Your practice members don’t leave because your adjusting isn’t good enough. They leave because of the little things nobody noticed.
In this episode of The Informed Chiropractor Podcast, Dr. Don MacDonald talks about trend lines: the health trend lines and behavior trend lines that tell you when a practice member is drifting off course. Catch it early and a simple conversation repairs it. Miss it and those micro ruptures accumulate until someone ghosts you.
Rupture and repair: the hidden engine of retention
Throughout every relationship, including doctor and practice member, there is rupture and repair. Small ruptures are unavoidable. What matters is whether you notice them and repair them. When micro ruptures accumulate without repair, practice members disengage, get frustrated, or simply disappear.
The rapport bank
Think of rapport as a bank account with every practice member. Keep it full and you have leeway when the office runs behind or a visit feels off. Run on empty and a single awkward moment is enough for someone to leave and never tell you why.
Your chiropractic assistants are your best noticers
Chiropractic assistants often hear what the chiropractor doesn’t. Practice members will tell the front desk about a concern they’d never raise in the adjusting room. When your team learns to notice behavior trend lines, like a practice member who stops pre-booking and starts checking their schedule, and relay what they hear, you can repair the relationship before it frays.
Incidental learnings beat scripts
The teaching moments practice members actually remember aren’t scripted visit-by-visit talks. They’re incidental learnings: when a practice member brings up something that matters to them and you connect it to chiropractic in the moment.
Learn this live in Toronto
This episode is a preview of what Don and Brandi MacDonald will be teaching at the Communication Extravaganza in Toronto on December 5, 2026. It’s a team event: bring your chiropractic assistants and associates and learn the communication skills behind retention, care planning, and noticing trend lines early.
Details and registration: https://theinformedchiropractor.com/toronto
Also mentioned in this episode
- The Communication Extravaganza comes to the Gold Coast on February 27, 2027
- The pelvic floor protocol seminar in Perth on February 20, 2027
- Don and Brandi’s book, The Polyvagal Shift, coming January 2027
Free “Intro to the Polyvagal Lens” for Chiropractors:
https://www.theinformedchiropractor.com/introduction-to-chiropractic-through-a-polyvagal-lens
- Trend Lines: The Chiropractic Communication Skill That Keeps Practice Members in Care - October 12, 2026
- Pelvic Floor Chiropractic: Pelvis, Fascia & Nervous System - August 30, 2026
- Women’s Health and Pelvic Floor Care in Chiropractic Practice - August 4, 2026
