All Case Studies
01

70% of your patients
never finish their
care plan.

An analysis of patient retention patterns across Australian chiropractic practices - and the system that brings them back.

Routiq - Australian Chiropractic Report 2026
02 - The Market

Chiropractic is one of Australia's fastest-growing allied health professions.

6,770
AHPRA-registered chiropractors growing 3-4% annually
~$337M
Combined Medicare + private health insurance chiropractic benefits annually
54.9%
of Australians have private health extras cover - chiro is one of the most claimed categories
22.4
chiropractors per 100,000 population - up 12% since 2014
80% intend to continue practising
75.8% practise in metropolitan areas
32.8 hrs average clinical hours per week
AHPRA Annual Report 2024/25, NHWDS, APRA
03 - The Problem

Chiropractic care is designed
to be ongoing. Patient behaviour
says otherwise.

70%
never complete their recommended care plan
20%
drop out after just 3 visits
70%
increased disengagement risk after a single missed appointment

Corrective care plans typically span 12-24 sessions. Maintenance protocols call for adjustments every 4-6 weeks. These are long-term treatment plans being abandoned after a handful of visits.

WebPT, SPRY PT, TrackStat
04 - The Cost

The economics of ignoring retention.

Most practices spend 80% of their marketing budget chasing new patients while existing patients silently disappear.

$300-$1,000
Cost to acquire a new patient
5-25x
cheaper to retain an existing patient than acquire a new one
$10,400+
lost per practitioner per year from just 2 weekly no-shows
25-95%
profit increase from 5% improvement in patient retention
Bain & Company, Harvard Business Review, TrackStat, Artisan Growth Strategies
05 - What We See

A consistent pattern across every chiropractic practice we analyse.

Across the practices we reviewed, a consistent pattern emerged - regardless of size, location, or specialty mix. The vast majority of patients in every database were lapsed, reachable by SMS, and had never received a single recall message.

What follows is representative of what we typically see in chiropractic practice databases.

06 - The Pattern
~70%
of patients are lapsed beyond 90 days

In a typical chiropractic practice database, around seven in ten patients haven't been seen in over 90 days. Many haven't visited in years.

Typical patient recency distribution

0-30 days
~15%
31-90 days
~15%
91-180 days
~10%
6-12 months
~12%
1-2 years
~13%
2-3 years
~10%
3+ years
~25%
Routiq Practice Analysis 2026
07 - The Gap
No system.

Most chiropractic practices have no automated system for identifying patients who've dropped out of their care plan, understanding where they are in their treatment, or sending clinically-relevant recall messages at scale.

Practice management software manages bookings. It was never designed to bring patients back.

08 - The Segments

Four reengagement segments hiding in every chiropractic database.

~35%
Care Plan Dropouts
Patients who started a corrective care plan but stopped before completing it. 8-16 sessions remaining at $65-$85 per visit.
8-16 sessions remaining at $65-$85/visit
~20%
Maintenance Lapsed
Patients who completed their corrective plan but fell out of their maintenance schedule. Should be returning every 4-6 weeks.
$65-$85/visit recurring every 4-6 weeks
~25%
Initial Contact Only
Patients who attended an initial consultation and never returned. The assessment identified issues. The care plan was never started.
Full care plan value $780-$1,800+
~5%
No-Show Recovery
Patients who booked and didn't arrive. The intent was there. Life got in the way. A simple, no-guilt rebooking message recovers the warmest leads.
Warmest leads in the database
Routiq Practice Analysis 2026, WebPT, TrackStat
09 - The Opportunity

What reengagement looks like for a typical chiropractic practice.

Based on a practice with 3,000 patients, ~70% lapsed, at standard Australian private chiropractic rates.

SegmentEstimated PoolReengagement RateRecoveredAvg ValueRevenue
Care Plan Dropouts~73510%74$525$38,850
Maintenance Lapsed~42012%50$75$3,750
Initial Contact Only~5258%42$975$40,950
No-Show Recovery~10525%26$75$1,950
Total - First Pass192$85,500

And maintenance patients don't come once - they come every 4-6 weeks. Those 50 recovered patients generate $3,750 every 4-6 weeks = $40,000+/year in recurring revenue.

