Why drop-offs happen before you ever meet your patients and what to do about it


Today, what I want to talk about is the issue on DROP OFFS. The first thing that you need to do with your drop-offs is you need to identify them. You need to have an idea of where you are. If you don’t know where your drop-offs are, you don’t know whether you’re improving them.

The steps you’re taking are actually bringing about a change. I can’t even stress this enough. I did this for years. I had no idea what my completed plan of care was, I had no idea what my drop offs were.

Somebody mentioned it — I ran from it like it was the plague because I really didn’t like to talk about it. It didn’t make me comfortable because I didn’t know what I was talking about. Then when I did start measuring the numbers, it made me really feel bad about myself because they weren’t good. I wasn’t doing a very good job. And so, I went on this mission and that’s how I got here.

What I really want to talk about today is the ATTRACTION PHASE: how we identify and attract the right patient in our system. A lot of what we do is focus on the drop offs once the person gets there. In a lot of cases, the drop off actually happens way before the person gets there.

Now, this isn’t always the case. Sometimes you screw something up, mess up, or you don’t talk to the patient about something that they really wanted to talk to you about. You’re not addressing their goals. There’s a ton of factors inside. But right now, what I really want to talk about are the drop offs that happen before they ever even get there.

TARGETING. Targeting our patient is a whole new kind of thing for a lot of therapists. For a lot of years, we had people who just send us patients and we really don’t have to do anything. Patients just showed up at our doorstep and we’re like, “Oh, hey great! We got a new patient. Bring him in!” Things have changed now, and we’re learning how to market. 

When you’re MARKETING, you just can’t target anybody. You really need to be diving in and Alex and Will actually help me a lot with this personally in my practice over the last couple of years. But you need that avatar. You need to know exactly who you’re looking at: what your ideal customer looks like and where they are coming from. 

As you’re doing Facebook ads and free content on-air, you need to make sure that the right message is getting in front of the right person. You need to make sure that you’re getting the right person to your facility at the right time. If not, they’re going to drop off just because they’re just not a good fit for what you do, and then it becomes worse than that.

It snowballs on you. Now, they tell other people that you aren’t that great. Maybe somebody who is a good fit for you is gone because you tried to bring the wrong person in.

That happens. A lot of this is done up front. This is our MESSAGING. The messaging of what we’re telling people, how we’re telling them, and identifying those people is key. The messaging before the patient gets there is huge.

I hear this problem all the time. I’m really interested in how many people have noticed the same thing: patients come in and they say that, “Oh, hey! I was with my doctor, and we started to talk about a number of things about surgery, MRIs, imaging… but they told me that they want me to try physical therapy first.

The word “TRY”. The doctor inadvertently set you up for a certain degree of failure by using the word “try”. They don’t tell people to try surgery. They tell them, “You need surgery.” So why would they tell them to try therapy? They don’t tell them to try this medication to see if it improves you. They say “Here, take this medication.

We kind of start out behind the eight ball a little bit, and this is why it is so important. You have to identify and address that right up front. The first person who will talk to them has to reset that mindset.

If you could go one step further, you could actually get into the physician and have a good relationship with them, you can actually tell and show them research that shows that the words that they’re using with a patient directly relate to the outcome that the patient has. Any intervention that they do, there’s research that shows that the WORDS that they use directly IMPACT the OUTCOME of what it is that they’ve done. 

If they’re telling their patient, “Try physical therapy”, it implies in the mind of the patient that failure in this is a real possibility. Surgery rates for certain things like stenosis are actually worse than therapy. Therapy has better outcomes and yet, they never say, “We’re going to try surgery.” They tell their patients that they need surgery.

You need to have a conversation with these doctors and tell them how they’re setting their patient up for failure by using the word “try”. Just that one little word — changing it from “try” to “need” or “get” is huge for the outcomes of these patients. It is going to allow the patients to help them feel better. That word “try” is huge. 

When the first phone call comes in your front office, you’re not always the first person who hears this. In most cases, you aren’t. The first person who hears this is your receptionist, the person answering the phone call. They pick up the phone and say, “Hello! How can I help you?” They will tell the receptionist, “Hey! My doctor said that I need to try physical therapy.” Is your receptionist on the phone addressing this right up front?

