Thu. Mar 28th, 2024

The above image is from my book on the subject of churn. I thought I would share it with those of you who are dealing with this issue. Patient turnover, or churn, sucks. In 2018, we decided to analyze things and we found the numbers in the image shown. Here’s some more data:

  • Total amount of patients lost = 181
  • Single = 39
  • Couples = 20
  • Families = 24
  • Total amount lost or written off for 2018 = $4,925.00

Now for some math.  We had 181 leave which when then divided over 12 months, which comes to 15 people leaving per month.  This is a little confusing because it may be just three or four big families but I am not going to adjust for that now.  This number is 2.5% of the practice each month.  From what I can tell, from other subscription-based industries, this is pretty good.  I also think it is standard for DPC but time will tell as others do this. 

It’s obvious that every DPC office could get better and we are no exception.   It is nice to see that the biggest reason for leaving the practice is that they moved.  The next biggest motivation is “unknown”, which means we need to do a better job finding out why.  “Finances”, “failed payments”, and “too expensive” are next and proves that money is ALWAYS an issue in DPC.  Only 7% of ours left because they got insurance and 8% were terminated for many reasons that I will go into in later chapters. 

So, what did we learn from this?  Well, every practice is different.  Sometimes you have no control over why people leave.  Sometimes you do and our office found that we need to dig in and find out what that “unknown reason” is for some of our churn.  My guess is that it isn’t a flattering answer.  The finances or money issue is real for some patients and embellished by others.  Remember, you can’t save them all.  If you can cut your churn rate in half then you will be much more profitable and less stressed.  It also makes it easier to get rid of some other patients who aren’t a fit. 

Click below to learn more about this and to find ways to keep sane in the DPC profession

13010cookie-checkAn Example of Churn (Patient Turnover)
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By Douglas Farrago, MD

Douglas Farrago MD is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website Authenticmedicine.com and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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