Modelled on Australian private chiropractic rates. Conservative reengagement assumptions.
10 - Industry Validation

These numbers aren't optimistic. They're conservative.

15-25%
of lapsed patients are successfully reengaged by targeted recall campaigns
42%
click-through rate on healthcare SMS messages (vs 2-3% for email)
38%
reduction in no-shows from SMS appointment reminders alone
97-99%
of SMS messages are read (vs 80-90% contact rate for phone calls)
60-70%
chance an established patient will rebook when prompted
~99%
of patients in practice databases have a mobile number on file - and virtually none have opted out of SMS
LionShare, Dialog Health, Klara, PMC, Etactics
11

“Can't I just get my CA
to send some texts?”

Sending messages is easy. Getting lapsed patients to act is the hard part.

12 - The Science

82 cognitive principles from Nobel Prize-winning research. Applied to every message, automatically.

Routiq's messaging engine is built on behavioral science frameworks from 20 seminal works in psychology and economics - not marketing copywriting.

Loss AversionCommitment & ConsistencyDefault EffectSocial ProofReciprocityShrink the ChangePlanning PromptsIdentity-Based FramingPratfall EffectAnchoringEndowment EffectFresh Start EffectGoal GradientImplementation IntentionsPeak-End Rule
82 behavioral principles
20 seminal research works
Chiropractic-specific treatment protocols
13 - In Practice: Care Plan Dropouts

Commitment & Consistency + Goal Gradient

Generic Recall
“Hi! We haven't seen you in a while. Call us to book your next chiropractic appointment!”
Behaviourally Optimised
“Hi Sarah, you're 8 sessions into your 16-session corrective plan - halfway there. Most patients really start feeling the difference around sessions 10-12. We'd love to get you back on track before you lose the progress you've made. Reply BOOK and we'll find a time.”

The first asks for action. The second activates commitment & consistency (you started this plan), goal gradient (you're halfway there), and loss aversion (don't lose the progress you've made). Loss-framed messages outperform gain-framed messages by 2-3x in healthcare settings.

14 - In Practice: Maintenance & No-Shows
Generic - Maintenance
“Time for your next adjustment?”
Behaviourally Optimised
“Hi James, your last adjustment was 10 weeks ago - we'd normally see you every 4-6 weeks to keep your spine aligned and prevent issues from building up. Most of our maintenance patients find that regular adjustments keep them feeling their best. Would you like to get back into your routine? Reply BOOK and we'll find a time.”
Generic - No-Show
“You missed your appointment. Please call to reschedule.”
Behaviourally Optimised
“Hi Alex, we noticed you couldn't make your appointment last week - no worries at all! Would you like to rebook? Reply 1 for Tuesday morning, 2 for Thursday arvo, or CALL and we'll ring you.”

Loss aversion (prevent issues from building up), anchoring (10 weeks vs. 4-6 week norm), pratfall effect (zero guilt for no-shows), and planning prompts (specific options, not open-ended).

15 - Campaign Architecture

The 3-touch behavioural escalation sequence.

Every campaign follows the same evidence-based structure. Three messages. Three psychological mechanisms. Automated and personalised.

Touch 1 - Day 1

Commitment & Consistency

“You started a corrective plan and made great progress through 8 sessions. Most patients start feeling real improvement around sessions 10-12. We'd love to help you finish what you started.”

Touch 2 - Day 5

Default Effect

“We've found a time for you on Wednesday at 2pm with Dr M - reply YES to confirm, or CHANGE for other options.”

Touch 3 - Day 10

Social Proof + Scarcity

“Most of our patients on maintenance plans find that regular adjustments keep them feeling their best. We have a couple of spots left this week if you'd like to get back on track.”

16 - Why Routiq

Three layers no one else has.