It needs to be addressed right then and right there regarding the word “try”. The receptionist needs to say, “Well, we’re going to do a little bit more than ‘try’. We have really great success with whatever and Ray is great with this.” We need to reframe that expectation on the patient’s part. We need to reframe that they believe that they might fail because if they believe that they might fail, certain percentage of these people will fail. 

We need to EDUCATE right up front and it’s really important that we say, “We don’t ‘try’. We’re very successful with what we do here. Ray, Tom, Joe, or whoever is a great therapist. They are so great at this.” A lot of this starts at the beginning.

With our advertising, we can control this a little bit more. We’re now actually able to identify the people that we want, target them, advertise specifically to them, create the messaging, and use the words necessary to ESTABLISH yourself as the expert. If they believe you’re the expert and they believe that you’re good, your outcomes are going to be better. Pretty much any research that you look at, there is an indisputable fact that if they believe in you, they’re going to get better and if they don’t believe in you, they’re not.

A lot of this is happening on the front end with that first phone call. This is Jerry Durham’s thing, that is, you need to slow down that first phone call. It can’t be just data collection. This is their first interaction with your business. You need to slow down and you need to have a conversation with them. You need to show them that you’re different, why you’re different, what it is that you do, and why they believe that they’re in the right place.

Again, we’re back to the “KNOW, LIKE, and TRUST” thing. You need to use this opportunity to get them to know you, to get them to like you, to get them to trust you. If you don’t, your drop-offs are going to go up or they’re not going to be as low as they should because it is absolutely imperative that we slow that first phone call down and we create this relationship.

That’s the only goal of all of this — the only goal of me, of my software, of the drop-offs, of Jerry’s patient experience, of Alex’s and Will’s advertising, or of Paul Gough’s — the only goal is to build a relationship with these people and to establish yourself as the expert. You need to use every opportunity.

We’re going to get into this a lot more, into the advertising aspect of this, into specifically within your clinic: the steps that you need to take to create this relationship, to create it, to maintain it, to foster it, and to grow it. How you stop drop-offs is by growing that relationship. 

A lot of drop offs say that their reasons for dropping off is due to personal and financial matters. If somebody’s dropping off due to his/her personal or financial reasons, there’s something else that is going on. They don’t know you, they don’t like you, and/or they don’t trust you.

We all know that these people are probably still going out to eat, buy a newer car in the next couple of years, buy a new television, or spend money on stuff. What they’re telling you is, “I don’t know you. I don’t like you. I don’t trust you to get me better. I don’t believe that what you’re telling me is going to improve my life.” So they drop off.

It starts from the very beginning. That expectation from the first contact when their doctor tells them to try physical therapy, then we’re already in a hole and we’ve got to dig out of that. They call in and the first thing that we do is we just do data collection and get them on the schedule. Another missed opportunity. We just collected their data, scheduled them and said, “Hey! We’ll see you then and everything’s great.” And then they drop off. 

Another big thing in drop-offs that we’re really going to address and discuss is your EMR. Your EMR costs you money. I can pretty much guarantee it because the first thing you do when your patient walks in after you’ve worked so hard to get them in the front door is when you set your computer down between you and them and then stare at your computer half of the time when they’re in with you.

Then you wonder why they don’t come back. They didn’t come for you to stare at your computer. We really have to address that too and we have to figure out how to get that to a minimum, some things that we’ve done, and some decisions to be made in this. I’m looking forward to share some of that with you. 

Next time, we’re going to get a little bit more into this. I’m hoping to bring Jerry and maybe a couple other people to start discussing some of the aspects of this, that first phone call, how it relates to advertising up front, and how it relates to some of the conversations that we need to have. Then we’re going to start bringing it into the clinic and start to look at the catch points that are costing you patients and money, ultimately.

Thanks for your time and looking forward to help you guys with your drop-offs this year. If anybody has any questions or anything, just send them here to the chat box and I’ll get back to them whenever.

Thanks a lot and have a good day!

2 thoughts on “Why drop-offs happen before you ever meet your patients and what to do about it

  1. Brian says:

    Great insight Ray. There is a definite need to change mindset regarding “try” and perceptions of “pain” or PT effects.

Leave a Reply

Your email address will not be published. Required fields are marked *