What to do about the disappearing patient?

We all have the experience of a patient who comines in once or twice and then never makes another appointment or does not show up for one that was already scheduled. It may be that you "cured" them in a couple sessions, but it is more likely that something in your new-patient procedure needs improvement or your bedside manner did not meet their needs on that day. When this happens to me, I try to reach that patient and learn from them what could have been done better or what did not work for them. This may be difficult in that they may be embarrassed to tell you what was wrong with their expeirence or they may not really be able to articulate it. They may not return you rmessages or emails or, if they do, they may just say "they could not afford any more appointments." However, if you can get them on the phone, I suggest the following approach that may disarm them enough to actually try and tell you about their experience of your clinic and your care. This can be painful if they are critical, but how can you improve what may need to be improved if you are unwilling to hear it?
Hopefully, you've already done a standard bonding call with the patient. If you have, you hopefully have some idea of how they responded to the first visit to your office. If you did not do a bonding call, this could be the first thing you need to add to your procedures. This is discussed at length in my book (link below) and in my upcoming, revised course on practice success (available early 2013).
In any case, first ask them how they are doing, how are their symptoms in comparison to when they came to see you. Tell them you were sorry that they did not return again and you wanted to know if their experience was not everything they expected it to be or hoped it would be. Tell them you'd be happy to assist them in finding anothe rpractitioner or another type of service to solve their health problem if your services don't seem to be a good fit. Such caring should disarm, to some extent at least, their embarrassment or discomfort at speaking with you.
Then explain to them that, as a health care practitioner, it is your responsibility to close their file with some "release from care" and you need to know that they are better or have determined another way to manage their problem.
Depending upon how they respond to this, ask if they have any advice about what you or your clinic staff could have done better or differently that would have allowed them to make the decision to return for further treatment. Then them for tring Chinese medicine or acupuncture care and assure them that, should they have further problems or questions about their health, you would be most happy to hear from them again and help them if you can.
This is a class act, and anyone that you'd really want to have as a patient will recognize it. Some may even reschedule on the spot. But even if they don't, tell them you will put them in your inactive files and consider their record closed for the present time but that any other practitioner of any discipline is welcome to request a copy of their file if it would be helpful in their future care.
If you are lucky enough to get advice or a complaint, do your best not to be defensive. Listen carefully, take notes, and decide if their statment is valid in all or in part and if there is anything you can do to improve in whatever area(s) they bring up.  Thank them for their honest feedback. Then discuss what they tell you with your staff or partners (if you have any) and try to find a way to respond that is workable for you.
If the patient really wanted to continue but money became an issue for them (this has happened to many people in some parts of the country), are their ways you can work with them? Do you have time-payment plans, community-style-clinic days, time-of-service or other discounts, package payment deals, or any other way to help them so that you don't just walk that business out your door? If you don't have any financial flexibility, maybe it's time to consider a few creative financial options for your patients.
If you follow this procedure with every dropped patient and listen carefully to any advice you receive, my experience is that the numbers of "disappearers" will decrease with time. Because of your forthright honesty and caring for them, some of the people you contact are likely become patients again when some other health condition presents itself.
I'd like to hear any feedback anyone has on this issue, as I know it is a real bugaboo for many acupuncturists and I believe there are creative ways to work with disappearing patients. Meanwhile, good luck, best wishes, and thank you to all my readers.
This article is excerpted and adapted from Points for Profit: The Essential Guide to Practice Success for Acupuncturists
Watch for Honora's revised and updated online course on Practice Success, coming in early 2013.