Feel the Churn
One of the most frustrating parts of Direct Primary Care is turnover. You spend so much time onboarding patients that it drives you nuts when they leave. Well, this book is about churn or patient turnover and it will help you tremendously.
This is for those DPC doctors, not only those in mature practices, but also for those newbies who are just starting out. Everyone needs to worry about losing patients. It’s not only a blow to your ego when people are going out the door seemingly as fast as they are coming in but also a blow to your bottom line. And it could put you out of business.
This book shows you how to do those things that slow patients from leaving. This is important because once they leave they are probably gone forever. In fact, this book will show you never to argue with anyone going out the door. It will show you the right way to ask “why” they left. This book will talk about value, subscription fatigue, building trust, and doing the little things and the extra touches that may save you a lot of money and heartache in the long run.
Some of the things you will learn by reading Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity):
•How and why to analyze why patients are churning through your practice
•Why some patients are not for you
•Why hedonistic adaptation is affecting your practice
•The traps of email and texting
•How to create a community around your practice
•The four agreements of DPC
•You are not an imposter
Doug I agree with most of your takes on churn. Churn exists. Churn is not a problem in my fast-growing rural clinic, because I have addressed avoidable churn as best as I can and continue to do so. But I think too often we blame our patients for churn, and the kind of churn that hurts us, is in my opinion, OUR FAULT.
There are 3 kinds of churn, from my perspective:
1) Good churn. (Bad fit patients who need to go, as Lara Briseno Kenney pointed out).
2) Normal churn. These are the unavoidable ones, where people move away, die, etc.
3) Avoidable Churn. From a customer service perspective, you can look at this churn as lost business, (or at least as lost efficiency, because replacing a patient is inefficient, new establish visits, etc.). Some kind of customer service or value issue is usually at the heart of any kind of business losing business or efficiency.
This last one is the one we all need to work on. Here are a few causes:
-Patients who were not properly educated on the model/workflows and have unrealistic expectations
-Lazy docs (think: too many/too aggressive boundaries)
-Improperly motivated staff/bad hires, who don’t do customer service right
-Bad business model (nickel-and-dime charges seen by the patient as hidden fees, membership rates too high, poor value proposition, doc with a narrow scope of practice who refers everything out, doesn’t listen/spend enough time, etc.
-Bad work flows (Delays in getting lab results back, phone calls/texts falling through cracks, etc.)
These are just a FEW causes of avoidable churn, and note: none of them are the patients’ fault. These are our fault, and fixing them reduces churn.
If we really treat people well, they will not only never leave, they’ll be scared of the thought of losing us. I hear that now and then from patients. They literally voice anxiety about us ever retiring. Those are patients who won’t churn. With our clinic’s focus on VALUE, customer service, and a mindset of not losing business, our clinic has really not had problems with avoidable churn.