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Ethical re-bookings: Developing treatment plans based on desired outcome

August 31, 2021  By Brad Cote

Photo: @ Vasyl / Adobe Stock

Patient re-booking strategies and associated ethics with re-booking is a frequent topic of discussion across all healthcare professionals. Some practitioners feel it is unethical, and if the patient wants to rebook they will do it on their own initiative while other practitioners embed the patient rebooking process into their business systems creating a streamlined process.

What all healthcare professionals can agree on is that rebooking is a critical step in both the patient’s treatment outcomes and overall results, as well as an improved consistency with both their schedules and income within their businesses.

The first step in securing re-bookings is to start at the beginning of your patient’s journey and have the discussion in the initial consultation prior to beginning the patient’s treatment plan of care. Part of our job as healthcare practitioners is to include a recommended therapy plan of care during your initial consultation with the patient. As a healthcare practitioner you will want to discuss and plan out the best treatment options based on your clinical impression after assessing and treating the patient. Most practitioners will include remedial exercises, stretches and other homecare that the patient can execute outside of your scheduled treatments and often will not include a specific recommended frequency of follow up treatments as noted by their clinical impression.

This can lead to patients not fully understanding the significance of re-booking in their recovery or prevention of injuries, performance or whichever specific outcome that the patient originally had inquired to achieve by using your services. As a result the patient often experiences temporary relief and their chief complaint frequently returns causing the patient to become frustrated and often seeking other solutions. This could be other types of practitioners, modalities or medications.


By providing the patient with a detailed treatment plan of care including homecare and your recommended frequency of treatment appointments, you are able to connect the importance to the patient of following your treatment plan of care to get to their ultimate desired outcomes from your services.

Once you have communicated and reviewed with your patient their recommended treatment plan of care the next step is scheduling their next series of appointments. If you are a solo-practitioner you may do these next steps yourself, or if you have a front desk administrative staff responsible for re-bookings then you will want to ensure that they follow these steps.

Having the patient schedule their following treatment appointments at their initial consultation is part of a successful patient rebooking strategy. Scheduling subsequent treatment appointments ensures that the patient has a confirmed time that won’t be booked by another patient and it helps to keep their treatment along with their desired outcomes as a priority meaning they will often experience results faster.

From a business perspective you will have more consistency with treatment bookings in your schedule along with less need to follow up in an attempt to connect with the patient to get them rebooked. This saves time and provides the patient with a better streamlined overall experience. Often patients will either discontinue their treatment plan of care or seek another practitioner due to the inconvenience of not being able to schedule easily or not understanding why their chief complaint has returned.

Ethical rebooking must be part of a patient’s treatment plan of care based on the patient’s ultimate desired outcomes. For example being able to run 10km races without knee pain. It is important to note that the patient’s desired outcomes may change during the period of treatment, in which a new treatment plan of care would be recommended. These changes in the patient’s treatment plan of care are common and can happen for a few reasons. For example, if we take the example of the runner wanting to run 10km races without knee pain, the treatment plan of care could change because the runner had a more significant issue that requires specialized medical attention, thus ending the current treatment plan of care due to medical referral out.

On the more positive side, the runner may experience significant improvements in a shorter time frame than recommended by the practitioner. If we discharge the patient at this point, we may be doing them a disservice. The reason why is the runner may have deeper, underlying dysfunctions that lead to their knee pain that may surface after the initial chief complaint has been fixed and they increase their running volume.

This explains the need for a maintenance treatment plan of care to best help the patient return to their regular desired running volume without risking a subsequent injury by having consistent treatments scheduled and a medical clinical impression.

Even if you have a system in place and re-book your patients at their initial consultation, it is very common that the patient doesn’t end up rebooking or schedules but cancels prior to coming for that appointment. This can happen for many reasons such as the patient got busy, they had a last minute event or work project, they moved away and so on. Life gets in the way and the patient doesn’t get back in your schedule for months. The important item to note is they most likely still have that chief complaint as the majority of the time the problem won’t just go away, especially if it is chronic.

For the patients who have not rebooked or have discontinued their treatment plan of care (drop offs) you will need a system and strategy to reactivate them in order to get them back on your schedule and moving towards their desired results.

One of the most successful ways for reactivation of past patients and drops offs is a strategy by an expert marketer named Dean Jackson called “Short Personal Expecting a Reply” (SPER) This is where you reach out to the past patient or drop off and ask them a specific question such as: “Have you been successful at running 10km races?” You can send these questions via email, text, or even during a phone call. These types of questions are based on the patient’s desired outcomes and are designed to elicit a response by the patient with the objective of engaging communication and ideally having the patient re-book so that they can get back on track with their desired outcomes of your treatment plan of care.

The importance of ethical re-booking from both perspectives is crucial and having a system and strategy that you implement will allow for better results, happier patients and a more profitable, consistent business.

BRAD COTE is the founder of Link Performance Therapy, a successful cash pay private practice with a focus on athletes. He has grown his clinic from zero to 7-figures revenue within 18 months of operation using a combination of proven structures, systems and strategies that he now shares with healthcare business owners across North America who are looking to gain new patients and grow their business.

This story originally appeared in the Fall 2020 edition of Massage Therapy Canada

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