The 4 “Fs” of a patient retention strategy


A patient retention strategy is more than just patient education

As chiropractors, we are guided by our principles. For example, “the body heals itself” or “the nervous system is the master system”. These principles guide what we do, and without them, who knows what we would be doing with our patients. Essentially, the principles tell us what to do to achieve the goal of restoring health. Just as chiropractic has principles that shape and guide our practice, developing a patient retention strategy has principles too.

Building retention into a practice is no accident. This happens when the principles I am about to reveal are applied.

It’s more than patient education

Before saying: “Retention is easy. All I have to do is educate my patients better,” let me be blunt with you. Have you ever had a well-educated patient who dropped out of care? Better yet, have you ever had a patient who was not well educated about chiropractic care and who always stuck with you through thick and thin?

OK, I hear you say, “But education is key. I have to do more.

Do you have patients or people who know they shouldn’t smoke, but do it anyway? Do you know someone who knows they should eat better but still eats like shit? How about someone who knows they have to exercise but never does? Ring bells?

People have more information at their fingertips than ever before in today’s world – and yet you could argue that people are sicker than ever.

I want you to realize that patient retention requires much more than simple patient education. In fact, of the four principles I’m about to share with you, this is the least important when it comes to a patient retention strategy.

Retention: lives depend on it

And why should you care about retention? Because your patients’ lives depend on it. Would you agree that one of the most common reasons patients don’t fully benefit from your care is because they don’t follow your recommendations? In other words, because of their premature abandonment of care?

The opposite is retention. A patient retention strategy leads to better clinical outcomes. Will it translate into personal success and financial rewards? Experience says yes.

These principles must be practiced and leveraged day in and day out to cultivate a high retention practice. They are the basis for long-term success.

To illustrate the foundations of success, let’s take a pyramid as an example, with the goal of success at the top. Imagine for a moment: what would that success look like to you? For me, it was being able to help my community and provide for my family while spending my evenings and weekends with them.

How I have been successful in practice, and am currently helping others achieve this, is to have a high retention practice. Imagine the pyramid again. High retention is the second layer and method to creating the success we crave.
To create this high-retention practice, our patients’ journey through our practice must be designed with this in mind. Every touchpoint and every interaction should be centered on a journey that cultivates patient loyalty. The journey of our patients is the third level of the pyramid.

The loyal patient journey

This brings us to the principles I mentioned earlier that are the basis for success. A loyal patient journey is based on four retention principles that lead to this success.

In chiropractic, constantly attracting new patients is a hot topic. However, what is the point of continually marketing new patients if you are losing them? Now, I know that saying you had 15 new patients in a week sounds a lot cooler than saying five existing patients signed up for wellness care, or no patients dropped out of care. But it would be better if you looked at the impact on your practice.

Patient retention makes a much more significant difference. Did you know that getting a new patient costs the practice more than retaining an existing patient?

Let’s dive deep into the principles of retention. There are four retention principles I’ve built my practice on, and thousands of successful offices are using them right now. To remember them easily, remember them as the “4 Fs”.

The 4 Fs of a patient retention strategy

  1. Return that is intuitive demonstrates the need for care and tracks progress throughout care.
  2. Care forecast ensures a clear path to wellness and does not leave the patient confused about the treatment game plan.
  3. Frictionless Payments remove financial discussions from the equation and remove the thought of money.
  4. Frequent contacts enables automated education and marketing.


How intuitive are your comments? Do your patients understand the need for care and the progress they are making? Do they realize that even if they are no longer in pain, there are still improvements to be made?

These questions are fundamental to think about. If a patient does not understand how they are or why they continue to see you, they will drop out of care. This hurts your retention.

Have you ever had a patient who has already consulted another chiropractor? Have you ever asked the patient, “Why are you coming to see me now?” Why aren’t you currently seeing your former chiropractor? If you’ve asked this question, you’ve probably heard the patient say something like, “I didn’t know how I was doing there” or “I felt like they just wanted me back, but I didn’t I don’t know why.

The underlying cause for why this patient chose not to return was that the previous physician had failed to effectively communicate the patient’s progress. You can prevent this from happening by providing feedback that your patient understands.

Care forecast

Do you plan care for your patients, outlining their treatment plans with all the recommendations you know they will need, rather than telling them verbally? Now think about your financial options for your patients. Do you have any? These go together and are so important for retention.

It would be best if you allowed your patients to not only pay, but also understand their financial obligation to the practice with a professional care plan with your recommendations included. This simple step can reduce those awkward financial conversations no one wants to have, and it will dramatically improve your conversion to wellness care.
By recommending a plan upfront and automating payments instead of having them paid every time, patients will say “yes,” stay in care even when their insurance runs out, and transition to wellness care.

Frictionless Payments

Checkout should be a seamless experience for your patient, as well as your team. Ask yourself, “How often do patients stop to pay at the front desk?” Could I make this more efficient and automated for everyone involved? »

The main reason patients drop out of care is the repeated thought of money, which directly affects retention. If you can focus on patient payments and patient care, you’ll increase your PVA (average patient visits), retention, and profits.

Automating all payments in practice will save the time, headache, and frustration of manually entering billing information for all parties involved. If you could save over 40 hours per month by simply automating billing, wouldn’t you?

However, not all payment systems are equal. It is essential to ensure that you follow your financial policies in practice.

Patient retention strategy: frequent contact

How do you currently educate your patients? Do you flood them with information about the first two visits? Or have you taken a more hands-on approach to small pieces of information shared over a long period of time? It is essential to have a constant link with your patients to inform them frequently of the benefits of chiropractic.

Sending emails to your patients, prospects, and occasional education and marketing campaigns is the perfect way to do this. Now, if you can automate those emails, even better. Building these relationships will help you attract more new patients to your practice and give your retention the boost it needs.

The best way to apply these principles is to use systems that implement the 4 Fs. You may understand each retention principle well, but they are useless without using them in your practice procedures and business model.

Imagine a practice full of lifetime wellness members who pay, stay, and refer. Imagine having the practice of your dreams, bringing more joy, freedom and profitability to your life. To do this, remember the pyramid.

Focus on retention systems for success

Think about success and what that looks like to you. To be successful, I strongly recommend that you focus on a patient retention strategy. Retention can be accomplished when you have a successful patient journey that cultivates patient loyalty.

To execute a patient journey that creates loyal patients, the focus must be on the 4 Fs. Applying the principles means giving intuitive feedback, planning care, accepting frictionless payments, and having frequent contact along the journey. of the patient. To consistently implement the 4 Fs throughout the patient journey, you use systems designed to accomplish each one.

Once you master these systems, you will have a practice on automation. It will be so convenient for new patients to say “yes” to care while removing any barriers to continuing care. You’ll increase your wellness conversions, which will increase your retention and revenue for the practice.

MILES BODZIN, DC, ran a successful, high-retention wellness practice in San Diego, CA. He retired from practice in 2011 to focus solely on helping chiropractors increase patient retention. As founder and CEO of Cash practice systems, “Chiropractic’s #1 Technology Platform for Creating Loyal Patients,” his leadership has helped serve more than 6,000 chiropractors, be listed on the Inc. 5000, as well as being named one of the San Diego Business Journal’s Most Admired CEOs. He can be booked for interviews and speaking engagements at [email protected] or contacted directly at [email protected] Her inspiring story can be viewed at


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