Doc, yesterday I asked THIS question…
“When you release a patient, when you know they are
satisfied and ready to cease care,
what do YOU do and say?… How do YOU let them go?”
Here is what they told me as well as my comments bolded below…
When a patient is out of pain or has reached MMI…… ” Looks like you’re doing pretty well! Would you like to just let me know at this point? I will be happy to do what ever you want” – Colette M.
“Things are looking good. Give us a call if you need anything or if your pain starts to return. We’ll get you right in.” – Derrik M.
My “recommendation” at the time of their first visit is: Come back as often as you can until you are feeling the way you want to feel. As soon as you are out of pain, we’ll kick you out of here and you can come back whenever you feel like you need to. On follow up visits: Come back tomorrow or the next day, if you are still in pain. Let’s just see how you do. If you’re out of pain, I’ll see you whenever you feel like you need me again.” – Dana W.
“Once they are starting to feel better, I release them and let them know I am here for them in the future if they or anyone they know needs care.” – James S.
“I usually say to live life but be mindful. You are Superman / woman and we all have problems from time to time. So you know where to come if and when you need us.” – Mac M.
“Typically around the time a patient deems themselves to be approximately 90% better, I leave it up to them. I let them know that they’ll likely get the rest of the way on their own, but if they wanna come back in a time or two to get closer to 100%, that’s fine too. Sometimes they’ll be a little hesitant to be released and want to come back in and other times they’ll be pretty happy that I didn’t make them keep coming in. Either way, the patient gets what he or she wants. It’s an easy way to let the ones go who feel their done and conversely it keeps me from releasing a patient before they are comfortable.” – Thomas O.
I say “OK, see how you do. If you’re still hurting get back in in the next few days.” If they have more questions about if they need more treatment I say, “Some of these types of problems take a few treatments to fix. Listen to your body. If you feel like you’re not there yet get back in. If you don’t, don’t.” – Stephen T.
“Based on how you’re doing, I would go as needed from here. Just come back when you feel the need. In the future, you can call the office and come in the same day or walk in without an appointment during office hours. Whatever works for you works for me.” – Eric L.
“You’ve done really great. So I’ll see you whenever you need me again. Don’t be a stranger.” – Eric M.
“I simply tell the patient to come back when he/she needs me. ie pain returns, or condition returns.” – Estelle N.
“It’s not always easy to determine, but they give clues. We have to listen to them stating how good they are feeling, and sense that they are approaching that point (in their mind). You hope to “beat them to the punch”, and release them before they release themselves. I tell them “When you need us again, just give us a call!” – Thomas G.
“Along the way, I tell them to let me know when they feel better and we will release them from care. For chronic pain patients, I tell them that we can help them but they may not get complete resolution of their pain (or the pain may go away for a while) but may return due to the length of time they have had their problem. I tell them to just let me know when they’re satisfied with the way they’re feeling and we can release them. I tell “I am not going anywhere and that I’m always here for them.” – Leonard M.
“I tell them they are looking good & come back when YOU need me. You & your loved ones are always welcome here. Walk ins are also welcome without making an appointment.” – Michael S.
“I tell our patients the following: “You’re all set for now. I recommend that you continue to listen to the signals your body is giving you. If/when this returns, I’ll be here to help you again. Whenever our doors are open we will get you on a table. So don’t hesitate to call or walk-in when you need us again.” – Douglas G.
“So at this point you’re out of pain. Come back whenever you’d like for any future visits. Remember walk ins are always welcome. It usually turns into a conversation and it’s not really a cookie cutter response. I suppose this is the closest thing I can provide to what actually happens. Doing this as a monologue is difficult.” – Wil H.
When I release a patient I tell them the following: “I don’t think you need more treatment for this injury so I would like to release you and have you come back if or when you think you need me. Do you feel comfortable with this?” Usually this is all I have to say. – Pat D.
No specific script, just relate that it has been a pleasure having them as a patient and if we can help them or a friend/ family member in the future to give us a call. – Patrick L.
I’m glad you’re feeling better! Call me when you need me. (Which is better…when you need me or if you need me?) – Richard D.
I usually let my patients go by saying: “…everything adjusted well and responded as I (we) expected. Now that you know how “good” feels you’ll be able to notice when it starts to “not feel right” or give you pain. Then you can just walk in and we will treat it a couple (few) times and kick you out again.” I usually ask if they will do some home exercises, if they agree, I’ll print out a set of exercises for them. It gets them more involved but I don’t push it, I tell them “If you know you’re not going to do these, I won’t print them.” – Rocky R.
