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My Five Star

“What happened to my 3:30 Report of Findings?”

Have you ever had to ask that? They may have rescheduled, but there are two all-too-common answers no chiropractor wants to hear:

“She called to cancel. I tried to get her to reschedule, she refused.”

“She no-showed. I called and left a message, but haven’t heard back.”

With the number one challenge for most chiropractors being not having enough new patients, when someone comes in for Day One and then disappears, it’s discouraging. I’ve been working on patient retention in general, and the one visit problem specifically, for over forty years. What went so wrong on their first visit that they didn’t want to hear what you found, see their x-rays, or start getting better?

“What did I do wrong?”

What indeed?

I heard a young pastor once explain that he was grateful for his critics, because of what they taught him. We can all learn from that. Can we put aside the excuses, irritation, or even hurt feelings that come from a no-show, and be smart enough to learn from the never-to-return?

Experience tells me to first check three areas for problems:


  1. What the patient sees: the office, staff, and doctor
  2.  How the patient is treated: the customer service
  3. How the patient is cared for: the patient care

The Visuals

You want to inspire confidence in our patients. However, there’s no need to be palatial, just neat, clean and fresh. Show them that you care about your look.
Here’s my short list for a visual review:


  1.  Is there trash in the parking lot? An overflowing ashtray somewhere near your entrance? Even though you may not own the parking lot, it’s “your” parking lot. Assign one of the CAs to outside trash detail and inspect the space regularly.
  2.  Have someone with a discerning eye visit your office and give it the once-over. Take suggested upgrades seriously. When I had an active practice, every Tuesday I inspected my offices with the CAs tasked to keep things ship-shape and gave them a to-do list.
  3. Dress the part. I won’t preach here, but there are many studies showing patients prefer a uniformed staff and doctor – clean-shaven if you’re male – wearing business attire.

Hot Tip: Ask one of your colleagues or BNI (Business Network International) buddies to trade critiques.

Customer Service

Many chiropractic offices grew up mimicking the bad influence of the ordinary doctor’s practice, where customer “service” included a rude receptionist and a forty-five-minute wait in reception, followed by another thirty minutes of freezing in your underwear in the exam room before you see the doctor. There were bad manners all around.

By contrast, great hotels and fine restaurants have customer care down to an art.


A few years ago, I made reservations at one of the country’s best restaurants. When I arrived, I was treated like a king. “Dr. Lloyd, welcome to the Herb Farm. This must be your son. Chris, are you excited to head off to Wheaton?”

When I’d made the reservation, the receptionist asked if we were celebrating a special occasion. I said yes, my son had been accepted to Wheaton College. Over the course of the evening, no fewer than four staff congratulated Chris on his acceptance to his college of choice. We felt very special. Magic? No, just great training.

Now imagine you’re a new chiropractic patient on Day One and not feeling well. Your coworker has already tried to talk you out of seeing a chiropractor, and you’re walking into a strange office where you know no one.

You push open the sparkling-clean glass door and enter a neat reception area that’s filled with pleasant music. The young woman behind the desk makes eye contact with a smile, stands and walks around the counter to shake your hand. “You must be [your name here]. My name is Mandy. Welcome to Sound Chiropractic.”

It’s an impressive way to begin, and you’re in a good place to hear the explanation of your intake forms.

How did she know who you were? Well, it’s 2:15 and the front desk CA sees a new patient appointment in that slot, and a stranger matching the right gender just walked in, so it was a good bet. It’s not rocket science; just thoughtful customer service. And it tells the patient they’re in the right place.

Hot Tip: Script and practice your CA’s greeting to show your patient they’re in an office that truly cares, and bonus your CA each time you hear the script done right.

Now it’s your turn: Hands down, the best way to ensure your patient comes back tomorrow is to do an excellent job connecting with them. Coming across as a caring expert on this first visit is even more important than the care itself.


For decades, I started my consultation with the following script. By the time I finish this sixty-second explanation, we are all on the same page.

Before we get started, I want to tell you how we do things here. I only have two concerns: what’s wrong and can chiropractic help you. I’m a stickler for detail, and I’ll ask a lot of questions.
What I’m looking for are good concise answers.

When we’re done talking, if I think I can help you, I’ll tell you. If not, I’ll try to find someone who can.

I'm also concerned about cost containment and won’t recommend any tests, x-rays, or treatment that aren’t absolutely necessary.

Finally, I believe in teamwork between doctor and patient. I think it’s the reason I get the good results that I do. I ask my patients to work with me like a team. And if I accept your case, I’m going to ask you to work as hard as I do. Can I count on you for that? Great, now tell me all about...”

When I’m finished, I’ve told the patient I care, framed our roles, and asked for a commitment.
The right patient is thrilled when you take control for their good.

My consulting clients – other chiropractors – tell me that this is the most powerful script they’ve ever used, too, and that it cuts in half their “one and done” problem of clients who never return.

Patient Care

This may sound counterintuitive, but I promise it’s true: Doctors who feel compelled to do everything, including an adjustment, on the first visit have a much higher “one and done” rate and a lower Patient Visit Average than those who take the time to properly analyze their exam and x-ray findings and bring the patient back the following day for their first adjustment.


As you release your patient on Day One, tell them that you’ll analyze everything tonight and will review it all with them tomorrow.
In addition, make yourself strict about giving home-care instructions. Patients respect this. Then walk them up to the front desk and explain to the CA what you both agreed on. By this point,
when you tell them you’ll see them tomorrow, you almost always do.


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