And hello, ChiroSecure viewers. Thank you for joining me today. I am Kim Klapp, Founder of Assistants for Chiropractic Excellence. But before I dive into those three keys of preventing missed appointments, I want to take a moment to express my gratitude to ChiroSecure.
I so appreciate how amazing they are. Not only do they sponsor these ChiroSecure Live programs, but they also support the profession in so many other ways. Now we all know that they have the best coverage hands-down, plus exceptional customer service. And really have just tons of fabulous resources.
Now I’m also grateful that you’ve chosen to watch. In addition to my coaching program, I’ve been managing my husband Dr. Tom’s practice in Ann Arbor, Michigan, for 25 years. Go blue. So if you have any questions at all, whether it’s hiring practice systems training, just post it, I’ll be happy to answer it either during today’s show or afterwards.
Now since my ACE course this month is on practice building appointment and recall systems, today I’m going to share with you the three keys to pre-venting missed appointments. Now in case you’re wondering why that’s hyphenated, especially since I have an English degree, let me just tell you.
One of my mantras is pre is key. In other words, I like getting things done beforehand and I always prefer to prevent problems whenever possible. Now as you know, missed appointment tracking wastes your valuable resources, time, energy, and money because it creates a lot of unnecessary tracking. Those follow-up texts, emails, phone calls, postcards, letters, all those things based on someone missing their appointment. Instead, we’d rather take our time and focus on the positive kind of contacts, the kind that build the relationship and further enhance the connection that you have with your clients.
So let’s get started, shall we? Now the first key, as with most topics that I team in ACE, is clarity. And so let’s start with the why? Why do you care about your practice volume? Well, when I ask that question at seminars, I usually get two answers. And the first is, of course, it’s always to help more people, to make a difference. As chiropractic assistants, we want this world to be a healthier, happier place.
And the second reason invariably is to enjoy the law of fair exchange. In other words, to get paid, collect more money, because if you serve out of abundance, it only stands to reason that you’ll receive from that same abundance, as well. So it’s important to realize that practice volume is directly proportional to the number of appointments that you, as a CA, schedule.
And if you plot the stats on a graph together like you see here, your appointments and volume virtually run in tandem. There we go. So if you want your volume to increase, start by increasing the number of appointments, it really is that easy.
Now there’s a caveat, of course, a negative intention always yields a negative result. In other words, it’s wrong to suggest unnecessary appointments. Suggesting to that family with nine kids that the kids should be checked five times this week, I’m not talking about that.
Instead, we’re talking about the right intention, which is keeping patients on their recommended care schedule. And speaking of getting clear, which clients refer others to your office, those who get great results, or those who don’t? Right, it’s the ones who get great results. And who are they? Those that missed their appointments, or those that keep their appointments?
So as CAs, we really want to help people get well and help them stay well, and that translates to one of the primary objectives as a CA, to get patients into the office and get them back according to the doctor’s recommendations.
Now in order to do that, we want to build as many long-term win/win relationships as possible between our practice and the people in our community. And as B. J. Palmer said, “Get the big idea and all else follows.”
So there we are. We want to start with the big picture, I apologize for slide issues, which is why I always starting with getting clear on the doctor’s practice vision, on your office mission, and on your objectives for your patient. And from that point, we want to make sure that all your recommendations and procedures are congruent.
Now only then at that point, that’s where we want to tailor the communications accordingly. So CAs, you want to determine with the doctor, the messages that are important and in alignment with what he or she is teaching your patients. Get clear on what the doctor tells the patients during the consultation, during the chiropractic orientation, and their report of findings.
And then as a CA, you want to reinforce those messages whenever you schedule or recall your clients. Now to help you gain clarity, I recommend six congruence checks. And the first one is your chiropractic schedule. Consider for a moment, how often do you get adjusted? How often do you get your spine checked? Well, based on my lifestyle and stress load, I get checked weekly. But whatever your answer is, why would you want any less for your patients?
We want to realize that people continue to encounter stresses as long as they live, right. So according to a University of Helsinki study, joint degeneration begins on a cellular level, five to seven days after an injury. And after two to three weeks of joint fixation, it takes 18 months for optimal healing. So we don’t want that much time elapsing after subluxation before someone gets care. We don’t want that happening to ourselves, our family, or our patients.
And that’s why in our practice, we recommend that most established clients get checked on a biweekly schedule at a minimum if they’re on a live better goal plan. Because like I just mentioned, we want to prevent the onset of spinal degeneration, and of course, we always want to deal with life’s physical, chemical, and emotional stresses, which just don’t seem to stop.
Now the second congruence check is your family’s chiropractic schedule. Now not only do I schedule an actual appointment day and time each week for myself, happens to be Monday morning at 10 a.m., but for our daughter, as well. Of course, it would be way easier for her dad to simply check her out on our adjusting table at home, but how can I expect other parents to take time out of their busy lives and their hectic schedules to make chiropractic care, and get their kids checked if I don’t make the same effort?
So number three is to do a congruence check on your personal schedule. Do you make and keep all of your appointments? Not just for your adjustments, but for your progress reexaminations and your reevaluation X-rays. What about with your dentist, or your nails, or your hair, for any classes you take, for getting to the office, because how can you possibly expect your clients to be on time and responsible if you’re not with your personal appointment schedule?
Now fourth, do a congruence check on the office appointment schedule. Is your office constantly running behind? Are people always waiting longer than they were told? Because you can only expect your clients to respect their appointment times if everyone in your office does, as well.
And fifth, how about a congruence check on the doctor’s recommendations. Hopefully, your doctor has clear objectives for each client, based on exam findings of how their nervous system is functioning rather than merely basing it on how the patient feels from visit-to-visit.
