to take up maintenance care. And I've got many, many examples in my practice of how this has gone wrong for other chiropractors and how their patients have come to see me. But one in particular stands out. This is a woman in her early 30s. She came to see me. She's had this flare up of quite bad back pain. Been going on for about six weeks. She'd had an episode previously about six to nine months ago, and it got quite bad and it was affecting her doing her job. And she went to see another local chiropractor, who I know who's a good chiropractor, and they went to see them. And over the course of two, three months, they had treatment, they were given exercises, they did the usual chiropractic thing and they got better. And then about three, four months after that, then it's flared up again. And I asked her during the history, I said, look, it sounds like you were really happy with that last chiropractor. She was singing their praise and said, oh, it was great. It really helped me, you know, they gave me some exercises to do as well. Really, really grateful. So I asked, well, why are you coming to see me? Why not go back and see them? Because it sounds like you were really happy with them and you trust them. I'm an unknown entity here. You don't know me. So what made you come here? And she said, well, like, after it got better, he said, look, you should come back in six weeks, because if you don't, it's probably going to come back and it's probably going to get worse, so you should come for some, some maintenance care. And I didn't. And now it's come back. And to be honest, I'm too embarrassed to go back there because I don't want. He's going to like, tell me off for not doing what I should have done. So I thought I'd come here instead. This is a really important thing. She spent a fair bit of money. She knows that, you know, the amount of care that she needed was not a couple of visits. It was going to be an investment. And she's coming to see a complete stranger. Even though somebody who's got a proven track record who could help them, she's taken a complete chance on seeing me, a new person, because of how they said goodbye, because of how that care ended. It wasn't handled well and now she feels embarrassed and guilty and is worried about being told off. So she's never going to see that chiropractor again. He's lost them for life. And it's not because they try to force them into maintenance care. I know this person, they wouldn't do that. They. But the end of that phase of care, the end of that relationship didn't work well and they didn't say goodbye. He left recommending one thing, thinking she'd do that. She left thinking she'd do another. Now there's this disconnect. So it's really important that we encourage patients to actually tell us if they're not going to come back and let them know the door is open. So the way I would talk about this, if I had a patient who I thought maintenance care is, this is the right time for them, this is something that's likely to be helpful. Maybe they've got a high score on the maintain tool is a. You want to let them know ahead of time you're going to have this conversation. Don't just spring it on them on the last physical. Right now, let's talk about maintenance. Here's a brand new option. You need to let them know that, look, next time, when I see you in a couple of weeks, we'll have a chat about how you're doing, we'll reassess things, hopefully you're doing a good review and we'll talk about your options from here and you can outline their options there. So some people, at this point, they feel they're happy with things, they're going to leave it for now and if it ever does come back, obviously you can come back and we'll take care of you. Others, though, opt to have some sort of ongoing maintenance care, supportive care, whatever you choose to call it, where they come back and see us on a preventative basis to stop it getting that bad in the first place. It's completely up to you. Have a Think about this and we can chat more next time. That means that they know what the options are, they have time to think about it, and when they come to you, you can have a discussion with an informed patient who has had time to consider what's important to them. And then when you outline things on that final visit, you can recommend one. That's fine, but offer them both options and say, this is option A, this is option B in your case. Most patients who choose option B tend to have whatever the results are. Less pain, less disability, less issues in the future. If you choose option A, there is a higher chance this may happen. But it's completely up to you and the door is open and let them decide. Trying to convince people doesn't work. Trying to justify why you're recommending it makes you seem insecure. Just offer them the choices and see which one they do. If they come up with questions, that's fine. If they seem a little bit unsure, here's another thing you can do. They can try before they buy. I'll say to people if they're not sure, say, look, if I was going to recommend maintenance care to you, I would recommend that we see you monthly for the next three months and then take it from there. So why don't we do that? We could book that in, we'll trial it for three months and then you can see how you feel. If you feel it's helping, great. If you'd rather leave it at that point, we can leave it. So it's letting them know that there are options here. I'm not emotionally invested in them making the right choice. I'm happy for them to do either. And we're happy to trial one before the other. That way patients know it's okay to say goodbye. Because if they turn around at that point and say, thanks, Chris, I appreciate that. I'm actually going to leave it for now, but I'll call you if I need anything. I can say, no problem, we're always here. And then they know that we're on the same page. There's none of this, oh, if I go back, is he going to tell me off? Is he going to look down his glasses at me? Am I going to get a lecture? None of this stuff. They know I'm happy with their choice and the door is always open. That means that if it does come back, if it becomes a recurrent issue, they can always come back and see me to someone they trust, they don't have to take a chance on somebody new. And many of them over Time, once they've had a few episodes, will realize maybe that maintenance care thing he was talking about, maybe that's an idea, because actually this has come back a few times now. But we have to let them reach their own decision and we have to let them decide on that based on their own individual values. This way you will actually have more patients coming in for maintenance care than you would otherwise because you're not putting off a lot of them. You're not having a lot of them go, oh yeah, I probably should have, but oh, they said I should and they're going to think I'm a bad patient. I didn't really follow, do what I was told to do. So have a discussion around that. Let them know what the options are ahead of time and then offer them. Make a recommendation if you want, but let them know the door is open to them. If they're not sure, let them try before they buy. Give this a go. That's a really good way for a lot of people to say try before they buy. It's actually something I do with my online course as well. Is any reason that you buy it and you decide it's not for you? You don't like the sound of my voice? You don't agree with the way I'm approaching things. Whatever it is, you can get a refund, complete money back after 30 days. I've always offered this because otherwise people worry about taking that leap and they worry they're going to have to commit to something and stick to it. Speaking of the course, there will be a Black Friday deal coming out Friday next week. For those of you who missed out on the last enrollment, this is the last time you'll be able to enroll this year. I will be closing enrollment for the rest of the year. I'm going to be changing the course around. I'm actually going to be taking some bits out and doing something different with them. So if you want to get the most complete version of the course, this will be the last time. There'll be a very good deal, but it's only going to be for a few places. There's only going to be a handful of spots available for this. If that sounds like it's for you, then keep an eye out. Next Friday, Friday 25th. That deal will be around for three days until the Cyber Monday, basically on the 28th. If not, absolutely fine. And you can always try before you buy as well. But hopefully that's been helpful for you. I'd love to hear from you though. How do you discuss discharge with patients? How do you say goodbye to them? Do you recommend everybody comes back for maintenance care no matter what? Do you discharge most people? When are you having these discussions? When are you bringing up maintenance care? Let me know. Reply to this email comment below and I'd love to chat to you more. Otherwise, I'll see you soon for another video. Take care of.