The careful, trust-building way to raise your PVA

Attract and retain patients in the modern chiropractic landscape

Attracting patients and keeping them are perennial problems for many health care providers. Tracking numbers such as your Patient Visit Average (PVA) will show whether your practice is doing well or missing the mark.

PVA measures the average number of visits a patient is seen at your practice. It is calculated by dividing the total number of new patients by the total number of visits seen during a period, typically one month. Practices with a PVA of less than 12 are pain-relief focused. A PVA of 12-24 indicates that a practice is moving beyond pain relief into functional improvement. A PVA of over 30 means the practice retains patients into the wellness phase of care (Sanna, 2023).

Addressing health care costs

One of the most significant barriers to care and patient retention is cost. With rising health care costs, we want our patients to have the peace of mind to make treatment decisions based on their needs, not their finances.

To do that, we must address their concerns about out-of-pocket costs. Some of us are well-versed when discussing money with our patients, while others feel uncomfortable and do their best to avoid the subject. One survey published in early 2018 stated that 44% of patients skipped care because of costs, while another study showed that number as high as 64%. Of those who do seek care, 41% are willing to ask for cost estimates before agreeing to treatment, and 57% check their health plans to ensure coverage (West Health Institute & NORC at the University of Chicago, 2018). Not addressing one of our patients’ biggest concerns is why they stop coming into our offices.

Implementing a “financial report of findings” in your practice is a great way to keep your patients happy, improve clinical outcomes, and improve collections by clearly and openly discussing your fees and payment policy up front.

Be transparent to build trust

Chiropractors are responsible for ensuring that current and prospective patients understand the services being provided, how they’re applied and the results they can produce. The most favorable outcomes rely on patient/practitioner teamwork.

Assure them you don’t want their care to last longer than necessary and that this can be achieved by working together. Most Americans — 58.9% of adults — live with pain. Back pain is the most common type of pain, affecting nearly two of five U.S. adults in the last three months, according to findings from a report released by the National Center for Health Statistics (Upham, 2021). Yet, only 14% of Americans see a chiropractor (Palmer College of Chiropractic, 2021).

Why did the patient seek help for pain now? In most cases, it has interfered with an area of their life that matters most to them: walking, gardening, playing sports, interacting with family, etc. It is essential to remind them at each visit that they are one step closer to getting back to those activities and not just focusing on pain management.

Communicate consistently and provide value

Good chiropractic communication is the key to retention. Today’s patients prefer interactive online portals similar to the consumer-grade interfaces they utilize in other areas of their lives.

However, they are less likely to engage with mobile health unless it’s easy, personal and secure. They want reminder text messages, personalized health care offers and customized notifications for their needs. Social media posts for your clinic should offer daily, concise and easy-to-understand messages that educate and entertain wherever possible. Pictures of your office can also engage prospective patients.

In years past, it was only necessary to have an optimized website visible across multiple devices and regularly updated with news, blog content or videos. Though essential, you also need a robust social presence and clinic app. Your clinic app should make it easy for patients to schedule and change appointments, complete home exercises, order items sold in your office, refer new patients and provide feedback and links to your social channels.

Optimize administration and automation

Patients may not see your internal operations, but they certainly know when they’re not working. Therefore, streamlined administration is one of the fundamental elements that must be done right if you want patients to consider returning. Some benefits for patients are:

• An organized system that effectively retains, updates and utilizes their personal and payment information.
• Online booking and cancellation of appointments (more accessible and less stressful than phone calls).
• Online completion of all necessary forms before arrival.
• Convenient digital payment methods and direct debits.

The right chiropractic software can make administration a breeze, allowing you to provide superior patient care through accurate and thorough record-keeping, easier in-house communication and more.

One of the most patient-pleasing aspects of a well-administered and automated practice is minimized wait times. But, of course, a short wait is even more enjoyable when it happens somewhere pleasant.

Define decoration and design

A big part of attraction and retention is how good your practice looks. Attractive premises can draw outside attention. A welcoming and comfortable space can make visitors happy to stay and return.

A friendly and functional chiropractic office hits the sweet spot between health care and hospitality. This is rooted in the following:

• Lighting gently and well. Today’s LED bulbs offer unprecedented control over luminosity levels and intensities.
• Coordinating the entire space (walls, floors and furnishings) on a single theme.
• Choosing colors linked to well-being, healing and calm, like cool greens and blues. Extra points if you can connect those to your brand colors!
• Providing well-spaced chairs designed for maximum comfort, ergonomics and support.
• Offering free Wi-Fi, refreshments or charging stations and encouraging patients to use them.

Lastly, make the space your own. Added character and personality make your practice more memorable and appealing than cookie-cutter clinics.

Re-engage, reactivate, retain

A little active pursuit of past patients can be healthy for your practice and easier than engaging new prospects. Let those who previously chose your services know you’d like to follow up on their progress and well-being. This is a more personal approach than an automated newsletter and is more likely to create engagement.

Success here requires tracking patients you last saw a few months ago. A well-timed courtesy card, email or text message — such as on a birthday — could help reactivate a former patient. If you’ve implemented the steps above, it will be easy and pleasant for them to reestablish contact. Following some, or all, of these recommendations will improve your PVA and increase the number of patients transitioning to wellness care in your office.

Although we would like all our patients to transition to wellness care in our offices, my dear friend Mark Sanna, DC, ACRB Level II, FICC, stated in a recent article, “While we would like all our patients to continue through wellness care, it might not be a realistic expectation. Many of these patients will cycle through episodes of care and return year after year when they feel they are in need. Make it easy for them to return. Welcome them back and give them a fresh report-of-findings and a plan for care. This may be the time they get the big picture! Every contact you have with a patient influences their decision on whether they’ll come back or not. As a rule of thumb, happy patients stay and pay. Retention results from keeping happy patients” (Sanna, “Seven Steps to Reboot Patient Retention: Post Pandemic Practice Recovery“, 2023).

He’s right. And with each patient having a great experience in a chiropractic office worldwide, we continue to expand our impact, helping more patients access safe and effective care, focused on improving function and optimizing their quality of life.

RAY FOXWORTH, DC, FICC, is a certified medical compliance specialist and president of ChiroHealthUSA. He has served as president of the Mississippi Chiropractic Association, is a former staff chiropractor at the G.V. Sonny Montgomery VA Medical Center and is a Fellow of the International College of Chiropractic. He can be contacted at chirohealthusa.com.

References

Palmer College of Chiropractic. (2021). Americans’ Perception of Chiropractic. Washington, DC: Gallup.

Sanna, D. M. (2023, March 1). Seven Steps to Reboot Patient Retention: Post Pandemic Practice Recovery. Retrieved from ChiroHealthUSA: https://www.chirohealthusa.com/consultants/seven-steps-to-reboot-patient-retention-post-pandemic-practice-recovery/

Upham, B. (2021, August 13). According to Report. Retrieved from Everyday Health: https://www.everydayhealth.com/pain-management/more-than-half-of-americans-live-with-pain-according-to-report/#:~:text=The%20majority%20of%20Americans%20%E2%80%94%2058.9,National%20Center%20for%20Health%20Statistics.

West Health Institute & NORC at the University of Chicago. (2018, March 26). American’s Views of Healthcare Costs, Coverage, and Policy. Chicago: NORC at the University of Chicago. Retrieved from https://www.westhealth.org/press-release/survey2018/