It’s not that your retention sucks. I would never judge your stats. I only attempt to help you with systems so most all of your patients achieve full spinal correction INCLUDING maintenance care.
Because you are a corrective care doctor potentially using CBP®, when your retention, PVA (office visits per week/new patients per week) prevents a number of your patients to completely follow through with their corrective care recommendations including maintenance care, you are left FEELING frustrated, like your systems for retention SUCK! If you are a principled, corrective care doctor, this can be very upsetting. I know in my years of practice as a corrective care doctor, I was left feeling VERY FRUSTRATED when some of my patients quit their care prematurely before achieving full spinal correction. What’s worse, there were no management systems technique specific enough to help me fix my problem. I had to create CBP® corrective care systems for high retention myself.
If you have a 0 – 25 PVA, your Day #1 and #2 are weak. Your problem is in the first week, most commonly Day #1. They didn’t buy you as their doctor on Day #1, and you may feel as though you are selling your care at the ROF on Day #2.
If you have a 30 – 50 PVA, you need a better re-exam and need to have the patient set better long term health goals and the doctor setting 30 day goals to each re-exam. With this PVA, they are completing the first phase of Corrective Care. If they are not completely corrected, they are probably not following through with the second 36 visits or continuing with maintenance.
I know what you are thinking. You are thinking, “I have patients completing care.” We are talking about the average patient, NOT all your patients. This may be a hard stat to confront, but stats don’t lie. In the last year of evaluating MANY, probably over 100 CBP® practice stats, frequently I see practices with PVA’s of 30 – 40, I often see the PVA stat in the 20’s and a handful at most, in the 50’s.
CBP® research states the average patient will achieve 50 percent structural correction in the first 36 visits. This means if you are making 36-visit initial recommendations, the average patient must commit to an additional 36 visits PLUS maintenance to achieve full correction. Isn’t that our responsibility? That is about a 90-visit recommendation by the time they are corrected with two (2), 36-visit recommendations and some maintenance visits for stabilization of their correction. In truth, a CBP® practice should have a 60 – 90 PVA. There are several reasons why most CBP® practices don’t have this level of retention. Briefly, here are a few of those reasons.
You are waiting to recommend the second 36 visits at the re-x-ray. This may be a practice with a 30-40 visit PVA. The challenge is the patient agreed to your initial recommendation, but perceived 36 visits to be an end point, regardless of what you communicated in the beginning of care and their initial intentions. If you wait until the END of their first block of 36 visits to convince them to commit to another block of 36 visits, you have a much higher probability of failing.
The re-exam and re-x-ray at the end of the initial 36 visits should be communicated as a check point, NOT an end point. From the BEGINNING of the first 36 visit block, the patient should be trained that you will be checking their progress and they should expect the next set of recommendations. In fact, two weeks before the re-x-ray, they should be quizzed on the next set of recommendations if they do not achieve full correction and how they will financially invest in the next phase of care. When their recommendations are handled in this manner, you will not see patients drop out of care prematurely. They know in advance and have already committed to their next set of 36 visit recommendations and their financial investment is already planned. This is a system of communication and management that is rock solid.
You are ONLY focusing on fixing the spine.
Our job is NOT to fix their spine. Our job is to teach them the philosophy and lifestyle of Optimal Spine = Optimal Health for LIFE! When new patients come in on Day #1, their spine is subluxated, their health is compromised and we teach them why and how to achieve a life of optimal health through spinal correction. Our first job is to fix their spine to get their body in a healthy state of homeostasis. Our ultimate job is to teach them how to keep an optimally functioning spine, posture and health for the rest of their lives. We teach and sell LIFESTYLE! If you teach and sell correction, they quit when they are close to corrected, at the end of 36 visits. The problem is they never set a goal for life long health.
This is why we have systems to set 30 year health goals in the beginning of care. We focus on the lifestyle AND, most importantly, their individual emotional reason to desire to live their optimal life, NOT just to fix their spine. Set their goals for LIFESTYLE, NOT just correction, have a system to support it and your PVA will increase dramatically.
You may be coaching with a system that is not technique specific.
Many coaching systems boast a 40-40-40 model. That’s 40 new patients per month, 40 PVA and $40.00 per visit. These management groups may recommend CBP®, yet they are not technique specific to handle the unique challenges of a CBP® practice. They do create successful practices and they are good consulting systems, yet you may find some of the demands of a CBP® practice are not being specifically addressed.
A 40 PVA system is low for CBP® technique and $40.00 per visit (total collections per month/patient visits per month) is low for a rehab based technique with higher overhead and time demands for the doctor and staff. Some groups will outwardly state this is their model. Some may not outwardly make this statement, but their model supports this PVA and visit reimbursement. Again, they may be a great group, just not CBP® specific with systems that support a 60 – 90 visit PVA.
I am committed to helping CBP® practices become the most successful practices in the profession. If you are experiencing any of these challenges, please call me for questions, advice or a practice evaluation to help you accelerate through these challenges in 2009. My number is 253-851-8353. We also give seminars and boot camps on how to attain a 60 – 90 visit PVA. Please visit our website at elitecoachingllc.com. Thank you.
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