Have you ever had a patient you thought was satisfied with his or her care, leave your practice and later found yourself wondering what in the world happened? Sometimes, it seems like patients have left our care without so much as a clue as to why they have made that choice. Or, is it possible that there were warning signs along the way that we simply missed?

Many D.C.s tell me that, in retrospect, they could see the patients they lost were sending them signals up until the day they actually "exited" the practice.

Others even admit that there were definite "red flag" conversations that should have gotten their full attention but for some reason didn't. They were typically conversations that included the word but. For instance, "I'm really happy with my care and I'm feeling great now, but I'm really concerned that my insurance isn't going to cover any more chiropractic care."

This type of exchange is a sure exit sign. What these individuals are really saying is that even though they are happy with the experience they're having in your office, they'll be leaving because of money issues if you can't help them resolve their financial concerns.

Another common exit conversation would be, "Doc, you know I really feel better and I love coming here, but my wife keeps giving me a hard time about it." It's easy to see that what this person is really asking for is help in communicating the value of chiropractic to his spouse or else he may have to quit his care!

Here's one you might have heard: "I keep coming to see you, but are you really sure this is helping me?" When you hear patients (who've had between 2, 3 and 4 adjustments with you) express this kind of uncertainty, then you should know they are considering exiting care.

Remember, exit signs are situations you will encounter on a consistent -- if not daily -- basis, which will cause your patients to continue to take steps towards the door if they are not addressed.

Now that you're familiar with some of these exit signs, it's important to know how you can respond to them so that the people you care about don't discontinue their care.

1. Never ignore the exit signs. Make sure that you and your team are prepared with an appropriate response or strategy to deal with them immediately upon their occurrence.

2. Have your staff practice what to say during these potential exit "situations" and have strategies in place that will help your patients choose to stay rather than exit.

3. Set policies and procedures that will prevent these exit signs from occurring even before they happen. This could include having the latest chiropractic research information available for your patients as well as financial policies that will support the type of care and vision of your practice and your patient's involvement.

4. Evaluate the way you communicate with referrals so that you can attract the right kind of people from the beginning.

5. Be proactive in your new patient orientation and patient education talks and confront potential exit sign issues before they confront you.

6. Actively listen to what your patients are saying and watch their body language.

Nothing is more frustrating to chiropractors committed to providing quality care to all of their patients, than finding one day that they have lost all of the ones that they had cared for when they first opened their practice.

Don't stick your head in the sand when it comes to confronting tough issues. Your patients deserve to experience the benefits of chiropractic care over the course of their lifetime with you. Be prepared for any potential patient objection and have the chiropractic confidence you need to keep your patients coming back.