Why Your Patients Aren’t Saying Yes—And How to Fix It Before the Report of Findings

You’ve been there.

The patient nods politely during your exam, seems engaged, maybe even says, “Wow, that makes sense.”

But then you present the treatment plan… and they vanish into the “I’ll think about it” black hole.

And if you’re like most chiropractors, you start second-guessing everything—your pricing, your explanation, your flow.

But here’s the truth: the case wasn’t lost at the report of findings. It was lost before that—on Day One.

The Real Reason Patients Don’t Commit

When patients say no (or worse, disappear without saying anything), it’s not usually about what you said during the ROF. It’s about what you didn’t uncover earlier.

Most chiropractors wait until the ROF to introduce treatment plans, costs, and long-term care options. But by then, the patient has already made a mental decision—often based on incomplete information or misunderstood expectations.

The fix? You’ve got to start the buying conversation before you ever talk about money or care plans.

Day One Isn’t Just a Consultation—It’s the First Decision Point

Let me be blunt: most chiropractors are losing patients on Day One because they’re only collecting symptoms, not commitment.

If you’re just running through O-P-Q-R-S-T and checking boxes for insurance, you're missing the emotional connection that drives real decisions.

You’ve got to ask the deeper questions:

• “How long has this been affecting your quality of life?”

• “Is health currently a high priority for you?”

• “Are you more interested in short-term relief or long-term restoration?”

You’re not just gathering information. You’re building a bridge—from where they are to where they want to go.

Pre-Framing Changes Everything

This is where pre-framing comes in. Think of it like tuning the patient’s mindset before you ever explain your treatment plan.

When you explain that symptoms are often the last sign of dysfunction—and not the full story—you start shifting their expectations.

When you compare low back pain to heart disease (“the first symptom is often a heart attack”), you’re creating what I call an epiphany bridge—a relatable moment that snaps them out of symptom-chasing and into long-term thinking.

That’s where real buy-in begins.

Time and Money: The Objections That Stop the Sale (If You Let Them)

Here’s what stops most chiropractors from closing more cases: they wait until the end to address the two biggest objections—time and money.

But these objections don’t start at the ROF. They exist in the patient’s mind from the very first conversation.

So why not surface them early?

One of my favorite questions to ask during the mini report of findings is:

“When it comes to committing to care, what’s going to be the bigger challenge for you—time or financial investment?”

That simple question uncovers the roadblocks before you ever get to the close. And it allows you to lead with empathy, clarity, and strategy.

The Mini ROF: Small Conversation, Big Commitment

I’ve taught this to thousands of chiropractors: the mini report of findings is a game-changer.

It’s a 5-10 minute conversation at the end of Day One that lays the groundwork for the actual ROF. You show them what’s going on. You introduce the idea of restorative vs. relief care. And you ask which direction they want to take.

It’s low-pressure, high-impact.

And best of all? It puts the patient in a mindset of ownership before you ever show them numbers.

Align Care Plans with Their Goals (Not Just Your Recommendations)

One of the biggest mistakes I made early on was assuming patients would automatically connect the dots.

They wouldn’t.

I’d give a thorough ROF, lay out a solid treatment plan, and they’d still hesitate—because I never took the time to align my recommendations with their stated goals.

When a patient tells you they want their migraines gone for good, that’s your anchor. You come back to it. You remind them what’s at stake. And you show them how your plan helps them get there.

Now you’re not just selling care. You’re guiding them to the future they already told you they want.

Bring the Health Partner to Day Two

If your patient is going to call their spouse after the appointment to ask, “Should I do this?”—why not have the spouse in the room?

Ask on Day One:

“Who do you talk to about your health decisions? Let’s have them join us for Day Two, so we can answer all your questions together.”

This one shift can dramatically increase retention and reduce confusion. Plus, it shows the patient you’re thinking ahead.

Influence Starts Before the ROF

If you wait until Day Two to “sell the plan,” you’re already behind.

The most successful chiropractors pre-frame, clarify, and align before they ever present treatment options.

They lead the patient through decision points early—so that by the time the report of findings arrives, it doesn’t feel like a pitch.

It feels like the next right step.

And that’s the goal. Not pressure. Not persuasion. Just clarity, confidence, and commitment.

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