May 4, 2018

The Real Problem Isn’t NEW Patients

By Tristan Schaub In Chiropractic Success

You Don’t NEED New Patients

You’ve had enough new patients

*Unless You Are a Startup Practice of Course….

The problem is RETENTION.

Retention Does Affect Growth Though…

Improving retention spurs growth in 4 key ways as Brian Balfour, the Founder & CEO of Reforge and former VP Growth @ HubSpot explained in one of my favorite essays.

1. Retention drives acquisition

2. Retention improves monetization

3. Retention builds an acquisition competitive edge

4. Retention accelerates payback period

So where do we start and how do we improve?

1. Know Your Stats

It’s NBA Playoff Basketball and one my favorite parts of NBA Playoff time is the post-game possible meltdowns…

One thing you will always notice present for coaches and players at the post-game podium is a STAT SHEET.

To start accessing and possibly fixing a retention problem you need to know your stats including: LTV, ARR, ACV, CAC….

Wait what? WTF are those? 

I know those don’t sound like the typical metric abbreviations for Chiropractors and it’s because their not. Those are for SaaS companies.

But if you have been following ChiroSushi for anytime now then you know we think the old-school PVA isn’t a great fit for everyone and what matters to investors (Bank loans hey hey hey) is the keystone of MRR.

Using technology like Cash Practice can help you understand better and here is a quick link to The Ultimate SaaS Metrics Cheat Sheet from Chart Mougul (a software ChiroSushi uses to analyze our growth and churn metrics) for a better understanding of SaaS metrics which we think can apply to CaaS or HaaS (Chiropractic as a Service or Health as a Service)

Analyzing  growth & churn metrics everyday shows you the health of your organization.

And just like any great postgame ritual – you might have some shocking revelations like Kyle Lowery of the Toronto Raptors….

2. Use Technology

We talked about using tech like Cash Practice above but this other technology you can use to help you with retention touch points and also help communicate ChiropracTIC more effectively.

  • Request4Feedback – R4F is going to help you proactively stay ahead of the game when it comes to positive and negative feedback. Their tool will also affect lower patient acquisition costs (better online reviews >>>>>lower PAC ) which will affect the LTV of your practice members.
  • ZingIt – ZingIt can help reduce no-shows, late appointments and reactivation via automation.
  • MyoVision, Insight, Titronics – At this point you SHOULD have some sort of visual storytelling aid to help YOU and YOUR practice members better understand the value of their care…. Thus helping you with better long-term retention metrics for wellness/maintenance care.

3. Control Your First, Second and Lasting Impressions

If you have heard me present before…

By the way this is a great time to invite you to the upcoming ChiroSushi Summit where many smart and savvy folks will be helping you with your business…. So please come…Learn more here 


If you have heard me present before you may have heard me say

“Google is your first impression”

And I probably repeat that several thousand times.

So how do you control that narrative?

  • Run Ad-Words on Your Name
  • Have a UGC heavy website that has a lower bounce rate and high stick rate
  • Make sure your third party listings are up to date
  • Be proactive with your online reputation

——Wondering where you get help with this? Join

4.Offer Better Options For Hours

It may be difficult for practice members to visit your practice during normal working hours.

  • Try having early mornings and/or later evenings to accommodate work schedules (even if it’s just one or two days a week).
  • Try being open during times that no one else in town is.

As the world shifts (thankfully) from the GRIND to Quality of Life I know this can be difficult.

One of the reasons I know my father’s practice has such great retention is because he offers Sat AM appointments – it’s actually one of his busiest and most productive days.



As a very famous plastic surgeon once said to me:

“Think about how many days you want to work and do one less”

Find your balance or harmony so you don’t kill yourself at the same time.

5.Follow Up on Missed Appointments


But if you are looking for KILLER strategies with this then look no further then Dr. Barbara Eatons 56 Day ChiroBootcamp. 

6.The Money is in the Phone

Money is calling – pick it up.

Another thing I picked up from my father was “Always answer the damn phone”

I think with technology, virtual assistants and cloud-based call centers you can reasonably accomplish this 24 hours at very low cost.

Also many after hour call centers offer roll-over solutions during the day – so if you are a solo provider you don’t have to answer a call WHILE WITH A PRACTICE MEMBER and still offer a human at the other end.

Nothing can frustrate practice members more than not getting a hold of their doctor.


The money is the personal phone call from the doctor or CA in regards to recare/reactivation calls.

You must be scheduling time in the office for this opportunities.

Make sure you are collecting primary and secondary phone numbers and email addresses for each patient so you’re always able to reach them.

7.Celebrate Your Practice Members

Shawn Dill from the Black Diamond Club offers a ton of solutions in this area and is one of the masters of building community.

One of his many ways at disrupting the old models of “Dinner with a Doc” is to turn something about YOU into something about THEM.


Dinner with a Doc becomes “Party for the Practice Member.”

I won’t dive too much into this because for literally $50 a month you can get the full details and more by joining BDC.

He’s also got tons of strategies on WOWing PM’s with Birthdays and other touch points.

8.Mystery Shop Like a Boss

From the auditing calls, experiencing your waiting room to finding out if your breath is an issue – WHAT AREN’T YOUR Practice Members telling you????

How do you find out?

I remember when we would terminate a front desk team member and patients telling us AFTER all the things they WANTED to tell us.

You need to follow the methods of companies like Verizon who not only implement a Mystery Shop protocol but trainer their employees to pass it at 100%….and then have their employees user their rules while mystery shopping AT&T and Sprint.

9. Be REALLY REALLY Good Looking?

I mean…Good…just GOOD.

It takes a village to retain a patient.

Have a meeting to discuss and get suggestions from the team (they may have a lot based on their own experiences), and then put up reminders or signs to keep everyone on track, because some days, let’s face it, we’d rather not.


However, it’s important to keep in mind that one bad day on our part can drive away a patient for a long time….

Maybe forever…

But if you get everyone on the same page and EXCITED….Your world can change!

Get your teams to Chiropractic Events like ChiroSushi, DE, MileHigh and the Berkshires.

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