Lay the Groundwork for Chiropractic,
Build Up to Long-Term Adjunct Therapies

“Language is a form of communication! Conversation isn’t just crossfire where you shoot and get shot at! Words aren’t only bombs and bullets - no, they’re little gifts, containing meanings!” –Philip Roth

By Jeffrey D. Olsen, DC

You’re telling your patients how wonderful chiropractic is all the time, but you wonder why some of them still don’t seem to get the message. The fact is, an over-emphasis on spreading the broad chiropractic message to your patients might be doing you and your practice a disservice. A message offered without proper planning is rarely a message delivered. With a little bit of thought, you can tailor your communication so it is heard on an entirely deeper level than you may be accustomed to.

A recent survey of chiropractic patient satisfaction sheds a little light on what patients think. In a survey of 150 randomly selected patients, more than 90% of them rated their chiropractors “excellent” in personal manner and 83% thought their technical skills were excellent. But only 73% believed that the doctor’s explanation of procedures was excellent, clearly leaving room for improvement in doctor-patient communication. (Gemmell HA, Hayes BM. Patient satisfaction with chiropractic physicians in an independent physicians’ association. Journal of Manipulative and Physiological Therapeutics 2001:24(9), pp. 556-559.)

In general, new patients want to hear three main pieces of information:

• What is my problem?

• How long is it going to take to get better?

• How much is it going to cost?

DCs who launch into a full-blown presentation of chiropractic without answering these three questions early in the conversation with a new patient might find themselves faced with a nodding, eye-glazed client.

That client might leave wondering what you were talking about and with his or her basic questions unanswered. To avoid overdosing a new patient with too much information, especially one who has been in pain for a long time, save a large part of your educational information for a time in the near future, after you demonstrate that you can, in fact, help the patient.

As their pain goes away, their “hearing” improves, and they will be able to understand and retain the information you offer. All this in no way implies you should ignore the patient’s long-term educational needs, or your need to communicate in a continuing manner. In fact, to relate to patients as their focus changes from pain relief to wellness, you’ll need to have paid attention and taken some notes on each patient in the early stages of your relationship. That way, when the time comes to offer more information, you’ll know how to proceed.

Learning Styles Differ
This involves listening for cues to the patient’s own learning style and desire for information. People vary in their styles of learning, and combinations of styles, including those who learn best by visual information, those who learn through auditory methods, those who learn by touching or doing (kinetic), and those who superimpose an emotional value to their learning.

Here’s how to listen for your patient’s style:

· If the patient says, “What do you do in a treatment? I want to see what it’s like,” the doctor needs to pick up on that and say, “Come on in, let’s look at a patient receiving this particular treatment (with patient B’s permission). The doctor could also offer a video for the patient to watch.

· If someone says, “I’ve heard chiropractic helps headaches,” the doctor can give them a video or audiocassette on the topic to watch and listen on their own.
· If someone says, “I just feel like chiropractic could help me, then the doctor needs to paint an emotional picture for them, helping them to imagine how much better they will feel in the morning when the pain is relieved. This would also be the person who would benefit most from reading through a book of letters/testimonials of patients who have been helped.

Listening and “Overhearing”
Once you have an organized way to record what you learn about your patients, make sure you’re not missing out on ways to communicate throughout your office. Posters, display models, CA training, videos and brochures are important ways to offer information to your patients.

But an interesting aspect that provides several benefits is to let patients overhear your discussions with other patients. Most treatment rooms have four walls and a door. In our practice, we have taken down some of the walls and put up partitions between treatment areas.

There is still a level of privacy, but now patient Smith can “overhear” you telling patient Jones how well her knee is doing. Maybe Smith never knew chiropractic could treat knee problems; he’s just there for help with neck pain. That makes him think of his friend or co-worker who complains of a bad knee.

Not only does “overhearing” spread information around to more than one patient at a time, but it keeps patient discussions on target to the treatment. Patients will realize you’re there to do a specific job and will be less likely to talk about the weather or the latest ballgame.

Of course, we still have an exam room with a door, and when it’s time to deal with someone’s personal, specific problem, it’s done behind closed doors.

When to Introduce Adjunctive Therapies
Often, doctors wonder when it’s appropriate to introduce adjunctive therapies - nutritional products, hair analysis, orthotics, and sleep aids, for example. The answer is: once you’ve dealt with the primary concern, then you can start talking about long-term stabilization. The pillows, orthotics, back rests, etc., are all designed to support a patient in a new, better health status and to reduce the stresses from daily living that they encounter so that they can avoid future problems.

You also want patients to know that the primary help is coming from the chiropractic adjustment, and you need to establish that first. The patient needs to realize that relief they are getting is coming from the relationship together, between the doctor and patient, making physical changes, and the patient following up with lifestyle changes. This is not to say that you don’t lay the foundation for a product or therapy you think may be helpful in the near future or long run for a patient.

On a first visit, let the patient know that your best care includes specific spinal care. In the case of orthotics, for example, mention that there are custom-made products that will support the patient’s posture, but that you’ll introduce those things over time as you find they are necessary and think they will help the patient.

By the third visit or so, you would determine whether the patient has improved and done well with the chiropractic adjustments and other changes he or she has made to their walking, sitting, or sleeping habits.

At this point, you could mention that now would be the time to consider orthotics (or nutrition, dieting, etc.). The patient would remember that you had mentioned this at an earlier visit, and not feel like you were springing something new on them.

Used at the right time and in the context of your physical care and knowledge of your patient, this sort of education/communication combines improvements in:

• patient satisfaction;
• their actual knowledge of chiropractic;
• their belief that you not only have a nice manner but explain procedures well; and
• their desire to continue the advances they are making in better health and vitality.

Now that’s a combination that should lead to long-term patient retention. In communicating such new and large amount of information, give your patients the big picture first, and then start them on the small steps to get there.

Dr. Olsen is a 1996 Presidential Scholar and summa cum laude graduate of Palmer College of Chiropractic. He has been in private practice with his two brothers/partners since 1997, in Roanoke, Va. Dr. Olsen has served as an adjunct faculty member at the College of Health Sciences in Roanoke, Va., teaching in the physician assistant department. He serves as technical advisor at Foot Levelers, Inc.