I used to complicate this. Would always be trying to get the patient to see the need for continued ‘maintenance’ care, even if non-symptomatic. Patients rightly saw through this. With ChiroTrust’s help – I now am just real with patients. I don’t push anything. Most patients know at some level when they have a problem that will need fairly extensive care. I will recommend a reasonable short course of care – and when it seems that they are doing good – will just say ‘looks like you’re doing great! Give us a call when you need to get back.’ Then I just let it up to the patient with zero expectations/pressure. I’m amazed by the number of patients who will, on their own, continue to come in. Or not…until something bothers them. Its all good either way. Patients can feel this and trust me/my office and refer. – Rustin G.
I haven’t given a formal treatment plan since 2009. There is absolutely no need to. I think you just need to “read the room” and let the patient tell you what they want and what experiences they’ve had. Most of the time the idea they have is completely reasonable and all I have to do is agree with them. Most of the time they’ll even tell me they “know it’s not going to get better after just one visit.” I have even had patients go try different offices thinking the care/policies will be the same due to location (or whatever reason) and they always end up back here and tell me the story of how the other office wanted to sign them up for a treatment plan they had no interest in. Regardless of what you think, all patients see that as a scam and just think you’re more interested in their money than you are in them. When they tell me they’re “feeling pretty good” or “a lot better” I just tell them they’re welcome to see how they do and give us a call. I’ve found also if they’re not quite there I ask “okay, so what are you more comfortable with? Would you like to set up an appointment for next week or just see how you do?” Let them call the shots. It’s been working great for over 10 years. – Seth K.
I simply tell them Hey its great that you’re out of pain. You can come back anytime if the pain returns or you feel like you need an adjustment. You can either call ahead or just come in. – Seth L.
“See me when you need me.” – Steve R.
When patients get better I always give them options. Come in the next time you need me, or come in regularly so it doesn’t hurt like that again. No hard selling, I tell them I’m happy to help them either way. Pretty much 100% of them call me when they need me, lol. All of my maintenance patients asked me if they could come in regularly. – Michael T.
If ready to release: “Would you like to schedule another visit, or would you like to just reach out when you need us again?” Unless I really feel strongly that they would benefit greatly from wellness care and their condition would worsen without supportive care than I might suggest they come back in a month or so. I believe in preventative wellness care so I offer it but don’t hard sell it. If it’s a DRX patient I always suggest once per month maintenance and position their case that way from the beginning. – Stephen B.
If the patient is completely better, I say, “you’re doing great. Were all done. If this flares up in the future, let me know, and if you have any other problems let me know, otherwise were done. Congratulations.” If the patient has some kind of a chronic problem that I’ve been able to return to resting levels, I tell the patient, “well, the pain is back down to its resting levels and you’re doing great at helping to keep it there. If it flares up again, you know where to come.” If the patient has a condition that is not getting better, I’ll refer the patient to another doctor and tell them, “what I’m doing is not helping. You need to go see this Dr. if anything else flares up you have any other problems in the future. Let me know.”- Ed O.
If it isn’t already clear, I ask the patient how well they feel they are doing. If they are happy with their status I tell them to give me a call when the need me again. I say “I’m a come see me when you need me kind of Doc”. It works very well. Even better now that I am consistently mailing my list! – Roy E.
I haven’t given a formal treatment plan since 2009. There is absolutely no need to. I think you just need to “read the room” and let the patient tell you what they want and what experiences they’ve had. Most of the time the idea they have is completely reasonable and all I have to do is agree with them. Most of the time they’ll even tell me they “know it’s not going to get better after just one visit.” I have even had patients go try different offices thinking the care/policies will be the same due to location (or whatever reason) and they always end up back here and tell me the story of how the other office wanted to sign them up for a treatment plan they had no interest in. Regardless of what you think, all patients see that as a scam and just think you’re more interested in their money than you are in them. When they tell me they’re “feeling pretty good” or “a lot better” I just tell them they’re welcome to see how they do and give us a call. I’ve found also if they’re not quite there I ask “okay, so what are you more comfortable with? Would you like to set up an appointment for next week or just see how you do?” Let them call the shots. It’s been working great for over 10 years. – Seth K.
THANK YOU DOCS FOR RESPONDING TO MY QUESTION. I’M SURE EVERY DOC READING THIS APPRECIATES IT TOO.
LIKE I (BEN) SAID YESTERDAY…
When you release them and what you say determines how, when, and if they not only come back but refer others.
Most Chiropractors should be able to build and maintain their practices simply by giving patients what they want and by maintaining communication, trust, credibility, and attention using ChiroTrust.
Sadly many DCs have no clue abthe damage that are doing to their practices by over treating and over charging…and how easy it is to fix it. It’s not their fault. They aren’t a ChiroTrust DC (yet).
I’D ALSO LIKE TO ADD THIS…
Releasing a patient is an art. Don’t cookie cut your treatment recommendations. Some of my most successful members treat their patients one visit at a time and release most of them in 1-8 visits. They are swamped with new patients and patient visits per week.
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