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Issue 3 - March 2005

Recall rights! How to keep your patients active
By Alan Rousso, DC, PCC

Do you know what is No. 1 on the “wish list” of most chiropractic offices? More new patients. Yet, if you were to look in the filing cabinets of these practices, you would probably find hundreds of people who are no longer coming in — patients on the inactive list.

The primary reason why these patients are inactive is because of ineffective recall systems. Most chiropractors choose to recall patients when the office is not attracting as many new patients as they would prefer or when the practice slows down a bit.

This is not an effective strategy. You never want to contact people when the energy is low or you’re in “need” of patients.

Here is a process that works effectively:

1. Nip it now! Patients often begin to miss appointments after they have been coming into the office two or three times a week. The pain has gone away and so does the regularity of scheduled appointments.

Train your CA to make the call at the first missed appointment.

2. Anticipate excuses. A common excuse for missing an appointment is, “I’m feeling better.” CAs often hear this, especially when they typically ask (in their phone call), “Hello, Mrs. Jones. How are you?” It’s difficult to respond to the answer “feeling better.” Instead, it’s better to anticipate and make the call with a different approach.

3. Use scripts. Train your CAs to use scripts to guide their conversations with your recall patients.

Script for “I forgot!”

CA: “Hi, Mrs. Patient! This is ____ from Dr. ____’s office. Did we make a mistake? Were you scheduled for an appointment today?”

Patient: “I forgot!” (or) “I was too busy today.”

CA: “Not problem! Would later today or early tomorrow be better for you?”

Script for “I’ll call later.”

Patient: “I can’t make an appointment right now. I’ll call you later.”

CA: “I’m sorry, Mr. Patient. I’m afraid I’m not authorized to change your schedule of care that Dr. ____ ordered. Would you like to speak with the doctor now or would you like Dr. _____ to call you later today to discuss your options?”

Script for a missed maintenance appointment

CA: “Hi, Mrs. Patient. The doctor was going through your permanent chiropractic file and wanted to know if she is still your chiropractor?”

Patient: (The patient will usually say, “Yes.”)

CA: “The reason we’re asking is because we haven’t seen you in the office for xx weeks (or months).”

Patient: (Patients will usually say that they feel fine; they don’t need you now; or that they’re busy.”

CA: “Mrs. Patient, we didn’t say you need care. We said you are overdue for your checkup. When would like to come in — this week or next?”

You can expect at least 20 percent or more of your patients to make an appointment with this approach.

4. Recognize the need for more education. If both the CA and you have to keep reminding the patient to keep appointments, this could signal the need for additional patient education.

Does the patient really understand why she is coming to your office in the first place? Patients need to know that you are developing a “program of care” designed to alleviate their pain and symptoms, slow down the progression of an ongoing chronic problem and eventually reach a time when they can choose to have regular checkups to obtain the necessary information about their spine, posture and nervous system.

Although recall procedures that incorporate prompt calls made by trained staff can work well, education is the key. If patients understood that they can change chiropractors but should never leave chiropractic, we would not have the need to do so many recalls.

Regular checkups

People hire professionals to check over things that are beyond their capabilities. For example, they hire:

• Mechanics to check their automobiles;

• Accountants to check their taxes;

• Dentists to check their teeth; and

• Optometrists to check their eyes.

Why don’t they go to chiropractors to check their spines, nervous systems and postures?

You would think that patients would know that chiropractors are experts at analyzing the function and structure of the spine and nervous system. However, if you asked your patients, “Why do you come into the office?” most would answer, “For my head, neck or back pain.” Perhaps they do not know you check the spine because you have never told them!

Albert Einstein said that you could never solve a problem with the same thinking that created it.

Maybe we need to change the initial conversation we have with patients and position chiropractic as something that cannot be replaced with anything else in the marketplace.

If you position chiropractic as only a means of taking care of symptoms or pain, then there are truly dozens of choices for the patient to make. However, if you position chiro-practic as the specialty of focusing on the structure of the spine and the function of the nervous system, then maybe we’d never need to do so many recalls in the first place.

Dr. Alan Rousso is a senior consultant for The Masters Circle. He is a Professional Certified Coach (International Coaching Federation). Dr. Rousso graduated from City University of New York (BS in Biology, 1976) and New York Chiropractic College (1979). He can be reached at 800-451-4514 or through

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