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As outcome-based providers, we dread re-evaluations that lack subjective or objective improvement. Many chiropractors internalize these failures, questioning what went wrong.  Retracing your treatments, advice, and exercises is frustrating; and now we are at the mercy of a skeptical patient to allow us to implement “plan B”. How you handle these types of challenging moments will define the success of your practice and your individual growth as a provider.

Satisfied patients stay, but excited patients refer.

Excited patients are eager to promote your practice (at no cost) to their friends, family, Google, and their medical providers.  Practices grow by consistently creating “promoters” In fact your ratio of promoters to detractors is the sentinel metric for predicting the success of your business.

So what are the THREE steps that you must consistently employ to create promoters?


  1. Instill Confidence

There is a 1-minute mental clock that starts ticking when you encounter a new patient.  In fact, a first impression of your trustworthiness, based solely on your appearance, occurs in the first second. Are you warmly smiling or tense and rushed? Do your shoes show that you have the ability to care for little things? Is your desk clean? Are you dressed one level better (or worse) than expected? Each of these factors weighs in on how patients perceive you and your office.

Most importantly, a new patient is looking for answers.  Providing a clear diagnosis with specific metrics to define progress will build trust and provide the roadmap to successful outcomes.  Patients should leave their first visit understanding their diagnosis, how you are going to help them, and what they can do to help themselves.

Watch this ChiroUp Defining Moments video demonstrating a sample new patient consultation.


Subscribers can review all seven Defining Moments videos in the ChiroUp marketing campaign for New Patient Experience.

Also, providing a clear written report of findings for every new presentation improves patient understanding, compliance, outcomes, and satisfaction.


  1. Deliver Clinical Excellence

When you call the mechanic because your car won’t start, you really don’t care about his 36-month transmission maintenance plan. Bottom line – patients desire a quick resolution of their presenting complaint. It seems obvious, but the most critical factor in determining your clinical success and patient satisfaction is identifying the correct diagnosis the first time.

Evidence-based chiropractors know that merging an orthopedic diagnosis with functional evaluation, ADL advice, and patient education will provide the framework for superior clinical care. Successful treatment necessitates a clear and definitive diagnosis to choose the appropriate treatment strategies for speedy recovery.

A 2018 paper in the European Spine Journal found “In a total of 657 referrals for sciatica, 72 patients (10.95%) were incorrectly diagnosed as suffering from sciatica, whereas, in fact, they were suffering from greater trochanteric bursitis.” (1)

It doesn’t matter how good the ingredients are if the initial recipe is wrong.  Continually hone your skills with quality continuing education like Rehab Diplomate classes, MPI classes, FAKTR Concept training, McKenzie Directional Therapy and Diplomate level orthopedic classes (Scheduled this year in IL, WI, OH, CA, NV, TX). Then review ChiroUp condition references to stay abreast of the latest best practices for more than 94 diagnoses.


  1. Be a Team Player

Some patients need other healthcare professionals.  Never shy away from asking for help.  Management of TMD may require co-management with a dentist.  Patients with lumbar radiculopathy may benefit from an epidural steroid injection.  If the patient is not progressing as expected, don’t wait until they discontinue care to endorse co-management. Our responsibility in the new outcomes-based system is to identify the best options for managing the patient’s complaint ASAP.

Taking a multidisciplinary approach to care has two benefits.  The first is that patient sees you as an integrated member of their healthcare team.  They appreciate your willingness to work with their other doctors. Additionally, staying in frequent contact with the medical community will position your clinic as the go-to choice for medical referrals.  Seeking help for the common good of the patient secures your reputation as a doctor who cares. Be sure to notify the patient’s primary provider about every new presentation and release.

Patient care can be a bumpy ride with varying levels of success.  Demonstrating clinical proficiency, making the right diagnosis, and working with other healthcare providers will spawn promoters and limit detractors.

Promoters tell their community and their social networks about you and your attention to detail.  Take the extra minute to clean off your desk before meeting a patient the first time, invest extra energy to confirm the right diagnosis the first time, and be sure to refer to other healthcare providers when necessary.

ChiroUp is not an exercise program; it is not practice management software, it is not a medical marketing program or a Google review service.  It is a seamless system to help you CREATE HIGHLY SATISFIED PATIENTS.  If you’re not yet a subscriber, take 30 seconds now to sign up for your free trial and see why more than 700 providers and students in nearly every school trust ChiroUp as a partner for delivering clinical excellence.

About the Author

Dr. Brandon Steele

Dr. Brandon Steele


Dr. Steele began his career at The Central Institute for Human Performance. Dr. Steele has trained with experts including Pavel Kolar, Stuart McGill, Brett Winchester, and Clayton Skaggs. He has been certified in Motion Palpation, DNS, ART, and McKenzie Therapy. Dr. Steele lectures extensively on clinical excellence and evidence-based musculoskeletal management. He currently practices in Swansea, IL and serves on the executive board of the ICS.

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