The First 6 Visits: How Chiropractors Stop Patient Drop-Off Before the Re-Exam

 Welcome to the Chiropractic Deep Dive. It is a part of the Successful Chiro podcast. Really glad to be here for this one. Yeah. And we at Five Star Management know how hard you work. You invest, um, an incredible amount of time, energy, and, you know, marketing capital just to get a new patient to walk through your front doors.

 

Right. The acquisition phase is huge. Exactly. But the, the most frustrating part of practice growth isn’t always acquisition. It’s, well, it’s the attrition. Yeah. It’s that sinking feeling when a patient you absolutely know you can help just disappears from the schedule before they even hit their first major milestone.

 

Exactly. So today we have a single, incredibly valuable source. It’s a recorded Zoom training led by Dr. Noel Lloyd. And it is focused entirely on one major concept, right? Delivering to re-exam. The mission today is to extract Dr. Lloyd’s best strategies for solving this massive problem of disappearing patients and giving you the exact systems to fix it.

 

Because the real secret to a thriving clinic isn’t just relentlessly hunting for new patients to fill a leaky bucket. It’s building an environment, an engineered system where they naturally stay, complete their care and become advocates. Okay. Let’s unpack this because the training frames the timeline in a really interesting way.

 

Dr. Lloyd calls the first six visits the danger zone, the most dangerous stretch of real estate inpatient care. Yeah. Because if you lose them early, they are gone. Yeah. And he uses this great analogy. He talks about a six month old baby. Going to grandma’s house. You wouldn’t just put an infant in the backseat, unbuckled and hope for the best.

 

No. You put them in a high tech carbon fiber car seat. You strap ’em in with a five point harness because they’re vulnerable. Exactly. Yeah. And a new patient in acute pain who might be a little skeptical of chiropractic is just as vulnerable. Yeah. They need that same level of engineered safety. What’s fascinating here is how Dr.

 

Lloyd connects this to his background as a pilot. Oh yeah. The aviation stuff, right? Aviation runs entirely on checklists. He pointed out that aviation safety checklists were developed back in 1936. Wow. 1936. And they keep pilots alive by removing human memory and assumptions from the equation. So the clinic needs a safety checklist to keep patient retention alive.

 

Exactly. It ensures specific things happen with every patient, every single time. But how do you measure that? Because we introduced a metric from the training for this, um, the safety index, right? The safety index. It’s simple math. The example in the Zoom was. If you have 36 new patients and 24 of them make it to their first re-exam, then your safety index is 66%.

 

Exactly. So you have to ask yourself, what is your clinic’s index? Right now it’s a stark look at how well your internal systems are working, and the wins of getting them to that re-exam are massive. As one participant in the training noted, that’s when skeptics become believers. They actually start feeling relief.

 

Yeah. They understand the big why. They stop just looking for quick pain relief and they become lifers. Lifers and referrers. Right? But getting them there means navigating what Dr. Lloyd calls the dangerous corners, the common retention mistakes. Let’s start with mistake number one. The I’m better trap. Oh, this happens all the time.

 

A patient comes in, gets adjusted four times, feels great, and says they want to cancel Thursday’s visit, and the front desk staff, naturally they wanna celebrate that. Yeah. Great news. Call us if you need us, but a participant pointed out that accepting that cancellation is a huge mistake because symptom relief isn’t the same as structural correction.

 

Exactly. The solution isn’t to just say, okay, you have to gently remind the patient of the doctor’s original recommendation, remind them that they need to reach the corrective phase. Right. You tell them they need to consult the doctor before altering the plan, which leads right into mistake number two.

 

Failing to future cast. Yes, a participant shared that if you don’t talk about the next steps, patients just feel like they’re on a treadmill. They get appointment fatigue, so the solution is building excitement about the upcoming re-exam. You have to make them actually look forward to seeing their progress.

 

I can’t wait to see how much your curve has improved next week. Right? Give ’em a goal. Okay. Here’s where it gets really interesting. Mistake number three. Treating missed appointments casually. This is a silent practice killer. A patient calls to cancel and the front desk says, no big deal. We’ll see you next time.

 

A participant in the training explain why that is so damaging. If the staff says it’s okay, the patient subconsciously registers that the treatment is optional. So they introduce the tone change solution? Yes, which is well, it’s about shifting to a disappointed tone. Not angry. No, not angry. Caring. But disappointed, right?

