How To Keep Clients Using The 3x3 Method For New Cash-Based Practice Owners

Early on as a practice owner, I remember how nervous I was to work with patients on my own. Sometimes I was worried about whether or not I would be able to solve their clinical problem, and that uncertainty found its way into how I would pitch my clinical plan to my new patients. My own lack of confidence then led to only seeing patients for one session because they would cancel their follow up or not show up. At the time, I felt like it was me and that maybe I wasn't a good enough clinician to do this on my own.

What I have since discovered is that it's not me that's the problem. The problem also wasn't whether I was the best clinician or not. The problem was that I didn't have a clear workflow I would take my patients through or present confidently and I didn't set proper expectations with the people I was working with.

Now, no matter what kind of work I am doing, I follow what I've decided to call my 3x3 Method to help with keeping clients and keeping them coming back.

What is the 3x3 Method?

I am very Type A through and through & a total organizing nerd. I love a good list, set of instructions, and a useful spreadsheet to keep everything together in my mind. Based on these things, I decided to start calling my process the 3x3 Method because it would help my mind understand the steps I need to complete in order to achieve a certain result.

When it comes to working with patients in cash-based practice, I think it pushes you to step up and be the very best clinician possible, understanding that people are paying out of pocket to work with you. While the clinical piece is important of course, something that we don't talk about as much is the fact that our clients are investing in someone (us) who they view as an expert and a leader, someone who can understand what is going on with our patient and someone who can create a plan to help them fix their problem. They also may or may not fully comprehend how working with a private practice or concierge medical service might work. Therefore, the more we can step into that leadership role and create clarity around our work with our clients the better.

The 3x3 Method is based on 3 core concepts of service design and delivery, as well as communication skills. It takes time to practice and get nailed down, however the more you practice, the better you'll get. And this is also why I decided to call it "3x3" because if it's only 3 items you need to remember, that makes it much simpler and easier to implement.

The 3x3 Method contains the following:

1. Service design

2. Preframing

3. Setting expectations

Let's get into it.

Step 1: Service design

In my coaching program DPT to CEO, the second phase of work I go through with my clients is a mini course called "Practice By Design." It's a very important part of the process because if you don't understand what you're selling or how you're selling your services in a clear and crisp manner, it makes it very difficult to communicate and sell to customers. Thus, we work on creating a clear workflow around a patient inquiry and what the stages are in their lifetime as a client.

For most cash-based practices, I like to use this 3 part model (where the x3 comes in as part of the title of this method!):

1. Initial Appointment/Assessment/Evaluation

2. Initial Plan of Care

3. Maintenance/Secondary Plan of Care

Your initial appointment with your client is always going to have the same basic outline and structure, no matter what kind of service you're offering. There's going to be an evaluation-type session where you're able to dive deep with your new client to figure out their current situation, what their goals are, what their challenges are, and a plan and prognosis that you recommend for them to reach their goals.

Second, once you confirm that both you and your client are in agreement about continuing to work together, you will begin the "initial plan of care" (you may or may not be offering a medical service, but I still like to refer to this segment of working with a client as such).

Third, once the initial plan of care is complete, you and your client will have the option to start another plan of care or move into a maintenance phase. Each service is completely up to you in how it works, but have these 3 steps clearly laid out in front of me allowed me to have a conversation with my clients about our plan without any confusion.

Step 2: Preframing

Preframing is one of the greatest skills you can use when speaking with clients and potential clients in order to develop trust. "Preframing" is very close to the same definition of setting expectations, however the way I differentiate them is that preframing is used as a way to check in and share what milestone you're at or moving to next. It can also include somewhat of a preview of what coming down the pipe for your client.

Step 3: Setting expectations

Setting expectations for me means not so much showing your client where they're at on the roadmap or in the plan of care, but more so sharing with them the details of what's going to be happening during each individual appointment, during your initial plan of care, and what we are looking for at the end of the initial amount of time spent together in the initial plan of care.

Think about the 3x3 Method as if you were going to take a cross country road trip: service design is the map, preframing is locating yourself on the map and planning out your route, and setting expectations is marking what tourist sites you're going to stop at along the way.

Right now, if you're just getting started, consider that maybe this is the first "cross country road trip" you've planned, but after you take a few of these trips, it becomes easier and now you know the best routes to go down and what stops along the way are the most important. And as you practice, the easier it will become to communicate this plan with your patients in a way where they trust you and understand that to truly reach their goals, they will have to follow this process.

The reason this 3x3 Method helps to keep patients is because when you take the time to listen to your patient to determine if they're a good fit for you, if they are, you'll be able to clearly walk them through your process and the patient will be able to see how your plan will help them achieve their goals. They will sign up to be there for the long haul in order to create life long change.

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