Why Patients Leave Care and the Conversation That Keeps Them: Communication in Chiropractic with Dr. Don and Brandi MacDonald

Why do practice members leave care, and what can you do before it's too late? In this episode, Brandi MacDonald is back on the show for the first time in a long while, and we talk about the early signs that someone is drifting off-trend, and the conversations that keep them in care.

Retention isn't a strategy. It's a lag indicator. What you control are the lead indicators: noticing health trends and behavioural trends early, and having the honest conversation while it still matters.

In this episode:

• Why "retention strategy" is the wrong goal, and lead vs. lag indicators
• Trend lines: catching someone drifting toward the ditch before they hit it
• Why results come first: adjusting through a polyvagal lens with the MacDonald Safety Corridor Protocol
• Health trending: what to do when something happens that nobody pre-framed
• Brandi's three lenses (chiropractic, salutogenic and polyvagal) and moving people from "the one thing" to the whole thing
• Behavioural trends: the missed second visit, the "I don't know my schedule next week" moment, and comments at the front desk
• Why your chiropractic assistants are your "connector detector"
• Amiable chiropractors and conflict: "It's not conflict, it's just the truth"
• Topping up the rapport bank, and practising these conversations like an athlete
• Scripting and table talk vs. incidental learning
• Brandi on storytelling, depth and meaning in practice

Read the article: Why Patients Leave Chiropractic Care (and How to Notice Early)

We'll go much deeper on all of this, with role-play and our actual first-visit, report-of-findings, re-evaluation and front-desk systems, at The Gathering: The Communication Extravaganza in Toronto on Saturday, December 5, 2026. Doctors, chiropractic assistants, spouses and students are welcome: https://theinformedchiropractor.com/toronto

Also mentioned: our book, The Polyvagal Shift, coming in January; Healing the Chiropractor in Phoenix in January; the Communication Extravaganza on the Gold Coast in February; and something in the UK we'll keep you posted on.

This is clinical experience, not medical advice.

Free "Intro to the Polyvagal Lens" for Chiropractors: https://www.theinformedchiropractor.com/introduction-to-chiropractic-through-a-polyvagal-lens Join the Informed Chiropractor Collective: https://www.theinformedchiropractor.com/the-informed-chiropractor

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