Strength Through Patient
Retention
An interview with Dr. Shawn Powers, Powersource Coaching
By Geoffrey S. Kohl
Today’s Chiropractic: What are some of the major challenges you
see in patient retention?
Dr. Shawn Powers: Helping people understand the necessity for chiropractic care
beyond their pain or what their insurance company will cover. Many chiropractors
who practice in a pain relief model will have retention challenges. If what
we are teaching and offering patients is incongruent that will produce retention
challenges. In our practice we focus on a “life-based” model of
practice. We don’t call our people “patients” because that
implies to people that they’re sick; we call them “practice members,”
helping them understand the relevance of regular chiropractic care in their
life. We felt we had to change the incongruence about why people think
that they come to a chiropractor, the idea that the purpose of chiropractic
is only helping people with pain and musculoskeletal conditions. Most chiropractors
will get caught in a pain model by the posters they use, the handouts they give,
and the questions they ask. So the key to retention comes from the very first
visit and how you educate, even what kind of paperwork practice members fill
out. Because of our educational community outreach, we’re educating people
to understand why they would want to get their families checked instead of waiting
for symptoms or conditions. We teach the practice member about specific life-based
principles, about their body and how the nervous system works. This helps them
understand the relevance of chiropractic care. With or without conditions or
symptoms, a person who understands the principles of health and wellness will
want regular chiropractic care to have a better quality of life.
TC: How are you attracting patients through education?
Dr. Powers: The primary way is still referral—asking to check family,
asking to check friends. We also do workshops every week in our office and sometimes
we advertise them in terms of a condition, because that’s how people think.
We attract people in and then we teach them about their nervous system. When
people understand that their nervous system runs and controls their body, they
don’t want any interference to the nervous system. When people truly understand
that, they won’t give up chiropractic because they want enhanced life,
enhanced performance and longevity. In our practices as well as many other chiropractic
offices with high retention, you will find that people who get regular chiropractic
care are significantly healthier than the general population. They’re
not diabetics, they’re not having heart attacks, and they’re not
developing cancer. That’s really how you get people to make that decision
that they want to stay under care, because they’re on a mission and a
purpose for their own total health. Think of yourself as a paradigm pioneer,
to switch the paradigm of the people who are coming to you. It’s helping
them have an understanding, and having faith and confidence in their body’s
ability to heal if there’s no interference in their nervous system. It
is vital to be a good communicator, to be able to connect with people and have
an atmosphere of trust, certainty and consistency in your practice.
TC: When someone comes into your office without having been to one of
your educational workshops and you know they’re thinking in terms of a
pain model, how do you change them to a life-based model?
Dr. Powers: That’s exactly what a chiropractor has to be prepared for.
Every person who comes through our doors, even a lot of people that come to
your workshops, are still going to be thinking from the outside-in; they’re
still going to be focused on aches or pains or conditions. You have to be aware
that that’s the way they’re thinking, and the key is to make them
understand how dangerous that mode of thinking is. We teach them what subluxation
is, how it interferes with expression, and how subluxation can be silent because
most people think they’re totally healthy if they don’t have any
symptoms. We take them through the paradigm of outside in and help them understand
the principles of how their body works from the inside out. One of the keys
I think to really helping patients understand is that the doctor has to really
work on their communication skills and their ability to connect.
TC: What does a good connection between the doctor and the patient entail?
Dr. Powers: You have to be willing to really talk to a person and I think that’s
probably part of the challenges within chiropractic. The most important thing
is to have dialogue that covers specific objective points that people understand.
But you have to do it in your words, consistent with your behavioral style;
consistent with your own identity and integrity; and you have to be willing
to practice in your model. You have to talk just like you would to a family
member or friend. The way you build retention is to make it become the practice
member’s responsibility that they are on a purpose to achieve an objective
criterion—which is improved health, improved expression, and if they’re
on a purpose to do that, they stay on the schedule. When we show someone their
X-rays in our office, we show patients what a good X-ray looks like, what a
bad X-ray looks like, and talk about the objective criteria that we’re
working toward.
TC: How do you keep maintaining that objective and not let it wane,
even after years have passed and expression is improved?