And sixth, lastly, do a congruence check on your appointment tracking mindset. Some CAs are actually apologetic when they make a missed appointment call, “Sorry to call and bother you,” yuck. It’s not your fault that the patient missed their appointment, is it? You’re not bothering someone when the only way your doctor can help them is if you get them back into the office.
So I believe that missed appointments are really missed opportunities for a miracle. So instead of dreading making missed appointment calls or contacts, get excited about the difference that you can make by helping get that client back on track. And what I find is that clarity and congruence are a couple of reasons why offices can follow the same procedures, but have vastly different results.
Now another reason that you can have vastly different results is empowerment, and that’s our second key. CAs, I really want you to understand that when it comes to patient volume, you make such a huge difference. So start out by expecting patients to schedule, based on the doctor’s recommendation.
And I love this Covey quote, “We tend to get what we expect, both from ourselves and from others. When we expect more, we tend to get more; when we expect less, we tend to get less.” So as a CA, you want to see the patient scheduling according to the doctor’s recommendations. You visualize it, see it perfectly in your mind first because if you expect more compliance, you’ll get more compliance. It really can be that easy. In other words, what you intend to happen, tends to happen.
And once you’re clear on your expectations, the third key is to clearly communicate that to your clients. Now we first communicate the importance of their appointments on their initial phone call to our office during the case history interview. And we find out what the best contact number is, in case they forget an appointment.
So this lets them know upfront that we’re going to be contacting them if they’re late for an appointment. We also find out if email is a good option, or if they prefer a text message, depending on whether they’re glued to their computer or their phone.
Now, of course, automated text and email reminders are by far the simplest way to prevent missed appointments, and we send those out automatically from our practice software every evening for the next day’s appointments. However, for extended visits, those that require more of the doctor’s time, or special equipment like that found in our exam or X-ray room, when we’re scheduling those appointments we ask, “So what number should we use to remind you the night before?” Again, we’re managing their expectations and preventing a problem.
So I’m talking about those key visits for new patients, updates, doctor’s reports, those progress, or exams, or X-rays report of findings, we find it’s actually a good return of investment of our time to make a reminder call instead of just texting or emailing. That way, too, we’re going to get a verbal commitment, which always increases their chance of showing up and further prevents missed appointments. Usually just saying, “So we’ll count on seeing you then, right?” And when they respond, “Yes,” we know they’ll be there.
Now our appointment policies are printed in our welcome booklet. And that’s what we give out at the end of the new patient’s initial visit. It clearly explains that we expect them to keep their appointments. We want them to be crystal clear why the doctor makes the recommendations that they do, and how important it is for them to comply.
Not to mention, exactly what they need to do if they have to change their appointment, including specific steps, the timeframe, and why. We also again, forewarn them that we’re going to contact them as a courtesy if they’re late for an appointment, and the rationale of why we do so.
So CAs, make sure that you’re not sending out mixed messages that can sabotage your success. For example, if a patient calls to cancel an appointment, unfortunately most CAs say something like, “Oh, no problem. Or that’s okay. Or don’t worry about it. Or no big deal.” But I need you to understand that that’s a mixed message because it’s not okay, they need to be concerned, and it’s a big deal to miss appointments. So instead, send a more congruent message such as, “I’m sorry to hear that, or that’s too bad,” before finding out when they can reschedule.
Now another pitfall is when CAs rely on chanced-based communication. For example asking a patient, “Do you want to schedule an appointment?” In which case, the client could answer, “No.” That’s certainly not what we want to hear. Instead, utilize a strategy-based technique, which is asking questions in a way that only allows acceptable responses such as, “Well, the doctor wants to check you again this week, which day is most convenient?” So pay attention to the wording that you’re using at the front desk and on the phone.
And lastly, make sure you equip your team with how to handle all those scheduling obstacles that come up. Even with the best communication strategies, when the patient leaves and says, tries to leave and say, “I’ll call you to set up my next appointment. Or I’m going on vacation, I don’t have insurance, I can’t afford care. I need to base my care on my insurance coverage.”
But you want to be able to handle all those obstacles, and you also want your team to have the right playbook when a patient calls to cancel. Whether it’s because they’re sick, or they feel worse since their last adjustment, they’re too busy, they don’t have childcare, they have car trouble, they’re contagious, there’s a problem with the weather. They tell you they’re not returning for care, or some idiotic medical doctor or PT has advised them to quit care.
So just so you know, that my pat responses for all these scenarios are included in this month’s CA Excellence Coaching Course, but otherwise, again, feel free to craft your own. Make sure you have those tools in your office either way.
Now, of course, these keys will not prevent 100 of missed appointments. I’m so sorry about that, not even in our practice. So because of that, you want to have an effective tracking system. I encourage you to evaluate though, whether your current tracking system, how it’s doing. Find out which types of contacts are the most productive. Are they the texts, or the emails, your postcards, your calls, whatever?
But remember, the definition of insanity is doing the same thing and expecting a different result. So that’s why I encourage you to evaluate your efforts so you can see which type of contact is the most effective for your practice and which ones you may need to scrap.
Again, if you have any questions, just add those to the comments and I’ll be happy to respond whether now or later. And if I can help you in any way, whether you’re looking for this month’s Excellent Coaching on appointment and tracking systems, training for new CAs, hiring systems, or practice systems, please visit my website chiropracticassistants.com. And you can either click or call to email me.
Now I’d love to help your team reach higher levels of excellence, and I’d like to thank ChiroSecure again for providing this forum to increase chiropractic success. Your host next week will be Dr. Janis Hughes, who is absolutely fabulous, so be sure to watch it.
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