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Should You Stop Using Care Plans?

Over the last 23 years of explaining our services to chiropractors, I’ll often hear a chiropractor say things like, “I gave up on care plans,” or “I don’t do care plans.” At that point, I’ll always ask them, “Why is that?” Quite often they’ll respond with, “I get all the patients of the guy down the street who does care plans.”

When I probe these chiropractors further, I find out they are usually averaging anywhere from 30 to 75 patient visits per week. And when I ask them how many patient visits “Mr. Care-Plan-Chiro” sees, it’s always over 150 PVs a week. In fact, quite often it’s more than 250 PVs per week.

At this point in the conversation I usually wait to see what this chiropractor will say next. Sometimes they’ll say this: “But I have my integrity.”

I think most of them believe that’s the truth. That’s really too bad because you know what else they’ve got? All the patients that refuse treatment plans. The non-compliant patients. The patients that complain the most. The patients that miss their appointments.

Yup. That’d be the bad patients. They comprise about 20% of the patient population. I’ll tell you something else. Mr. or Ms. Care-Plan-Chiro doesn’t want those patients. In fact, they may be sending them to that other chiro’s practice.

And here’s the rest of the story. Sorry, Paul Harvey.

In my experience, the chiropractor that does care plans successfully and in an ethical manner has a nice paid-off house, new cars, takes long vacations without worrying about how much income he’ll lose, and writes checks for his kids’ college education. While the chiropractor who thinks care plans are a bad thing is usually not making much more than his or her overhead and hasn’t had a two-week vacation in years.

So what’s the truth? The real truth is that chiropractors who dislike care plans fall into two categories:

They don’t really understand the ethical way to do care plans.
They understand ethical care plans but haven’t been successful at selling them.

The above points should make two things crystal clear: 1) No one likes anything they don’t understand, and 2) No one likes doing something they’re unsuccessful at.

Let’s talk about Category #1 first. What is a care plan?

First of all, words mean something. So why have chiropractors been using the terms “care plan” or “treatment plan”? Would you like to be told you need care or treatment forever? I don’t think so.

So why don’t we call them what they really are? HEALTH PLANS. Most people can get behind wanting better health forever. And you are giving them better health. So let’s start calling them “health plans.”

There. I feel better already. So what is a health plan?

It is an estimated number of visits over a period of time. It’s as simple as that. I understand that each chiropractor will have their own philosophy. So I don’t care if your health plan is 12 visits for 2 months or 50 visits for the year. It is your health plan for your patient.

You are the doctor. Why did you pay all that money to go to chiropractic college? Didn’t you learn how to examine a patient and estimate a plan of care to improve their health? If you didn’t, tell them you want your money back.

I asked a doc the other day if he does care plans. He said, “No.” So I asked him if he examines people and tells them what he thinks they need. And he said, “Yes.” Hmm … isn’t … that … a … care plan?

So a care plan … I’m sorry … a health plan is an estimated number of visits over a specified period of time. Most chiropractors who say they don’t do care plans are actually still doing care plans. Whether they know how to get their patients to complete their care plan is usually a different story. That being said, there is an ethical way to carry out a health plan.

Even if you don’t feel confident estimating a plan of care, you can still sell a block of 40 or 50 visits ethically. Remember this, you can sell the same amount of visits to everyone but never, never, never treat anyone the same.

I’ll repeat that. You can sell the same, but don’t treat the same. Here’s an example:

You have two chiropractors—Frank and Bill. Let’s say both sell 48 visit health plans for a year. But Bill tells the patient the year is only his estimate for the amount time they will use the visits in.

Between the two doctors, Frank rarely does re-exams and treats everyone the same—one month of 3 visits each week (12), one month at 2 visits each week (8), three months of 1 visit each week (13), and seven months of 1 visit every other week (15). Therefore, all Frank’s plans take exactly one year to deliver.

Bill, on the other hand, does regular checks or re-exams and adjusts the patient’s schedule up or down as he sees fit, according to the patient’s needs. Consequently, all of Bill’s health plans take varying lengths of time—possibly anywhere from 9 months to 15 months. Even though Bill estimated they would take a year, being a conscientious chiropractor, he adjusted the visit frequency according to the patient’s needs.

Which of the above chiropractors do you think is being more ethical?

One of the main differences in chiropractors is their frequency of care. But in consulting our clients, we always caution them not to treat every patient the same.

To sum up Category #1: While it is true that every chiropractor has a different philosophy and each will treat their patients as they see fit, 99.9% of chiropractors can agree on one thing—regular chiropractic care is part of a healthy lifestyle. You’re improving people’s health.

So let’s call care plans what they are—health plans.

Which brings us to Category #2.

One of the most important and valuable things we do is train chiropractors (and their staff) how to get patients to want and buy their health plans. Getting a patient to decide to buy your health plan is a skill—a skill that anyone can learn.

Really get that. It’s a skill. Just like adjusting the atlas is a skill. Getting a patient to decide on their own determination to buy a health plan is a skill too.

Great patient retention is the desire of many chiropractors. Most of their patient retention problems would go away if they got their patients to buy their health plans. This is one of the most efficient things you can do for your practice.


It’s efficient because your front desk person no longer has to collect a payment every time a patient comes in. All finances are completed on the second visit. This leaves the front desk time to do other things like reactivation or implement an internal referral system.

We make this possible because we train our clients to administratively have only three ways for a patient to pay for their health plan. Here they are:

The patient pays in advance and receives a discount.
The patient pays through affordable outside financing.
The patient pays monthly by auto debit.

But the method of payment is unimportant. The real key is getting your patient to buy your health plan on their own determination.

If you want to know how to do that you can call Joanna at 888-989-0855 and schedule to talk to one of our consultants for free. Or, if you’re afraid of consultants, you can wait for my next blog article where I will cover why getting a patient to understand chiropractic is NOT what gets them to buy it.

That’s right. Understanding is secondary. There is something even more important.

“Ready to give up? Or are you thirsty for more?” ~ Macaulay Culkin, Home Alone

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