Issue 3 - March 2004

Promises, promises!
How to get your patients to comply
By Rob Jackson, DC

Do all of your patients do as you tell them? And even if they do — are they complying to please you or because they have embraced a regular schedule of chiropractic as a way to a healthier, more active life?

As a practicing chiropractor for more than 20 years, I’ve always envisioned my desire to have patients comply as something positive. The key isn’t to force patients to do what you want them to do, but to educate them with the proper amount of data at the appropriate time.

If you offer too much, your patients may feel overwhelmed and frustrated. If you don’t relay enough, then what you say may seem too simple to be true. And if you give the right information but at the wrong time (such as when the patient is in acute pain), your patients won’t hear it, even if they appear to be listening.

Timing, as they say, is everything. And it is critical, if your patients are to benefit from chiropractic to the fullest extent possible.

Here are some tips on improving your timing — and getting your patients to comply with your chiropractic wishes:

1Listen to hear. Use active listening to truly hear what patients tell you.

I’ve had a lot of experience with active listening. Having given thousands of reports of findings, I have spent a great deal of time challenging my hearing skills with my patients, without putting their thoughts and feelings through my personal “doctor filter.”

One of the most frequent complaints that patients have with their medical doctor, is that the doctor always seems to be writing and rarely seems to be listening. These doctors give precedence to completing the chart and paperwork over listening to their patients.

Learn a lesson from patient complaints: Be sure you are present with your patients. Tune out the outside world and minimize distractions within the adjusting and exam rooms. Allow interruptions only under the most extreme of circumstances.

Sit just below eye level with your patients, even if you have to raise or lower your chair. Look at them when they are speaking and ask questions relative to what they are saying.

Ask them about their previous experiences with other doctors and learn why they’ve changed clinics or are trying a new approach. This information will help you have some insight as to what makes each individual patient tick.

2Watch your body language. Remember that as patients are speaking, they are learning about you as well. As people relay the details of their experiences, try not to shake your head with disapproval concerning the previous choices they have made.

Try nodding your head in approval about their new decision to come to your office and explore chiropractic and show understanding of their feelings. Let them know by your body language that you are listening and you care.

3Use patient-education protocols. Offering a patient what they need to know when they are capable of receiving it takes a little practice, but mostly just requires basic common sense. Simplify your office educational system by using a protocol that has structure for everyone to follow.

Use a system that offers information on the first twelve visits, so when the protocol is complete, you have helped inform a more wellness-oriented patient who can then successfully refer others.

4Train your staff. The staff is often more important in carrying out procedures than the doctor, so be sure they are in full awareness of your protocol. Encourage your staff to be focused and knowledgeable enough about protocols so they won’t act like robots but instead will be dynamic participants who can adjust their thinking and actions according to situations that arise.

5Adapt to the situation. Use common sense when a specific protocol doesn’t match where a particular patient is with his or her care.

For example, when you have a patient with acute, debilitating back pain who looks more like the letter “r” than an upright human, skip the educational video on the benefits of chiropractic, complete their paperwork in interview style so they do not have to do the writing and get them into your relief care program as soon as possible.

Save your typical first visit procedures until the patient is well enough to accept the information.

6Be upfront about the costs of services. This is as simple as it sounds. Let your patients know how much every stage of their care will cost, what forms of payment you accept and the boundaries of their insurance coverage, if appropriate.

Put these items in writing and be sure they sign a financial agreement on a legal document that lets them know, without question, your policies.

Be direct. Be succinct. And be sure that either you or a staff member is always on hand to ask for payment and relay financial information to your patients upon their request.

7Respect your patients’ time. More people stop coming in for wellness care because they don’t have the time than because they don’t have the money. If you take appointments, stay on schedule and let patients know how far behind you may be. Realize that if patients don’t feel that you are respectful of their time and are notoriously off schedule, they’ll stop coming in.

Consider changing your lunch break to earlier or later than normal. Patients would like to come in during their lunch hour, but if you’re closed for the time they can commonly take lunch, working around your schedule may not be workable at all.

Remember you’re providing a service so be more service-oriented. Try scattering your schedule so you have a doctor available before and after normal work hours, during lunch hours and for at least a partial day on the weekends. An office with this kind of flexibility is much more likely to attract the masses than one who has restricted availability.

Compliance really isn’t about brainwashing patients to do as you say. I prefer, for chiropractic purposes, to redefine it as the act of informing patients with what they need to know, when they need to know it, so they can make the best, most educated decisions for the greater health of themselves and their family.

Dr. Rob Jackson is president and CEO of Backtalk Systems, Inc., a company that provides contemporary patient-education communication tools and patient-centered protocols to advance the acceptance and utilization of chiropractic. He also owns an active, multi-doctor practice in Denver, Colo. He can be reached at 800-937-3113 or through his Web site, www.backtalksystems.com