Handling missed appointments is a daily task in any doctor's office. Since spinal correction requires consistency, it is essential patients adhere to their recommended schedule. Very few will make every appointment, but with the right communication strategies, they will make most.

The first thing to remember is our patients have lives and they do not live for chiropractic like we do. They use chiropractic to live better. We have to work with their schedules as much as they have to fit into ours.

The key to minimizing missed appointments is educating patients up front correctly so they value the care they are receiving and its impact on their health.

This starts with the repositioning strategies from the very first visit that I've talked about elsewhere.

*** Cover the philosophy. Share the medical research to back it up.

*** Use "touch or tell" to impact them on how the subluxation is affecting parts of their body.

*** Give them the four essentials so they see how nerve impulse is essential for health.

*** Explain the maintenance problem crisis fundamental so the condition they are in is because of lack of maintenance.

*** Show them before and after x-rays and testimonials to show uniqueness in your correction.

Once you've done these things patients will have a new value for how chiropractic influences their health and will want to follow the corrective care program. When they understand chiropractic philosophy, they understand the need to maintain their spine because it affects their health. When they see testimonials, especially before and after x-rays, they have the confidence and certainty it can be corrected.

All of the education, up until this point, are the "whys." If this isn't done correctly to create a huge amount of value, the "hows" won't matter.

After you explain the "hows" of correction (frequency, duration, monitoring, criteria for end point), the key to preventing missed appointments is to give patients "guidelines" to adhere to for successful correction.

Tell them to only start if they are going to finish, i.e. start with the end in mind. They need to maintain the spine with regular adjustments or not bother fixing it. Tell them how many adjustments they should have between each re-exam for the best results.

If they miss adjustments, they should try to make them up within a week and if they miss too many adjustments, tell them you will stop care to protect their investment until they can do the program correctly.

The next point to cover is if they have to miss, they must call vs. just not showing up. The key is to set guidelines before they start, so if they do miss, you can fall back on the guidelines you gave them.

The C.A. plays an integral part in preventing missed appointments and enforces the guidelines the doctor presented.

When patients call to reschedule an appointment, schedule them for the same day, different time. Remind them this is because consistency is very important. The body adapts to a schedule and progresses a lot faster when it stays the same.

Consistently educate your patients as opposed to mechanically just telling them what to do. If a patient is unable to make an appointment the same day then schedule him or her on a day he or she doesn't normally come in, same time, and explain why you're making this recommendation. If done consistently, patient appointments will become a priority and rescheduled appointments will decrease.

Make missed appointment calls 15 minutes following the missed appointment. If no one is reached, then try again during the next shift. Don't just put people on the missed appointment sheet for the day and forget about them, because you already left a message earlier.

When making a missed appointment call, explain to the patient the importance of scheduling a make-up appointment. Patients should understand that they are re-examined every six weeks. It is very important they stay consistent with the schedule you've outlined for them in order to make as much progress as possible by the time of the re-exam. This will allow them to achieve correction in the shortest amount of time so it is most cost effective.

If patients are consistently missing appointments or rescheduling appointments and you keep telling them the same things, then change your approach.

Obviously, when this problem continues you are not getting through to them. Advise them what they are doing to themselves by being inconsistent or not making up appointments. Have a "help" attitude. Let them know you want to help them. Suggest a different MAS time, etc. Make sure they understand the road they choose determines how quickly they reach an end point.

Preventing missed appointments is a team approach and is ideally prevented by establishing values through proper communication strategies, then giving guidelines for patients to follow at the beginning of care.

One last important point. Once you've set guidelines you and your staff need to stick to them if you expect your patients to. The first time – and every time – a patient misses an appointment, you and your staff need to notice it and mention it. If you don't, expect trouble.

Although missed appointments will always occur this will cut down on them, making your practice more fun, and increase overall retention.