38% of your patients drop off before finishing their treatment plan.
An analysis of patient retention patterns across Australian osteopathy practices — and the system that fixes it.
Routiq — Australian Osteopathy Report 2026Osteopathy is one of Australia's fastest-growing allied health professions.
Osteopathy care plans are designed for resolution.
Patient behaviour says otherwise.
Typical osteopathy care plans run 4–8 sessions for acute presentations, with maintenance every 4–6 weeks for ongoing management. Most patients disengage well before the plan is complete.
BMC Health Services Research (ORION Study), WebPTThe economics of ignoring retention.
Most practices spend their marketing budget chasing new patients while existing patients silently disappear.
A consistent pattern across every osteopathy practice we analyse.
Across the practices we reviewed, the same story repeated — the majority of patients are lapsed beyond their treatment plan window, reachable by SMS, and have never received a clinically-relevant message prompting them to return.
What follows is representative of what we typically see in osteopathy practice databases.
In a typical osteopathy practice database, more than two-thirds of all patients haven't been seen in over 90 days. Many haven't returned in years.
Typical patient recency distribution
Most osteopathy practices have no automated treatment-plan-aware recall system. No system that knows a patient is 3 sessions into a 6-session plan, or 8 weeks past their maintenance window, and triggers the right message at the right moment.
Practice management software manages bookings. It was never designed to bring patients back.
Four reengagement segments hiding in every osteopathy database.
What reengagement looks like for a typical osteopathy practice.
Based on a practice with 2,000 patients, ~70% lapsed beyond 90 days, at standard Australian osteopathy rates.
| Segment | Estimated Pool | Reengagement Rate | Recovered | Revenue |
|---|---|---|---|---|
| Care Plan Dropouts | ~490 | 10% | 49 | $20,580 |
| Maintenance Lapsed | ~280 | 12% | 34 | $4,760 |
| Initial Contact Only | ~350 | 8% | 28 | $23,520 |
| No-Show Recovery | ~70 | 25% | 18 | $2,520 |
| Total — First Pass | 129 | $51,380 |
Those 34 recovered maintenance patients generate $4,760 every 4–6 weeks in recurring revenue. And care plan dropouts who finish their plans often convert to maintenance patients themselves.
Modelled on Australian private osteopathy rates. Conservative reengagement assumptions.These numbers aren't optimistic. They're conservative.
“Can't I just get my receptionist to send some texts?”
Sending messages is easy. Getting lapsed patients to act is the hard part.
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.
Commitment & Consistency + Goal Gradient
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). Patients who see their progress quantified are significantly more likely to complete their plan.
Anchoring (10 weeks vs 4–6 week norm), loss aversion (improvements reversing), default effect (a spot already held), pratfall effect (zero guilt for no-shows), and planning prompts (specific options, not open-ended).
The 3-touch behavioural escalation sequence.
Every campaign follows the same evidence-based structure. Three messages. Three psychological mechanisms. Automated and personalised.
Commitment & Consistency
“You're 3 sessions into your 6-session treatment plan. Most patients notice real improvement around sessions 4–5. We'd love to keep your progress on track.”
Default Effect
“We've held a spot for you on Thursday at 2pm. Without regular sessions, the progress we've made can start to reverse. Reply YES to confirm.”
Social Proof + Scarcity
“Most of our patients who complete their full treatment plan report lasting improvement. We have a couple of spots left this week if you'd like to get back on track.”
Three layers no one else has.
Routiq doesn't just know a patient is “overdue.” It knows they're 3 sessions into a 6-session plan for their lower back, their last visit was 10 weeks ago, and their maintenance interval is every 4–6 weeks. Osteopathy-specific protocols built in.
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.
Daily monitoring against each patient's treatment plan and maintenance schedule. Messages sent from your own practice number at the exact overdue moment. Replies handled instantly with AI-powered clinical context. Works nights, weekends, holidays.
Where Routiq sits.
| Capability | Front Desk | PMS / Cliniko | Routiq |
|---|---|---|---|
| Messages per day | ~20 phone calls | Basic reminders | Unlimited, daily |
| Knows treatment history | If they check the chart | Stores data, doesn't act on it | Yes — protocol-based |
| Triggers at overdue moment | No | Manual setup | Yes — treatment-plan-aware |
| Segments by priority | No | No | Yes — 4 segments |
| Behavioral science messaging | No | No | 82 principles, systematic |
| Multi-touch campaign escalation | No | No | 3-touch, automated |
| AI-powered reply handling | During office hours | No | Instant, 24/7 |
| Works after hours | No | No | Yes — always on |
Your PMS holds the data. Routiq turns that data into revenue.
Reengagement isn't a campaign. It's a system that compounds.
15 maintenance patients recovered per month at $140/visit. Each reactivated maintenance patient becomes recurring revenue every 4–6 weeks.
By month 6: 90 reactivated maintenance patients generating $12,600 every 4–6 weeks in recurring revenue.
What this means for your practice.
The pattern is universal. The opportunity scales with your database size.
| Your Database Size | Conservative Recovery | Moderate Recovery |
|---|---|---|
| 1,000 patients | $12,600 | $25,200 |
| 2,000 patients | $25,200 | $50,400 |
| 3,000 patients | $37,800 | $75,600 |
| 5,000 patients | $63,000 | $126,000 |
Based on blended average of $360 per recovered patient and industry-standard lapse rates across osteopathy practices. Excludes recurring revenue multiplier from maintenance cycle.
Industry benchmark: 15-25% of lapsed patients can be successfully re-engaged via recall campaignsWithout Routiq
Front desk making ~20 calls a day (80% voicemail)
Revenue dependent on new patient acquisition
No visibility into incomplete treatment plans
Maintenance patients quietly disappearing
No system to detect overdue care plan dropouts
With Routiq
Osteopathy-specific protocols running daily
Revenue from patients you've already acquired
Automated behavioral campaigns for every segment
Treatment-plan-aware recall intervals
Fraction of the cost, 10x the ROI
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 body 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?
routiq.
Clinical Intelligence Meets Behavioral Science
routiq.ai
AHPRA Osteopathy Board of Australia
Osteopathy Board of Australia — Registration Data
BMC Health Services Research (ORION Study)
Australian Institute of Health and Welfare (AIHW)
Medicare Benefits Schedule Data
Bain & Company / Harvard Business Review
WebPT / TrackStat
Dialog Health / LionShare Marketing
PMC Systematic Reviews
Practice analysis data from Routiq platform analysis. All data anonymised and presented as industry patterns. February 2026.