We spend a lot of energy worrying about how to keep people in care. Better reminders, nicer follow-ups, the occasional guilt text. But most of the drop-off happens for the same reasons: the pain eases, motivation dips, and the patient decides they are "good enough" before the job is actually done.
Reminders don't work with patients, but a carrot to chase does.
In my clinic, I call it the Shift Score. One honest number out of 100, captured at regular intervals and shown to the patient every time. It makes progress visible, and people stay when they can see they are improving. It also keeps everyone honest, because "I feel okay" and "I am actually rebuilt" are two very different numbers.
We re-score every four weeks. It serves as a self-check that things are progressing the way I want them to, and keeps patients motivated for the long game.
What tests are you currently using at the start of care and at your progress evaluations?