Most chiropractors would agree that their practices could use more new patients. The number one question on the lips of most D.C.s is how to get new patients. It's almost like a mantra -- new patients, new patients, new patients.

The real question that must be posed is what happened to your previous patients? Need proof? Go through all of your old patient files and x-rays and ask yourself where would your practice be now, if only 10% of them were returning for ongoing wellness adjustments?

Does this mean that new patients are bad for a practice? Of course not. Every office needs a steady influx of new patients. Yet, the time and energy of an office is better spent in holding on to quality patients who want to be in your office rather than the continual cycle of attracting new patients that will need to be replaced. You must learn how to get the new patient monkey off your back for good.

Patient visit average (PVA) is the number of visits per month divided by the number of new patients that month. For instance, if you saw 800 patient visits in a certain month and you had 40 new patients that month your PVA would be 20. The lower the number the more stress there is for the replacement of the patients that departed.

What would happen if your office was geared toward higher PVAs? It would mean less stress on the doctor, the staff, and a much more enjoyable and profitable practice.

If it sounds impossible, be assured that it isn't. Continually depending on attracting a bucketful of new patients, only to be used up and discarded is the same philosophy of crash dieting... it doesn't work. Your practice (or for that matter your body) continues to be on a roller coaster, with highs and lows over and over again. Isn't it about time we stop this nonsense?

If you will incorporate wellness along with office procedures and the communication necessary to alert patients to the need of removing VSC, your PVAs will start to climb upward. The new patient monkey will be starting to get off of your back.

When patients are alerted to the fact of what VSC is and the consequence of not removing it, the stress of replacing patients almost "magically" diminishes. Practice becomes fun and profitable again, you attract patients who want to stay, pay, and refer other happy enthusiastic patients just like themselves.

When you actually get right down to it, PVA and new patients are different sides of the same coin. They are as connected as Yin and Yang. Just like the Greek god Janus, one head is looking forward and the other head is looking backward. The higher your PVA, the less stress there is for new patients. The lower your PVA the higher stress there is for new patients.

Most D.C.s are unwittingly attracted to "the glass is half-empty" philosophy of new patient addiction. Without the new patient monkey on your back, think of how wonderful and easy it would be to arrive each day in practice and of the care and undivided focus you could give each patient.

If you're still skeptical, let's go to dollars and "sense."

When a patient discontinues care, the stream of income stops and you have to replace that patient with a new one. This is very expensive. If fact, it takes much more time and energy to continually attract new patients rather than keep the ones you have. Marketing gurus like Martha Rogers say it costs eight times as much to attract a new client as to keep the client (patient) that you have right now.

To satisfy the thirst for new patients, you as a doctor have to do it yourself or hire others to do it for you. Either way, it takes time, energy and money. Also when you replace new patients you are robbing Peter to pay Paul. You are not growing when you are replacing something you already had. Think of the advertising budgets of many offices. Some don't even perform the intended task of attracting new patients. Remember, you pay for advertising whether it produces patients or not.

Isn't it time to get that monkey off your back for good? Your office needs to have procedures and communication that allow patients to make decisions based on what is best for them in the long run. Given the choice, most people want a higher quality of health and life for their families, period.

Goodbye monkey.