Consumer Empowerment: How to Meet Patients’ Wants and Needs
By Louis Sportelli, DC

Information overload is perhaps one way to describe the bombardment of material being disseminated daily via TV, newspaper, radio, Internet, e-mail, and other methods of delivering "messages" to would-be targeted audiences. The traditional advertising outlets have given way to newer and more creative small screens on the gas pump, to the television monitor at the grocery checkout counter, to the monitor in the elevator. Every waking moment is filled with someone wanting to get our attention.

Take the pharmaceutical industry. Television and magazines have changed 180 degrees in how pharmaceutical ads have been revised from an originally very focused sales program involving detail salespeople calling only on doctors and pharmacies, to the launching of a new bold and aggressive “direct-to-consumer” approach. The ads are all fairly similar. They begin with an image of someone in distress, followed by an image of smiles and contentment made possible by the ingestion of “this drug” or “that drug,” with the tagline... “ask your doctor about…”, followed by a rapid fire, almost non-intelligible litany of adverse side effects. Then the smiling faces appear once again.

This message of supposed hope and health, delivered in 60 seconds or less, transforms an image of discomfort into an image of vibrancy, and all this can be yours by asking your doctor for the “brand-named” drug as advertised. It is a very clever, almost brilliant, move to drive the utilization of the drug from the consumer end-user influence. This new movement of consumer information, coupled with consumer empowerment, is driving most of the decisions affecting healthcare today.

What about chiropractic information and education? There simply are no multi-million dollar ad campaigns driving the potential chiropractic patient to the offices of doctors of chiropractic. There are no television programs featuring chiropractors as heroes with successful outcomes for life-threatening conditions.

There is no inherent glamour or sex appeal in wellness, and certainly no multi-million dollar pharmaceutical budgets allotted to advancing the cause of a non-drug, non-surgical profession.

How then does the doctor of chiropractic market his or her profession and develop a practice that is successful and focuses on expanding new “market share” rather than trying to entice the already-established chiropractic patient away from the chiropractor down the street?

Education, Education, Education
People cannot accept what they do not understand. Chiropractic is a different paradigm of healthcare. It is not an easy task to change a paradigm, much less to do it without huge financial outlays. In the case of chiropractic and the pragmatic economics of our profession, this task has been relegated to education - one patient at a time.

Undoubtedly, the “Baby Boomer” consumer is a more sophisticated, more educated, more discerning and more discriminating health-care consumer than ever before. There is also a different attitude among these new health-care consumers that makes them very receptive to the model of health and wellness that chiropractic can potentially offer.

The word empowerment is the most appropriate term to describe the attitude of today’s health-care consumer. They are empowered by the Internet, the ease of access to information, the lack of reverence for the established medical community, a financial stability unknown to any previous generation, and a political savvy unparalleled in the history of our democracy. Facts and information drive the new breed of health-care consumer.

The chiropractic profession has undergone an evolution from 1960 to 2000 that virtually has come full circle. In the early ’60s, with the efforts of the American Medical Association to contain and eliminate the chiropractic profession, doctors of chiropractic took great pains to educate each and every patient that entered their doors. Chiropractic care, if sought by the patient, was paid for from the discretionary funds of the family budget. On each and every visit, the doctor of chiropractic had to earn his or her stripes.

Through education and experience, patients in the ’60s became chiropractic advocates and told others, and the story repeated itself over and over again. During those years, chiropractic enjoyed a 10-15% market share increase - not as a result of Madison Avenue public relations programs, but by one-to-one communication.

Enter the ’70s and ’80s - the decades of reimbursement - and many patients were provided chiropractic coverage under their health benefit programs. They went to the doctor of chiropractic with health coverage, and there was seemingly less precious time to explain the benefits of chiropractic to each and every patient each and every time. Economic success for the DC was short-lived and a new era emerged - that of managed care.

