Thu. May 2nd, 2024

Patients will leave your practice. Sometimes they move. Sometimes they “get insurance.” Sometimes you have no idea why they are leaving. I recently read a few FB posts where patients have left their DPC docs’ practices and these same physicians were stressed about it. One had a really valid excuse about being away for a few days and yet 4 patients canceled.

When patients leave for unknown reasons it is about money 99% of the time. They somehow forget the skin procedures you did, the ten visits that year, and the dozen emails/calls. All they know is that for the past four months they didn’t use you and they saw money coming out of their bank account. They were unable to process the “whole year” and average out their savings. Will they be back? Maybe. Will they admit why they left if you ask? Probably not. They may say they don’t use you enough and there is not enough value in being a member. You may respond with all the things you did and then the email tennis volley goes back and forth.

DON’T DO THIS.

If you want to show how much you do for your patients then let them know. When you do a mole removal, for example, send an email letter afterward expressing how awesome it is to save them money. “We are so happy to save money for our patients. Did you know that a mole removal at a dermatology office is often $700?”

Telling them this after they cancel never gets them back.

You can read more about this in my book Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity).

The important thing is that you keep your sanity. It is not always a bad thing when patients leave, especially if they did it for ridiculous reasons. PRUNING YOUR BONSAI TREE IS A GOOD THING.

123440cookie-checkChurn Happens
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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.

2 thoughts on “Churn Happens”
  1. Hi Dr. Farrago,

    I’m a newcomer to this site and an aspiring DPC family doc. I
    read your DPC guide a few months ago and was at the summit in July this year when you gave the closing talk. I went to the Summit wanting that final bit of convincing…for me to undoubtedly believe that DPC is not only what I WANT to do in my future (which I knew), but that I CAN do it (which I now know), and there was a line in your speech that I recite to myself every day. “We don’t need to reinvent family medicine. We need to remember family medicine.” This quote alone changed my entire perspective on medicine and the career in medicine I truly believe I am meant to lead.

    So I just wanted to say that I’m always appreciative of your words, and I look forward to these blog posts now and read every single one.

    Cheers,
    – Ali.

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