Issue 3 - March 2004

Tips and tools for effective patient education
By William D. Esteb

Do you need grounds for “adjusting” your patients’ brains as well as their spines? If you need an excuse for delivering a systematic patient-education program, consider that educated patients spend more money, are better satisfied with their care, have greater respect for you, set appropriate expectations, remain under care longer and are better equipped to refer others.

Patient education starts with identifying your intentions when accepting a new patient. What outcome(s) are you hoping to achieve? To have a patient only for as long as insurance will reimburse — or to have a patient for life? If your intent is to foster relationships that extend beyond the reduction of symptoms and insurance coverage, an organized program of patient education is essential.

While you should personalize the education process for each patient, every patient needs to be exposed to a core body of information. To help you avoid sounding like a repetitious parrot, use tools that leverage your time and talent and convey information quickly and consistently. Here are the most essential:

Visit 1: Orientation

Begin teaching patients what chiropractic is and isn’t on their first visit.

• Introductory video. Show new patients a short video before your consultation to reduce apprehension and the fear of the unknown and to provide orientation. The staff should introduce the video in terms of how the patient benefits, such as: “The doctor would like you to see a short, six-minute video so you’ll know what to expect on your first visit with us.”

Although a few of the most cynical patients may see this video as some type of “sales” effort, the intent is merely to put the patient at ease and offer hope.

• Consultation. The primary focus of your consultation is to listen to new patients, in order to determine if they’re good candidates for chiropractic care. Shy away from using this occasion to tell the history of chiropractic or explain aspects of your chiropractic philosophy. That comes later. Instead, use this time to ask questions, build rapport and listen.

• First visit take-home piece. Whether you adjust on the first visit or not, be sure to send each new patient home with a brochure that answers the most common questions new patients and their spouses have. These days, since you rarely even get to meet the key influencer in your patient’s life, it’s essential to get the spouse invested in the process from the beginning.

Visit 2: The report of findings

Use the patient’s second visit to communicate what you found during your examination and to explain how and why chiropractic works.

• Pre-report video. Videos can save you time, since virtually every patient benefits from a basic understanding of spinal anatomy and nervous system function. Avoid videos that are too long or use complex terms that needlessly complicate the simplicity of chiropractic.

Ask your CA to introduce the video in this way: “… so that you’ll understand what the doctor has found and how we may be able to help you, the doctor would like you to see this short six-minute video.”

• Report environment. Place the tools you need within easy reach. If you take x-rays, make sure your view box is clean. Install a dimmer switch so you can slowly dim the lights as you discuss the causes of your patients’ subluxations and their impact on the nervous system. Later, as you describe your adjusting technique and how each visit builds on the ones before, slowly bring the light level back up.

• Anatomical models. If your emphasis is on the nervous system, be careful about how much attention you give your anatomical models. You don’t want your patients to see you as a “bone doctor,” rather than the “nerve doctor.”

However, if your focus is proper posture, restored spinal curves or degenerative changes, refer to your anatomical models as needed. Even more effective: Ask your patient to hold one of your models while you’re reviewing x-rays.

• Report documents. The greatest flaw of most reports is that they are too long, attempt to turn patients into chiropractors or are largely visual affairs that lack written support — making it difficult for patients to answer their spouses’ question, “What did the doctor say?”

Make your findings relevant and support them with an easy-to-understand narrative (written at the eighth grade reading level) or use documents with spinal anatomy illustrations, examples of spinal decay, the “wiring” of the nervous system, proper spinal curves or their EMG scans. Present these documents in a report folder and send it home with the patient so your findings can be explained to the spouse.

Visit 12:
Progress exam visit

If you’ve recommended care in “chunks” — perhaps 12 visits — use this occasion to review what’s better, what’s worse and what’s stayed the same. Then lay out a visit plan for the future.

• Progress exam video. With you and chiropractic validated by the patient’s improvement, it is now appropriate to introduce wellness care, referrals and the value of chiropractic care for children.

Show a short video to explain the cultural notions of health (symptom treating), the value of post-symptomatic chiropractic care and the likelihood of a relapse if a patient chooses to discontinue care once he feels better.

• Wellness care brochure. Even though the patient may require continued relief care, introduce the wellness concept in written form. If you discuss it too soon in the relationship, the patient may dismiss the concept. Broach this subject too late and you may never get another opportunity.

On-going visits
Most offices have excellent first- and second-visit patient education protocols. But the most effective offices acknowledge that patient education never stops.

• Educational sign-in sheet. Write a brief educational message or provocative question on your sign-in sheet. Share a “Did you know…” factoid or pose a question such as, “What’s the difference between being healthy and feeling good?” You can discuss these topics with the patient during their visit.

• Adjusting room table talk. Rather than talk about the weather and sports scores, use these brief moments to ask questions and stimulate thoughtful conversations: “Why do you suppose we recommend three visits per week at the beginning of care?” Or, “What’s the difference between a good drug and a bad drug?”

• Brochure rack. Use your brochure rack. Pull brochures out, write the patient’s name (or the name of someone the patient mentions) on the cover, highlight a key passage and give it to the patient.

Some brochues will end up on the backseats of cars but many will get to prospective new patients and possibly begin to change their ideas about health, healing and chiropractic.

Institute a system of patient education and follow it rigorously. Offices that do this find that they attract higher-quality patients who take their health seriously. Create an information-rich environment that makes chiropractic relevant, meaningful and rewarding. Recognize that some seeds will fall on barren soil and wither, but others will fall on fertile soil and return your investment a hundredfold!

William D. Esteb is the president and creative director of Patient Media, Inc. His company provides state-of-the-art, visually based patient communication tools. He can be contacted by by visiting www.patientmedia.com or by calling 800-486-2337.