Layer 1
Clinical Intelligence

Routiq doesn't know a patient is “overdue.” It knows they're 8 sessions into a 16-session corrective plan, their last adjustment was 10 weeks ago vs. a 4-6 week protocol, which practitioner they see, and which location they attend.

Layer 2
Behavioral Science

82 principles from 20 seminal works in psychology and behavioral economics. Not copywriting tips - systematic frameworks applied automatically. Each segment gets the right lever at the right time.

Layer 3
Automation at Scale

Every patient monitored daily. Messages sent at the exact overdue moment. Replies handled instantly with AI-powered clinical context. Works nights, weekends, holidays. Sends from your own clinic number.

17 - Comparison

Where Routiq sits.

CapabilityFront Desk / CAPMS / ClinikoRoutiq
Messages per day~20 (manual)Basic remindersUnlimited, daily
Knows care plan progressIf they checkStores data, doesn't act on itYes - protocol-based
Triggers at exact overdue momentNoNoYes - chiropractic protocols
Segments by priorityNoNoYes - 4 segments
Behavioral science messagingNoNo82 principles, systematic
Multi-touch campaign escalationNoNo3-touch, automated
AI-powered reply handlingDuring office hoursNoInstant, 24/7
Works after hoursNoNoYes - always on

Your PMS holds the data. Routiq turns that data into revenue.

18 - The Compound Effect

Reengagement isn't a campaign. It's a system that compounds.

Maintenance patients don't come once - they come every 4-6 weeks. Each reactivated patient becomes recurring revenue. Based on recovering 30 patients per month at $75/visit.

Month 1
$2,250
Month 2
$6,750
Month 3
$11,250
Month 4
$18,000
Month 5
$24,750
Month 6
$31,500

By month 6: 180 reactivated patients. Care plan completions worth $500-$1,800 per patient in additional treatment value.

19 - Your Practice

What this means for your practice.

The pattern is universal. The opportunity scales with your database size.

Your Database SizeEstimated Lapsed (~70%)Conservative RecoveryModerate Recovery
1,000 patients700$15,750$31,500
2,000 patients1,400$31,500$63,000
3,000 patients2,100$47,250$94,500
5,000 patients3,500$78,750$157,500
10,000 patients7,000$157,500$315,000

Based on blended average treatment value of $450 per patient and industry-standard 70% lapse rate across chiropractic practices. Excludes recurring revenue multiplier from maintenance patients.

Industry benchmark: 15-25% of lapsed patients can be successfully re-engaged via recall campaigns
20 - The Bottom Line

Without Routiq

Thousands of lapsed patients sitting idle
No automated recall system
Revenue dependent on new patient acquisition
CA doing manual follow-ups (when they remember)
No care plan visibility on who dropped out or when
80% of marketing budget on acquisition

With Routiq

Every patient actively monitored and reengaged
Chiropractic treatment protocols running daily
Revenue from patients you've already acquired
Automated campaigns with behavioral escalation
Care plan progress tracked for every patient
Fraction of the cost, 10x the ROI
21

You already did the hard part - building a patient base, earning their trust, helping them move without pain.

Those patients didn't leave because they were unhappy. They left because life got busy and nobody reminded them.

Their spine hasn't stopped needing care. They just need the right nudge.

How much of your dormant revenue do you want to leave on the table?

22 - Sources

routiq.

Clinical Intelligence Meets Behavioral Science

routiq.ai

Industry statistics sourced from:
AHPRA Annual Report 2024/25
National Health Workforce Dataset (NHWDS)
AHPRA Workforce Registrant Aggregated Profile (WRAP)
Australian Institute of Health and Welfare (AIHW)
Australian Prudential Regulation Authority (APRA)
Medicare Benefits Schedule Data
Bain & Company / Harvard Business Review
WebPT / SPRY PT / TrackStat
Dialog Health / LionShare
PMC Systematic Reviews

Practice analysis data from Routiq platform analysis. All data anonymised and presented as industry patterns. February 2026.