 

The staff should say, the treatment plan is designed to get you the best possible outcome, and we’d hate for you to regress. Dr. Lloyd even said, he tells patients it scares him when they miss visits because he’s seen so many good patients hurt by missing their appointments. That level of honesty is so powerful.

 

Now, mistake number four is about unclear expectations. Another big one, a participant emphasized that patients need to understand retracing and restructuring Yes, the physical ups and downs of healing, because if they don’t know. They might feel a little sore or worse on week two, they panning and quit.

 

Exactly. You have to prep them for the reality of those first six weeks. And mistake number five is just a harsh operational reality. Wasting the patient’s time. Yeah. Making them wait 40 minutes in the reception area. A participant brought this up and it’s so true. Patients will get even with you for that.

 

Yeah. They won’t complain. They’ll just drive right past your full parking lot next time and never come back. So what’s the solution when you inevitably get backed up? Acknowledge it, apologize immediately, and offer them VIP status for their next visit. Right. Turn a failure into a chance to show them how much you value them.

 

If we connect this to the bigger picture, none of these scripts or solutions work without training. Exactly. A participant shared their strategy called the script of the week. You have to memorize objection handling scripts and role play them. Constantly, the doctors absolutely must audit this performance, right?

 

Because if you don’t audit it, the staff drifts off script under pressure, and you lose that engineered safety, which brings us to an incredible five star management procedure. A participant shared the three-way handoff. This is a masterclass in psychology. After the report of findings, you don’t just send the patient to the front desk alone.

 

The doctor, the ca, and the patient stand together. A physical triangle. Yes. And the doctor verbally confirms the schedule in front of everyone. Sarah, you’re coming in Monday and Wednesday at 3:00 PM It locks in the agreement. It makes it so hard for the patient to wiggle out of it later. And they confirmed the financials right then and there too.

 

Yes. Wrapping the financials in a bow, another participant had a great insight on this. Handle the money completely at the beginning because if the money is handled upfront. The anxiety is gone. The patient can just focus purely on healing, and Dr. Lloyd also instructed clinics to pre-schedule all visits through to that first re-exam.

 

Don’t go visit by visit, lock it in. He calls it assuming Benevolent control. Benevolent control. I love that phrase, right. You give him a home care sheet, you hold him accountable for icing and resting. You lead them. You’re the expert, act like it. Exactly, but it’s not just rigid systems. The deep dive also covered the personal touch.

 

Creating lifers requires humanity. In Dr. Lloyd’s patient focus group lunches, he found the number one thing patients loved wasn’t a technique. It was simply that the staff knew their name, the Cheers greeting. Yes, someone walks in, you look them in the eye, smile and use their name. And a participant noted.

 

You also have to celebrate their wins. If they finally slept through the night, give them a high five. Show genuine excitement that shared joy builds so much loyalty. And then there’s the first adjustment call. This is huge. Calling the patient within 24 hours of their first adjustment. A participant said it’s a massive relationship builder, and you shared that story about Dr.

 

Lloyd’s dentist. Yeah, this really drives it home. Dr. Lloyd’s 2-year-old son broke a tooth and needed a root canal. So stressful, incredibly stressful. But that evening, the dentist personally called just to check on the boy, and Dr. Lloyd remembered that call 37 years later. This raises an important question.

 

Think about how deeply a simple phone call like that could impact your own patient’s loyalty. It proves you actually care about them outside the office walls. Absolutely. So what does all mean? It means delivering a patient to their first re-exam is never left to chance, right? It takes a safety checklist.

 

It takes clear communication about things like retracing, properly trained staff role-playing their scripts, a solid three-way handoff. And most importantly, genuine personal care. Think about your own clinic tomorrow morning. Yeah. Are you acting as a passive provider, just hoping patients return, or are you an active guide?

 

Engineering their safe arrival to that first re-exam? That is the perfect question to end on. If you wanna fix your attention and build these exact systems in your practice, you need to book a free call with the Dr. George Birnbach. He is a master at this. He really is. The link to book that free call with Dr.

 

Birnbach is right there in the show notes. Highly recommend doing that today and don’t miss out on our live two day event in Chicago, Illinois. It’s called Too Many New Patients, and it’s happening March 21st and 22nd. It’s gonna be an incredible weekend. You can find the link for that live event. In the show notes as well.

 

Make sure to subscribe to the Successful Chiro Podcast for more actionable tips to grow your practice. Thanks for tuning in. Thanks for joining us on this deep dive.