Dr. Powers: Just because somebody committed today or has been with me for years
and years doesn’t mean they’re committed forever. We have a system
that we have developed in the past 22 years that enhances our retention. We
have specific strategies that add value to every visit. The system also includes
regular progress exams with questionnaires, to make sure we’re providing
practice members the information they need to make their empowered healthcare
decisions. Our mindset is that our practice is a resource for the community
and I believe our practice members see it that way as well. We provide regular
workshops; we have special events; every once in a while we have a party. And
we have an awards ceremony recognizing people for their ability to help change
more people’s lives. These are the people that do a lot of referrals.
TC: When you have people who don’t seem to be getting results, how do
you keep them on board and help them understand that this is not a quick pop-and-fix
scenario?
Dr. Powers: Again, that comes down to education starting on the first visit
and every day on. We really teach them the principle of time and when we show
them their pictures—we have them identify what phase of subluxation and
what organs are affected, how much damage there is to the spine, the objective
criteria that we look at—they can then rationally see what their body
needs so that the function improves. I tell them that the innate intelligence
within their body is smarter than the two of us put together and it might have
a different priority than their neck pain. Maybe today it’s really working
on preventing a tumor that could become cancer and malignant; it’s not
concerned with neck pain because that’s not a top priority. I make sure
people are learning something. Every 20 visits we review where they’re
at on the road to health. Before the first adjustment I explain what results
they may experience. The possibility of improving 100 percent, if they had a
symptom it could completely go away, or they might feel exactly the same, worse
or have new sensations. I explain that people may have instant results even
in extreme and chronic conditions but it is the correction of objective criteria
not the symptom that is the main concern. When a person gets instant results
which is so typical in chiropractic we have to caution the person to stay focused
on the quality of health of their nervous system not on how they feel. I let
them know 40 percent of the people with heart disease experience death as their
first symptom, that happened to my own father, and therefore I am dedicated
to helping people be as healthy as possible and stop making their healthcare
decisions based on symptoms.
TC: And that’s kind of a Catch-22 of the industry?
Dr. Powers: Well, if you don’t practice in a life-based model, it can
be your Catch-22. Doctors who are life-based make people understand “I’m
here for my life. I have an objective criteria which is to make sure my body
performs at 100 percent, regardless if I have symptoms or not.”
TC: Any other thoughts on retention?
Dr. Powers: The no. 1 key to retention is taking extraordinary care of the people
you have. That doesn’t mean we fawn over them, but we teach them and we’re
connected to them. Whether it’s their 700th visit or their first, they
feel like the red carpet is rolled out for them. You’ve got to be willing
to know that people come to your door with one objective in mind. And that’s
to get rid of what they’ve got and do it as quickly as possible and with
as little money as possible. Once you understand that, you know what you’re
dealing with. We are building a lifelong relationship with these people and
we want them to think of us as their chiropractic family. Our office is obsessed
with service; it’s obsessed with changing lives through chiropractic;
and we’re obsessed with the mastery of simple, effective procedures and
systems that will allow us to serve people. A lot of times people don’t
want to keep coming back to an office if it’s not easy for them to use.
So much of it comes down to your systems in your practice. You could be a great
educator, but if people have to wait to long, or if the office isn’t clean,
or if the front desk is surly, people will stay in chiropractic but they’re
not going to stay with you.
TC: What are some of the other physical factors that can affect patient
retention?
Dr. Powers: When they look around the office, it has to be special. Our office
does not look like an allopathic office. The office is sprinkled with messages
about better life, we have environment of education and support. The office
needs to be kid-friendly and safe. The office has a great atmosphere, competent,
calm and high energy. We focus on our office being remarkable in every aspect,
a place they talk about and want to bring others to. You make your office user-friendly
so that practice members choose what they want and what they don’t want,
but you’re there to give them the best of everything.
Dr. Shawn Powers is owner of Powersource Coaching in Austin, Texas. She
is a noted lecturer, and serves on the executive board of the World Congress
of Woman Chiropractors. She was named Woman Chiropractor of the Year in 1997
and Chiropractor of the Year in 1998 by Palmer College of Chiropractic, and
also has served as president on the board of the Colorado State Chiropractic
Society. She can be reached via in8coach@swbell.net.
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