The managed care model has fostered the concept of chiropractic exclusion from health-care programs. Chiropractic went from the 10-15% utilization to less than one half of one percent in many managed-care health plans. Discretionary dollars in the family budget were rapidly eliminated, and the decision to pay for chiropractic care out-of-pocket became problematic.

Now, times are changing and many consumers are demanding chiropractic services as part of a health-care benefit. Many doctors of chiropractic who survived and flourished during these tough times did so because of a systematic program of education for their patients.

Modern Measures
The patient report of findings has been, and in all probability always will be, one of the most significant discussions a provider will have in order to establish a doctor-patient relationship. The report of findings can establish confidence, promote understanding, and become the fundamental basis for why chiropractic care is the approach that is right for this patient and the patient’s family and friends.

Patients visit doctors of chiropractic for a variety of reasons. Some are pre-conditioned and positive about the ability of chiropractic to help them. Often this is the patient referred by another enthusiastic and satisfied patient who truly understands the value of chiropractic. This may be about 10% of the population.

Others come because they have not been satisfied with the traditional care they have been receiving, but still are skeptical about chiropractic, often times because of previous negativity or articles or programs that did not portray chiropractic in a very favorable light. These two groups constitute approximately 10% to 15%.

Then there is the 10% who are so prejudiced and biased that they would sooner walk on hot coals than visit a doctor of chiropractic. This group has been so poisoned from whatever influence that they are lost to any chiropractic education.

There is, however, a huge percentage - at least 70% of the population - that has no preconceived notion about chiropractic. They do not harbor prejudice or bias, they simply do not have any understanding of what a doctor of chiropractic is or what a doctor of chiropractic does. This is the group that must be targeted with an educational program designed to answer questions in a reasonable, rational way. This is the group that when they elect to visit a doctor of chiropractic must be provided with a believable report of findings as the foundational basis for a long-term relationship.

Doctors of chiropractic need to examine closely their educational materials and see if the message contained within those brochures, videos or pamphlets is congruent with the mind set of today’s consumer. These consumers don’t want to hear why “medicine is bad” or “how medicine is going to kill you,” or an type of attack on medicine.

They want to know why chiropractic is good and why the chiropractic model of healthcare is consistent with their belief system or can provide a logical or reasonable explanation of how health can be restored with chiropractic care. They are looking for alternative ways to obtain health. Every study to date has validated the concept that today’s patients are looking to become educated, looking to participate in their healthcare, and looking for a doctor with whom they can establish trust.

The patient education programs that are undertaken by doctors of chiropractic to educate the public must be well-designed, systematic, credible and believable. The consumers of today are not looking for ethereal explanations, mystical concepts or supernatural overtones. They are looking for reasonable, rational, logical and believable explanations of why chiropractic care is appropriate for their condition(s).

It is with this thought in mind that the best practice-building procedure in the world is a satisfied patient who understands chiropractic concepts as they relate to his or her own paradigm of the world. Patients who have grown up with the allopathic model and have opted to seek non-allopathic care have taken a giant leap in responsibility for their own health. Many desire a health-care partnership with their doctor and are empowered by the information age.

When this combination of attitudes and circumstances collide, the chiropractic model of health and wellness simply makes sense.

When the communication is effective, practices will explode, referrals will increase, risk will be minimized, enjoyment of practice will be restored, and the profession will advance with astonishing speed. It is important to recognize that the first visit is an opportunity to establish a bond with the patient that is not afforded any other time. The history, physical examination, diagnostic evaluation, and ultimately the report of findings, will provide the basis for a long-standing relationship. The report of findings is an ideal opportunity for the doctor of chiropractic to educate patients both verbally and through effective patient literature about the importance of chiropractic care.

To make the ’00s (and beyond) a successful period in chiropractic history, it will require the diligent effort of the profession to transform each and every patient into a student and each and every practitioner into a teacher.

Dr. Sportelli is the president of Practice Makers Products, Inc., and the author of the patient education brochure "Introduction to Chiropractic." He can be reached at 800-345-3099 or practicemakers@aol.com; or sign on to www.practicemakers.com for a sample copy of the brochure.