Getting Clear Agreements for Care: The Key to Patient Retention
Are you asking these key questions during the ROF?
As chiropractors, one of our primary goals is to help patients achieve lasting results through corrective care. Recently, we've noticed that our patient retention numbers have been slipping, coinciding with two fee increases totaling 16% last year. After digging deep into our clinic statistics, we found that while our case collection average remained about the same, our churn rate had increased slightly.
The numbers don’t lie and after further evaluation, we realized that we needed to have better conversations with patients about the financial aspects of their care. Patients were discontinuing care due to finances before their corrective program was complete.
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We discovered we were missing key discussion points during the report of findings. Although our patients understood their condition and the nature of the care we would provide, their commitment level was similar to “Let’s give it a shot and see what happens,” as opposed to “I’m committed to this process.”
This is where the importance of getting clear agreements from patients comes into play. It all starts with understanding informed consent, which essentially means obtaining a patient's permission before proceeding with any treatment plan. While informed consent is a great starting point when discussing treatment options and risk, in our practice, we needed to take this a step further by actively seeking agreements from patients at various stages of their care journey.
Before we even begin the examination process, we engage in what we call "pre-framing." This involves setting the stage for a successful doctor-patient relationship by establishing mutual understanding and expectations.
For example, we might ask, "Have you ever been adjusted before?" or "Before we begin, let me provide you with a detailed explanation of your condition and a plan of action."
Once we've identified the patient's condition and developed a corrective care plan, we have another crucial conversation where we outline the expected costs and duration of treatment. This is where we emphasize the importance of commitment – both in terms of time and financial investment.
This is where we were missing the mark.
We were too eager to get started and get the patient feeling better. We were not detailing the full scope of corrective care and the costs involved. Soft commitments were producing soft results. Without a patient agreement committing to the entire process, we were missing an opportunity to address any future objections related to money/time/value/priorities.
When a patient starts care, they have an expectation of quick results, with a financial commitment that will not exceed their insurance coverage. Chiropractors who seek to do corrective work need to have a better conversation about money with their patients to prepare for any future concerns.
In our office, we needed to do a better job at communicating the full scope of care needed and getting feedback from the patient if they might have a problem committing to care in the future.
To correct the problem, we began to ask better questions. For example, we might say:
"Understand that we do corrective work. It takes longer, but the results are more permanent.”
“Insurance will likely not cover the full amount. You will probably need to pay extra out-of-pocket to get the results. Do you understand?”
“Here is the expected cost. You can pay any way you want, and the cost is the same (no discounts). Can you commit to this?”
“Maintenance or protective care afterward is essential. Most of our patients will continue to get adjusted once or twice a month afterwards. You can make that decision later.”
Simply put: “Can you commit to the time it will take? Can you commit to the cost?"
While some patients may agree simply to avoid an uncomfortable situation, the importance lies in our ability to clearly communicate our expectations. The key is to get verbal feedback and agreements that reflect a patient’s understanding of their expectations as a patient in our clinic.
We don't necessarily need a definitive "hell yes" from them, or a solemn promise; what's more important is that we've asked the question and provided them with all the necessary information to make an informed decision.
By having these open and honest conversations upfront, we're not only honoring the principles of informed consent but also setting the stage for a successful patient journey. Patients who understand and agree to the commitments required for their care are more likely to stick with the program and experience the lasting results we aim to provide.
In the end, getting clear agreements from patients is not just about securing their buy-in; it's about fostering a transparent, trust-based relationship that ultimately leads to better patient outcomes and improved retention rates for our practice.