In the words of the great William Shakespeare, “All the world's a stage; and all the men and women merely players.” Whether we’re talking about the world’s stage or an actual stage, the success of every great performance hinges on each actor’s ability to fully embrace his or her role. In the case of a rehab therapy ensemble, each role is instrumental to ensuring the success of the entire practice. And when it comes to measuring that success, patient retention can tell you a lot about the efficacy of your services as well as all-around patient satisfaction. But high-quality care isn’t the only driver of patient retention, and your providers aren’t the only ones who play a part in creating loyal clients. Front-office employees also play a vital role when it comes to turning new patients into return patients. And when you and your staff understand that role, you can breathe new life into your patient retention strategy.

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Setting the Stage

Many clinics are all about first impressions. But according to the peak-end rule, the first act probably isn’t the only reason patients keep returning to your clinic. If it’s been a while since you took Psych 101, here’s a refresher: the peak-end rule is a heuristic stating that individuals tend to judge an experience based on the peak and the end of the event. For therapy patients, the “peak” of a session typically occurs during a meaningful connection with the provider. The “end” usually happens at the front desk as the patient schedules his or her next appointment or makes a copayment.

So, what does all of this have to do with patient retention? While therapists are responsible for providing impactful therapy sessions, the folks at the front desk are responsible for leaving clients with a positive last impression. Don’t get me wrong—the first impression is crucial, and it sets the tone for the patient’s initial visit. But to leave patients with a great feeling between appointments—one that compels them to return for their next session—you have to give ’em a strong conclusion.

Checking Out

According to this article from Scott Hebert, the co-founder of Strive Labs, an estimated 40% of PT patients drop out of therapy before the seventh visit. Patients who recover faster than expected may account for some of those dropouts, but it’s safe to assume that most of them simply stop showing up for therapy. WebPT president and co-founder Heidi Jannenga is no stranger to this phenomenon. During her time as a clinic director, Jannenga found that her clinic’s cancellation and no-show rate had hit a staggering 87% despite high patient satisfaction ratings. To combat this, “we added a checkout step—which required patients to stop by the front desk before leaving—to our patient visit workflow,” Jannenga said. “This gave our administrative team the opportunity to review future appointments, book additional sessions if needed, and distribute reminder cards to patients.” She also notes that this process creates the perfect opportunity for front desk staff to collect missed copayments and patient satisfaction surveys.

During the checkout process, staff should also offer to send the patient an appointment reminder before his or her next visit. Studies show that appointment reminders are pretty effective when it comes to decreasing no-shows and last-minute cancellations. And as the front office person sets up the reminder, he or she should also take a moment to confirm the contact information on file, thus minimizing the risk of missed reminders or follow-up calls.

Following Up

If you think documentation is a formality exclusive to providers, think again. Keeping a clear record of cancellations and no-shows can help front office staff track patients who may be in danger of stepping out before the final curtain call. If a patient has cancelled without scheduling a future appointment, that’s a pretty good indication that he or she may not return to therapy. For some patients, receiving simple follow-up calls from the front desk is all the push they need to feel accountable.

Tracking down lost patients can be an overwhelming task. That’s why some practices develop protocols around addressing this—like choosing a set day of the week to reach out to active patients who don’t have future appointments. It’s also important to document a patient’s reason for cancelling—if he or she provides one. This helps determine which patients are truly at risk, and which ones have bowed out temporarily.

Promoting Services

Who are your clinic’s biggest fans? Aside from your most loyal patients, your most vocal supporters should be your employees. In fact, employees sometimes are your most loyal patients. In previous posts, we’ve talked about the value of cash-based services in terms of improving patient retention. If your practice offers wellness services or retail items, the front office staff should be familiar with—or even using—those offerings. That way, they can promote your products and services from a place of genuine experience. That’s not to say that you need to hire a salesperson to run your front desk, but this staff member should be well-versed in customer service basics. When staff members casually engage with patients about services and products, it not only promotes your clinic, but also creates an opportunity to build real rapport.


Of course, new business is great, but the constant churn of new patients can be draining. And depending on a clinic’s location and surrounding demographic, it may not be sustainable. Increased retention leads to increased revenue, but the responsibility to keep patients coming back doesn’t fall squarely on the therapist’s shoulders. The front office staff should be equally invested in winning over the loyalty of existing patients. When every employee in your practice commits to cultivating an amazing patient experience, the result is a devoted, engaged client base. And that alone is worthy of a standing ovation.

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